Form 10-Q
Table of Contents

 

 

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 JUNE 30, 2011

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)

 

 

 

Minnesota   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 and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    No  ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one):

 

Large accelerated filer   x    Accelerated filer   ¨
Non-accelerated filer   ¨    Smaller reporting company   ¨

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 July 29, 2011, there were 1,076,159,413 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.

 

 

 


Table of Contents

UNITEDHEALTH GROUP

Table of Contents

 

          Page  

Part I. Financial Information

  

Item 1.

   Financial Statements      1   
  

Condensed Consolidated Balance Sheets as of June 30, 2011 and December 31, 2010

     1   
  

Condensed Consolidated Statements of Operations for the three and six months ended June 30, 2011 and 2010

     2   
  

Condensed Consolidated Statements of Changes in Shareholders’ Equity for the six months ended June 30, 2011 and 2010

     3   
  

Condensed Consolidated Statements of Cash Flows for the six months ended June 30, 2011 and 2010

     4   
   Notes to the Condensed Consolidated Financial Statements      5   

Item 2.

   Management’s Discussion and Analysis of Financial Condition and Results of Operations      23   

Item 3.

   Quantitative and Qualitative Disclosures about Market Risk      33   

Item 4.

   Controls and Procedures      34   

Part II. Other Information

  

Item 1.

   Legal Proceedings      34   

Item 1A.

   Risk Factors      34   

Item 2.

   Unregistered Sales of Equity Securities and Use of Proceeds      35   

Item 6.

   Exhibits      36   

Signatures

     38   


Table of Contents

PART I. FINANCIAL INFORMATION

 

ITEM 1. FINANCIAL STATEMENTS

UnitedHealth Group

Condensed Consolidated Balance Sheets

(Unaudited)

 

(in millions, except per share data)

   June 30,
2011
    December 31,
2010
 

Assets

    

Current assets:

    

Cash and cash equivalents

   $ 9,775      $ 9,123   

Short-term investments

     2,532        2,072   

Accounts receivable, net

     2,851        2,061   

Assets under management

     2,510        2,550   

Deferred income taxes

     153        403   

Other current receivables, net

     1,961        1,643   

Prepaid expenses and other current assets

     647        541   
  

 

 

   

 

 

 

Total current assets

     20,429        18,393   

Long-term investments

     14,935        14,707   

Property, equipment and capitalized software, net

     2,302        2,200   

Goodwill

     23,423        22,745   

Other intangible assets, net

     2,878        2,910   

Other assets

     2,148        2,108   
  

 

 

   

 

 

 

Total assets

   $ 66,115      $ 63,063   
  

 

 

   

 

 

 

Liabilities and shareholders’ equity

    

Current liabilities:

    

Medical costs payable

   $ 9,521      $ 9,220   

Accounts payable and accrued liabilities

     6,373        6,488   

Other policy liabilities

     5,317        3,979   

Commercial paper and current maturities of long-term debt

     1,689        2,480   

Unearned revenues

     1,474        1,533   
  

 

 

   

 

 

 

Total current liabilities

     24,374        23,700   

Long-term debt, less current maturities

     9,442        8,662   

Future policy benefits

     2,448        2,361   

Deferred income taxes and other liabilities

     2,488        2,515   
  

 

 

   

 

 

 

Total liabilities

     38,752        37,238   
  

 

 

   

 

 

 

Commitments and contingencies (Note 12)

    

Shareholders’ equity:

    

Preferred stock, $0.001 par value - 10 shares authorized;
no shares issued or outstanding

     0        0   

Common stock, $0.01 par value - 3,000 shares authorized;
1,069 and 1,086 issued and outstanding

     11        11   

Retained earnings

     27,020        25,562   

Accumulated other comprehensive income (loss):

    

Net unrealized gains on investments, net of tax effects

     338        280   

Foreign currency translation losses

     (6     (28
  

 

 

   

 

 

 

Total shareholders’ equity

     27,363        25,825   
  

 

 

   

 

 

 

Total liabilities and shareholders’ equity

   $ 66,115      $ 63,063   
  

 

 

   

 

 

 

See Notes to the Condensed Consolidated Financial Statements

 

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Table of Contents

UnitedHealth Group

Condensed Consolidated Statements of Operations

(Unaudited)

 

     Three Months Ended
June 30,
    Six Months Ended
June 30,
 

(in millions, except per share data)

   2011     2010     2011     2010  

Revenues:

        

Premiums

   $ 22,813      $ 21,125      $ 45,816      $ 42,253   

Services

     1,656        1,413        3,254        2,777   

Products

     605        577        1,254        1,105   

Investment and other income

     160        149        342        322   
                                

Total revenues

     25,234        23,264        50,666        46,457   
                                

Operating costs:

        

Medical costs

     18,578        17,221        37,303        34,391   

Operating costs

     3,733        3,359        7,350        6,635   

Cost of products sold

     554        534        1,153        1,017   

Depreciation and amortization

     270        249        540        497   
                                

Total operating costs

     23,135        21,363        46,346        42,540   
                                

Earnings from operations

     2,099        1,901        4,320        3,917   

Interest expense

     (119     (119     (237     (244
                                

Earnings before income taxes

     1,980        1,782        4,083        3,673   

Provision for income taxes

     (713     (659     (1,470     (1,359
                                

Net earnings

   $ 1,267      $ 1,123      $ 2,613      $ 2,314   
                                

Basic net earnings per common share

   $ 1.18      $ 1.00      $ 2.42      $ 2.04   
                                

Diluted net earnings per common share

   $ 1.16      $ 0.99      $ 2.38      $ 2.02   
                                

Basic weighted-average number of common shares outstanding

     1,075        1,127        1,079        1,136   

Dilutive effect of common stock equivalents

     19        8        17        10   
                                

Diluted weighted-average number of common shares outstanding

     1,094        1,135        1,096        1,146   
                                

Anti-dilutive shares excluded from the calculation of dilutive effect of common stock equivalents

     44        100        52        98   

Cash dividends per common share

   $ 0.1625      $ 0.1550      $ 0.2875      $ 0.1550   

See Notes to the Condensed Consolidated Financial Statements

 

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UnitedHealth Group

Condensed Consolidated Statements of Changes in Shareholders’ Equity

(Unaudited)

 

                  Additional           Accumulated        
                Other     Total  
     Common Stock      Paid-In     Retained     Comprehensive     Shareholders’  

(in millions)

   Shares     Amount      Capital     Earnings     Income (Loss)     Equity  

Balance at January 1, 2011

     1,086      $ 11       $ 0      $ 25,562      $ 252      $ 25,825   

Net earnings

            2,613          2,613   

Unrealized holding gains on investment securities during the period, net of tax expense

              102        102   

Reclassification adjustment for net realized gains included in net earnings, net of tax expense

              (44     (44

Foreign currency translation gain

              22        22   

Issuances of common stock, and related tax benefits

     11        0         153            153   

Common stock repurchases

     (28     0         (409     (846       (1,255

Share-based compensation, and related tax benefits

          256            256   

Common stock dividends

            (309       (309
                                                 

Balance at June 30, 2011

     1,069      $ 11       $ 0      $ 27,020      $ 332      $ 27,363   
                                                 

Balance at January 1, 2010

     1,147      $ 11       $ 0      $ 23,342      $ 253      $ 23,606   

Net earnings

            2,314          2,314   

Unrealized holding gains on investment securities during the period, net of tax expense

              148        148   

Reclassification adjustment for net realized gains included in net earnings, net of tax expense

              (35     (35

Foreign currency translation loss

              (13     (13

Issuances of common stock, and related tax benefits

     7        0         46            46   

Common stock repurchases

     (39     0         (224     (1,017       (1,241

Share-based compensation, and related tax benefits

          178            178   

Common stock dividends

            (174       (174
                                                 

Balance at June 30, 2010

     1,115      $ 11       $ 0      $ 24,465      $ 353      $ 24,829   
                                                 

See Notes to the Condensed Consolidated Financial Statements

 

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UnitedHealth Group

Condensed Consolidated Statements of Cash Flows

(Unaudited)

 

     Six Months Ended
June 30,
 

(in millions)

   2011     2010  

Operating activities

    

Net earnings

   $ 2,613      $ 2,314   

Noncash items:

    

Depreciation and amortization

     540        497   

Deferred income taxes

     264        59   

Share-based compensation

     218        167   

Other

     (62     9   

Net change in other operating items, net of effects from acquisitions and changes in AARP balances:

    

Accounts receivable

     (843     (789

Other assets

     (281     (70

Medical costs payable

     120        41   

Accounts payable and other liabilities

     (128     (14

Other policy liabilities

     37        (97

Unearned revenues

     (59     (189
                

Cash flows from operating activities

     2,419        1,928   
                

Investing activities

    

Purchases of investments

     (4,479     (3,258

Sales of investments

     1,985        1,522   

Maturities of investments

     1,901        1,426   

Cash paid for acquisitions, net of cash assumed

     (827     (165

Cash received for dispositions

     378        0   

Purchases of property, equipment and capitalized software

     (516     (343
                

Cash flows used for investing activities

     (1,558     (818
                

Financing activities

    

Common stock repurchases

     (1,255     (1,241

Proceeds from common stock issuances

     225        106   

Dividends paid

     (309     (174

Proceeds from commercial paper, net

     154        880   

Proceeds from issuance of long-term debt

     747        0   

Payments for retirement of long-term debt

     (955     (1,333

Customer funds administered

     1,228        1,108   

Checks outstanding

     (88     (222

Other

     44        (51
                

Cash flows used for financing activities

     (209     (927
                

Increase in cash and cash equivalents

     652        183   

Cash and cash equivalents, beginning of period

     9,123        9,800   
                

Cash and cash equivalents, end of period

   $ 9,775      $ 9,983   
                

See Notes to the Condensed Consolidated Financial Statements

 

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UNITEDHEALTH GROUP

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(Unaudited)

 

1. Basis of Presentation

The accompanying Condensed Consolidated Financial Statements include the consolidated accounts of UnitedHealth Group Incorporated and its subsidiaries (the Company). The Company has eliminated intercompany balances and transactions. The year-end condensed consolidated balance sheet data was derived from audited financial statements, but does not include all disclosures required by U.S. Generally Accepted Accounting Principles (U.S. 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. However, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2010 as filed with the SEC (2010 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.

During the first quarter of 2011, the Company renamed its reportable segments to conform to the naming conventions of its market facing businesses. Consequently, the Health Benefits reportable segment is now UnitedHealthcare, and the health services businesses, OptumHealth, Ingenix, and Prescriptions Solutions, are now under the Company’s Optum brand as OptumHealth, OptumInsight, and OptumRx, respectively. On January 1, 2011, the Company realigned certain of its businesses to respond to changes in the markets it serves and the opportunities that are emerging as the health system evolves. For example, OptumHealth’s results of operations now include the Company’s clinical services assets, including Southwest Medical multi-specialty clinics in Nevada and Evercare nurse practitioners serving the frail and elderly, which had historically been reported in UnitedHealthcare Employer & Individual and UnitedHealthcare Medicare & Retirement, respectively. UnitedHealthcare Employer & Individual’s results of operations now include OptumHealth Specialty Benefits, including dental, vision, life and disability. The Company’s reportable segments remain the same and prior period segment financial information has been recast to conform to the 2011 presentation. See Note 11 of Notes to the Condensed Consolidated Financial Statements for segment financial information.

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, medical costs payable, revenues, goodwill, other policy liabilities, other current receivables, other intangible assets, investments, income taxes and contingent liabilities. 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 changes in estimates is included in earnings in the period in which the estimate is adjusted.

Recently Issued Accounting Standards. In July 2011, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2011-06, “Other Expenses (Topic 720): Fees Paid to the Federal Government by Health Insurers a consensus of the FASB Emerging Issues Task Force” (ASU 2011-06). This update addresses the recognition and classification of an entity’s share of the annual health insurance industry assessment (the “fee”) mandated by the Patient Protection and Affordable Care Act and its related reconciliation act (Health Reform Legislation). The fee will be levied on health insurers for each calendar year beginning on or after January 1, 2014 and is not deductible for income tax purposes. For reporting entities subject to the fee, the amendments in ASU 2011-06 specify that the liability for the fee should be estimated and recorded in full once the entity provides qualifying health insurance in the applicable calendar year in which the fee is payable with a corresponding deferred cost that is amortized to expense using a straight-line method of allocation unless another method better allocates the fee over the calendar year that it is payable.

The Company has determined that there have been no other recently issued accounting standards that will have a material impact on its Condensed Consolidated Financial Statements.

 

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2. Investments

A summary of short-term and long-term investments is as follows:

 

(in millions)

   Amortized
Cost
     Gross
Unrealized
Gains
     Gross
Unrealized
Losses
    Fair
Value
 

June 30, 2011

          

Debt securities - available-for-sale:

          

U.S. government and agency obligations

   $ 1,897       $ 28       $ (3   $ 1,922   

State and municipal obligations

     6,148         236         (12     6,372   

Corporate obligations

     5,409         198         (7     5,600   

U.S. agency mortgage-backed securities

     2,165         67         (3     2,229   

Non-U.S. agency mortgage-backed securities

     557         28         0        585   
                                  

Total debt securities - available-for-sale

     16,176         557         (25     16,708   
                                  

Equity securities - available-for-sale

     552         20         (14     558   

Debt securities - held-to-maturity:

          

U.S. government and agency obligations

     168         5         0        173   

State and municipal obligations

     15         0         0        15   

Corporate obligations

     18         0         0        18   
                                  

Total debt securities - held-to-maturity

     201         5         0        206   
                                  

Total investments

   $ 16,929       $ 582       $ (39   $ 17,472   
                                  

December 31, 2010

          

Debt securities - available-for-sale:

          

U.S. government and agency obligations

   $ 2,214       $ 28       $ (8   $ 2,234   

State and municipal obligations

     6,007         183         (42     6,148   

Corporate obligations

     5,111         210         (11     5,310   

U.S. agency mortgage-backed securities

     1,851         58         (6     1,903   

Non-U.S. agency mortgage-backed securities

     439         26         0        465   
                                  

Total debt securities - available-for-sale

     15,622         505         (67     16,060   
                                  

Equity securities - available-for-sale

     508         22         (14     516   

Debt securities - held-to-maturity:

          

U.S. government and agency obligations

     167         5         0        172   

State and municipal obligations

     15         0         0        15   

Corporate obligations

     21         0         0        21   
                                  

Total debt securities - held-to-maturity

     203         5         0        208   
                                  

Total investments

   $ 16,333       $ 532       $ (81   $ 16,784   
                                  

Included in the Company’s investment portfolio were securities collateralized by sub-prime home equity lines of credit with fair values of $3 million and $6 million as of June 30, 2011 and December 31, 2010, respectively. Also included were Alt-A securities with fair values of $11 million and $15 million as of June 30, 2011 and December 31, 2010, respectively.

 

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The fair values of the Company’s mortgage-backed securities by credit rating and origination as of June 30, 2011 were as follows:

 

(in millions)

   AAA      A      Non-Investment
Grade
     Total Fair
Value
 

2011

   $ 20       $ 0       $ 0       $ 20   

2010

     8         0         0         8   

2007

     123         0         3         126   

2006

     196         0         12         208   

2005

     138         0         3         141   

Pre - 2005

     78         4         0         82   

U.S. agency mortgage-backed securities

     2,229         0         0         2,229   
                                   

Total

   $ 2,792       $ 4       $ 18       $ 2,814   
                                   

The amortized cost and fair value of available-for-sale debt securities as of June 30, 2011, by contractual maturity, were as follows:

 

(in millions)

   Amortized
Cost
     Fair
Value
 

Due in one year or less

   $ 2,673       $ 2,686   

Due after one year through five years

     4,875         5,078   

Due after five years through ten years

     4,078         4,250   

Due after ten years

     1,828         1,880   

U.S. agency mortgage-backed securities

     2,165         2,229   

Non-U.S. agency mortgage-backed securities

     557         585   
                 

Total debt securities - available-for-sale

   $ 16,176       $ 16,708   
                 

The amortized cost and fair value of held-to-maturity debt securities as of June 30, 2011, by contractual maturity, were as follows:

 

(in millions)

   Amortized
Cost
     Fair
Value
 

Due in one year or less

   $ 38       $ 38   

Due after one year through five years

     136         139   

Due after five years through ten years

     18         19   

Due after ten years

     9         10   
                 

Total debt securities - held-to-maturity

   $ 201       $ 206   
                 

The fair value of available-for-sale investments with gross unrealized losses by investment 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
 

June 30, 2011

               

Debt securities - available-for-sale:

               

U.S. government and agency obligations

   $ 179       $ (3   $ 0       $ 0      $ 179       $ (3

State and municipal obligations

     536         (10     19         (2     555         (12

Corporate obligations

     699         (7     9         0        708         (7

U.S. agency mortgage-backed securities

     306         (3     1         0        307         (3
                                                   

Total debt securities - available-for-sale

   $ 1,720       $ (23   $ 29       $ (2   $ 1,749       $ (25
                                                   

Equity securities - available-for-sale

   $ 243       $ (13   $ 12       $ (1   $ 255       $ (14
                                                   

December 31, 2010

               

Debt securities - available-for-sale:

               

U.S. government and agency obligations

   $ 548       $ (8   $ 0       $ 0      $ 548       $ (8

State and municipal obligations

     1,383         (40     18         (2     1,401         (42

Corporate obligations

     949         (11     14         0        963         (11

U.S. agency mortgage-backed securities

     355         (6     0         0        355         (6
                                                   

Total debt securities - available-for-sale

   $ 3,235       $ (65   $ 32       $ (2   $ 3,267       $ (67
                                                   

Equity securities - available-for-sale

   $ 206       $ (14   $ 11       $ 0      $ 217       $ (14
                                                   

 

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The unrealized losses from all securities as of June 30, 2011 were generated from 1,700 positions out of a total of 14,700 positions. The Company believes that it will collect the principal and interest due on its investments that have an amortized cost in excess of fair value. The unrealized losses on investments in U.S. government and agency obligations, state and municipal obligations and corporate obligations as of June 30, 2011 were primarily caused by interest rate increases and not by unfavorable changes in the credit ratings associated with these securities. The Company evaluates impairment at each reporting period for securities where the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality of the issuers and the credit ratings of the state and municipal obligations and the corporate obligations, noting neither a significant deterioration since purchase nor other factors leading to an other-than-temporary impairment (OTTI). The unrealized losses on mortgage-backed securities as of June 30, 2011 were primarily caused by higher interest rates in the marketplace. These unrealized losses represented less than 1% of the total amortized cost of the Company’s mortgage-backed security holdings as of June 30, 2011. The Company believes these losses to be temporary. All of the Company’s mortgage-backed securities in an unrealized loss position as of June 30, 2011 were rated “AAA” with no known deterioration or other factors leading to an OTTI. As of June 30, 2011, the Company did not have the intent to sell any of the securities in an unrealized loss position.

As of June 30, 2011, the Company’s holdings of non-U.S. agency mortgage-backed securities included $8 million of commercial mortgage loans in default. These investments were acquired in the first quarter of 2008 pursuant to an acquisition and were recorded at fair value. They represented less than 1% of the Company’s total mortgage-backed security holdings as of June 30, 2011.

A portion of the Company’s investments in equity securities and venture capital funds consists of investments held in various public and nonpublic companies concentrated in the areas of health care services and related information technologies. Market conditions that affect the value of health care and related technology stocks will likewise impact the value of the Company’s equity portfolio. The equity securities and venture capital funds were evaluated for severity and duration of unrealized loss, overall market volatility and other market factors.

Net realized gains included in Investment and Other Income on the Condensed Consolidated Statements of Operations were from the following sources:

 

     Three Months Ended
June 30,
    Six Months Ended
June  30,
 

(in millions)

   2011     2010     2011     2010  

Total OTTI

   $ (2   $ (4   $ (6   $ (5

Portion of loss recognized in other comprehensive income

     0        0        0        0   
                                

Net OTTI recognized in earnings

     (2     (4     (6     (5

Gross realized losses from sales

     (3     (2     (4     (3

Gross realized gains from sales

     26        22        79        62   
                                

Net realized gains

   $ 21      $ 16      $ 69      $ 54   
                                

For the three and six months ended June 30, 2011 and 2010, all of the recorded OTTI charges resulted from the Company’s intent to sell certain impaired securities.

 

3. Fair Value

Fair values of available-for-sale debt and equity securities are based on quoted market prices, where available. The Company obtains one price for each security primarily from a third-party pricing service (pricing service), which generally uses quoted or other observable inputs for the determination of fair value. The pricing service normally derives the security prices through recently reported trades for identical or similar securities, making adjustments through the reporting date based upon available observable market information. For securities not actively traded, the pricing service may use quoted market prices of comparable instruments or discounted cash flow analyses, incorporating inputs that are currently observable in the markets for similar securities. Inputs that are often used in the valuation methodologies include, but are not limited to, benchmark yields, credit spreads, default rates, prepayment speeds and non-binding broker quotes. As the Company is responsible for the determination of fair value, it performs quarterly analyses on the prices received from the pricing service to determine whether the prices are reasonable estimates of fair value. Specifically, the Company compares the prices received from the pricing service to prices reported by its custodian, its investment consultant and third-party investment advisors. Additionally, the Company compares changes in the reported market values and returns to relevant market indices to test the reasonableness of the reported prices. The Company’s internal price verification procedures and review of fair value methodology documentation provided by independent pricing services has not historically resulted in adjustment in the prices obtained from the pricing service.

In instances in which the inputs used to measure fair value fall into different levels of the fair value hierarchy, the fair value measurement has been determined based on the lowest level input that is significant to the fair value measurement in its entirety. The Company’s assessment of the significance of a particular item to the fair value measurement in its entirety requires judgment, including the consideration of inputs specific to the asset or liability.

 

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The fair value hierarchy is as follows:

Level 1 — Quoted (unadjusted) prices for identical assets/liabilities in active markets.

Level 2 — Other observable inputs, either directly or indirectly, including:

 

   

Quoted prices for similar assets/liabilities in active markets;

 

   

Quoted prices for identical or similar assets in non-active markets (e.g., few transactions, limited information, non-current prices, high variability over time);

 

   

Inputs other than quoted prices that are observable for the asset/liability (e.g., interest rates, yield curves, volatilities, default rates); and

 

   

Inputs that are derived principally from or corroborated by other observable market data.

Level 3 — Unobservable inputs that cannot be corroborated by observable market data.

The following table presents a summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis excluding AARP related assets and liabilities.

 

(in millions)

   Quoted Prices
in Active
Markets
(Level 1)
    Other
Observable
Inputs
(Level 2)
    Unobservable
Inputs

(Level 3)
    Total
Fair
Value
 

June 30, 2011

        

Cash and cash equivalents

   $ 8,600      $ 1,175      $ 0      $ 9,775   

Debt securities - available-for-sale:

        

U.S. government and agency obligations

     1,303        619        0        1,922   

State and municipal obligations

     0        6,372        0        6,372   

Corporate obligations

     51        5,417        132        5,600   

U.S. agency mortgage-backed securities

     0        2,229        0        2,229   

Non-U.S. agency mortgage-backed securities

     0        577        8        585   
                                

Total debt securities - available-for-sale

     1,354        15,214        140        16,708   

Equity securities - available-for-sale

     334        2        222        558   
                                

Total cash, cash equivalents and investments at fair value

     10,288        16,391        362        27,041   
                                

Interest rate swap assets

     0        63        0        63   
                                

Total assets at fair value

   $ 10,288      $ 16,454      $ 362      $ 27,104   
                                

Percentage of total assets at fair value

     38     61     1     100
                                

Interest rate swap liabilities

   $ 0      $ 63      $ 0      $ 63   
                                

December 31, 2010

        

Cash and cash equivalents

   $ 8,069      $ 1,054      $ 0      $ 9,123   

Debt securities - available-for-sale:

        

U.S. government and agency obligations

     1,515        719        0        2,234   

State and municipal obligations

     0        6,148        0        6,148   

Corporate obligations

     31        5,146        133        5,310   

U.S. agency mortgage-backed securities

     0        1,903        0        1,903   

Non-U.S. agency mortgage-backed securities

     0        457        8        465   
                                

Total debt securities - available-for-sale

     1,546        14,373        141        16,060   

Equity securities - available-for-sale

     306        2        208        516   
                                

Total cash, cash equivalents and investments at fair value

     9,921        15,429        349        25,699   
                                

Interest rate swap assets

     0        46        0        46   
                                

Total assets at fair value

   $ 9,921      $ 15,475      $ 349      $ 25,745   
                                

Percentage of total assets at fair value

     39     60     1     100
                                

Interest rate swap liabilities

   $ 0      $ 104      $ 0      $ 104   
                                

There were no transfers between Levels 1 and 2 during the three and six months ended June 30, 2011 and 2010.

 

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The Company provides health insurance products and services to members of AARP under a Supplemental Health Insurance Program (the Program). The Company elected to measure the entirety of the AARP Assets Under Management at fair value pursuant to the fair value option. See Note 12 of Notes to the Consolidated Financial Statements in the Company’s 2010 10-K for further detail on AARP. The following table presents fair value information about the AARP Program-related financial assets and liabilities:

 

(in millions)

   Quoted Prices
in Active
Markets
(Level 1)
     Other
Observable
Inputs
(Level 2)
     Unobservable
Inputs

(Level 3)
     Total
Fair
Value
 

June 30, 2011

           

Cash and cash equivalents

   $ 103       $ 0       $ 0       $ 103   

Debt securities:

           

U.S. government and agency obligations

     426         215         0         641   

State and municipal obligations

     0         21         0         21   

Corporate obligations

     0         1,168         0         1,168   

U.S. agency mortgage-backed securities

     0         424         0         424   

Non-U.S. agency mortgage-backed securities

     0         151         0         151   
                                   

Total debt securities

     426         1,979         0         2,405   
                                   

Equity securities - available-for-sale

     0         2         0         2   
                                   

Total cash, cash equivalents and investments at fair value

   $ 529       $ 1,981       $ 0       $ 2,510   
                                   

Other liabilities

   $ 13       $ 52       $ 0       $ 65   
                                   

Total liabilities at fair value

   $ 13       $ 52       $ 0       $ 65   
                                   

December 31, 2010

           

Cash and cash equivalents

   $ 115       $ 0       $ 0       $ 115   

Debt securities:

           

U.S. government and agency obligations

     515         244         0         759   

State and municipal obligations

     0         15         0         15   

Corporate obligations

     0         1,129         0         1,129   

U.S. agency mortgage-backed securities

     0         393         0         393   

Non-U.S. agency mortgage-backed securities

     0         137         0         137   
                                   

Total debt securities

     515         1,918         0         2,433   
                                   

Equity securities - available-for-sale

     0         2         0         2   
                                   

Total cash, cash equivalents and investments at fair value

   $ 630       $ 1,920       $ 0       $ 2,550   
                                   

Other liabilities

   $ 0       $ 0       $ 59       $ 59   
                                   

Total liabilities at fair value

   $ 0       $ 0       $ 59       $ 59   
                                   

There were no transfers between Levels 1 and 2 during the three and six months ended June 30, 2011 and 2010.

 

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The table below includes fair values for certain financial instruments for which it is practicable to estimate fair value. The carrying values and fair values of these financial instruments were as follows:

 

     June 30, 2011      December 31, 2010  

(in millions)

   Carrying Value      Fair Value      Carrying Value      Fair Value  

Assets

           

Debt securities - available-for-sale

   $ 16,708       $ 16,708       $ 16,060       $ 16,060   

Equity securities - available-for-sale

     558         558         516         516   

Debt securities - held-to-maturity

     201         206         203         208   

AARP Program-related investments

     2,407         2,407         2,435         2,435   

Interest rate swap assets

     63         63         46         46   

Liabilities

           

Senior unsecured notes

     10,046         10,733         10,212         10,903   

Interest rate swap liabilities

     63         63         104         104   

AARP Program-related other liabilities

     65         65         59         59   

The carrying amounts reported in the Condensed Consolidated Balance Sheets for cash and cash equivalents, accounts and other current receivables, unearned revenues, commercial paper, accounts payable and accrued liabilities approximate fair value because of their short-term nature. These assets and liabilities are not listed in the table above.

The following methods and assumptions were used to estimate the fair value of each class of financial instrument:

Cash and Cash Equivalents. The carrying value of cash and cash equivalents approximates fair value as maturities are less than three months. Fair values of cash equivalent instruments that do not trade on a regular basis in active markets are classified as Level 2.

Debt Securities. The estimated fair values of debt securities held as available-for-sale are based on quoted market prices and/or other market data for the same or comparable instruments and transactions in establishing the prices. Fair values of debt securities that do not trade on a regular basis in active markets but are priced using other observable inputs are classified as Level 2. The Company’s Level 3 debt securities consist mainly of low income housing investments that are unique and non transferrable.

Equity Securities. Equity securities are held as available-for-sale investments. Fair value estimates for Level 1 and Level 2 publicly traded equity securities are based on quoted market prices and/or other market data for the same or comparable instruments and transactions in establishing the prices. The fair values of Level 3 investments in venture capital portfolios are estimated using market modeling approaches that rely heavily on management assumptions and qualitative observations. These investments totaled $181 million and $166 million as of June 30, 2011 and December 31, 2010, respectively. The fair values of the Company’s various venture capital investments are computed using limited quantitative and qualitative observations of activity for similar companies in the current market. The key inputs utilized in the Company’s market modeling include, as applicable, transactions for comparable companies in similar industries and having similar revenue and growth characteristics; similar preferences in the capital structure; discounted cash flows; liquidation values and milestones established at initial funding; and the assumption that the values of the Company’s venture capital investments can be inferred from these inputs. The Company’s remaining Level 3 equity securities holdings of $41 million and $42 million as of June 30, 2011 and December 31, 2010, respectively, consist of preferred stock and other items for which there are no active markets.

Interest Rate Swaps. Fair values of the Company’s interest rate swaps are estimated using the terms of the swaps and publicly available market yield curves. Because the swaps are unique and not actively traded, the fair values are classified as Level 2.

AARP Program-related Investments. AARP Program-related investments consist of debt and equity securities held to fund costs associated with the AARP Program and are priced and classified using the same methodologies as the Company’s other securities.

Senior Unsecured Notes. The fair values of the senior unsecured notes are estimated based on third-party quoted market prices for the same or similar issues.

AARP Program-related Other Liabilities. AARP Program-related other liabilities consist of liabilities that represent the amount of net investment gains and losses related to AARP Program-related investments that accrue to the benefit of the AARP policyholders.

 

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A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using Level 3 inputs is as follows:

 

     Three Months Ended     Six Months Ended  

(in millions)

   Debt
Securities
    Equity
Securities
    Total     Debt
Securities
    Equity
Securities
    Total  

June 30, 2011

            

Balance at beginning of period

   $ 135      $ 201      $ 336      $ 141      $ 208      $ 349   

Purchases

     9        27        36        9        31        40   

Sales

     0        (5     (5     0        (14     (14

Settlements

     (4     0        (4     (10     0        (10

Net unrealized losses in accumulated other comprehensive income

     0        (1     (1     0        (3     (3
                                                

Balance at end of period

   $ 140      $ 222      $ 362      $ 140      $ 222      $ 362   
                                                

June 30, 2010

            

Balance at beginning of period

   $ 114      $ 324      $ 438      $ 120      $ 312      $ 432   

Purchases

     0        1        1        1        21        22   

Sales

     (7     0        (7     (8     (10     (18

Settlements

     (2     (153     (155     (7     (153     (160

Net unrealized gains in accumulated other comprehensive income

     0        6        6        0        6        6   

Net realized gains in investment and other income

     2        8        10        1        10        11   
                                                

Balance at end of period

   $ 107      $ 186      $ 293      $ 107      $ 186      $ 293   
                                                

Non-financial 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 three and six months ended June 30, 2011 and 2010.

 

4. Medicare Part D Pharmacy Benefits Contract

The Condensed Consolidated Balance Sheets include the following amounts associated with the Medicare Part D program:

 

     June 30, 2011      December 31, 2010  

(in millions)

   CMS Subsidies (a)      Drug Discount      Risk-Share      CMS Subsidies (a)      Risk-Share  

Other current receivables

   $ 0       $ 161       $ 62       $ 0       $ 0   

Other policy liabilities

     1,310         345         0         475         265   

 

(a) Includes the Catastrophic Reinsurance Subsidy and the Low-Income Member Cost Sharing Subsidy.

The Catastrophic Reinsurance and the Low-Income Member Cost Sharing Subsidies represent cost reimbursements under the Medicare Part D program. The Company is fully reimbursed by the Centers for Medicare & Medicaid Services (CMS) for costs incurred for these contract elements and, accordingly, there is no insurance risk to the Company. Beginning in 2011, the Health Reform Legislation mandates consumer discounts of 50% on brand name prescription drugs and 7% on generic prescription drugs for Part D plan participants in the coverage gap. These discounts are funded by CMS and pharmaceutical manufacturers while the Company administers the application of these funds. Amounts received for these subsidies and discounts are not reflected as premium revenues, but rather are accounted for as deposits. Related cash flows are presented as Customer Funds Administered within financing activities in the Condensed Consolidated Statements of Cash Flows.

Premiums from CMS are subject to risk-sharing provisions based on a comparison of the Company’s annual bid estimates of prescription drug costs and the actual costs incurred. Variances may result in CMS making additional payments to the Company or require the Company to remit funds to CMS subsequent to the end of the year. The Company records risk-share adjustments to premium revenue and other current receivables or other policy liabilities in the Condensed Consolidated Balance Sheets.

 

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5. Goodwill

Changes in the carrying amount of goodwill, by reportable segment, were as follows:

 

(in millions)

   UnitedHealthcare     OptumHealth      OptumInsight     OptumRx      Consolidated  

Balance at December 31, 2010 (a)

   $ 17,837      $ 760       $ 3,308      $ 840       $ 22,745   

Acquisitions

     7        892         0        0         899   

Dispositions

     (2     0         (214     0         (216

Subsequent payments and adjustments, net

     (2     0         (3     0         (5
                                          

Balance at June 30, 2011

   $ 17,840      $ 1,652       $ 3,091      $ 840       $ 23,423   
                                          

 

(a) Prior period reportable segment financial information has been recast to conform to the 2011 presentation as discussed in Note 1 of Notes to the Condensed Consolidated Financial Statements.

 

6. Medical Costs and Medical Costs Payable

Medical costs and medical costs payable include estimates of the Company’s obligations for medical care services that have been rendered on behalf of insured consumers, but for which claims have either not yet been received or processed, and for liabilities for physician, hospital and other medical cost disputes. The Company develops estimates for medical costs incurred but not reported using an actuarial process that is consistently applied, centrally controlled and automated. The actuarial models consider factors such as time from date of service to claim receipt, claim backlogs, care provider contract rate changes, medical care consumption and other medical cost trends. The Company estimates liabilities for physician, hospital and other medical cost disputes based upon an analysis of potential outcomes, assuming a combination of litigation and settlement strategies. Each period, the Company re-examines previously established medical costs payable estimates based on actual claim submissions and other changes in facts and circumstances. As the medical costs payable estimates recorded in prior periods develop, the Company adjusts the amount of the estimates and includes the changes in estimates in medical costs in the period in which the change is identified.

For the three months ended June 30, 2011, there was $120 million of net favorable medical cost development related to prior fiscal years and $60 million of net favorable medical cost development related to the first quarter of 2011. For the six months ended June 30, 2011, medical costs included $560 million of net favorable medical cost development related to prior fiscal years. The favorable development for both the three and six months ended June 30, 2011 was primarily driven by changes in previous estimates related to lower than expected health system utilization levels and continued efficiencies in claims submission, handling and processing, which results in higher completion factors.

For the three months ended June 30, 2010, there was $90 million of net favorable medical cost development related to prior fiscal years and $180 million of net favorable medical cost development related to the first quarter of 2010. For the six months ended June 30, 2010, medical costs included $580 million of net favorable medical cost development related to prior fiscal years. The favorable development for both the three and six months ended June 30, 2010 was primarily driven by changes in previous estimates related to more efficient claims handling and processing, resulting in higher completion factors and lower than expected health system utilization levels.

 

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7. Commercial Paper and Long-Term Debt

Commercial paper and long-term debt consisted of the following:

 

     June 30, 2011      December 31, 2010  

(in millions)

   Par
Value
     Carrying
Value
     Fair
Value
     Par
Value
     Carrying
Value
     Fair
Value
 

Commercial paper

   $ 1,085       $ 1,085       $ 1,085       $ 930       $ 930       $ 930   

Senior unsecured floating-rate notes due February 2011

     0         0         0         250         250         250   

5.3% senior unsecured notes due March 2011

     0         0         0         705         712         711   

5.5% senior unsecured notes due November 2012

     352         368         373         352         372         377   

4.9% senior unsecured notes due February 2013

     534         542         564         534         541         568   

4.9% senior unsecured notes due April 2013

     409         424         433         409         425         437   

4.8% senior unsecured notes due February 2014

     172         186         186         172         186         184   

5.0% senior unsecured notes due August 2014

     389         424         427         389         425         423   

4.9% senior unsecured notes due March 2015

     416         457         454         416         456         444   

5.4% senior unsecured notes due March 2016

     601         669         673         601         666         661   

5.4% senior unsecured notes due November 2016

     95         95         107         95         95         105   

6.0% senior unsecured notes due June 2017

     441         488         499         441         484         491   

6.0% senior unsecured notes due November 2017

     156         169         177         156         167         174   

6.0% senior unsecured notes due February 2018

     1,100         1,085         1,247         1,100         1,065         1,249   

3.9% senior unsecured notes due October 2020

     450         422         440         450         413         429   

4.7% senior unsecured notes due February 2021

     400         399         417         0         0         0   

Zero coupon senior unsecured notes due November 2022

     1,095         604         697         1,095         588         677   

5.8% senior unsecured notes due March 2036

     850         844         858         850         844         862   

6.5% senior unsecured notes due June 2037

     500         495         547         500         495         552   

6.6% senior unsecured notes due November 2037

     650         645         721         650         645         729   

6.9% senior unsecured notes due February 2038

     1,100         1,084         1,258         1,100         1,085         1,281   

5.7% senior unsecured notes due October 2040

     300         298         297         300         298         299   

6.0% senior unsecured notes due February 2041

     350         348         358         0         0         0   
                                                     

Total commercial paper and long-term debt

   $ 11,445       $ 11,131       $ 11,818       $ 11,495       $ 11,142       $ 11,833   
                                                     

Commercial Paper and Bank Credit Facility

Commercial paper consists of senior unsecured debt privately placed on a discount basis through broker-dealers with maturities up to 270 days. As of June 30, 2011, the Company’s outstanding commercial paper had a weighted-average annual interest rate of 0.4%.

The Company has a $2.5 billion five-year revolving bank credit facility with 23 banks, which matures in May 2012. This facility supports the Company’s commercial paper program and is available for general corporate purposes. There were no amounts outstanding under this facility during the six months ended June 30, 2011. The interest rate on borrowings is variable based on term and amount and is calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. As of June 30, 2011, the annual interest rate on this facility, had it been drawn, would have ranged from 0.4% to 0.6%.

Debt Covenants

The Company’s bank credit facility contains various covenants including requiring the Company to maintain a debt-to-total-capital ratio, calculated as debt divided by the sum of debt and shareholders’ equity, below 50%. The Company was in compliance with its debt covenants as of June 30, 2011.

Long-Term Debt

In February 2011, the Company issued $750 million in senior unsecured notes. The issuance included $400 million of 4.7% fixed-rate notes due February 2021 and $350 million of 5.95% fixed-rate notes due February 2041.

Interest Rate Swap Contracts

During 2010, the Company entered into interest rate swap contracts to convert a portion of its interest rate exposure from fixed rates to floating rates to more closely align interest expense with interest income received on its cash equivalent and investment balances. The floating rates are benchmarked to LIBOR. The swaps are designated as fair value hedges on fixed-rate debt issues maturing between November 2012 through March 2016 and June 2017 through October 2020. Since the specific terms and notional amounts of the swaps match those of the debt being hedged, they were assumed to be highly effective hedges and all changes in fair value of the

 

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swaps were recorded on the Condensed Consolidated Balance Sheets with no net impact recorded in the Condensed Consolidated Statements of Operations.

The following table summarizes the location and fair value of fair value hedges on the Company’s Condensed Consolidated Balance Sheets:

 

     June 30, 2011      December 31, 2010  

(in millions)

   ($5,020 Notional Amount)      ($5,725 Notional Amount)  

Balance Sheet Location

     

Other assets

   $ 63       $ 46   

Other liabilities

     63         104   

The following table provides a summary of the effect of changes in fair value of fair value hedges on the Company’s Condensed Consolidated Statements of Operations:

 

     Three Months Ended
June 30,
    Six Months Ended
June 30,
 

(in millions)

   2011     2010     2011     2010  

Hedge gain recognized in interest expense

   $ 96      $ 47      $ 58      $ 33   

Hedged item loss recognized in interest expense

     (96     (47     (58     (33
                                

Net impact on the Company’s Condensed Consolidated Statements of Operations

   $ 0      $ 0      $ 0      $ 0   
                                

 

8. Shareholders’ Equity

Share Repurchase Program

Under its Board of Directors’ authorization, the Company maintains a share repurchase program. The objectives of the share repurchase program are to optimize the Company’s capital structure and cost of capital, thereby improving returns to shareholders, as well as to offset the dilutive impact of share-based awards. Repurchases may be made from time to time at prevailing prices in the open market, subject to certain Board restrictions. In May 2011, the Board renewed the Company’s share repurchase program with an authorization to repurchase up to 110 million shares of its common stock. During the six months ended June 30, 2011, the Company repurchased 28 million shares at an average price of approximately $45 per share and an aggregate cost of $1.3 billion. As of June 30, 2011, the Company had Board authorization to purchase up to an additional 101 million shares of its common stock.

Dividends

In May 2011, the Company’s Board of Directors increased the Company’s cash dividend to shareholders to an annual dividend rate of $0.65 per share, paid quarterly. Since June 2010, the Company had paid a quarterly dividend of $0.125 per share. 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 dividend payments in 2011:

 

Payment Date

   Amount per Share      Total Amount Paid  
            (in millions)  

3/21/2011

   $ 0.1250       $ 135   

6/21/2011

     0.1625         174   

 

9. Share-Based Compensation

In May 2011, the Company’s shareholders approved the 2011 Stock Incentive Plan (Plan). The Plan is intended to attract and retain employees and non-employee directors, offer them incentives to put forth maximum efforts for the success of the Company’s business and afford them an opportunity to acquire a proprietary interest in the Company. The Plan allows the Company to grant stock options, stock appreciation rights, restricted stock, restricted stock units, performance awards or other stock-based awards to eligible employees and non-employee directors. The Plan incorporates the following plans adopted by the Company: 2002 Stock and Incentive Plan, 1991 Stock and Incentive Plan, 1998 Broad-Based Stock Incentive Plan and Non-employee Director Stock Option Plan. All outstanding stock options, restricted stock and other awards issued under the prior plans will remain subject to the terms and conditions of the plans under which they were issued.

As of June 30, 2011, the Company had 49 million shares available for future grants of share-based awards under its share-based compensation plan, including, but not limited to, incentive or non-qualified stock options, stock-settled stock appreciation rights (SARs), and up to 23 million of awards in restricted stock and restricted stock units (collectively, restricted shares). The Company’s outstanding share-based awards consist mainly of non-qualified stock options, SARs and restricted shares.

 

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Stock Options and SARs

Stock options and SARs generally vest ratably over four to six years and may be exercised up to 10 years from the date of grant. Stock option and SAR activity for the six months ended June 30, 2011 is summarized in the table below:

 

     Shares     Weighted-
Average
Exercise
Price
     Weighted-
Average
Remaining
Contractual Life
     Aggregate
Intrinsic Value
 
     (in millions)            (in years)      (in millions)  

Outstanding at beginning of period

     112      $ 40         

Granted

     1        43         

Exercised

     (11     30         

Forfeited

     (2     42         
                      

Outstanding at end of period

     100      $ 41         5.0       $ 1,156   
                      

Exercisable at end of period

     82      $ 43         4.4       $ 821   

Vested and expected to vest end of period

     99      $ 41         5.0       $ 1,136   

To determine compensation expense related to the Company’s stock options and SARs, the fair value of each award is estimated on the date of grant using an option-pricing model. For purposes of estimating the fair value of the Company’s employee stock option and SAR grants, the Company uses a binomial model. The principal assumptions the Company used in applying the option-pricing models were as follows:

 

     Three Months Ended June 30,     Six Months Ended June 30,
     2011     2010     2011   2010

Risk free interest rate

     1.8     1.9   1.8% - 2.3%   1.9% -2.1%

Expected volatility

     44.3     46.2   44.3%   45.8% - 46.2%

Expected dividend yield

     1.0     1.7   1.0% - 1.2%   0.1% -1.7%

Forfeiture rate

     5.0     5.0   5.0%   5.0%

Expected life in years

     4.9        4.6      4.9   4.6 -5.1

Risk-free interest rates are based on U.S. Treasury yields in effect at the time of grant. Expected volatilities are based on the historical volatility of the Company’s common stock and the implied volatility from exchange-traded options on the Company’s common stock. The Company uses historical data to estimate option and SAR exercises and forfeitures within the valuation model. The expected lives of options and SARs granted represents the period of time that the awards granted are expected to be outstanding based on historical exercise patterns.

The weighted-average grant date fair value of stock options and SARs granted during the three and six months ended June 30, 2011 was approximately $17 per share and $15 per share, respectively. The weighted-average grant date fair value of stock options and SARs granted during the three and six months ended June 30, 2010 was approximately $10 per share and $13 per share, respectively. The total intrinsic value of stock options and SARs exercised during the three and six months ended June 30, 2011 was $107 million and $174 million, respectively. The total intrinsic value of stock options and SARs exercised during the three and six months ended June 30, 2010 was $9 million and $62 million, respectively.

Restricted Shares

Restricted shares generally vest ratably over three to four years. Compensation expense related to restricted shares is based on the share price on date of grant. Restricted share activity for the six months ended June 30, 2011 is summarized in the table below:

 

(shares in millions)

   Shares     Weighted-Average
Grant Date
Fair Value
per Share
 

Nonvested at beginning of period

     13      $ 31   

Granted

     8        42   

Vested

     (4     32   
                

Nonvested at end of period

     17      $ 36   
                

The weighted-average grant date fair value of restricted shares granted during the three and six months ended June 30, 2011 was approximately $48 per share and $42 per share, respectively. The weighted-average grant date fair value of restricted shares granted during the three and six months ended June 30, 2010 was approximately $29 per share and $33 per share, respectively. The total fair value of restricted shares vested during the three and six months ended June 30, 2011 was $39 million and $108 million, respectively.

 

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The total fair value of restricted shares vested during the three and six months ended June 30, 2010 was $41 million and $85 million, respectively.

Share-Based Compensation Recognition

The Company recognizes compensation expense for share-based awards, including stock options, SARs and restricted shares, on a straight-line basis over the related service period (generally the vesting period) of the award, or to an employee’s eligible retirement date under the award agreement, if earlier. For the three and six months ended June 30, 2011, the Company recognized compensation expense related to its share-based compensation plans of $95 million ($70 million net of tax effects) and $218 million ($154 million net of tax effects), respectively. For the three and six months ended June 30, 2010, the Company recognized compensation expense related to its share-based compensation plans of $67 million ($65 million net of tax effects) and $167 million ($152 million net of tax effects), respectively. Share-based compensation expense is recognized in Operating Costs in the Company’s Condensed Consolidated Statements of Operations. As of June 30, 2011, there was $522 million of total unrecognized compensation cost related to share awards that is expected to be recognized over a weighted-average period of 1.2 years. For the three and six months ended June 30, 2011 the income tax benefit realized from share-based award exercises was $59 million and $116 million, respectively. For the three and six months ended June 30, 2010 the income tax benefit realized from share-based award exercises was $16 million and $44 million, respectively.

As further discussed in Note 8 of Notes to the Condensed Consolidated Financial Statements, the Company maintains a share repurchase program. The objectives of the share repurchase program are to optimize the Company’s capital structure, cost of capital and return to shareholders, as well as to offset the dilutive impact of shares issued for share-based award exercises.

 

10. Comprehensive Income

The table below presents comprehensive income, defined as changes in the equity of the Company’s business excluding changes resulting from investments by and distributions to its shareholders.

 

     Three Months Ended
June 30,
    Six Months Ended
June 30,
 

(in millions)

   2011     2010     2011     2010  

Net earnings

   $ 1,267      $ 1,123      $ 2,613      $ 2,314   

Unrealized holding gains on investment securities arising during the period, net of tax expense of $73, $65, $59 and $82, respectively

     125        121        102        148   

Reclassification adjustment for net realized gains included in net earnings, net of tax expense of $8, $5, $25 and $19, respectively

     (13     (11     (44     (35

Foreign currency translation gains (losses)

     13        (9     22        (13
                                

Comprehensive income

   $ 1,392      $ 1,224      $ 2,693      $ 2,414   
                                

 

11. Segment Financial Information

The Company has four reportable segments:

 

   

UnitedHealthcare;

 

   

OptumHealth;

 

   

OptumInsight; and

 

   

OptumRx.

The following is a description of the types of products and services from which each of the Company’s reportable segments derives its revenues:

 

   

UnitedHealthcare includes the combined results of operations of UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State because they have similar economic characteristics, products and services, types of customers, distribution methods and operational processes and operate in a similar regulatory environment. These businesses also share significant common assets, including a contracted network of physicians, health care professionals, hospitals and other facilities, information technology infrastructure and other resources. UnitedHealthcare Employer & Individual offers a comprehensive array of consumer-oriented health benefit plans and services for large national employers, public sector employers, mid-sized employers, small businesses and individuals nationwide. UnitedHealthcare Medicare & Retirement provides health and well-being services to individuals age 50 and older, addressing their unique needs for preventive and acute health care services as well as services dealing with chronic disease and other specialized issues for older individuals. UnitedHealthcare Community & State provides network-based health and well-being services to beneficiaries of State Medicaid and Children’s Health Insurance Programs (CHIP) and other government-sponsored health care programs.

 

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OptumHealth provides behavioral benefit solutions, clinical services and financial services to help consumers navigate the health care system, finance their health care needs and achieve their health and well-being goals.

 

   

OptumInsight offers health information and technology solutions, including connectivity, compliance, clinical workflow and electronic medical record software, and consulting and outsourced services to employers, health plan sponsors, physicians, hospital systems, life sciences companies, and other users of health information.

 

   

OptumRx offers a comprehensive suite of integrated pharmacy benefit management services, including retail network pharmacy management, mail order pharmacy services, specialty pharmacy services, benefit design consultation, drug utilization review, formulary management programs, disease management and compliance and therapy management programs.

Transactions between reportable segments principally consist of sales of pharmacy benefit products and services to UnitedHealthcare customers by OptumRx, certain product offerings and clinical services sold to UnitedHealthcare by OptumHealth, and consulting and other services sold to UnitedHealthcare by OptumInsight. These transactions are recorded at management’s estimate of fair value. Intersegment transactions are eliminated in consolidation.

 

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Prior period reportable segment financial information has been recast to conform to the 2011 presentation as discussed in Note 1 of Notes to the Condensed Consolidated Financial Statements. The following table presents reportable segment financial information:

 

            Optum               

(in millions)

   UnitedHealthcare      OptumHealth (a)      OptumInsight      OptumRx      Total Optum      Corporate and
Intersegment
Eliminations
    Consolidated  

Three Months Ended June 30, 2011

  

                

Revenues - external customers:

                   

Premiums

   $ 22,438       $ 375       $ 0       $ 0       $ 375       $ 0      $ 22,813   

Services

     1,080         137         421         18         576         0        1,656   

Products

     0         6         11         588         605         0        605   
                                                             

Total revenues - external customers

     23,518         518         432         606         1,556         0        25,074   
                                                             

Total revenues - intersegment

     0         1,127         226         4,082         5,435         (5,435     0   

Investment and other income

     135         25         0         0         25         0        160   
                                                             

Total revenues

   $ 23,653       $ 1,670       $ 658       $ 4,688       $ 7,016       $ (5,435   $ 25,234   
                                                             

Earnings from operations

   $ 1,759       $ 135       $ 87       $ 118       $ 340       $ 0      $ 2,099   

Interest expense

     0         0         0         0         0         (119     (119
                                                             

Earnings before income taxes

   $ 1,759       $ 135       $ 87       $ 118       $ 340       $ (119   $ 1,980   
                                                             

Three Months Ended June 30, 2010

                   

Revenues - external customers:

                   

Premiums

   $ 20,812       $ 313       $ 0       $ 0       $ 313       $ 0      $ 21,125   

Services

     1,008         82         308         15         405         0        1,413   

Products

     0         4         11         562         577         0        577   
                                                             

Total revenues - external customers

     21,820         399         319         577         1,295         0        23,115   
                                                             

Total revenues - intersegment

     0         729         210         3,625         4,564         (4,564     0   

Investment and other income

     135         14         0         0         14         0        149   
                                                             

Total revenues

   $ 21,955       $ 1,142       $ 529       $ 4,202       $ 5,873       $ (4,564   $ 23,264   
                                                             

Earnings from operations

   $ 1,565       $ 142       $ 60       $ 134       $ 336       $ 0      $ 1,901   

Interest expense

     0         0         0         0         0         (119     (119
                                                             

Earnings before income taxes

   $ 1,565       $ 142       $ 60       $ 134       $ 336       $ (119   $ 1,782   
                                                             

Six Months Ended June 30, 2011

                   

Revenues - external customers:

                   

Premiums

   $ 45,094       $ 722       $ 0       $ 0       $ 722       $ 0      $ 45,816   

Services

     2,136         224         857         37         1,118         0        3,254   

Products

     0         12         27         1,215         1,254         0        1,254   
                                                             

Total revenues - external customers

     47,230         958         884         1,252         3,094         0        50,324   
                                                             

Total revenues - intersegment

     0         2,174         445         8,068         10,687         (10,687     0   

Investment and other income

     297         45         0         0         45         0        342   
                                                             

Total revenues

   $ 47,527       $ 3,177       $ 1,329       $ 9,320       $ 13,826       $ (10,687   $ 50,666   
                                                             

Earnings from operations

   $ 3,658       $ 244       $ 170       $ 248       $ 662       $ 0      $ 4,320   

Interest expense

     0         0         0         0         0         (237     (237
                                                             

Earnings before income taxes

   $ 3,658       $ 244       $ 170       $ 248       $ 662       $ (237   $ 4,083   
                                                             

Six Months Ended June 30, 2010

                   

Revenues - external customers:

                   

Premiums

   $ 41,641       $ 612       $ 0       $ 0       $ 612       $ 0      $ 42,253   

Services

     1,988         154         604         31         789         0        2,777   

Products

     0         8         25         1,072         1,105         0        1,105   
                                                             

Total revenues - external customers

     43,629         774         629         1,103         2,506         0        46,135   
                                                             

Total revenues - intersegment

     0         1,441         405         7,181         9,027         (9,027     0   

Investment and other income

     293         29         0         0         29         0        322   
                                                             

Total revenues

   $ 43,922       $ 2,244       $ 1,034       $ 8,284       $ 11,562       $ (9,027   $ 46,457   
                                                             

Earnings from operations

   $ 3,256       $ 285       $ 113       $ 263       $ 661       $ 0      $ 3,917   

Interest expense

     0         0         0         0         0         (244     (244
                                                             

Earnings before income taxes

   $ 3,256       $ 285       $ 113       $ 263       $ 661       $ (244   $ 3,673   
                                                             

 

(a) As of June 30, 2011, OptumHealth’s total assets were $5.8 billion as compared to $3.9 billion as of December 31, 2010. The increase was due to acquisitions completed in the first half of 2011.

 

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12. 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, providers, customers and regulators, relating to the Company’s management and administration of health benefit plans. 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 probable 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 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.

Litigation Matters

MDL Litigation. Beginning in 1999, a series of class action lawsuits were filed against the Company by health care providers alleging various claims relating to the Company’s reimbursement practices, including alleged violations of the Racketeer Influenced Corrupt Organization Act (RICO) and state prompt payment laws and breach of contract claims. Many of these lawsuits were consolidated in a multi-district litigation in the United States District Court for the Southern District Court of Florida (MDL). In 2006, the trial court dismissed all of the claims against the Company in the lead MDL lawsuit, and the Eleventh Circuit Court of Appeals later affirmed that dismissal. Seven related class action lawsuits that were stayed during the litigation of the lead MDL lawsuit (tag-along suits) remain pending before the District Court, and the Company is a defendant in one other related tag-along suit that was referred to arbitration. The Company is vigorously defending against the claims in these cases. The Company cannot reasonably estimate the range of loss, if any, that may result from these matters given the procedural status of the cases, the potential effect of prior rulings in related cases, the plaintiffs’ failure to provide any evidence-based damages analyses, and the indeterminate number of claims and parties involved. In fact, no formal demands have been made in any of the remaining suits and the plaintiffs have not provided an estimate of alleged damages. However, the Company does not believe that the remaining MDL proceedings will have a material adverse effect on the Company.

Out-of-Network Reimbursement Litigation. In 2000, a group of plaintiffs including the American Medical Association filed a lawsuit against the Company asserting a variety of claims challenging the Company’s determination of reimbursement amounts for non-network health care services based on the Company’s use of a database previously maintained by Ingenix, Inc. (now known as OptumInsight). The parties entered into a settlement agreement in 2009 and this class action lawsuit, along with a related industry-wide investigation by the New York Attorney General, is now resolved. The Company remains a party to a number of other lawsuits, including putative class actions and multidistrict litigation, brought on behalf of members of other health insurance companies, including Aetna, WellPoint and CIGNA, challenging those companies’ determinations of out-of network reimbursement amounts based on their use of the same database. Those suits allege, among other things, that the database licensed to these companies by Ingenix was flawed and that Ingenix conspired with these companies to underpay their members’ claims and seek unspecified damages and treble damages, injunctive and declaratory relief, interest, costs and attorneys fees. The Company is vigorously defending these suits. The Company cannot reasonably estimate the range of loss, if any, that may result from these matters due to the procedural status of the cases, motions to dismiss that are pending in all of the cases, the absence of class certification in any of the cases, the lack of a formal demand on the Company by the plaintiffs, and the involvement of other insurance companies as defendants.

California Claims Processing Matter. In 2007, the California Department of Insurance (CDI) examined the Company’s PacifiCare health insurance plan in California. The examination findings related to the timeliness and accuracy of claims processing, interest payments, provider contract implementation, provider dispute resolution and other related matters. On January 25, 2008, the CDI issued an Order to Show Cause to PacifiCare Life and Health Insurance Company, a subsidiary of the Company, alleging violations of certain insurance statutes and regulations in connection with the CDI’s examination findings. On June 3, 2009, the Company filed a Notice of Defense to the Order to Show Cause denying all material allegations and asserting certain defenses. The matter has been the subject of an administrative hearing before a California administrative law judge (ALJ) since December 2009. CDI amended its Order to Show Cause three times in 2010 to allege a total of 992,936 violations, the large majority of which relate to an alleged failure to include certain language in standard claims correspondence during a four month period in 2007. Although we believe that CDI has never issued an aggregate penalty in excess of $8 million, CDI alleges in press reports and releases that the Company could theoretically be subject to penalties of up to $10,000 per violation. The Company is vigorously defending against these claims. After the ALJ issues a ruling at the conclusion of the administrative proceeding, the California Insurance Commissioner may accept, reject or modify the ALJ’s ruling, issue his own decision, and impose a fine or penalty. The Commissioner’s decision is subject to challenge in court. The Company cannot reasonably estimate the range of loss, if any, that may result from this matter given the procedural

 

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status of the dispute, the novel legal issues presented, the inherent difficulty in predicting regulatory fines and penalties, and the various remedies and levels of judicial review available to the Company in the event a fine or penalty is assessed.

Government Regulation

The Company’s business is regulated at federal, state, local and international levels. The laws and rules governing the Company’s business and interpretations of those laws and rules are subject to frequent change. Broad latitude is given to the agencies administering those regulations. Further, the Company must obtain and maintain regulatory approvals to market and sell many of its products.

The Company has been and is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by CMS, state insurance and health and welfare departments, state attorneys general, the Office of Inspector General (OIG), the Office of Personnel Management, the Office of Civil Rights, U.S. Congressional committees, the U.S. Department of Justice, U.S. Attorneys, the SEC, the IRS, the U.S. Department of Labor, the Federal Deposit Insurance Corporation and other governmental authorities. Examples of audits include the risk adjustment data validation (RADV) audits discussed below and a review by the U.S. Department of Labor of the Company’s administration of applicable customer employee benefit plans with respect to ERISA compliance.

Government actions can result in assessment of damages, civil or criminal fines or penalties, or other sanctions, including loss of licensure or exclusion from participation in government programs and could have a material adverse effect on the Company’s financial results.

Risk Adjustment Data Validation Audits. CMS adjusts capitation payments to Medicare Advantage and Medicare Part D plans according to the predicted health status of each beneficiary, as supported by data provided by health care providers. The Company collects claim and encounter data from providers, who the Company generally relies on to appropriately code their claim submissions and document their medical records. CMS then determines the risk score and payment amount for each enrolled member based on the health care data submitted and member demographic information.

In 2008, CMS announced that it would perform RADV audits of selected Medicare Advantage health plans each year to validate the coding practices of and supporting documentation maintained by health care providers. These audits involve a review of medical records maintained by providers and may result in retrospective adjustments to payments made to health plans. Certain of the Company’s health plans have been selected for audit. These audits are focused on medical records supporting risk adjustment data for 2006 that were used to determine 2007 payment amounts. Although these audits are ongoing, the Company does not believe they will have a material impact on the Company’s results of operations, financial position or cash flows.

In December 2010, CMS published for public comment a new proposed RADV audit and payment adjustment methodology. The proposed methodology contains provisions allowing retroactive contract level payment adjustments for the year audited using an extrapolation of the “error rate” identified in audit samples. The Company has submitted comments to CMS regarding concerns the Company has with CMS’ proposed methodology. These concerns include, among others, the fact that the proposed methodology does not take into account the “error rate” in the original Medicare fee-for-service data that was used to develop the risk adjustment system. Additionally, payments received from CMS, as well as benefits offered and premiums charged to members, are based on actuarially certified bids that did not include any assumption of retroactive audit payment adjustments. The Company believes that applying retroactive audit and payment adjustments after CMS acceptance of bids undermines the actuarial soundness of the bids. On February 3, 2011, CMS notified the Company that CMS was evaluating all comments received on the proposed methodology and that it anticipated making changes to the draft, based on input CMS had received. CMS also indicated that it anticipated the final methodology would be issued in the near future. Depending on the methodology utilized, potential payment adjustments could have a material adverse effect on the Company’s results of operations, financial position and cash flows.

The Company is also in discussions with the OIG for Health and Human Services (HHS) regarding audits of the Company’s risk adjustment data for two plans. While the Company does not believe OIG has governing authority to directly impose payment adjustments for risk adjustment audits of Medicare health plans operated under the regulatory authority of CMS, the OIG can recommend to CMS a proposed payment adjustment, and the Company is unable to predict the outcome of these discussions and audits.

Guaranty Fund Assessments. Under state guaranty assessment laws, certain insurance companies (and health maintenance organizations in some states), including those issuing health (which includes long-term care), life and accident insurance policies, doing business in those states can be assessed (up to prescribed limits) for certain obligations to the policyholders and claimants of insolvent insurance companies that write the same line or lines of business. Assessments are generally based on premiums in the state compared to the premiums of other insurers, and could be spread out over a period of years. Some states permit member insurers to recover assessments paid through full or partial premium tax offsets.

 

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The Pennsylvania Insurance Commissioner has placed Penn Treaty Network America Insurance Company and its subsidiary (Penn Treaty), neither of which is affiliated with the Company, in rehabilitation, an intermediate action before insolvency, and has petitioned a state court for liquidation. If Penn Treaty is liquidated, the Company’s insurance entities and other insurers may be required to pay a portion of Penn Treaty’s policyholder claims through guaranty association assessments in future periods. The Company has estimated a potential assessment of $250 million to $300 million, or $0.12 to $0.15 per share, in 2011 related to this matter, and the Company would accrue the assessment in operating costs if and when the state court renders such a decision. The timing, actual amount and impact, if any, of any guaranty fund assessments will depend on several factors, including if and when the court declares Penn Treaty insolvent, the amount of the insolvency, the availability and amount of any potential offsets, such as an offset of any premium taxes otherwise payable by the Company, and the impact of any such assessments on potential premium rebate payments under the Health Reform Legislation, which have been considered in the Company’s per-share estimate above.

See Item 1, “Business — Government Regulation,” and Item 1A, “Risk Factors,” in the Company’s 2010 10-K for additional regulatory information and related risks.

 

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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. References to the terms “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 subsidiaries.

EXECUTIVE OVERVIEW

General

UnitedHealth Group is a diversified health and well-being company, whose focus is on improving the overall health and well-being of the people and communities we serve and enhancing the performance of the health system. We work with health care professionals and other key partners to expand access to high quality health care. We help people get the care they need at an affordable cost; support the physician/patient relationship; and empower people with the information, guidance and tools they need to make personal health choices and decisions.

Through our diversified family of businesses, we leverage core competencies in advanced technology-based transactional capabilities; health care data, knowledge and information; and health care resource organization and care facilitation to help make health care work better. We use these core competencies to address distinct market needs across the health economy through our two business platforms – Health Benefits through the UnitedHealthcare master brand and Health Services through the Optum master brand. UnitedHealthcare, our Health Benefits platform, includes three distinct businesses that share systems, networks and one unified brand name to offer customers broad access to high-quality, cost-effective health care at the local level. Health Benefits are offered in the individual and employer markets and the public and senior markets through our UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement, and UnitedHealthcare Community & State businesses. Optum, our Health Services platform, includes three diversified information and technology-enabled services businesses, OptumHealth, OptumInsight (formerly Ingenix) and OptumRx (formerly Prescription Solutions), serving the broad health care marketplace, ranging from employers and health plans to physicians, hospitals and life sciences companies. In aggregate, our two business platforms have more than two dozen distinct business units that address specific end markets. Each of these business units focuses on helping improve overall health system performance by optimizing care quality, reducing costs and improving the consumer experience.

Revenues

Our revenues are primarily comprised of premiums derived from risk-based health insurance arrangements in which the premium is typically at a fixed rate per individual served for a one-year period, and we assume the economic risk of funding our customers’ health care benefits and related administrative costs. Effective in 2011, commercial health plans with medical loss ratios on fully insured products, as calculated under the definitions in the Health Reform Legislation and implementing regulations, that fall below certain targets (85% for large employer groups, 80% for small employer groups and 80% for individuals, subject to state-specific exceptions) are required to rebate ratable portions of their premiums to their customers annually. Rebate payments for 2011 would be made in mid 2012. As a result, quarterly premium revenue may be reduced by a pro rata estimate of our full-year medical loss ratio rebate payable under the Health Reform Legislation. We also generate revenues from fee-based services performed for customers that self-insure the health care costs of their employees and employees’ dependants. For both risk-based and fee-based health care benefit arrangements, we provide coordination and facilitation of medical services; transaction processing; health care professional services; and access to contracted networks of physicians, hospitals and other health care professionals. We also generate service revenues from our health intelligence and consulting businesses. Product revenues are mainly comprised of products sold by our pharmacy benefit management business. We derive investment income primarily from interest earned on our investments in debt securities; investment income also includes gains or losses when investment securities are sold, or other-than-temporarily impaired.

Operating Costs

Medical Costs. Our operating results depend in large part on our ability to effectively estimate, price for and manage our medical costs through underwriting criteria, product design, negotiation of favorable care provider contracts and care coordination programs. Controlling medical costs requires a comprehensive and integrated approach to organize and advance the full range of interrelationships among patients/consumers, health professionals, hospitals, pharmaceutical/technology manufacturers and other key stakeholders.

Medical costs include estimates of our obligations for medical care services rendered on behalf of insured consumers for which we have not yet received or processed claims, and our estimates for physician, hospital and other medical cost disputes. In every reporting period, our operating results include the effects of more completely developed medical costs payable estimates associated with previously reported periods.

Our medical care ratio, calculated as medical costs as a percentage of premium revenues, reflects the combination of pricing, rebates, benefit designs, consumer health care utilization and comprehensive care facilitation efforts. We seek to sustain a stable medical care

 

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ratio for an equivalent mix of business. However, changes in business mix, such as expanding participation in comparatively higher medical care ratio government-sponsored public sector programs and Health Reform Legislation may impact our premiums, medical costs and medical care ratio.

Operating Costs. Operating costs are primarily comprised of costs related to employee compensation and benefits, agent and broker commissions, premium taxes and assessments, professional fees, advertising and occupancy costs. We seek to improve our operating cost ratio, calculated as operating costs as a percentage of total revenues, for an equivalent mix of business. However, changes in business mix, such as increases in the size of our health services businesses may impact our operating costs and operating cost ratio.

Cash Flows

We generate cash primarily from premiums, service and product revenues and investment income, as well as proceeds from the sale or maturity of our investments. Our primary uses of cash are for payments of medical claims and operating costs, payments on debt, purchases of investments, acquisitions, dividends to shareholders and common stock repurchases. For more information on our cash flows, see “Liquidity” below.

Business Trends

Our businesses participate in the U.S. health economy, which comprises approximately 18% of U.S. gross domestic product and which has grown consistently for many years. We expect overall spending on health care in the U.S. to continue to rise in the future, due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the U.S. 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 enacted health care reforms, which could also impact our results of operations.

Health Care Reforms. In the first quarter of 2010, the Health Reform Legislation was signed into law. The Health Reform Legislation expands access to coverage and modifies aspects of the commercial insurance market, the Medicaid and Medicare programs, CHIP and other aspects of the health care system. HHS, the Department of Labor and the Treasury Department have issued regulations (or proposed regulations) on a number of aspects of Health Reform Legislation, but we await final rules and interim guidance on other key aspects of the legislation, all of which have a variety of effective dates.

We operate a diversified set of businesses that focus on health care, and our business model is designed to address a multitude of market sectors. The Health Reform Legislation and the related federal and state regulations will impact how we do business and could restrict growth in certain products and market segments, restrict premium rate increases for certain products and market segments, increase our medical and administrative costs or expose us to an increased risk of liability, any or all of which could have a material adverse effect on us. We also anticipate that the Health Reform Legislation will further increase attention on the need for health care cost containment and improvements in quality, as well as in prevention, wellness and disease management. We believe demand for many of our service offerings, such as consulting services, data management, information technology and related infrastructure construction, disease management, and population-based health and wellness programs will continue to grow.

As previously discussed, effective in 2011, commercial health plans with medical loss ratios on fully insured products are required to rebate ratable portions of their premiums to their customers annually. The potential for and size of the rebates will be measured by state, by group size and by licensed subsidiary. This disaggregation of insurance pools into much smaller pools will likely decrease the predictability of results for any given pool and could lead to variation over time in the estimates of rebates owed in total. In the aggregate, the rebate regulations cap the level of margin that can be attained.

Depending on the results of the calculation, there is a broad range of potential rebate and other business impacts and there could be meaningful disruption in local health care markets if companies decide to adjust their offerings in response to these requirements. For example, companies could elect to change pricing, modify product features or benefits, adjust their mix of business or even exit segments of the market. Companies could also seek to adjust their operating costs to support reduced premiums by making changes to their distribution arrangements or decreasing spending on non-medical product features and services. Companies continue to face a significant amount of uncertainty given the breadth of possible changes, including changes in the competitive environment, state rate approval, fluctuations in medical costs, the statistical variation that results from assessing business by state, by license and by group size and the potential for meaningful market disruption in 2011 and 2012. We have made changes to reduce our product distribution costs in the individual market in response to the Health Reform Legislation, including reducing broker commissions, and are implementing changes to distribution in the large group insured market segment. These changes could impact future growth in these products. Other market participants could also implement changes to their business practices in response to the Health Reform Legislation, which could positively or negatively impact our growth and market share.

The Health Reform Legislation also requires HHS to maintain an annual review of “unreasonable” increases in premium rates for commercial health plans. HHS issued final regulations in May 2011 that defined a review threshold of annual premium rate increases generally at or above 10% (with state-specific thresholds to be applicable commencing September 2012), and clarified that the HHS

 

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review will not supersede existing state review and approval processes. The regulations further require commercial health plans to provide to the states and HHS extensive information supporting any rate increase of 10% (or applicable state threshold) or more.

The Federal government is encouraging states to intensify their reviews of requests for rate increases by commercial health plans and providing funding to assist in those state-level reviews. Generally, rate approval responsibility still lies with the states under the HHS regulations. Since August 2010, HHS has allocated approximately $245 million for grants to states to enable the states to conduct more robust reviews of requests for premium increases. Many states have applied for and received grants, and state regulators have signaled their intent to more closely scrutinize premium rates. For example, premium rate review legislation (ranging from new or enhanced rate filing requirements to prior approval requirements) has been introduced or passed in more than half of the states in 2011. As a result, we have begun to experience greater regulatory challenges to appropriate premium rate increases in several states, including California and New York. Depending on the level of anticipated increased scrutiny by the states, there is a broad range of potential business impacts. For example, it may become more difficult to price our commercial risk business consistent with expected underlying cost trends, leading to the risk of operating margin compression.

Effective in 2011, the Health Reform Legislation mandates consumer discounts of 50% on brand name prescription drugs and 7% on generic prescription drugs for Part D plan participants in the coverage gap. This statutory reduction in drug prices for seniors in the coverage gap may cause individuals who may have had difficulty affording their medications to increase their pharmaceutical usage. The change in pricing could also have secondary effects, such as changing the mix of brand name and generic drug usage by seniors. We have incorporated the anticipated impact of these changes in our 2011 product pricing and pharmacy benefit management business plan.

As part of the Health Reform Legislation, Medicare Advantage payment rates for 2011 were frozen at 2010 levels. Separately, CMS implemented a reduction in Medicare Advantage reimbursements of 1.6% for 2011. We expect the 2011 rates will be outpaced by underlying medical trends, placing continued importance on effective medical management and ongoing improvements in administrative costs. Beginning in 2012, additional cuts to Medicare Advantage plans will take effect (plans will ultimately receive rates ranging from 95% of Medicare fee-for-service rates in high cost areas to 115% in low cost areas), with changes being phased-in over two to six years, depending on the level of payment reduction in a county. All of these changes could result in reduced enrollment or reimbursement or payment levels. There are a number of annual adjustments we can make to our operations, which may partially offset any impact from these rate reductions. For example, we can seek to intensify our medical and operating cost management, adjust members’ benefits and decide on a county-by-county basis in which geographies to participate. Additionally, achieving high quality scores from CMS for improving upon certain clinical and operational performance standards will impact future quality bonuses. The impact of CMS quality bonus payments may further offset these anticipated rate reductions beginning in 2012. We also may be able to mitigate the effects of reduced funding on margins by increasing enrollment due to the anticipated increase in the number of people eligible for Medicare in coming years. Longer term, market wide decreases in the availability or relative quality of Medicare Advantage products may increase demand for other senior health benefits products such as our Medicare Part D and Medicare Supplement insurance offerings.

The Health Reform Legislation includes a “maintenance of effort” (MOE) provision that requires states to maintain their eligibility rules for people covered by Medicaid, until the Secretary of HHS determines that an insurance exchange is operational in a given state. The MOE provision is intended to prevent states from reducing eligibility standards and determination procedures as a way to remove adults above 133 percent of the federal poverty level from Medicaid before implementation of expanded Medicaid coverage effective in January 2014. However, states with, or projecting, a budget deficit may apply for an exception to the MOE provision. If states are successful in obtaining MOE waivers and allow certain Medicaid programs to expire, we could experience reduced Medicaid enrollment.

The Health Reform Legislation presents additional opportunities and challenges over the longer term, including the assessment of an annual $8 billion insurance industry assessment beginning in 2014, the operation of state-based exchanges for individuals and small businesses beginning in 2014, and numerous other commercial and governmental plan requirements. Individual states may also accelerate their procurement of Medicaid managed care services for sizeable groups of Medicaid program beneficiaries in order to even their administrative workloads when Medicaid market expansions take place in 2014. The law could increase near-term business growth opportunities for UnitedHealthcare Community & State. Due to the complexity of the health care system and the numerous changes that are taking place, the longer term effects of the new legislation, positive and negative, remain difficult to assess.

Court proceedings related to the Health Reform Legislation continue to evolve. For example, three federal district courts have declared the law constitutional, with the 6th U.S. Circuit Court of Appeals affirming one of the rulings in June 2011 and two federal district courts have declared all or part of the legislation unconstitutional. These court proceedings, and the potential for Congressional action to impede implementation, create additional uncertainties with respect to the law. For additional information regarding the Health Reform Legislation, see Item 1, “Business - Government Regulation” and Item 1A, “Risk Factors,” in our 2010 10-K.

 

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RESULTS SUMMARY

 

(in millions, except percentages and per share data)

   Three Months Ended
June 30,
    Change     Six Months Ended
June 30,
    Change  
   2011     2010     2011 vs. 2010     2011     2010     2011 vs. 2010  

Revenues:

                 

Premiums

   $ 22,813      $ 21,125      $ 1,688         8   $ 45,816      $ 42,253      $ 3,563        8

Services

     1,656        1,413        243         17        3,254        2,777        477        17   

Products

     605        577        28         5        1,254        1,105        149        13   

Investment and other income

     160        149        11         7        342        322        20        6   
                                                     

Total revenues

     25,234        23,264        1,970         8        50,666        46,457        4,209        9   
                                                     

Operating costs:

                 

Medical costs

     18,578        17,221        1,357         8        37,303        34,391        2,912        8   

Operating costs

     3,733        3,359        374         11        7,350        6,635        715        11   

Cost of products sold

     554        534        20         4        1,153        1,017        136        13   

Depreciation and amortization

     270        249        21         8        540        497        43        9   
                                                     

Total operating costs

     23,135        21,363        1,772         8        46,346        42,540        3,806        9   
                                                     

Earnings from operations

     2,099        1,901        198         10        4,320        3,917        403        10   

Interest expense

     (119     (119     0         0        (237     (244     (7     (3
                                                     

Earnings before income taxes

     1,980        1,782        198         11        4,083        3,673        410        11   

Provision for income taxes

     (713     (659     54         8        (1,470     (1,359     111        8   
                                                     

Net earnings

   $ 1,267      $ 1,123      $ 144         13   $ 2,613      $ 2,314      $ 299        13
                                                     

Diluted net earnings per common share

   $ 1.16      $ 0.99      $ 0.17         17   $ 2.38      $ 2.02      $ 0.36        18

Medical care ratio

     81.4     81.5        (0.1 )%      81.4     81.4       0.0

Operating cost ratio

     14.8        14.4           0.4        14.5        14.3          0.2   

Operating margin

     8.3        8.2           0.1        8.5        8.4          0.1   

Tax rate

     36.0        37.0           (1.0     36.0        37.0          (1.0

Net margin

     5.0        4.8           0.2        5.2        5.0          0.2   

Return on equity (a)

     18.8     18.3        0.5     19.7     19.1       0.6

 

(a) 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 periods presented.

2011 RESULTS OF OPERATIONS COMPARED TO 2010 RESULTS

Consolidated Financial Results

Revenues

The increases in revenues for both the three and six months ended June 30, 2011 were driven by strong organic growth in risk-based offerings in our UnitedHealthcare businesses and revenue growth across all Optum businesses.

Medical Costs

Medical costs for both the three and six months ended June 30, 2011 increased due to membership growth in our commercial and public and senior markets risk-based businesses and continued increases in the cost per service we pay for health system use, and higher, though moderated, levels of overall health system use.

For each period, our operating results include the effects of revisions in medical cost estimates related to prior periods. Changes in medical cost estimates related to prior periods, resulting from more complete claim information identified in the current period, are included in total medical costs reported for the current period. For the three months ended June 30, 2011 there was $120 million of net favorable medical cost development related to prior fiscal years and $60 million of net favorable medical cost development related to the first quarter of 2011. For the six months ended June 30, 2011, medical costs included $560 million of net favorable medical cost development related to prior fiscal years. The favorable development in 2011 was primarily driven by lower than expected health system utilization levels and continued efficiencies in claims submission, handling and processing, which results in higher completion factors.

For the three months ended June 30, 2010, there was $90 million of net favorable medical cost development related to prior fiscal years and $180 million of net favorable medical cost development related to the first quarter of 2010. For the six months ended

 

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June 30, 2010, medical costs included $580 million of net favorable medical cost development related to prior fiscal years. The favorable development for both the three and six months ended June 30, 2010 was primarily driven by changes in previous estimates related to more efficient claims handling and processing, resulting in higher completion factors and lower than expected health system utilization levels.

In the second half of 2011, we expect consumer usage of the health system to increase seasonally, resuming its growth trend from the recent moderation in utilization growth. An increase in utilization will result in increased medical costs and an increase in our medical care ratio. We will work to manage medical cost trends through affordable network relationships, pay-for-performance reimbursement programs for care providers, and targeted clinical initiatives around improving quality and affordability.

Operating Costs

Operating costs for both the three and six months ended June 30, 2011 increased due to acquired and organic business growth, partially offset by ongoing cost management and quality improvements.

We expect to incur $250 million - $300 million for an assessment of our pro rata portion of policyholder claims of Penn Treaty. While we forecast these expenses for the fourth quarter of 2011, we have no ability to control the timing or the legal process. See Note 12 of Notes to Condensed Consolidated Financial Statements for more detail on Penn Treaty.

Income Tax Rate

The decrease in our effective income tax rate for both the three and six months ended June 30, 2011 resulted primarily from the cumulative implementation of changes that increased income taxes under the Health Reform Legislation which were included in our income tax rate for the three and six months ended June 30, 2010.

Due to the anticipated favorable resolution of various tax matters, we project our income tax rate for the second half of 2011 to decrease by 2% as compared to the first six months of 2011.

Reportable Segments

We have four reportable segments:

 

   

UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State;

 

   

OptumHealth;

 

   

OptumInsight; and

 

   

OptumRx.

See Note 11 of Notes to the Condensed Consolidated Financial Statements for a description of the types and services from which each of these reportable segments derives its revenues.

Transactions between reportable segments principally consist of sales of pharmacy benefit products and services to UnitedHealthcare customers by OptumRx, certain product offerings and clinical services sold to UnitedHealthcare by OptumHealth, and consulting and other services sold to UnitedHealthcare by OptumInsight. These transactions are recorded at management’s estimate of fair value. Intersegment transactions are eliminated in consolidation.

 

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On January 1, 2011, we realigned certain of our businesses to respond to changes in the markets we serve. Prior period segment financial information has been recast to conform to the 2011 presentation. See Note 1 of Notes to Condensed Consolidated Financial Statements for more information on our business realignment. The following table presents reportable segment financial information:

 

     Three Months Ended
June 30,
    Change     Six Months Ended
June 30,
    Change  

(in millions, except percentages)

   2011     2010     2011 vs. 2010     2011     2010     2011 vs. 2010  

Revenues

                

UnitedHealthcare

   $ 23,653      $ 21,955      $ 1,698        8   $ 47,527      $ 43,922      $ 3,605        8
                                                    

OptumHealth

     1,670        1,142        528        46        3,177        2,244        933        42   

OptumInsight

     658        529        129        24        1,329        1,034        295        29   

OptumRx

     4,688        4,202        486        12        9,320        8,284        1,036        13   
                                                    

Total Optum

     7,016        5,873        1,143        19        13,826        11,562        2,264        20   
                                                    

Eliminations

     (5,435     (4,564     (871     nm        (10,687     (9,027     (1,660     nm   
                                                    

Consolidated revenues

   $ 25,234      $ 23,264      $ 1,970        8   $ 50,666      $ 46,457      $ 4,209        9
                                                    

Earnings from operations

                

UnitedHealthcare

   $ 1,759      $ 1,565      $ 194        12   $ 3,658      $ 3,256      $ 402        12
                                                    

OptumHealth

     135        142        (7     (5     244        285        (41     (14

OptumInsight

     87        60        27        45        170        113        57        50   

OptumRx

     118        134        (16     (12     248        263        (15     (6
                                                    

Total Optum

     340        336        4        1        662        661        1        0   
                                                    

Consolidated earnings from operations

   $ 2,099      $ 1,901      $ 198        10   $ 4,320      $ 3,917      $ 403        10
                                                    

Operating margin

                

UnitedHealthcare

     7.4     7.1       0.3     7.7     7.4       0.3

OptumHealth

     8.1        12.4          (4.3     7.7        12.7          (5.0

OptumInsight

     13.2        11.3