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Watchlist
Account
UnitedHealth
UNH
#59
Rank
ยฃ193.64 B
Marketcap
๐บ๐ธ
United States
Country
ยฃ213.77
Share price
0.06%
Change (1 day)
-45.48%
Change (1 year)
โ๏ธ Healthcare
๐ฆ Insurance
๐บ๐ธ Dow jones
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Annual Reports (10-K)
UnitedHealth
Quarterly Reports (10-Q)
Financial Year FY2018 Q3
UnitedHealth - 10-Q quarterly report FY2018 Q3
Text size:
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________
Form 10-Q
__________________________________________________________
[X]
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED
SEPTEMBER 30, 2018
or
[ ]
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM _______ TO _______
Commission File Number: 1-10864
__________________________________________________________
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
__________________________________________________________
Delaware
41-1321939
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota
55343
(Address of principal executive offices)
(Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
__________________________________________________________
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes [X] No [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act
Large accelerated filer
[X]
Accelerated filer
[ ]
Non-accelerated filer
[ ]
Smaller reporting company
[ ]
Emerging growth company
[ ]
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. [ ]
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes [ ]
No [X]
As of October 31, 2018, there were
962,034,200
shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.
UNITEDHEALTH GROUP
Table of Contents
Page
Part I. Financial Information
Item 1.
Financial Statements (unaudited)
1
Condensed Consolidated Balance Sheets as of September 30, 2018 and December 31, 2017
1
Condensed Consolidated Statements of Operations for the Three and Nine Months Ended September 30, 2018 and 2017
2
Condensed Consolidated Statements of Comprehensive Income for the Three and Nine Months Ended September 30, 2018 and 2017
3
Condensed Consolidated Statements of Changes in Equity for the Nine Months Ended September 30, 2018 and 2017
4
Condensed Consolidated Statements of Cash Flows for the Nine Months Ended September 30, 2018 and 2017
5
Notes to the Condensed Consolidated Financial Statements
6
1.
Basis of Presentation
6
2.
Investments
7
3.
Fair Value
8
4.
Medical Costs Payable
10
5.
Commercial Paper and Long-Term Debt
11
6.
Shareholder’s Equity
12
7.
Commitments and Contingencies
12
8.
Segment Financial Information
14
Item 2.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
16
Item 3.
Quantitative and Qualitative Disclosures About Market Risk
23
Item 4.
Controls and Procedures
24
Part II. Other Information
Item 1.
Legal Proceedings
25
Item 1A.
Risk Factors
25
Item 2.
Unregistered Sales of Equity Securities and Use of Proceeds
25
Item 6.
Exhibits
26
Signatures
27
PART I
ITEM 1. FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)
September 30,
2018
December 31,
2017
Assets
Current assets:
Cash and cash equivalents
$
10,263
$
11,981
Short-term investments
3,586
3,509
Accounts receivable, net
10,992
9,568
Other current receivables, net
7,270
6,262
Assets under management
2,936
3,101
Prepaid expenses and other current assets
3,707
2,663
Total current assets
38,754
37,084
Long-term investments
31,929
28,341
Property, equipment and capitalized software, net
8,042
7,013
Goodwill
58,703
54,556
Other intangible assets, net
9,498
8,489
Other assets
4,161
3,575
Total assets
$
151,087
$
139,058
Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable
$
19,850
$
17,871
Accounts payable and accrued liabilities
18,991
15,180
Commercial paper and current maturities of long-term debt
1,500
2,857
Unearned revenues
2,388
2,269
Other current liabilities
13,648
12,286
Total current liabilities
56,377
50,463
Long-term debt, less current maturities
32,053
28,835
Deferred income taxes
2,434
2,182
Other liabilities
5,858
5,556
Total liabilities
96,722
87,036
Commitments and contingencies (Note 7)
Redeemable noncontrolling interests
1,769
2,189
Equity:
Preferred stock, $0.001 par value - 10 shares authorized; no shares issued or outstanding
—
—
Common stock, $0.01 par value - 3,000 shares authorized; 962 and 969 issued and outstanding
10
10
Additional paid-in capital
—
1,703
Retained earnings
54,386
48,730
Accumulated other comprehensive loss
(4,386
)
(2,667
)
Nonredeemable noncontrolling interests
2,586
2,057
Total equity
52,596
49,833
Total liabilities, redeemable noncontrolling interests and equity
$
151,087
$
139,058
See
Notes to the Condensed Consolidated Financial Statements
1
Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
Three Months Ended September 30,
Nine Months Ended
September 30,
(in millions, except per share data)
2018
2017
2018
2017
Revenues:
Premiums
$
44,613
$
39,552
$
133,155
$
118,075
Products
7,344
6,665
21,050
19,209
Services
4,217
3,858
12,590
11,089
Investment and other income
382
247
1,035
725
Total revenues
56,556
50,322
167,830
149,098
Operating costs:
Medical costs
36,158
32,201
108,448
96,829
Operating costs
8,479
7,387
25,371
21,737
Cost of products sold
6,718
6,068
19,373
17,633
Depreciation and amortization
611
578
1,791
1,667
Total operating costs
51,966
46,234
154,983
137,866
Earnings from operations
4,590
4,088
12,847
11,232
Interest expense
(353
)
(294
)
(1,026
)
(878
)
Earnings before income taxes
4,237
3,794
11,821
10,354
Provision for income taxes
(953
)
(1,233
)
(2,603
)
(3,252
)
Net earnings
3,284
2,561
9,218
7,102
Earnings attributable to noncontrolling interests
(96
)
(76
)
(272
)
(161
)
Net earnings attributable to UnitedHealth Group common shareholders
$
3,188
$
2,485
$
8,946
$
6,941
Earnings per share attributable to UnitedHealth Group common shareholders:
Basic
$
3.31
$
2.57
$
9.29
$
7.22
Diluted
$
3.24
$
2.51
$
9.09
$
7.06
Basic weighted-average number of common shares outstanding
962
968
963
962
Dilutive effect of common share equivalents
21
21
21
21
Diluted weighted-average number of common shares outstanding
983
989
984
983
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents
7
1
7
6
See
Notes to the Condensed Consolidated Financial Statements
2
Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
Three Months Ended September 30,
Nine Months Ended September 30,
(in millions)
2018
2017
2018
2017
Net earnings
$
3,284
$
2,561
$
9,218
$
7,102
Other comprehensive (loss) income:
Gross unrealized (losses) gains on investment securities during the period
(91
)
44
(512
)
313
Income tax effect
21
(17
)
117
(111
)
Total unrealized (losses) gains, net of tax
(70
)
27
(395
)
202
Gross reclassification adjustment for net realized gains included in net earnings
(3
)
(10
)
(58
)
(51
)
Income tax effect
—
4
13
19
Total reclassification adjustment, net of tax
(3
)
(6
)
(45
)
(32
)
Total foreign currency translation (losses) gains
(233
)
217
(1,303
)
158
Other comprehensive (loss) income
(306
)
238
(1,743
)
328
Comprehensive income
2,978
2,799
7,475
7,430
Comprehensive income attributable to noncontrolling interests
(96
)
(76
)
(272
)
(161
)
Comprehensive income attributable to UnitedHealth Group common shareholders
$
2,882
$
2,723
$
7,203
$
7,269
See
Notes to the Condensed Consolidated Financial Statements
3
Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common Stock
Additional Paid-In Capital
Retained Earnings
Accumulated Other Comprehensive (Loss)
Income
Nonredeemable Noncontrolling Interests
Total
Equity
(in millions)
Shares
Amount
Net Unrealized (Losses) Gains on Investments
Foreign Currency Translation (Losses) Gains
Balance at January 1, 2018
969
$
10
$
1,703
$
48,730
$
(13
)
$
(2,654
)
$
2,057
$
49,833
Adjustment to adopt ASU 2016-01
(24
)
24
—
Net earnings
8,946
183
9,129
Other comprehensive loss
(440
)
(1,303
)
(1,743
)
Issuances of common stock,
and related tax effects
9
—
761
761
Share-based compensation
493
493
Common share repurchases
(16
)
—
(2,838
)
(812
)
(3,650
)
Cash dividends paid on common shares ($2.55 per share)
(2,454
)
(2,454
)
Redeemable noncontrolling interests fair value and other adjustments
(119
)
(119
)
Acquisition of nonredeemable noncontrolling interests
518
518
Distribution to nonredeemable noncontrolling interests
(172
)
(172
)
Balance at September 30, 2018
962
$
10
$
—
$
54,386
$
(429
)
$
(3,957
)
$
2,586
$
52,596
Balance at January 1, 2017
952
$
10
$
—
$
40,945
$
(97
)
$
(2,584
)
$
(97
)
$
38,177
Net earnings
6,941
120
7,061
Other comprehensive income
170
158
328
Issuances of common stock, and related tax effects
24
—
2,156
2,156
Share-based compensation
447
447
Common share repurchases
(7
)
—
(1,173
)
(1,173
)
Cash dividends paid on common shares ($2.125 per share)
(2,046
)
(2,046
)
Redeemable noncontrolling interests fair value and other adjustments
371
371
Acquisition of nonredeemable noncontrolling interests
2,111
2,111
Distribution to nonredeemable noncontrolling interests
(122
)
(122
)
Balance at September 30, 2017
969
$
10
$
1,801
$
45,840
$
73
$
(2,426
)
$
2,012
$
47,310
See
Notes to the Condensed Consolidated Financial Statements
4
Table of Contents
UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Nine Months Ended September 30,
(in millions)
2018
2017
Operating activities
Net earnings
$
9,218
$
7,102
Noncash items:
Depreciation and amortization
1,791
1,667
Deferred income taxes
9
(459
)
Share-based compensation
512
456
Other, net
(136
)
168
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable
(984
)
(244
)
Other assets
(1,641
)
(763
)
Medical costs payable
1,745
1,305
Accounts payable and other liabilities
2,783
2,283
Unearned revenues
20
4,658
Cash flows from operating activities
13,317
16,173
Investing activities
Purchases of investments
(11,316
)
(10,626
)
Sales of investments
2,872
2,809
Maturities of investments
4,715
4,251
Cash paid for acquisitions, net of cash assumed
(5,824
)
(908
)
Purchases of property, equipment and capitalized software
(1,505
)
(1,391
)
Other, net
(187
)
(30
)
Cash flows used for investing activities
(11,245
)
(5,895
)
Financing activities
Common share repurchases
(3,650
)
(1,173
)
Cash dividends paid
(2,454
)
(2,046
)
Proceeds from common stock issuances
745
604
Repayments of long-term debt
(2,600
)
(2,867
)
Repayments of commercial paper, net
(164
)
(3,352
)
Proceeds from issuance of long-term debt
3,964
1,342
Customer funds administered
1,552
3,659
Other, net
(1,086
)
(624
)
Cash flows used for financing activities
(3,693
)
(4,457
)
Effect of exchange rate changes on cash and cash equivalents
(97
)
18
(Decrease) increase in cash and cash equivalents
(1,718
)
5,839
Cash and cash equivalents, beginning of period
11,981
10,430
Cash and cash equivalents, end of period
$
10,263
$
16,269
Supplemental schedule of noncash investing activities
Common stock issued for acquisition
$
—
$
2,164
See
Notes to the Condensed Consolidated Financial Statements
5
Table of Contents
UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1. Basis of Presentation
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and the “Company”) is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through its diversified family of businesses, the Company leverages core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements” in the Company’s Annual Report on Form 10-K for the year ended
December 31, 2017
as filed with the SEC (
2017
10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to medical costs payable, revenues, and goodwill and other intangible assets. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Recently Issued Accounting Standards
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2016-02, “Leases (Topic 842)”, as modified by ASUs 2018-01, 2018-10 and 2018-11 (collectively, ASU 2016-02). Under ASU 2016-02, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both finance and operating leases. For leases with a term of 12 months or less, an entity can elect to not recognize lease assets and lease liabilities and expense the lease over a straight-line basis for the term of the lease. ASU 2016-02 will require new disclosures that depict the amount, timing and uncertainty of cash flows pertaining to an entity’s leases. Companies may adopt the new standard using a modified retrospective approach or a cumulative effect upon adoption approach for the annual and interim periods beginning after December 15, 2018. Early adoption of ASU 2016-02 is permitted. When adopted, ASU 2016-02 will not have a material impact on the Company’s balance sheet, results of operations, equity or cash flows.
Recently Adopted Accounting Standards
In January 2016, the FASB issued ASU 2016-01, “Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (ASU 2016-01). Most notably, the new guidance requires that equity investments, with certain exemptions, be measured at fair value with changes in fair value recognized in net income as opposed to other comprehensive income. The Company adopted ASU 2016-01 on a prospective basis effective January 1, 2018, as required, and reclassified
$24 million
from accumulated other comprehensive income to retained earnings.
The Company has determined that there have been no other recently adopted or issued accounting standards that had, or will have, a material impact on its Condensed Consolidated Financial Statements.
6
Table of Contents
2. Investments
A summary of debt securities by major security type is as follows:
(in millions)
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2018
Debt securities - available-for-sale:
U.S. government and agency obligations
$
3,291
$
—
$
(76
)
$
3,215
State and municipal obligations
6,962
30
(112
)
6,880
Corporate obligations
15,561
10
(208
)
15,363
U.S. agency mortgage-backed securities
4,846
1
(171
)
4,676
Non-U.S. agency mortgage-backed securities
1,329
—
(30
)
1,299
Total debt securities - available-for-sale
31,989
41
(597
)
31,433
Debt securities - held-to-maturity:
U.S. government and agency obligations
246
1
(3
)
244
State and municipal obligations
11
—
—
11
Corporate obligations
342
—
—
342
Total debt securities - held-to-maturity
599
1
(3
)
597
Total debt securities
$
32,588
$
42
$
(600
)
$
32,030
December 31, 2017
Debt securities - available-for-sale:
U.S. government and agency obligations
$
2,673
$
1
$
(30
)
$
2,644
State and municipal obligations
7,596
99
(35
)
7,660
Corporate obligations
13,181
57
(44
)
13,194
U.S. agency mortgage-backed securities
3,942
7
(38
)
3,911
Non-U.S. agency mortgage-backed securities
1,018
3
(6
)
1,015
Total debt securities - available-for-sale
28,410
167
(153
)
28,424
Debt securities - held-to-maturity:
U.S. government and agency obligations
254
1
(1
)
254
State and municipal obligations
2
—
—
2
Corporate obligations
280
—
—
280
Total debt securities - held-to-maturity
536
1
(1
)
536
Total debt securities
$
28,946
$
168
$
(154
)
$
28,960
The Company held $2.0 billion of equity securities as of September 30, 2018 and December 31, 2017. The Company’s investments in equity securities primarily consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments and dividend paying stocks, with readily determinable fair values.
Additionally, the Company’s investments included $
1.5 billion
and
$0.9 billion
of equity method investments in operating businesses in the health care sector as of September 30, 2018 and December 31, 2017, respectively.
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Table of Contents
The amortized cost and fair value of debt securities as of
September 30, 2018
, by contractual maturity, were as follows:
Available-for-Sale
Held-to-Maturity
(in millions)
Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less
$
3,683
$
3,675
$
145
$
145
Due after one year through five years
12,362
12,197
180
178
Due after five years through ten years
7,194
7,041
102
101
Due after ten years
2,575
2,545
172
173
U.S. agency mortgage-backed securities
4,846
4,676
—
—
Non-U.S. agency mortgage-backed securities
1,329
1,299
—
—
Total debt securities
$
31,989
$
31,433
$
599
$
597
The fair value of available-for-sale debt securities with gross unrealized losses by security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
Less Than 12 Months
12 Months or Greater
Total
(in millions)
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
September 30, 2018
Debt securities - available-for-sale:
U.S. government and agency obligations
$
2,025
$
(33
)
$
1,068
$
(43
)
$
3,093
$
(76
)
State and municipal obligations
3,471
(54
)
1,596
(58
)
5,067
(112
)
Corporate obligations
9,933
(136
)
2,334
(72
)
12,267
(208
)
U.S. agency mortgage-backed securities
2,762
(74
)
1,811
(97
)
4,573
(171
)
Non-U.S. agency mortgage-backed securities
956
(19
)
265
(11
)
1,221
(30
)
Total debt securities - available-for-sale
$
19,147
$
(316
)
$
7,074
$
(281
)
$
26,221
$
(597
)
December 31, 2017
Debt securities - available-for-sale:
U.S. government and agency obligations
$
1,249
$
(8
)
$
1,027
$
(22
)
$
2,276
$
(30
)
State and municipal obligations
2,599
(21
)
866
(14
)
3,465
(35
)
Corporate obligations
5,901
(23
)
1,242
(21
)
7,143
(44
)
U.S. agency mortgage-backed securities
1,657
(12
)
1,162
(26
)
2,819
(38
)
Non-U.S. agency mortgage-backed securities
411
(3
)
144
(3
)
555
(6
)
Total debt securities - available-for-sale
$
11,817
$
(67
)
$
4,441
$
(86
)
$
16,258
$
(153
)
The Company’s unrealized losses from debt securities as of
September 30, 2018
were generated from
20,000
positions out of a total of
29,000
positions. The Company believes that it will collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. At each reporting period, the Company evaluates securities for impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality and credit ratings of the issuers, noting no significant deterioration since purchase. As of
September 30, 2018
, the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary.
3. Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.
8
Table of Contents
For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
September 30, 2018
Cash and cash equivalents
$
10,220
$
43
$
—
$
10,263
Debt securities - available-for-sale:
U.S. government and agency obligations
2,928
287
—
3,215
State and municipal obligations
—
6,880
—
6,880
Corporate obligations
41
15,163
159
15,363
U.S. agency mortgage-backed securities
—
4,676
—
4,676
Non-U.S. agency mortgage-backed securities
—
1,299
—
1,299
Total debt securities - available-for-sale
2,969
28,305
159
31,433
Equity securities
1,885
13
100
1,998
Assets under management
993
1,939
4
2,936
Total assets at fair value
$
16,067
$
30,300
$
263
$
46,630
Percentage of total assets at fair value
34
%
65
%
1
%
100
%
December 31, 2017
Cash and cash equivalents
$
11,718
$
263
$
—
$
11,981
Debt securities - available-for-sale:
U.S. government and agency obligations
2,428
216
—
2,644
State and municipal obligations
—
7,660
—
7,660
Corporate obligations
65
12,989
140
13,194
U.S. agency mortgage-backed securities
—
3,911
—
3,911
Non-U.S. agency mortgage-backed securities
—
1,015
—
1,015
Total debt securities - available-for-sale
2,493
25,791
140
28,424
Equity securities
1,784
14
194
1,992
Assets under management
1,117
1,984
—
3,101
Total assets at fair value
$
17,112
$
28,052
$
334
$
45,498
Percentage of total assets at fair value
38
%
61
%
1
%
100
%
Transfers between levels, if any, are recorded as of the beginning of the reporting period in which the transfer occurs; there were
no
transfers between Levels 1, 2 or 3 of any financial assets during the
nine months ended
September 30, 2018
or
2017
.
9
Table of Contents
The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
September 30, 2018
Debt securities - held-to-maturity
$
257
$
71
$
269
$
597
$
599
Long-term debt and other financing obligations
$
—
$
34,908
$
—
$
34,908
$
33,533
December 31, 2017
Debt securities - held-to-maturity
$
267
$
4
$
265
$
536
$
536
Long-term debt and other financing obligations
$
—
$
34,504
$
—
$
34,504
$
31,542
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the
nine months ended
September 30, 2018
or
2017
.
4. Medical Costs Payable
The following table shows the components of the change in medical costs payable for the nine months ended September 30:
(in millions)
2018
2017
Medical costs payable, beginning of period
$
17,871
$
16,391
Acquisitions
333
76
Reported medical costs:
Current year
108,658
97,519
Prior years
(210
)
(690
)
Total reported medical costs
108,448
96,829
Medical payments:
Payments for current year
(90,348
)
(81,237
)
Payments for prior years
(16,454
)
(14,096
)
Total medical payments
(106,802
)
(95,333
)
Medical costs payable, end of period
$
19,850
$
17,963
For the
nine months
ended
September 30, 2018
, the medical cost reserve development included no individual factors that were significant. For the nine months ended September 30, 2017, the medical cost reserve development was primarily driven by lower than expected health system utilization levels. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of
$13.8 billion
and
$12.3 billion
at
September 30, 2018
and December 31, 2017, respectively.
10
Table of Contents
5. Commercial Paper and Long-Term Debt
Commercial paper and senior unsecured long-term debt consisted of the following:
September 30, 2018
December 31, 2017
(in millions, except percentages)
Par
Value
Carrying
Value
Fair
Value
Par
Value
Carrying
Value
Fair
Value
Commercial paper
$
20
$
20
$
20
$
150
$
150
$
150
6.000% notes due February 2018
—
—
—
1,100
1,101
1,106
1.900% notes due July 2018
—
—
—
1,500
1,499
1,501
1.700% notes due February 2019
750
750
747
750
749
747
1.625% notes due March 2019
500
500
498
500
501
497
2.300% notes due December 2019
500
492
496
500
495
501
2.700% notes due July 2020
1,500
1,497
1,491
1,500
1,496
1,517
Floating rate notes due October 2020
300
299
300
300
299
300
3.875% notes due October 2020
450
439
456
450
446
467
1.950% notes due October 2020
900
897
881
900
895
892
4.700% notes due February 2021
400
395
412
400
403
425
2.125% notes due March 2021
750
747
732
750
746
744
Floating rate notes due June 2021
350
349
350
—
—
—
3.150% notes due June 2021
400
398
399
—
—
—
3.375% notes due November 2021
500
481
502
500
493
516
2.875% notes due December 2021
750
724
741
750
741
760
2.875% notes due March 2022
1,100
1,031
1,083
1,100
1,054
1,114
3.350% notes due July 2022
1,000
997
999
1,000
996
1,033
2.375% notes due October 2022
900
894
863
900
893
891
0.000% notes due November 2022
15
12
12
15
12
12
2.750% notes due February 2023
625
588
606
625
606
626
2.875% notes due March 2023
750
734
731
750
762
759
3.500% notes due June 2023
750
746
752
—
—
—
3.750% notes due July 2025
2,000
1,989
2,010
2,000
1,987
2,108
3.100% notes due March 2026
1,000
995
961
1,000
995
1,007
3.450% notes due January 2027
750
745
734
750
745
776
3.375% notes due April 2027
625
619
607
625
618
642
2.950% notes due October 2027
950
938
890
950
937
947
3.850% notes due June 2028
1,150
1,142
1,153
—
—
—
4.625% notes due July 2035
1,000
991
1,064
1,000
991
1,165
5.800% notes due March 2036
850
838
1,013
850
837
1,105
6.500% notes due June 2037
500
492
640
500
491
698
6.625% notes due November 2037
650
641
844
650
641
923
6.875% notes due February 2038
1,100
1,076
1,467
1,100
1,075
1,596
5.700% notes due October 2040
300
296
358
300
296
389
5.950% notes due February 2041
350
345
428
350
345
466
4.625% notes due November 2041
600
588
630
600
588
685
4.375% notes due March 2042
502
484
510
502
483
555
3.950% notes due October 2042
625
607
596
625
607
650
4.250% notes due March 2043
750
734
749
750
734
822
4.750% notes due July 2045
2,000
1,972
2,140
2,000
1,972
2,362
4.200% notes due January 2047
750
738
743
750
738
808
4.250% notes due April 2047
725
717
728
725
717
798
3.750% notes due October 2047
950
933
883
950
933
969
4.250% notes due June 2048
1,350
1,329
1,355
—
—
—
Total commercial paper and long-term debt
$
32,687
$
32,199
$
33,574
$
31,417
$
31,067
$
34,029
The Company’s long-term debt obligations included $
1.4 billion
and
$625 million
of other financing obligations, of which
$230 million
and
$107 million
were classified as current as of
September 30, 2018
and
December 31, 2017
, respectively.
11
Table of Contents
Commercial Paper and Bank Credit Facilities
Commercial paper consists of short-duration, senior unsecured debt privately placed on a discount basis through broker-dealers. As of
September 30, 2018
, the Company’s outstanding commercial paper had a weighted average annual interest rate of
2.1%
.
The Company has
$3.0 billion
five-year,
$3.0 billion
three-year and
$4.0 billion
364-day revolving bank credit facilities with
26
banks, which mature in
December 2022
,
December 2020
and December 2018, respectively. These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of
September 30, 2018
, no amounts had been drawn on any of the bank credit facilities. The annual interest rates, which are variable based on term, are calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. If amounts had been drawn on the bank credit facilities as of
September 30, 2018
, annual interest rates would have ranged from
3.1%
to
3.4%
.
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain a
defined debt to debt-plus-shareholders’ equity ratio of not more than
55%
. The Company was in compliance with its debt covenants as of
September 30, 2018
.
6. Shareholders' Equity
Share Repurchase Program
In June 2018, the Company’s Board of Directors renewed the Company’s share repurchase program with an authorization to repurchase up to
100 million
shares of the Company’s common stock. The following table provides details of the Company’s share repurchase activity for the
nine months ended
September 30, 2018
:
(in millions, except per share data)
Common share repurchases, shares
16
Common share repurchases, average price per share
$
232.61
Common share repurchases, aggregate cost
$
3,650
Board authorized shares remaining
98
Dividends
In June 2018, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to an annual dividend rate of $
3.60
per share from $
3.00
per share, which the Company had paid since June 2017. Declaration and payment of future quarterly dividends is at the discretion of the Board and may be adjusted as business needs or market conditions change.
The following table provides details of the Company’s 2018 dividend payments:
Payment Date
Amount per Share
Total Amount Paid
(in millions)
March 20
$
0.75
$
722
June 26
0.90
866
September 18
0.90
866
7. Commitments and Contingencies
Legal Matters
Because of the nature of its businesses, the Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the
12
Table of Contents
early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable that a loss may be incurred.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by the Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, the Brazilian national regulatory agency for private health insurance and plans (the Agência Nacional de Saúde Suplementar), state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice, the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the Brazilian federal revenue service (the Secretaria da Receita Federal), the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the Department of Justice (DOJ) announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges that the Company made improper risk adjustment submissions and violated the False Claims Act. On February 12, 2018, the court granted in part and denied in part the Company’s motion to dismiss. In May 2018, DOJ moved to dismiss the Company’s counterclaims, which were filed in March 2018, and moved for partial summary judgment. Those motions were argued in September 2018. The Company cannot reasonably estimate the outcome that may result from this matter given its procedural status.
13
Table of Contents
8. Segment Financial Information
The Company’s
four
reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx
.
For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following tables present reportable segment financial information:
Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Three Months Ended September 30, 2018
Revenues - unaffiliated customers:
Premiums
$
43,628
$
985
$
—
$
—
$
—
$
985
$
—
$
44,613
Products
—
13
29
7,302
—
7,344
—
7,344
Services
2,067
1,196
790
164
—
2,150
—
4,217
Total revenues - unaffiliated customers
45,695
2,194
819
7,466
—
10,479
—
56,174
Total revenues - affiliated customers
—
3,733
1,431
9,960
(352
)
14,772
(14,772
)
—
Investment and other income
242
125
4
11
—
140
—
382
Total revenues
$
45,937
$
6,052
$
2,254
$
17,437
$
(352
)
$
25,391
$
(14,772
)
$
56,556
Earnings from operations
$
2,559
$
622
$
534
$
875
$
—
$
2,031
$
—
$
4,590
Interest expense
—
—
—
—
—
—
(353
)
(353
)
Earnings before income taxes
$
2,559
$
622
$
534
$
875
$
—
$
2,031
$
(353
)
$
4,237
Three Months Ended September 30, 2017
Revenues - unaffiliated customers:
Premiums
$
38,576
$
976
$
—
$
—
$
—
$
976
$
—
$
39,552
Products
—
10
29
6,626
—
6,665
—
6,665
Services
2,005
1,040
677
136
—
1,853
—
3,858
Total revenues - unaffiliated customers
40,581
2,026
706
6,762
—
9,494
—
50,075
Total revenues - affiliated customers
—
3,138
1,297
9,186
(324
)
13,297
(13,297
)
—
Investment and other income
153
88
1
5
—
94
—
247
Total revenues
$
40,734
$
5,252
$
2,004
$
15,953
$
(324
)
$
22,885
$
(13,297
)
$
50,322
Earnings from operations
$
2,391
$
513
$
414
$
770
$
—
$
1,697
$
—
$
4,088
Interest expense
—
—
—
—
—
—
(294
)
(294
)
Earnings before income taxes
$
2,391
$
513
$
414
$
770
$
—
$
1,697
$
(294
)
$
3,794
14
Table of Contents
Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Nine Months Ended September 30, 2018
Revenues - unaffiliated customers:
Premiums
$
130,361
$
2,794
$
—
$
—
$
—
$
2,794
$
—
$
133,155
Products
—
37
72
20,941
—
21,050
—
21,050
Services
6,248
3,587
2,306
449
—
6,342
—
12,590
Total revenues - unaffiliated customers
136,609
6,418
2,378
21,390
—
30,186
—
166,795
Total revenues - affiliated customers
—
10,979
4,115
29,062
(1,026
)
43,130
(43,130
)
—
Investment and other income
633
355
15
32
—
402
—
1,035
Total revenues
$
137,242
$
17,752
$
6,508
$
50,484
$
(1,026
)
$
73,718
$
(43,130
)
$
167,830
Earnings from operations
$
7,316
$
1,680
$
1,382
$
2,469
$
—
$
5,531
$
—
$
12,847
Interest expense
—
—
—
—
—
—
(1,026
)
(1,026
)
Earnings before income taxes
$
7,316
$
1,680
$
1,382
$
2,469
$
—
$
5,531
$
(1,026
)
$
11,821
Nine Months Ended September 30, 2017
Revenues - unaffiliated customers:
Premiums
$
115,295
$
2,780
$
—
$
—
$
—
$
2,780
$
—
$
118,075
Products
—
33
69
19,107
—
19,209
—
19,209
Services
5,885
2,769
2,011
424
—
5,204
—
11,089
Total revenues - unaffiliated customers
121,180
5,582
2,080
19,531
—
27,193
—
148,373
Total revenues - affiliated customers
—
9,294
3,757
27,196
(894
)
39,353
(39,353
)
—
Investment and other income
478
231
3
13
—
247
—
725
Total revenues
$
121,658
$
15,107
$
5,840
$
46,740
$
(894
)
$
66,793
$
(39,353
)
$
149,098
Earnings from operations
$
6,736
$
1,267
$
1,080
$
2,149
$
—
$
4,496
$
—
$
11,232
Interest expense
—
—
—
—
—
—
(878
)
(878
)
Earnings before income taxes
$
6,736
$
1,267
$
1,080
$
2,149
$
—
$
4,496
$
(878
)
$
10,354
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ITEM 2.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2017 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2017 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through our diversified family of businesses, we leverage core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within our two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K and additional information on our segments can be found in this Item 2 and in
Note 8 of Notes to the Condensed Consolidated Financial Statements
included in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the United States, South American and certain other international health markets. In the United States, health care spending has grown consistently for many years and comprises approximately 18% of gross domestic product. We expect overall spending on health care to continue to grow in the future due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macro-economic conditions and regulatory changes, which have impacted and could further impact our results of operations.
Pricing Trends
. To price our health care benefit products, we start with our view of expected future costs, including any impact from the Health Insurance Industry Tax. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations, including minimum medical loss ratio (MLR) thresholds. We will continue seeking to balance growth and profitability across all of these dimensions.
The commercial risk market remains highly competitive in both the small group and large group segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs amid reform changes. In 2019, there will be a one year moratorium on the collection of the Health Insurance Industry Tax. Pricing for contracts that cover some portion of calendar year 2019 will reflect the impact of the moratorium.
Government programs in the public and senior sector tend to receive lower rates of increase than the commercial market due to governmental budget pressures and intrinsically lower cost trends.
Medical Cost Trends.
Our medical cost trends primarily relate to changes in unit costs, health system utilization and prescription drug costs. We endeavor to mitigate those increases by engaging physicians and consumers with information and helping them make clinically sound choices, with the objective of helping them achieve high quality, affordable care.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of regulatory trends and uncertainties. For additional information regarding regulatory trends and uncertainties, see Part I, Item 1 “Business - Government Regulation,” Part 1, Item 1A, “Risk Factors” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K.
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Table of Contents
Medicare Advantage Rates.
Final 2019 Medicare Advantage rates resulted in an increase in industry base rates of approximately 3.4%, short of the industry forward medical cost trend, which creates continued pressure in the Medicare Advantage program.
The Tax Cut and Jobs Act (Tax Reform).
Tax Reform was enacted by the U.S federal government in December 2017, changing existing federal tax law, including reducing the U.S. corporate income tax rate. The impact of Tax Reform is partially offset by the return of the nondeductible Health Insurance Industry Tax in 2018.
Health Insurance Industry Tax.
After a moratorium in 2017, the industry-wide amount of the Health Insurance Industry Tax in 2018 is $14.3 billion, with our portion being $2.6 billion. The return of the tax impacts year-over-year comparability of our financial statements, including revenues, the medical care ratio (MCR), operating cost ratio and effective tax rate. A one year moratorium on the collection of the Health Insurance Industry Tax will occur in 2019.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select
third quarter
2018
year-over-year operating comparisons to
third quarter
2017
and other
2018
significant items.
•
Consolidated revenues grew
12%
, UnitedHealthcare revenues grew
13%
and Optum revenues grew
11%
.
•
UnitedHealthcare served
75,000
fewer people primarily as a result of completion of its commitment to the 2.9 million people under the TRICARE military health care program, partially offset by the addition of 2.2 million people through acquisition and the remainder from organic growth.
•
Earnings from operations increased
12%
, including increases of
7%
at UnitedHealthcare and
20%
at Optum.
•
Due primarily to the impact of Tax Reform, our effective income tax rate decreased 10 percentage points to
22.5%
.
•
Diluted earnings per common share increased
29%
.
•
Cash flows from operations for the nine months ended were
$13.3 billion
.
17
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RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
Revenues:
Premiums
$
44,613
$
39,552
$
5,061
13
%
$
133,155
$
118,075
$
15,080
13
%
Products
7,344
6,665
679
10
21,050
19,209
1,841
10
Services
4,217
3,858
359
9
12,590
11,089
1,501
14
Investment and other income
382
247
135
55
1,035
725
310
43
Total revenues
56,556
50,322
6,234
12
167,830
149,098
18,732
13
Operating costs:
Medical costs
36,158
32,201
3,957
12
108,448
96,829
11,619
12
Operating costs
8,479
7,387
1,092
15
25,371
21,737
3,634
17
Cost of products sold
6,718
6,068
650
11
19,373
17,633
1,740
10
Depreciation and amortization
611
578
33
6
1,791
1,667
124
7
Total operating costs
51,966
46,234
5,732
12
154,983
137,866
17,117
12
Earnings from operations
4,590
4,088
502
12
12,847
11,232
1,615
14
Interest expense
(353
)
(294
)
(59
)
20
(1,026
)
(878
)
(148
)
17
Earnings before income taxes
4,237
3,794
443
12
11,821
10,354
1,467
14
Provision for income taxes
(953
)
(1,233
)
280
(23
)
(2,603
)
(3,252
)
649
(20
)
Net earnings
3,284
2,561
723
28
9,218
7,102
2,116
30
Earnings attributable to noncontrolling interests
(96
)
(76
)
(20
)
26
(272
)
(161
)
(111
)
69
Net earnings attributable to UnitedHealth Group common shareholders
$
3,188
$
2,485
$
703
28
%
$
8,946
$
6,941
$
2,005
29
%
Diluted earnings per share attributable to UnitedHealth Group common shareholders
$
3.24
$
2.51
$
0.73
29
%
$
9.09
$
7.06
$
2.03
29
%
Medical care ratio (a)
81.0
%
81.4
%
(0.4
)%
81.4
%
82.0
%
(0.6
)%
Operating cost ratio
15.0
14.7
0.3
15.1
14.6
0.5
Operating margin
8.1
8.1
—
7.7
7.5
0.2
Tax rate
22.5
32.5
(10.0
)
22.0
31.4
(9.4
)
Net earnings margin (b)
5.6
4.9
0.7
5.3
4.7
0.6
Return on equity (c)
25.9
%
22.5
%
3.4
%
24.6
%
22.0
%
2.6
%
(a)
Medical care ratio is calculated as medical costs divided by premium revenue.
(b)
Net earnings margin attributable to UnitedHealth Group shareholders.
(c)
Return on equity is calculated as annualized net earnings divided by average equity. Average equity is calculated using the equity balance at the end of the preceding year and the equity balances at the end of each of the quarters in the year presented.
2018 RESULTS OF OPERATIONS COMPARED TO 2017 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenue
The increase in revenue was primarily driven by the increase in the number of individuals served through risk-based products across our UnitedHealthcare benefits businesses, pricing trends, including for the return of the Health Insurance Industry Tax in 2018, and growth across the Optum business, primarily due to expansion in care delivery, pharmacy care services, and outsourcing and advisory services.
Medical Costs and MCR
Medical costs increased due to growth in people served through risk-based products and medical cost trends. The MCR decreased due to the revenue effects of the Health Insurance Industry Tax, which more than offset business mix changes and lower favorable reserve development.
Income Tax Rate
Our effective tax rate decreased due to the impact of Tax Reform, which was partially offset by the return of the nondeductible Health Insurance Industry Tax.
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Reportable Segments
See
Note 8 of Notes to the Condensed Consolidated Financial Statements
included in Part I, Item 1 of this report for more information on our segments. The following table presents a summary of the reportable segment financial information:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
Revenues
UnitedHealthcare
$
45,937
$
40,734
$
5,203
13
%
$
137,242
$
121,658
$
15,584
13
%
OptumHealth
6,052
5,252
800
15
17,752
15,107
2,645
18
OptumInsight
2,254
2,004
250
12
6,508
5,840
668
11
OptumRx
17,437
15,953
1,484
9
50,484
46,740
3,744
8
Optum eliminations
(352
)
(324
)
(28
)
9
(1,026
)
(894
)
(132
)
15
Optum
25,391
22,885
2,506
11
73,718
66,793
6,925
10
Eliminations
(14,772
)
(13,297
)
(1,475
)
11
(43,130
)
(39,353
)
(3,777
)
10
Consolidated revenues
$
56,556
$
50,322
$
6,234
12
%
$
167,830
$
149,098
$
18,732
13
%
Earnings from operations
UnitedHealthcare
$
2,559
$
2,391
$
168
7
%
$
7,316
$
6,736
$
580
9
%
OptumHealth
622
513
109
21
1,680
1,267
413
33
OptumInsight
534
414
120
29
1,382
1,080
302
28
OptumRx
875
770
105
14
2,469
2,149
320
15
Optum
2,031
1,697
334
20
5,531
4,496
1,035
23
Consolidated earnings from operations
$
4,590
$
4,088
$
502
12
%
$
12,847
$
11,232
$
1,615
14
%
Operating margin
UnitedHealthcare
5.6
%
5.9
%
(0.3
)%
5.3
%
5.5
%
(0.2
)%
OptumHealth
10.3
9.8
0.5
9.5
8.4
1.1
OptumInsight
23.7
20.7
3.0
21.2
18.5
2.7
OptumRx
5.0
4.8
0.2
4.9
4.6
0.3
Optum
8.0
7.4
0.6
7.5
6.7
0.8
Consolidated operating margin
8.1
%
8.1
%
—
%
7.7
%
7.5
%
0.2
%
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
UnitedHealthcare Employer & Individual
$
13,734
$
13,054
$
680
5
%
$
40,856
$
38,759
$
2,097
5
%
UnitedHealthcare Medicare & Retirement
18,789
16,306
2,483
15
56,573
49,605
6,968
14
UnitedHealthcare Community & State
11,054
9,378
1,676
18
32,471
27,505
4,966
18
UnitedHealthcare Global
2,360
1,996
364
18
7,342
5,789
1,553
27
Total UnitedHealthcare revenues
$
45,937
$
40,734
$
5,203
13
%
$
137,242
$
121,658
$
15,584
13
%
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The following table summarizes the number of individuals served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
September 30,
Increase/(Decrease)
(in thousands, except percentages)
2018
2017
2018 vs. 2017
Commercial group:
Risk-based
7,955
7,805
150
2
%
Fee-based
18,365
18,610
(245
)
(1
)
Total commercial group
26,320
26,415
(95
)
—
Individual
495
515
(20
)
(4
)
Fee-based TRICARE
—
2,855
(2,855
)
(100
)
Total commercial
26,815
29,785
(2,970
)
(10
)
Medicare Advantage
4,915
4,390
525
12
Medicaid
6,630
6,375
255
4
Medicare Supplement (Standardized)
4,540
4,415
125
3
Total public and senior
16,085
15,180
905
6
Total UnitedHealthcare - domestic medical
42,900
44,965
(2,065
)
(5
)
International
6,070
4,080
1,990
49
Total UnitedHealthcare - medical
48,970
49,045
(75
)
—
%
Supplemental Data:
Medicare Part D stand-alone
4,725
4,945
(220
)
(4
)%
The overall increase in people served through risk-based benefit plans in the commercial group market was driven by broad-based growth, primarily in services to small groups. Fee-based commercial group business declined primarily due to attrition at certain large commercial accounts. Medicare Advantage increased year-over-year due to growth in people served through individual and employer-sponsored group Medicare Advantage plans. Medicaid growth was driven by the combination of new state-based awards and growth in established programs. Medicare Supplement growth reflected strong customer retention and new sales. International growth was primarily driven by an acquisition in the first quarter.
UnitedHealthcare’s revenue and earnings from operations increased due to growth in the number of individuals served across its risk-based businesses, a higher revenue membership mix, rate increases for underlying medical cost trends and the impact of the return of the Health Insurance Industry Tax.
Optum
Total revenues and earnings from operations increased as each segment reported increased revenues and earnings from operations as a result of productivity and overall cost management initiatives in addition to the factors discussed below.
The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth primarily due to organic and acquisition-related growth in care delivery and behavioral health, digital consumer engagement and health financial services.
OptumInsight
Revenue and earnings from operations at OptumInsight increased primarily due to organic and acquisition-related growth in business process outsourcing and care provider advisory services.
OptumRx
Revenue and earnings from operations at OptumRx increased primarily due to growth in specialty pharmacy, home delivery services, and overall prescription growth. OptumRx fulfilled 331 million and 321 million adjusted scripts, in the third quarters of 2018 and 2017, respectively.
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LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Summary of our Major Sources and Uses of Cash and Cash Equivalents
Nine Months Ended September 30,
Increase/(Decrease)
(in millions)
2018
2017
2018 vs. 2017
Sources of cash:
Cash provided by operating activities
$
13,317
$
16,173
$
(2,856
)
Issuances of commercial paper and long-term debt, net of repayments
1,200
—
1,200
Proceeds from common stock issuances
745
604
141
Customer funds administered
1,552
3,659
(2,107
)
Total sources of cash
16,814
20,436
Uses of cash:
Common stock repurchases
(3,650
)
(1,173
)
(2,477
)
Cash paid for acquisitions, net of cash assumed
(5,824
)
(908
)
(4,916
)
Purchases of investments, net of sales and maturities
(3,729
)
(3,566
)
(163
)
Repayments of commercial paper and long-term debt, net of issuances
—
(4,877
)
4,877
Purchases of property, equipment and capitalized software
(1,505
)
(1,391
)
(114
)
Cash dividends paid
(2,454
)
(2,046
)
(408
)
Other
(1,273
)
(654
)
(619
)
Total uses of cash
(18,435
)
(14,615
)
Effect of exchange rate changes on cash and cash equivalents
(97
)
18
(115
)
Net (decrease) increase in cash and cash equivalents
$
(1,718
)
$
5,839
$
(7,557
)
2018 Cash Flows Compared to 2017 Cash Flows
Decreased cash flows provided by operating activities were primarily driven by a decrease in unearned revenues due to the September 2017 receipt of our October CMS premium payment of $4.6 billion, offset by higher net earnings, and the year-over-year impact of the return of the Health Insurance Industry Tax. In October 2018, we paid our portion of the 2018 Health Insurance Industry Tax of $2.6 billion.
Other significant changes in sources or uses of cash year-over-year included net issuances of debt in 2018 compared to net repayments in 2017, an increase in cash paid for acquisitions, increased share repurchases and a decrease in customer funds administered primarily due to the September 2017 receipt of our October CMS payment.
Financial Condition
As of
September 30, 2018
, our cash, cash equivalent, available-for-sale debt securities and equity securities balances of
$44 billion
included approximately
$10 billion
of cash and cash equivalents (of which $0.9 billion was available for general corporate use),
$31 billion
of debt securities and
$2 billion
of investments in equity securities. Given the significant portion of our portfolio held in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt portfolio had a weighted-average duration of 3.3 years and a weighted-average credit rating of “Double A” as of
September 30, 2018
. When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Commercial Paper and Bank Credit Facilities.
Our revolving bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through third-party broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see
Note 5 of Notes to the Condensed Consolidated Financial Statements
included in Part I, Item 1 of this report.
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Our revolving bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. As of
September 30, 2018
, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 37%.
Long-Term Debt.
Periodically, we access capital markets and issue long-term debt for general corporate purposes, such as to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. For more information on our long-term debt, see
Note 5 of Notes to the Condensed Consolidated Financial Statements
included in Part I, Item 1 of this report.
Credit Ratings.
Our credit ratings as of
September 30, 2018
were as follows:
Moody’s
S&P Global
Fitch
A.M. Best
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Senior unsecured debt
A3
Stable
A+
Stable
A-
Stable
A-
Stable
Commercial paper
P-2
n/a
A-1
n/a
F1
n/a
AMB-1
n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. For example, a significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program.
As of
September 30, 2018
, we had Board authorization to purchase up to 98 million shares of our common stock. For more information on our share repurchase program, see
Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1
of this report.
Dividends.
In June 2018, our Board increased our quarterly cash dividend to shareholders to an annual dividend rate of $
3.60
per share. For more information on our dividend, see
Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1
of this report.
For additional liquidity discussion, see Note 10 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2017 was disclosed in our 2017 10-K. During the
nine months ended
September 30, 2018
, there were no material changes to this previously disclosed information outside the ordinary course of business. However, we continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
RECENTLY ISSUED ACCOUNTING STANDARDS
See
Note 1 of Notes to the Condensed Consolidated Financial Statements
in Part I, Item 1 of this report for a discussion of new accounting pronouncements that affect us.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments, assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates, and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable, revenues, and goodwill and other intangible assets. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in our 2017 10-K.
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FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements within the meaning of the PSLRA. These statements are intended to take advantage of the “safe harbor” provisions of the PSLRA. Generally the words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements, which generally are not historical in nature. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. We caution that actual results could differ materially from those that management expects, depending on the outcome of certain factors.
Some factors that could cause actual results to differ materially from results discussed or implied in the forward-looking statements include: our ability to effectively estimate, price for and manage our medical costs, including the impact of any new coverage requirements; new laws or regulations, or changes in existing laws or regulations, or their enforcement or application, including increases in medical, administrative, technology or other costs or decreases in enrollment resulting from U.S., South American and other jurisdictions’ regulations affecting the health care industry; the outcome of the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in CMS star ratings and other quality scores that impact revenue; reductions in revenue or delays to cash flows received under Medicare, Medicaid and other government programs, including the effects of a prolonged U.S. government shutdown or debt ceiling constraints; changes in Medicare, including changes in payment methodology, the CMS star ratings program or the application of risk adjustment data validation audits; cyber-attacks or other privacy or data security incidents; failure to comply with privacy and data security regulations; regulatory and other risks and uncertainties of the pharmacy benefits management industry; competitive pressures, which could affect our ability to maintain or increase our market share; changes in or challenges to our public sector contract awards; our ability to execute contracts on competitive terms with physicians, hospitals and other service providers; failure to achieve targeted operating cost productivity improvements, including savings resulting from technology enhancement and administrative modernization; increases in costs and other liabilities associated with increased litigation, government investigations, audits or reviews; failure to manage successfully our strategic alliances or complete or receive anticipated benefits of acquisitions and other strategic transactions, fluctuations in foreign currency exchange rates on our reported shareholders’ equity and results of operations; downgrades in our credit ratings; the performance of our investment portfolio; impairment of the value of our goodwill and intangible assets if estimated future results do not adequately support goodwill and intangible assets recorded for our existing businesses or the businesses that we acquire; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; and our ability to obtain sufficient funds from our regulated subsidiaries or the debt or capital markets to fund our obligations, to maintain our debt to total capital ratio at targeted levels, to maintain our quarterly dividend payment cycle or to continue repurchasing shares of our common stock.
This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain risk factors that may affect our business operations, financial condition and results of operations, in our other periodic and current filings with the SEC, including our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Any or all forward-looking statements we make may turn out to be wrong, and can be affected by inaccurate assumptions we might make or by known or unknown risks and uncertainties. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual future results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by applicable securities laws.
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We manage exposure to market interest rates by diversifying investments across different fixed-income market sectors and debt across maturities, as well as by endeavoring to match our floating-rate assets and liabilities over time, either directly or through the use of interest rate swap contracts. Unrealized gains and losses on investments in available-for-sale debt securities are reported in comprehensive income.
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The following table summarizes the impact of hypothetical changes in market interest rates across the entire yield curve by 1% point or 2% points as of
September 30, 2018
on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
September 30, 2018
Increase (Decrease) in Market Interest Rate
Investment
Income Per
Annum (a)
Interest
Expense Per
Annum
Fair Value of
Financial Assets (b)
Fair Value of
Financial Liabilities
2 %
$
261
$
187
$
(2,192
)
$
(4,652
)
1
131
94
(1,118
)
(2,557
)
(1)
(131
)
(94
)
1,109
2,814
(2)
(254
)
(187
)
2,167
6,283
(a)
Given the low absolute level of short-term market rates on our floating-rate assets as of
September 30, 2018
, the assumed hypothetical change in interest rates does not reflect the full 200 basis point reduction in investment income as the rate cannot fall below zero.
(b)
As of
September 30, 2018
, some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
ITEM 4. CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this quarterly report on Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of
September 30, 2018
. Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of
September 30, 2018
.
CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended
September 30, 2018
that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
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PART II. OTHER INFORMATION
ITEM 1.
LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to
Note 7 of Notes to the Condensed Consolidated Financial Statements
contained in Part I, Item 1 of this report.
ITEM 1A. RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” of our 2017 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2017 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or future results.
There have been no material changes to the risk factors disclosed in our 2017 10-K.
ITEM 2.
UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
In November 1997, our Board of Directors adopted a share repurchase program, which the Board evaluates periodically. There is no established expiration date for the program. During the third quarter 2018, we repurchased approximately 2 million shares at an average price of $259.78 per share. As of September 30, 2018, we had Board authorization to purchase up to 98 million shares of our common stock.
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ITEM 6.
EXHIBITS*
The following exhibits are filed or incorporated by reference herein in response to Item 601 of Regulation S-K. The Company files Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q and Current Reports on Form 8-K pursuant to the Securities Exchange Act of 1934 under Commission File No. 1-10864.
3.1
Certificate of Incorporation of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.1 to the Company’s Registration Statement on Form 8-A/A filed on July 1, 2015)
3.2
Bylaws of UnitedHealth Group Incorporated, effective August 15, 2017 (incorporated by reference to Exhibit 3.1 to the Company’s Current Report on Form 8-K filed on August 16, 2017)
4.1
Senior Indenture, dated as of November 15, 1998, between United HealthCare Corporation and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3/A, SEC File Number 333-66013, filed on January 11, 1999)
4.2
Amendment, dated as of November 6, 2000, to Senior Indenture, dated as of November 15, 1998, between UnitedHealth Group Incorporated and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2001)
4.3
Instrument of Resignation, Appointment and Acceptance of Trustee, dated January 8, 2007, pursuant to the Senior Indenture, dated as of November 15, 1998, amended November 6, 2000, among UnitedHealth Group Incorporated, The Bank of New York and Wilmington Trust Company (incorporated by reference to Exhibit 4.3 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2007)
4.4
Indenture, dated as of February 4, 2008, between UnitedHealth Group Incorporated and U.S. Bank National Association (incorporated by reference to Exhibit 4.1 to the Company’s Registration Statement on Form S-3, SEC File Number 333-149031, filed on February 4, 2008)
31.1
Certifications pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1
Certifications pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101
The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2018 filed on November 8, 2018, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
________________
*
Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
UNITEDHEALTH GROUP INCORPORATED
/s/ D
AVID
S. W
ICHMANN
Chief Executive Officer
(principal executive officer)
Dated:
November 8, 2018
David S. Wichmann
/s/ J
OHN
F. R
EX
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:
November 8, 2018
John F. Rex
/s/
T
HOMAS
E. R
OOS
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:
November 8, 2018
Thomas E. Roos
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