UNH 10-Q Quarterly Report Sept. 30, 2015 | Alphaminr
UNITEDHEALTH GROUP INC

UNH 10-Q Quarter ended Sept. 30, 2015

UNITEDHEALTH GROUP INC
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10-Q 1 unh201593010-q.htm 10-Q 10-Q

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________
Form 10-Q
__________________________________________________________
[X]
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED SEPTEMBER 30, 2015
or
[ ]
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM _______ TO _______
Commission file number: 1-10864
__________________________________________________________
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
__________________________________________________________
Delaware
41-1321939
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota
55343
(Address of principal executive offices)
(Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
__________________________________________________________
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically 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:
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 October 30, 2015, there were 953,108,435 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.




UNITEDHEALTH GROUP
Table of Contents
Page




PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)
September 30,
2015
December 31,
2014
Assets
Current assets:
Cash and cash equivalents
$
7,983

$
7,495

Short-term investments
1,942

1,741

Accounts receivable, net
6,752

4,252

Other current receivables, net
7,667

5,498

Assets under management
2,948

2,962

Deferred income taxes
670

556

Prepaid expenses and other current assets
1,973

1,052

Total current assets
29,935

23,556

Long-term investments
18,535

18,827

Property, equipment and capitalized software, net
4,532

4,418

Goodwill
43,680

32,940

Other intangible assets, net
8,405

3,669

Other assets
3,185

2,972

Total assets
$
108,272

$
86,382

Liabilities and equity
Current liabilities:
Medical costs payable
$
13,906

$
12,040

Accounts payable and accrued liabilities
11,300

9,247

Other policy liabilities
7,249

5,965

Commercial paper and current maturities of long-term debt
5,767

1,399

Unearned revenues
1,731

1,972

Total current liabilities
39,953

30,623

Long-term debt, less current maturities
26,015

16,007

Future policy benefits
2,489

2,488

Deferred income taxes
3,593

2,065

Other liabilities
1,529

1,357

Total liabilities
73,579

52,540

Commitments and contingencies (Note 12)


Redeemable noncontrolling interests
1,571

1,388

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


Common stock, $0.01 par value - 3,000 shares authorized; 953 and 954 issued and outstanding
10

10

Additional paid in capital
69


Retained earnings
36,382

33,836

Accumulated other comprehensive loss
(3,347
)
(1,392
)
Nonredeemable noncontrolling interest
8


Total equity
33,122

32,454

Total liabilities and equity
$
108,272

$
86,382


See Notes to the Condensed Consolidated Financial Statements

1


UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
Three Months Ended September 30,
Nine Months Ended September 30,
(in millions, except per share data)
2015
2014
2015
2014
Revenues:
Premiums
$
31,801

$
28,972

$
95,436

$
85,927

Products
6,482

1,080

8,935

3,115

Services
3,036

2,535

8,607

7,386

Investment and other income
170

172

530

613

Total revenues
41,489

32,759

113,508

97,041

Operating costs:
Medical costs
25,618

23,092

77,333

69,823

Operating costs
6,301

5,436

18,102

15,836

Cost of products sold
6,100

955

8,311

2,776

Depreciation and amortization
452

373

1,209

1,097

Total operating costs
38,471

29,856

104,955

89,532

Earnings from operations
3,018

2,903

8,553

7,509

Interest expense
(229
)
(152
)
(530
)
(467
)
Earnings before income taxes
2,789

2,751

8,023

7,042

Provision for income taxes
(1,171
)
(1,149
)
(3,407
)
(2,933
)
Net earnings
1,618

1,602

4,616

4,109

Earnings attributable to noncontrolling interests
(21
)

(21
)

Net earnings attributable to UnitedHealth Group common shareholders
$
1,597

$
1,602

$
4,595

$
4,109

Earnings per share attributable to UnitedHealth Group common shareholders:
Basic
$
1.68

$
1.65

$
4.82

$
4.21

Diluted
$
1.65

$
1.63

$
4.75

$
4.15

Basic weighted-average number of common shares outstanding
953

969

953

977

Dilutive effect of common share equivalents
14

13

14

13

Diluted weighted-average number of common shares outstanding
967

982

967

990

Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents
8

7

8

8

Cash dividends declared per common share
$
0.5000

$
0.3750

$
1.3750

$
1.0300


See Notes to the Condensed Consolidated Financial Statements

2



UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)

Three Months Ended September 30,
Nine Months Ended September 30,
(in millions)
2015
2014
2015
2014
Net earnings
$
1,618

$
1,602

$
4,616

$
4,109

Other comprehensive loss:
Gross unrealized gains (losses) on investment securities during the period
66

(53
)
(51
)
427

Income tax effect
(26
)
20

17

(155
)
Total unrealized gains (losses), net of tax
40

(33
)
(34
)
272

Gross reclassification adjustment for net realized gains included in net earnings
(28
)
(30
)
(99
)
(183
)
Income tax effect
11

11

37

67

Total reclassification adjustment, net of tax
(17
)
(19
)
(62
)
(116
)
Total foreign currency translation losses
(1,063
)
(642
)
(1,859
)
(232
)
Other comprehensive loss
(1,040
)
(694
)
(1,955
)
(76
)
Comprehensive income
578

908

2,661

4,033

Comprehensive income attributable to noncontrolling interests
(21
)

(21
)

Comprehensive income attributable to UnitedHealth Group common shareholders
$
557

$
908

$
2,640

$
4,033


See Notes to the Condensed Consolidated Financial Statements

3


UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common Stock
Additional Paid-In Capital
Retained Earnings
Accumulated Other Comprehensive (Loss) Income
Nonredeemable Noncontrolling Interest
Total
Equity
(in millions)
Shares
Amount
Net Unrealized Gains (Losses) on Investments
Foreign Currency Translation Losses
Balance at January 1, 2015
954

$
10

$

$
33,836

$
223

$
(1,615
)
$

$
32,454

Net earnings
4,595

11

4,606

Other comprehensive loss
(96
)
(1,859
)
(1,955
)
Issuances of common shares, and related tax effects
9


112

112

Share-based compensation, and related tax benefits
477

477

Common share repurchases
(10
)

(391
)
(739
)
(1,130
)
Cash dividends paid on common shares
(1,310
)
(1,310
)
Redeemable noncontrolling interests fair value and other adjustments
(129
)
(129
)
Acquisition of nonredeemable noncontrolling interest
9

9

Distribution to nonredeemable noncontrolling interest
(12
)
(12
)
Balance at September 30, 2015
953

$
10

$
69

$
36,382

$
127

$
(3,474
)
$
8

$
33,122

Balance at January 1, 2014
988

$
10

$

$
33,047

$
54

$
(962
)
$

$
32,149

Net earnings
4,109


4,109

Other comprehensive income (loss)
156

(232
)
(76
)
Issuances of common shares, and related tax effects
12


130

130

Share-based compensation, and related tax benefits
320

320

Common share repurchases
(38
)

(450
)
(2,574
)
(3,024
)
Cash dividends paid on common shares
(1,004
)
(1,004
)
Balance at September 30, 2014
962

$
10

$

$
33,578

$
210

$
(1,194
)
$

$
32,604



See Notes to the Condensed Consolidated Financial Statements

4


UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Nine Months Ended September 30,
(in millions)
2015
2014
Operating activities
Net earnings
$
4,616

$
4,109

Noncash items:
Depreciation and amortization
1,209

1,097

Deferred income taxes
(49
)
(107
)
Share-based compensation
306

269

Other, net
(208
)
(253
)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable
(907
)
(545
)
Other assets
(1,686
)
(819
)
Medical costs payable
2,137

654

Accounts payable and other liabilities
616

1,126

Other policy liabilities
374


Unearned revenues
(179
)
91

Cash flows from operating activities
6,229

5,622

Investing activities
Purchases of investments
(6,712
)
(7,823
)
Sales of investments
4,041

5,810

Maturities of investments
2,557

2,266

Cash paid for acquisitions, net of cash assumed
(16,183
)
(851
)
Purchases of property, equipment and capitalized software
(1,072
)
(1,121
)
Other, net
(51
)
(139
)
Cash flows used for investing activities
(17,420
)
(1,858
)
Financing activities
Common stock repurchases
(1,130
)
(3,024
)
Cash dividends paid
(1,310
)
(1,004
)
Proceeds from common stock issuances
366

400

Proceeds from long-term debt
11,982


Repayments of long-term debt
(416
)
(812
)
Proceeds from commercial paper, net
2,665

1,355

Customer funds administered
119

(440
)
Other, net
(446
)
(285
)
Cash flows from (used for) financing activities
11,830

(3,810
)
Effect of exchange rate changes on cash and cash equivalents
(151
)
3

Increase (decrease) in cash and cash equivalents
488

(43
)
Cash and cash equivalents, beginning of period
7,495

7,276

Cash and cash equivalents, end of period
$
7,983

$
7,233


See Notes to the Condensed Consolidated Financial Statements

5


UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1. Basis of Presentation
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and “the Company”) is a diversified health and well-being company dedicated to helping people live healthier lives and making the health system work better for everyone. Through its diversified family of businesses, the Company leverages core competencies in advanced, enabling technology; health care data, information and intelligence; and clinical care management and coordination to help meet the demands of the health system. The Company offers a broad spectrum of products and services through two distinct platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides pharmacy care services and information and technology-enabled health services.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements” of the Company’s Annual Report on Form 10-K for the year ended December 31, 2014 as filed with the SEC ( 2014 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to estimates and judgments for medical costs payable and revenues, valuation and impairment analysis of goodwill and other intangible assets, estimates of other policy liabilities and other current receivables, valuations of certain investments, and estimates and judgments related to income taxes and contingent liabilities. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
The accounting policies disclosed in Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2014 10-K remain unchanged.
Reincorporation
On July 1, 2015, UnitedHealth Group Incorporated changed its state of incorporation from Minnesota to Delaware pursuant to a plan of conversion. The reincorporation was approved by the Company’s shareholders at its 2015 Annual Meeting of Shareholders held on June 1, 2015. Upon reincorporation, the affairs of UnitedHealth Group Incorporated became subject to the Delaware General Corporation Law, a new certificate of incorporation and new bylaws, and each previously outstanding share of UnitedHealth Group Incorporated’s common stock as a Minnesota corporation (UNH Minnesota) converted into an outstanding share of common stock of UnitedHealth Group Incorporated as a Delaware corporation after the reincorporation (UNH Delaware). The reincorporation was a tax-free reorganization under the U.S. Internal Revenue Code and did not affect the Company’s business operations.
Recently Issued Accounting Standards
In May 2014, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2014-09, “Revenue from Contracts with Customers (Topic 606)” (ASU 2014-09) as modified by ASU No. 2015-14, “Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date.” ASU 2014-09 will supersede existing revenue recognition standards with a single model unless those contracts are within the scope of other standards (e.g., an insurance entity’s insurance contracts). The revenue recognition principle in ASU 2014-09 is that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, new and enhanced disclosures will be required. Companies can adopt the new standard either using the full retrospective approach, a modified retrospective approach with practical expedients, or a cumulative effect upon adoption approach. ASU 2014-09 is effective for annual and interim reporting periods beginning after December 15, 2017. Early adoption at the original effective date, interim and annual periods beginning after December 15, 2016, will be permitted. The Company is currently evaluating the effect of the new revenue recognition guidance.

6


The Company has determined that there have been no other recently adopted or issued accounting standards that had, or will have, a material impact on its Condensed Consolidated Financial Statements.
2. Business Combination

On July 23, 2015, the Company acquired all of the outstanding common shares of Catamaran Corporation (Catamaran) and funded Catamaran’s payoff of its outstanding debt and credit facility for $14.3 billion in cash. Catamaran offers pharmacy benefits management services similar to OptumRx to a broad client portfolio, including health plans and employers serving 35 million people, and provides health care information technology solutions to the pharmacy benefits management industry.
The Company paid for the acquisition primarily with the proceeds of new indebtedness. Debt issuances included $10.5 billion of senior unsecured notes, approximately $2.4 billion of commercial paper and a $1.5 billion term loan. The total consideration exceeded the estimated fair value of the net tangible assets acquired by $15.6 billion , of which $5.4 billion has been allocated to finite-lived intangible assets and $10.2 billion to goodwill. The goodwill is not deductible for income tax purposes.
Acquired tangible assets (liabilities) for Catamaran at acquisition date were:
(in millions)
Accounts receivable and other current assets
$
1,947

Rebates receivable
602

Property, equipment and other long-term assets
215

Accounts payable and other current liabilities
(2,038
)
Deferred income taxes and other long-term liabilities
(2,019
)
Nonredeemable noncontrolling interest
(9
)
Total net tangible liabilities
$
(1,302
)
Since the Catamaran acquisition closed during the three months ended September 30, 2015, the preliminary purchase price allocation is subject to adjustment as valuation analyses, primarily related to intangible assets and contingent and tax liabilities, are finalized.
The acquisition date fair values and weighted-average useful lives assigned to Catamaran’s finite-lived intangible assets were:
(in millions, except years)
Fair Value
Weighted-Average Useful Life
Customer-related
$
5,278

19 years
Trademarks and technology
159

4 years
Total acquired finite-lived intangible assets
$
5,437

19 years

The results of operations and financial condition of Catamaran have been included in the Company’s consolidated results and the results of the OptumRx segment as of July 23, 2015. Since then, the Catamaran business has generated $5.3 billion in revenue, and had an immaterial impact on net earnings.
Unaudited pro forma revenues for the nine months ended September 30, 2015 and 2014 as if the acquisition of Catamaran had occurred on January 1, 2014 were $128 billion and $113 billion , respectively. The pro forma effects of this acquisition on net earnings were immaterial for both periods.

7


3.    Goodwill and Other Intangible Assets
Changes in the carrying amount of goodwill, by reportable segment, were as follows:
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx
Consolidated
Balance at January 1, 2014
$
24,251

$
2,860

$
3,653

$
840

$
31,604

Acquisitions
266

978

591


1,835

Foreign currency effects and adjustments, net
(487
)
(4
)
(8
)

(499
)
Balance at December 31, 2014
24,030

3,834

4,236

840

32,940

Acquisitions
51

1,679

89

10,238

12,057

Foreign currency effects and adjustments, net
(1,288
)
(1
)
(28
)

(1,317
)
Balance at September 30, 2015
$
22,793

$
5,512

$
4,297

$
11,078

$
43,680

The increase in the Company’s goodwill is primarily due to the acquisition of Catamaran in July 2015. For more detail on the Catamaran acquisition, see Note 2 of the Notes to the Condensed Consolidated Financial Statements.
During the three months ended September 30, 2015, the Company changed its annual quantitative goodwill impairment testing date from January 1 to October 1 of each year. The change in the goodwill impairment test date better aligns the impairment testing procedures with the timing of the Company’s long-term planning process, which is a significant input to the testing. This change in testing date did not delay, accelerate, or avoid a goodwill impairment charge.
Estimated full year amortization expense relating to intangible assets for each of the next five years ending September 30 is as follows:
(in millions)
2016
$
799

2017
768

2018
675

2019
617

2020
543



8


4.    Investments
A summary of short-term and long-term investments by major security type is as follows:
(in millions)
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2015
Debt securities - available-for-sale:
U.S. government and agency obligations
$
1,890

$
14

$

$
1,904

State and municipal obligations
5,993

155

(6
)
6,142

Corporate obligations
7,441

77

(47
)
7,471

U.S. agency mortgage-backed securities
2,026

27

(6
)
2,047

Non-U.S. agency mortgage-backed securities
872

11

(4
)
879

Total debt securities - available-for-sale
18,222

284

(63
)
18,443

Equity securities - available-for-sale
1,526

44

(58
)
1,512

Debt securities - held-to-maturity:
U.S. government and agency obligations
162

2


164

State and municipal obligations
15



15

Corporate obligations
345



345

Total debt securities - held-to-maturity
522

2


524

Total investments
$
20,270

$
330

$
(121
)
$
20,479

December 31, 2014
Debt securities - available-for-sale:
U.S. government and agency obligations
$
1,614

$
7

$
(1
)
$
1,620

State and municipal obligations
6,456

217

(5
)
6,668

Corporate obligations
7,241

112

(26
)
7,327

U.S. agency mortgage-backed securities
2,022

39

(5
)
2,056

Non-U.S. agency mortgage-backed securities
872

12

(4
)
880

Total debt securities - available-for-sale
18,205

387

(41
)
18,551

Equity securities - available-for-sale
1,511

36

(25
)
1,522

Debt securities - held-to-maturity:
U.S. government and agency obligations
178

2


180

State and municipal obligations
19



19

Corporate obligations
298



298

Total debt securities - held-to-maturity
495

2


497

Total investments
$
20,211

$
425

$
(66
)
$
20,570

The amortized cost and fair value of available-for-sale debt securities as of September 30, 2015 , by contractual maturity, were as follows:
(in millions)
Amortized
Cost
Fair
Value
Due in one year or less
$
2,047

$
2,051

Due after one year through five years
6,830

6,901

Due after five years through ten years
4,720

4,793

Due after ten years
1,727

1,772

U.S. agency mortgage-backed securities
2,026

2,047

Non-U.S. agency mortgage-backed securities
872

879

Total debt securities - available-for-sale
$
18,222

$
18,443


9


The amortized cost and fair value of held-to-maturity debt securities as of September 30, 2015 , by contractual maturity, were as follows:
(in millions)
Amortized
Cost
Fair
Value
Due in one year or less
$
121

$
121

Due after one year through five years
203

204

Due after five years through ten years
84

84

Due after ten years
114

115

Total debt securities - held-to-maturity
$
522

$
524

The fair value of available-for-sale investments with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
Less Than 12 Months
12 Months or Greater
Total
(in millions)
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
September 30, 2015
Debt securities - available-for-sale:
State and municipal obligations
$
507

$
(5
)
$
17

$
(1
)
$
524

$
(6
)
Corporate obligations
2,799

(39
)
270

(8
)
3,069

(47
)
U.S. agency mortgage-backed securities
365

(3
)
122

(3
)
487

(6
)
Non-U.S. agency mortgage-backed securities
317

(3
)
93

(1
)
410

(4
)
Total debt securities - available-for-sale
$
3,988

$
(50
)
$
502

$
(13
)
$
4,490

$
(63
)
Equity securities - available-for-sale
$
140

$
(16
)
$
82

$
(42
)
$
222

$
(58
)
December 31, 2014
Debt securities - available-for-sale:
U.S. government and agency obligations
$
420

$
(1
)
$

$

$
420

$
(1
)
State and municipal obligations
711

(4
)
99

(1
)
810

(5
)
Corporate obligations
2,595

(17
)
464

(9
)
3,059

(26
)
U.S. agency mortgage-backed securities


272

(5
)
272

(5
)
Non-U.S. agency mortgage-backed securities
254

(2
)
114

(2
)
368

(4
)
Total debt securities - available-for-sale
$
3,980

$
(24
)
$
949

$
(17
)
$
4,929

$
(41
)
Equity securities - available-for-sale
$
107

$
(6
)
$
88

$
(19
)
$
195

$
(25
)
The Company’s unrealized losses from all securities as of September 30, 2015 were generated from approximately 6,000 positions out of a total of 23,000 positions. The Company believes that it will collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. At each reporting period, the Company evaluates securities for impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality and credit ratings of the issuers, noting neither a significant deterioration since purchase nor other factors leading to an other-than-temporary impairment (OTTI). As of September 30, 2015 , the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary.
The Company’s investments in equity securities consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments, venture capital funds, and dividend paying stocks. The Company evaluated its investments in equity securities for severity and duration of unrealized loss, overall market volatility and other market factors.

10


Net realized gains reclassified out of accumulated other comprehensive income were from the following sources:
Three Months Ended September 30,
Nine Months Ended September 30,
(in millions)
2015
2014
2015
2014
Total OTTI
$
(4
)
$
(18
)
$
(8
)
$
(25
)
Portion of loss recognized in other comprehensive income




Net OTTI recognized in earnings
(4
)
(18
)
(8
)

(25
)
Gross realized losses from sales
(9
)
(3
)
(20
)
(42
)
Gross realized gains from sales
41

51

127

250

Net realized gains (included in investment and other income on the Condensed Consolidated Statements of Operations)
28

30

99

183

Income tax effect (included in provision for income taxes on the Condensed Consolidated Statements of Operations)
(11
)
(11
)
(37
)
(67
)
Realized gains, net of taxes
$
17

$
19

$
62

$
116

5.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.
For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2014 10-K.


11


The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets excluding assets and liabilities, related to a Supplemental Health Insurance Program (AARP Program), which are presented in a separate table below:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
September 30, 2015
Cash and cash equivalents
$
7,865

$
118

$

$
7,983

Debt securities - available-for-sale:
U.S. government and agency obligations
1,705

199


1,904

State and municipal obligations

6,142


6,142

Corporate obligations
15

7,368

88

7,471

U.S. agency mortgage-backed securities

2,047


2,047

Non-U.S. agency mortgage-backed securities

874

5

879

Total debt securities - available-for-sale
1,720

16,630

93

18,443

Equity securities - available-for-sale
1,137

12

363

1,512

Interest rate swap assets

168


168

Total assets at fair value

$
10,722

$
16,928

$
456

$
28,106

Percentage of total assets at fair value
38
%
60
%
2
%
100
%
Interest rate swap liabilities
$

$
1

$

$
1

December 31, 2014
Cash and cash equivalents
$
7,472

$
23

$

$
7,495

Debt securities - available-for-sale:
U.S. government and agency obligations
1,427

193


1,620

State and municipal obligations

6,668


6,668

Corporate obligations
2

7,257

68

7,327

U.S. agency mortgage-backed securities

2,056


2,056

Non-U.S. agency mortgage-backed securities

874

6

880

Total debt securities - available-for-sale
1,429

17,048

74

18,551

Equity securities - available-for-sale
1,200

12

310

1,522

Interest rate swap assets

62


62

Total assets at fair value
$
10,101

$
17,145

$
384

$
27,630

Percentage of total assets at fair value
37
%
62
%
1
%
100
%
Interest rate swap liabilities
$

$
55

$

$
55

Transfers between levels, if any, are recorded as of the beginning of the reporting period in which the transfer occurs; there were no transfers between Levels 1, 2 or 3 of any financial assets or liabilities during the nine months ended September 30, 2015 or 2014 .



12


The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
September 30, 2015
Debt securities - held-to-maturity:
U.S. government and agency obligations
$
164

$

$

$
164

$
162

State and municipal obligations


15

15

15

Corporate obligations
91

13

241

345

345

Total debt securities - held-to-maturity
$
255

$
13

$
256

$
524

$
522

Other assets
$

$
478

$

$
478

$
480

Long-term debt and other financing obligations
$

$
30,309

$

$
30,309

$
28,796

December 31, 2014
Debt securities - held-to-maturity:
U.S. government and agency obligations
$
180

$

$

$
180

$
178

State and municipal obligations


19

19

19

Corporate obligations
46

10

242

298

298

Total debt securities - held-to-maturity
$
226

$
10

$
261

$
497

$
495

Other assets
$

$
478

$

$
478

$
484

Long-term debt and other financing obligations
$

$
18,863

$

$
18,863

$
17,085

Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the nine months ended September 30, 2015 or 2014 .
The carrying amounts reported on the Condensed Consolidated Balance Sheets for other current financial assets and liabilities approximate fair value because of their short-term nature. These assets and liabilities are not listed in the table above.

13


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
Nine Months Ended
(in millions)
Debt
Securities
Equity
Securities
Total
Debt
Securities
Equity
Securities
Total
September 30, 2015
Balance at beginning of period
$
84

$
319

$
403

$
74

$
310

$
384

Purchases
12

45

57

22

59

81

Sales
(2
)
(6
)
(8
)
(4
)
(20
)
(24
)
Net unrealized gains in accumulated other comprehensive income

6

6

2

1

3

Net realized (losses) gains in investment and other income
(1
)
(1
)
(2
)
(1
)
13

12

Balance at end of period
$
93

$
363

$
456

$
93

$
363

$
456

September 30, 2014
Balance at beginning of period
$
57

$
302

$
359

$
42

$
269

$
311

Purchases
11

36

47

24

86

110

Sales

(18
)
(18
)

(169
)
(169
)
Net unrealized (losses) gains in accumulated other comprehensive income
(2
)
(4
)
(6
)

6

6

Net realized (losses) gains in investment and other income

(15
)
(15
)

109

109

Balance at end of period
$
66

$
301

$
367

$
66

$
301

$
367

The following table presents quantitative information regarding unobservable inputs that were significant to the valuation of assets measured at fair value on a recurring basis using Level 3 inputs:
Range
(in millions, except ranges)
Fair Value
Valuation Technique
Unobservable Input
Low
High
September 30, 2015
Equity securities - available-for-sale:
Venture capital portfolios
$
322

Market approach - comparable companies
Revenue multiple
1.0
5.0
EBITDA multiple
9.0
10.0
41

Market approach - recent transactions
Inactive market transactions
N/A
N/A
Total equity securities
available-for-sale
$
363

Also included in the Company’s assets measured at fair value on a recurring basis using Level 3 inputs were $93 million of available-for-sale debt securities as of September 30, 2015 , which were not significant.

14


The Company elected to measure the entirety of the AARP Program assets under management at fair value pursuant to the fair value option. See Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the Company’s 2014 10-K for further detail on the AARP Program. 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)
Total
Fair and Carrying
Value
September 30, 2015
Cash and cash equivalents
$
292

$

$
292

Debt securities:
U.S. government and agency obligations
444

142

586

State and municipal obligations

105

105

Corporate obligations

1,292

1,292

U.S. agency mortgage-backed securities

391

391

Non-U.S. agency mortgage-backed securities

199

199

Total debt securities
444

2,129

2,573

Other investments

83

83

Total assets at fair value
$
736

$
2,212

$
2,948

Other liabilities
$
7

$
6

$
13

December 31, 2014
Cash and cash equivalents
$
415

$

$
415

Debt securities:
U.S. government and agency obligations
409

245

654

State and municipal obligations

95

95

Corporate obligations

1,200

1,200

U.S. agency mortgage-backed securities

340

340

Non-U.S. agency mortgage-backed securities

177

177

Total debt securities
409

2,057

2,466

Other investments

81

81

Total assets at fair value
$
824

$
2,138

$
2,962

Other liabilities
$
5

$
13

$
18

6.    Medicare Part D Pharmacy Benefits
The Condensed Consolidated Balance Sheets include the following amounts associated with the Medicare Part D program:
September 30, 2015
December 31, 2014
(in millions)
Subsidies
Drug Discount
Risk-Share
Subsidies
Drug Discount
Risk-Share
Other current receivables
$
2,466

$
690

$

$
1,801

$
719

$
20

Other policy liabilities

377

200


302


See Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the Company’s 2014 10-K for further detail on Medicare Part D.

15


7.    Medical Costs Reserve Development
The following table provides details of the Company's medical cost reserve development:
Three Months Ended September 30,
Nine Months Ended September 30,
(in millions)
2015
2014
2015
2014
Related to Prior Years
$
100

$
120

$
230

$
380

Related to Current Year
50

150

N/A

N/A

In the three and nine months ended September 30, 2015 and 2014 , the medical cost reserve development was driven by a number of individual factors that were not material .
8.    Health Insurance Industry Tax
The Patient Protection and Affordable Care Act and a reconciliation measure, the Health Care and Education Reconciliation Act of 2010 (together, Health Reform Legislation) includes an annual, nondeductible insurance industry tax (Health Insurance Industry Tax). In September 2015, the Company paid its full year 2015 Health Insurance Industry Tax of $1.8 billion . As of September 30, 2015 , the deferred cost recorded in prepaid expenses and other current assets on the Condensed Consolidated Balance Sheets related to the Health Insurance Industry Tax was $450 million . There was no liability or asset related to the Health Insurance Industry Tax recorded as of December 31, 2014 as the Health Insurance Industry Tax was paid in September 2014 and the asset was fully expensed by year end. See Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the Company’s 2014 10-K for further detail on the Health Insurance Industry Tax.

16


9.     Commercial Paper and Long-Term Debt
Commercial paper, term loan and senior unsecured long-term debt consisted of the following:
September 30, 2015
December 31, 2014
(in millions, except percentages)
Par
Value
Carrying
Value
Fair
Value
Par
Value
Carrying
Value
Fair
Value
Commercial paper
$
2,986

$
2,986

$
2,986

$
321

$
321

$
321

Floating rate term loan due July 2016
1,500

1,500

1,500




4.875% notes due March 2015 (a)



416

419

419

0.850% notes due October 2015 (a), (b)
625

625

625

625

625

627

5.375% notes due March 2016 (a), (b)
601

610

612

601

623

634

1.875% notes due November 2016 (a), (b)
400

400

405

400

397

406

5.360% notes due November 2016
95

95

100

95

95

103

Floating rate notes due January 2017 (c)
750

750

750




6.000% notes due June 2017 (a), (b)
441

461

476

441

466

489

1.450% notes due July 2017 (c)
750

750

754




1.400% notes due October 2017 (a), (b)
625

625

629

625

616

624

6.000% notes due November 2017 (a), (b)
156

164

171

156

164

175

1.400% notes due December 2017 (a), (b)
750

753

749

750

745

749

6.000% notes due February 2018 (a), (b)
1,100

1,117

1,212

1,100

1,106

1,238

1.900% notes due July 2018 (c)
1,500

1,498

1,516




1.625% notes due March 2019 (a), (b)
500

504

497

500

496

493

2.300% notes due December 2019 (a)
500

508

507

500

496

502

2.700% notes due July 2020 (c)
1,500

1,499

1,535




3.875% notes due October 2020 (a)
450

461

483

450

450

477

4.700% notes due February 2021 (a)
400

422

445

400

413

450

3.375% notes due November 2021 (a)
500

510

525

500

496

519

2.875% notes due December 2021 (a)
750

768

761

750

748

759

2.875% notes due March 2022 (a)
1,100

1,077

1,110

1,100

1,042

1,104

3.350% notes due July 2022 (c)
1,000

999

1,032




0.000% notes due November 2022
15

10

12

15

10

11

2.750% notes due February 2023 (a)
625

623

616

625

604

613

2.875% notes due March 2023 (a)
750

797

747

750

777

745

3.750% notes due July 2025 (c)
2,000

1,995

2,067




4.625% notes due July 2035 (c)
1,000

1,000

1,055




5.800% notes due March 2036
850

845

1,016

850

845

1,052

6.500% notes due June 2037
500

495

637

500

495

670

6.625% notes due November 2037
650

646

836

650

646

888

6.875% notes due February 2038
1,100

1,085

1,465

1,100

1,085

1,544

5.700% notes due October 2040
300

298

354

300

298

378

5.950% notes due February 2041
350

348

424

350

348

455

4.625% notes due November 2041
600

593

615

600

593

646

4.375% notes due March 2042
502

486

494

502

486

536

3.950% notes due October 2042
625

612

589

625

611

621

4.250% notes due March 2043
750

740

742

750

740

786

4.750% notes due July 2045 (c)
2,000

1,992

2,111




Total commercial paper, term loan and long-term debt
$
31,596

$
31,647

$
33,160

$
17,347

$
17,256

$
19,034

(a)
Fixed-rate debt instruments hedged with interest rate swap contracts. See below for more information on the Company’s interest rate swaps.
(b)
The Company terminated the interest rate swap contacts on these hedged instruments during the three months ended September 30, 2015. See below for more information on this termination.
(c)
Debt issued to fund the Catamaran acquisition. For more detail on Catamaran, see Note 2 of Notes to the Condensed Consolidated Financial Statements.
The Company’s long-term debt obligations also included $135 million and $150 million of other financing obligations, of which $46 million and $34 million were current as of September 30, 2015 and December 31, 2014 , respectively.

17


Commercial Paper and Bank Credit Facilities
Commercial paper consists of short-duration, senior unsecured debt privately placed on a discount basis through broker-dealers. As of September 30, 2015 , the Company’s outstanding commercial paper had a weighted-average annual interest rate of 0.4% .
The Company has $3.0 billion five-year and $1.0 billion 364-day revolving bank credit facilities with 23 banks, which mature in November 2019 and November 2015 , respectively. The Company also has a $2.0 billion 364-day revolving bank credit facility with 22 banks maturing in April 2016 . These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of September 30, 2015 , no amounts had been drawn on any of the bank credit facilities. The annual interest rates, which are variable based on term, are calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. If amounts had been drawn on the bank credit facilities as of September 30, 2015 , annual interest rates would have ranged from 1.0% to 1.4% .
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 50% . The Company was in compliance with its debt covenants as of September 30, 2015 .
Interest Rate Swap Contracts
The Company uses 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 variable rate financial assets. The floating rates are benchmarked to LIBOR. The swaps are designated as fair value hedges on the Company’s fixed-rate debt. Since the critical terms of the swaps match those of the debt being hedged, they are considered to be highly effective hedges and all changes in the fair values of the swaps are recorded as adjustments to the carrying value of the related debt with no net impact recorded on the Condensed Consolidated Statements of Operations. Both the hedge fair value changes and the offsetting debt adjustments are recorded in interest expense on the Condensed Consolidated Statements of Operations. The following table summarizes the location and fair value of the interest rate swap fair value hedges on the Company’s Condensed Consolidated Balance Sheet:
Type of Fair Value Hedge
Notional Amount
Fair Value
Balance Sheet Location
(in billions)
(in millions)
September 30, 2015
Interest rate swap contracts
$
5.1

$
168

Other assets
1

Other liabilities
December 31, 2014
Interest rate swap contracts
$
10.7

$
62

Other assets

55

Other liabilities
During the three months ended September 30, 2015, the Company terminated $5.2 billion notional amount of its interest rate swap fair value hedges. The resulting gain was not material.
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 September 30,
Nine Months Ended September 30,
(in millions)
2015
2014
2015
2014
Hedge - interest rate swap gain (loss) recognized in interest expense
$
146

$
(11
)
$
160

$
122

Hedged item - long-term debt (loss) gain recognized in interest expense
(146
)
11

(160
)
(122
)
Net impact on the Company’s Condensed Consolidated Statements of Operations
$

$

$

$

10.    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 in

18


open market purchases or other types of transactions (including prepaid or structured repurchase programs), subject to certain Board restrictions. During the nine months ended September 30, 2015 , the Company repurchased 10 million shares at an average price of $112.30 per share and an aggregate cost of $1.1 billion . As of September 30, 2015 , the Company had Board authorization to purchase up to 61 million shares of its common stock.
Dividends
In June 2015 , the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to equal an annual dividend rate of $2.00 per share compared to the annual dividend rate of $1.50 per share, which the Company had paid since June 2014 . 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 2015 dividend payments:
Payment Date
Amount per Share
Total Amount Paid
(in millions)
March 24, 2015
$
0.3750

$
357

June 24, 2015
0.5000

476

September 22, 2015
0.5000

477

11.    Share-Based Compensation
In June 2015, the Company’s shareholders approved an amendment to the 2011 Stock Incentive Plan (Plan). The approved amendment increased the number of shares authorized for issuance under the Plan by 70 million and removed the limit in the Plan for shares other than options and stock-settled stock appreciation rights (SARs) that can be awarded. The Company’s outstanding share-based awards consist mainly of nonqualified stock options, SARs and restricted stock and restricted stock units (collectively, restricted shares). As of September 30, 2015 , the Company had 85 million shares available for future grants of share-based awards under its share-based compensation plan.
Stock Options and SARs
Stock option and SAR activity for the nine months ended September 30, 2015 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
33

$
53

Granted
9

110

Exercised
(6
)
52

Forfeited
(1
)
79

Outstanding at end of period
35

68

6.1

$
1,693

Exercisable at end of period
17

47

3.5

1,167

Vested and expected to vest, end of period
34

67

6.0

1,668


19


Restricted Shares
Restricted share activity for the nine months ended September 30, 2015 is summarized in the table below:
(shares in millions)
Shares
Weighted-Average Grant Date Fair Value per Share
Nonvested at beginning of period
9

$
61

Granted
3

110

Vested
(5
)
61

Nonvested at end of period
7

82

Other Share-Based Compensation Data
(in millions, except per share amounts)
Three Months Ended September 30,
Nine Months Ended September 30,
2015
2014
2015
2014
Stock Options and SARs
Weighted-average grant date fair value of shares granted, per share
$
22

$
17

$
23

$
22

Total intrinsic value of stock options and SARs exercised
74

89

402

375

Restricted Shares
Weighted-average grant date fair value of shares granted, per share
122

80

110

71

Total fair value of restricted shares vested
41

5

448

428

Share-Based Compensation Items
Share-based compensation expense, before tax
95

81

306

269

Share-based compensation expense, net of tax effects
86

73

263

230

Income tax benefit realized from share-based award exercises
38

39

212

182

(in millions, except years)
September 30, 2015
Unrecognized compensation expense related to share awards
$
536

Weighted-average years to recognize compensation expense
1.4

Share-Based Compensation Recognition and Estimates
The principal assumptions the Company used in calculating grant-date fair value for stock options and SARs were as follows:
Three Months Ended September 30,
Nine Months Ended September 30,
2015
2014
2015
2014
Risk-free interest rate
1.6%
1.7%
1.6% - 1.7%
1.7% - 1.8%
Expected volatility
22.3%
27.2%
22.3% - 24.1%
27.2% - 39.6%
Expected dividend yield
1.6%
1.9%
1.4% - 1.7%
1.6% - 1.9%
Forfeiture rate
5.0%
5.0%
5.0%
5.0%
Expected life in years
5.5
5.4
5.5 - 6.1
5.4
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, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims, and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present

20


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
California Claims Processing Matter. On January 25, 2008, the California Department of Insurance (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 related to an alleged failure to include certain language in standard claims correspondence, timeliness and accuracy of claims processing, interest payments, care provider contract implementation, care provider dispute resolution and other related matters. Although the Company believes that CDI had never before issued a fine in excess of $8 million , CDI advocated a fine of approximately $325 million in this matter. The matter was the subject of an administrative hearing before a California administrative law judge beginning in December 2009, and in August 2013, the administrative law judge issued a nonbinding proposed decision recommending a fine of $11.5 million . The California Insurance Commissioner rejected the administrative law judge’s recommendation and on June 9, 2014, issued his own decision imposing a fine of approximately $174 million . On July 10, 2014, the Company filed a lawsuit in California state court challenging the Commissioner’s decision. On September 8, 2015, in the first phase of that lawsuit, the California state court issued an order invalidating certain of the regulations the Commissioner had relied upon in issuing his decision and penalty. The Company cannot reasonably estimate the range of loss, if any, that may result from this matter given the procedural status of the dispute, the wide range of possible outcomes, the legal issues presented (including the legal basis for the majority of the alleged violations), the inherent difficulty in predicting a regulatory fine in the event of a remand, and the various remedies and levels of judicial review that remain available to the Company.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by CMS, state insurance and health and welfare departments, the Brazilian national regulatory agency for private health insurance and plans (the Agência Nacional de Saúde Suplementar), state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice, the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the Brazilian federal revenue service (the Secretaria da Receita Federal), the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other things, compliance with coding and other requirements under the Medicare risk-adjustment model.
In February 2012, CMS announced a final Risk Adjustment Data Validation (RADV) audit and payment adjustment methodology and that it will conduct RADV audits beginning with the 2011 payment year. These audits involve a review of medical records maintained by care providers and may result in retrospective adjustments to payments made to health plans. CMS has not communicated how the final payment adjustment under its methodology will be implemented.
The Company cannot reasonably estimate the range of loss, if any, that may result from any material government investigations, audits and reviews in which it is currently involved given the inherent difficulty in predicting regulatory action, fines and penalties, if any, and the various remedies and levels of judicial review available to the Company in the event of an adverse finding.
Guaranty Fund Assessments
Under state guaranty fund laws, certain insurance companies can be assessed (up to prescribed limits) for certain obligations to the policyholders and claimants of insolvent insurance companies (including certain state health insurance cooperatives). In 2009, the Pennsylvania Insurance Commissioner placed long term care insurer Penn Treaty Network America Insurance Company and its subsidiary (Penn Treaty), neither of which is affiliated with the Company, in rehabilitation and petitioned a state court for approval to liquidate Penn Treaty. In 2012, the court denied the liquidation petition and ordered the Insurance Commissioner to submit a rehabilitation plan. The court held a hearing on July 13-14, 2015 to begin its consideration of the latest proposed rehabilitation plan. The hearing is scheduled to continue on February 16, 2016.
If the current proposed rehabilitation plan, which contemplates the partial liquidation of Penn Treaty, is approved by the court, the Company’s insurance entities and other insurers may be required to pay a portion of Penn Treaty’s policyholder claims through state guaranty association assessments in future periods. The Company intends to vigorously challenge the proposed rehabilitation plan. The Company is currently unable to estimate losses or ranges of losses because the Company cannot predict whether, when or to what extent Penn Treaty will ultimately be declared insolvent, the amount of the insolvency, if any, the

21


amount and timing of any associated guaranty fund assessments or the availability and amount of any premium tax and other potential offsets.
13.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx . For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the Company's 2014 10-K.
The following table presents the reportable segment financial information:
Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx (a)
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Three Months Ended September 30, 2015
Revenues - external customers:
Premiums
$
30,978

$
823

$

$

$

$
823

$

$
31,801

Products

8

31

6,443


6,482


6,482

Services
1,710

594

592

140


1,326


3,036

Total revenues - external customers
32,688

1,425

623

6,583


8,631


41,319

Total revenues - intersegment

2,067

961

7,824

(222
)
10,630

(10,630
)

Investment and other income
129

40

1



41


170

Total revenues
$
32,817

$
3,532

$
1,585

$
14,407

$
(222
)
$
19,302

$
(10,630
)
$
41,489

Earnings from operations
$
1,876

$
363

$
289

$
490

$

$
1,142

$

$
3,018

Interest expense






(229
)
(229
)
Earnings before income taxes
$
1,876

$
363

$
289

$
490

$

$
1,142

$
(229
)
$
2,789

Three Months Ended September 30, 2014
Revenues - external customers:
Premiums
$
28,287

$
685

$

$

$

$
685

$

$
28,972

Products

6

23

1,051


1,080


1,080

Services
1,617

373

521

24


918


2,535

Total revenues - external customers
29,904

1,064

544

1,075


2,683


32,587

Total revenues - intersegment

1,749

705

6,936

(124
)
9,266

(9,266
)

Investment and other income
135

36

1



37


172

Total revenues
$
30,039

$
2,849

$
1,250

$
8,011

$
(124
)
$
11,986

$
(9,266
)
$
32,759

Earnings from operations
$
2,038

$
314

$
225

$
326

$

$
865

$

$
2,903

Interest expense






(152
)
(152
)
Earnings before income taxes
$
2,038

$
314

$
225

$
326

$

$
865

$
(152
)
$
2,751


22


Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx (a)
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Nine Months Ended September 30, 2015
Revenues - external customers:
Premiums
$
93,069

$
2,367

$

$

$

$
2,367

$

$
95,436

Products
1

24

67

8,843


8,934


8,935

Services
5,028

1,694

1,693

192


3,579


8,607

Total revenues - external customers
98,098

4,085

1,760

9,035


14,880


112,978

Total revenues - intersegment

6,061

2,623

22,579

(553
)
30,710

(30,710
)

Investment and other income
415

113

1

1


115


530

Total revenues
$
98,513

$
10,259

$
4,384

$
31,615

$
(553
)
$
45,705

$
(30,710
)
$
113,508

Earnings from operations
$
5,805

$
850

$
782

$
1,116

$

$
2,748

$

$
8,553

Interest expense






(530
)
(530
)
Earnings before income taxes
$
5,805

$
850

$
782

$
1,116

$

$
2,748

$
(530
)
$
8,023

Nine Months Ended September 30, 2014
Revenues - external customers:
Premiums
$
84,011

$
1,916

$

$

$

$
1,916

$

$
85,927

Products
2

17

63

3,033


3,113


3,115

Services
4,849

878

1,578

81


2,537


7,386

Total revenues - external customers
88,862

2,811

1,641

3,114


7,566


96,428

Total revenues - intersegment

5,094

2,098

20,355

(354
)
27,193

(27,193
)

Investment and other income
502

110

1



111


613

Total revenues
$
89,364

$
8,015

$
3,740

$
23,469

$
(354
)
$
34,870

$
(27,193
)
$
97,041

Earnings from operations
$
5,266

$
749

$
635

$
859

$

$
2,243

$

$
7,509

Interest expense






(467
)
(467
)
Earnings before income taxes
$
5,266

$
749

$
635

$
859

$

$
2,243

$
(467
)
$
7,042

(a)
As of September 30, 2015, OptumRx’s total assets were $25.7 billion as compared to $5.5 billion as of December 31, 2014. The increase was due to the Catamaran acquisition completed during the three months ended September 30, 2015. See Note 2 of Notes to the Condensed Consolidated Financial Statements for more information on the Company’s acquisition of Catamaran.
ITEM 2.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2014 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2014 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a diversified health and well-being company dedicated to helping people live healthier lives and making the health system work better for everyone. Through our diversified family of businesses, we leverage core competencies in advanced, enabling technology; health care data, information and intelligence; and clinical care management and coordination to help meet the demands of the health system. We offer a broad spectrum of products and services through two distinct

23


platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides pharmacy care services and information and technology-enabled health services.
Further information on our business is included in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2014 10-K and additional information on our segments can be found in this Item 2 and in Note 13 of Notes to the Condensed Consolidated Financial Statements in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the U.S., Brazilian and certain other international health economies. In the United States, health care spending comprises approximately 18% of gross domestic product and has grown consistently for many years. We expect overall spending on health care to continue to grow in the future, due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macro-economic conditions and regulatory changes, including enacted health reform legislation in the United States, which have impacted and could further impact our results of operations.
Pricing Trends . To price our health care benefit products, we start with our view of expected future costs. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations. Our review of regulatory considerations involves a focus on minimum loss ratio (MLR) thresholds and the risk adjustment, risk corridor and reinsurance provisions that impact the small group and individual markets. We will continue seeking to balance growth and profitability across all of these dimensions.
We continue to be under pressure from ongoing market competition in commercial products and from government payment rates. The intensity of commercial pricing competition depends on local market conditions and competitive dynamics. Annual commercial premium rate increases are subject to federal and state review and approval procedures. The Medicare Advantage rate structure is changing and funding has been cut in recent years, with additional reductions taking effect in 2015, as discussed below in “Regulatory Trends and Uncertainties.” Although we expect continued Medicaid revenue increases due to anticipated growth in the number of people served through our offerings, the reimbursement rate environment creates the risk of downward pressure on Medicaid net margin percentages.
Medical Cost Trends. Our medical cost trends are primarily related to changes in unit costs, health system utilization and prescription drug costs. Although Health Reform Legislation and prescription drug utilization, particularly use of new specialty medications, have exerted upward pressure on medical cost trends, our medical cost management strategies have had a moderating impact on utilization trends in recent years.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of the trends and uncertainties related to some of the key provisions of Health Reform Legislation and other regulatory items. For additional information regarding Health Reform Legislation and regulatory trends and uncertainties, see Part I, Item 1, “Business - Government Regulation”, Item 1A, “Risk Factors”, and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2014 10-K.
Medicare Advantage Rates. Medicare Advantage rates have been cut over the last several years, with additional funding reductions to be phased-in through 2017. The impact of these cuts to our 2015 Medicare Advantage revenues is partially mitigated by reductions in provider reimbursements for those care providers with rates indexed to Medicare Advantage revenues or Medicare fee-for-service reimbursement rates. These factors affected our plan benefit designs, market participation, growth prospects and earnings expectations for our Medicare Advantage plans this year.
The 2016 Final Rate notice released by CMS in April 2015 provided some progress toward more stable program rates, with the industry seeing an average increase in funding of 125 basis points. However, these rates still trail the pace of the rising cost of medical care and create continued pressure on the Medicare Advantage program.
Our Medicare Advantage rates are currently enhanced by CMS quality bonuses in certain counties based on our local plans’ Star ratings. The level of Star ratings from CMS, based upon specified clinical and operational performance standards, will impact future quality bonuses. In addition, Star ratings affect the amount of savings a plan has to generate to offer supplemental benefits, which ultimately may affect the plan’s membership and revenue. The previous Star bonus program, which paid bonuses to qualifying plans rated 3 stars or higher, expired after 2014. In 2015, quality bonus payments will be paid only to plans rated 4 stars and higher. For the 2015 Star bonus payment year, 39% of our Medicare Advantage members are enrolled in plans rated 4 stars or higher. For the 2016 and 2017 Star bonus payment years, we estimate approximately 56% and 63%,

24


respectively, of our Medicare Advantage members will be enrolled in plans rated 4 stars or higher, based on current enrollment. We are dedicating substantial resources to advance our quality scores and Star ratings to strengthen our local market programs and further improve our performance in future years.
Health Insurance Industry Tax and Premium Stabilization Programs. Health Reform Legislation includes a Health Insurance Industry Tax levied on risk-based products proportionally across the industry. The industry-wide amount of the annual tax is $11.3 billion in 2015 and we paid our proportionate share of $1.8 billion in September 2015. Health Reform Legislation also includes three programs designed to stabilize the health insurance markets. These programs encompass: a temporary reinsurance program; a temporary risk corridors program; and a permanent risk adjustment program. Of the $8 billion for the reinsurance program in 2015, $6 billion will fund the reinsurance pool and $2 billion will fund the U.S. Treasury. While funding for the reinsurance program will come from all commercial lines of business, only market reform compliant individual business will be eligible for reinsurance recoveries.
For further detail on the Health Insurance Industry Tax and Premium Stabilization Programs, see Note 2 of Notes to the Consolidated Financial Statements included in Part II, Item 8, “Financial Statements” in our 2014 10-K.
Exchanges and Coverage Expansion. We and our competitors are adapting product, network and marketing strategies across markets to anticipate new or expanding distribution channels, including public exchanges, private exchanges and off exchange purchasing. In 2015, we are participating in 23 individual public exchanges and in 12 small group public exchanges.
RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
2015
2014
2015 vs. 2014
2015
2014
2015 vs. 2014
Revenues:
Premiums
$
31,801

$
28,972

$
2,829

10
%
$
95,436

$
85,927

$
9,509

11
%
Products
6,482

1,080

5,402

500

8,935

3,115

5,820

187

Services
3,036

2,535

501

20

8,607

7,386

1,221

17

Investment and other income
170

172

(2
)
(1
)
530

613

(83
)
(14
)
Total revenues
41,489

32,759

8,730

27

113,508

97,041

16,467

17

Operating costs:
Medical costs
25,618

23,092

2,526

11

77,333

69,823

7,510

11

Operating costs
6,301

5,436

865

16

18,102

15,836

2,266

14

Cost of products sold
6,100

955

5,145

539

8,311

2,776

5,535

199

Depreciation and amortization
452

373

79

21

1,209

1,097

112

10

Total operating costs
38,471

29,856

8,615

29

104,955

89,532

15,423

17

Earnings from operations
3,018

2,903

115

4

8,553

7,509

1,044

14

Interest expense
(229
)
(152
)
77

51

(530
)
(467
)
63

13

Earnings before income taxes
2,789

2,751

38

1

8,023

7,042

981

14

Provision for income taxes
(1,171
)
(1,149
)
22

2

(3,407
)
(2,933
)
474

16

Net earnings
1,618

1,602

16

1

4,616

4,109

507

12

Earnings attributable to noncontrolling interests
(21
)

(21
)
nm

(21
)

(21
)
nm

Net earnings attributable to UnitedHealth Group common shareholders
$
1,597

$
1,602

$
(5
)
%
$
4,595

$
4,109

$
486

12
%
Diluted earnings per share attributable to UnitedHealth Group common shareholders
$
1.65

$
1.63

$
0.02

1
%
$
4.75

$
4.15

$
0.60

14
%
Medical care ratio (a)
80.6
%
79.7
%
0.9
%
81.0
%
81.3
%
(0.3
)%
Operating cost ratio
15.2

16.6

(1.4
)
15.9

16.3

(0.4
)
Operating margin
7.3

8.9

(1.6
)
7.5

7.7

(0.2
)
Tax rate
42.0

41.8

0.2

42.5

41.7

0.8

Net earnings margin (b)
3.8

4.9

(1.1
)
4.0

4.2

(0.2
)
Return on equity (c)
19.3
%
19.6
%
(0.3
)%
18.8
%
16.8
%
2.0
%
(a)
Medical care ratio is calculated as medical costs divided by premium revenue.
(b)
Net earnings margin attributable to UnitedHealth Group shareholders.
(c)
Return on equity is calculated as annualized net earnings divided by average equity. Average equity is calculated using the equity balance at the end of the preceding year and the equity balances at the end of each of the quarters in the periods presented.

25


SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select third quarter 2015 year-over-year operating comparisons to third quarter 2014 and other 2015 significant items.
Consolidated revenues grew 27% , UnitedHealthcare revenues grew 9% and Optum revenues grew 61% .
UnitedHealthcare grew to serve an additional 1.7 million people domestically.
Earnings from operations increased 4% , including an increase of 32% at Optum partially offset by a decrease of 8% at UnitedHealthcare.
Diluted earnings per common share increased 1% to $1.65 .
Year-to-date 2015 cash flows from operations were $6.2 billion , an increase of 11% .
On July 23, 2015, we acquired Catamaran through the purchase of all of its outstanding common stock for cash. See Note 2 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information.
2015 RESULTS OF OPERATIONS COMPARED TO 2014 RESULTS
Our results of operations for the three and nine months ended September 30, 2015 compared to the corresponding prior periods was affected by our acquisition of Catamaran on July 23, 2015.
Consolidated Financial Results
Revenues
The increase in revenues during the three and nine months ended September 30, 2015 was primarily driven by the effect of the Catamaran acquisition and organic growth in the number of individuals served across our benefits businesses and across all of Optum’s businesses.
Medical Costs and Medical Care Ratio
Medical costs during the three and nine months ended September 30, 2015 increased due to risk-based membership growth in our benefits businesses. The medical care ratio for the three months ended September 30, 2015 increased primarily due to increased medical spending for Medicare Star quality performance, an increased mix of government sponsored benefits businesses and lower levels of favorable reserve development. The medical care ratio for the nine months ended September 30, 2015 was consistent with 2014.
Operating Cost Ratio
The decrease in our operating cost ratio during the three and nine months ended September 30, 2015 was due to the inclusion of Catamaran and by growth in government benefits programs, both of which have lower operating cost ratios, and Company-wide productivity gains.

26


Reportable Segments
See Note 13 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1, “Financial Statements” for more information on our segments. The following table presents a summary of the reportable segment financial information:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2015
2014
2015 vs. 2014
2015
2014
2015 vs. 2014
Revenues
UnitedHealthcare
$
32,817

$
30,039

$
2,778

9
%
$
98,513

$
89,364

$
9,149

10
%
OptumHealth
3,532

2,849

683

24

10,259

8,015

2,244

28

OptumInsight
1,585

1,250

335

27

4,384

3,740

644

17

OptumRx
14,407

8,011

6,396

80

31,615

23,469

8,146

35

Optum eliminations
(222
)
(124
)
98

79

(553
)
(354
)
199

56

Optum
19,302

11,986

7,316

61

45,705

34,870

10,835

31

Eliminations
(10,630
)
(9,266
)
1,364

15

(30,710
)
(27,193
)
3,517

13

Consolidated revenues
$
41,489

$
32,759

$
8,730

27
%
$
113,508

$
97,041

$
16,467

17
%
Earnings from operations
UnitedHealthcare
$
1,876

$
2,038

$
(162
)
(8
)%
$
5,805

$
5,266

$
539

10
%
OptumHealth
363

314

49

16

850

749

101

13

OptumInsight
289

225

64

28

782

635

147

23

OptumRx
490

326

164

50

1,116

859

257

30

Optum
1,142

865

277

32

2,748

2,243

505

23

Consolidated earnings from operations
$
3,018

$
2,903

$
115

4
%
$
8,553

$
7,509

$
1,044

14
%
Operating margin
UnitedHealthcare
5.7
%
6.8
%
(1.1
)%
5.9
%
5.9
%
%
OptumHealth
10.3

11.0

(0.7
)
8.3

9.3

(1.0
)
OptumInsight
18.2

18.0

0.2

17.8

17.0

0.8

OptumRx
3.4

4.1

(0.7
)
3.5

3.7

(0.2
)
Optum
5.9

7.2

(1.3
)
6.0

6.4

(0.4
)
Consolidated operating margin
7.3
%
8.9
%
(1.6
)%
7.5
%
7.7
%
(0.2
)%
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2015
2014
2015 vs. 2014
2015
2014
2015 vs. 2014
UnitedHealthcare Employer & Individual
$
11,871

$
10,610

$
1,261

12
%
$
35,139

$
32,296

$
2,843

9
%
UnitedHealthcare Medicare & Retirement
12,267

11,477

790

7

37,607

34,764

2,843

8

UnitedHealthcare Community & State
7,392

6,131

1,261

21

21,502

17,069

4,433

26

UnitedHealthcare Global
1,287

1,821

(534
)
(29
)
4,265

5,235

(970
)
(19
)
Total UnitedHealthcare revenues
$
32,817

$
30,039

$
2,778

9
%
$
98,513

$
89,364

$
9,149

10
%

27


The following table summarizes the number of individuals served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
September 30,
Increase/(Decrease)
(in thousands, except percentages)
2015
2014
2015 vs. 2014
Commercial risk-based
8,180

7,545

635

8
%
Commercial fee-based, including TRICARE
21,350

21,210

140

1

Total commercial
29,530

28,755

775

3

Medicare Advantage
3,225

2,995

230

8

Medicaid
5,305

4,920

385

8

Medicare Supplement (Standardized)
4,010

3,715

295

8

Total public and senior
12,540

11,630

910

8

Total UnitedHealthcare - domestic medical
42,070

40,385

1,685

4

International
4,010

4,550

(540
)
(12
)
Total UnitedHealthcare - medical
46,080

44,935

1,145

3
%
Supplemental Data:
Medicare Part D stand-alone
5,075

5,155

(80
)
(2
)%
The increase in commercial risk-based enrollment was a result of strong participation in UnitedHealthcare’s individual public exchange products and favorable annual renewal activity and new business wins in the employer group segment. Medicare Advantage participation increased year-over-year primarily due to growth in people served through employer-sponsored group Medicare Advantage plans. Medicaid growth was driven by the combination of ACA Medicaid expansion, states launching new programs to complement established programs and growth in established programs, which was partially offset by a decrease of 175,000 people in one market, where an additional offering was introduced by the state in the first quarter of 2015. Medicare Supplement growth reflected strong customer retention and new sales. The number of people served internationally decreased year-over-year primarily due to pricing and underwriting disciplines in Brazil in response to regulatory actions and declining employment levels in Brazil.
UnitedHealthcare’s revenue growth during the three and nine months ended September 30, 2015 was due to growth in the number of individuals served across its businesses and price increases reflecting underlying medical cost trends.
UnitedHealthcare’s operating earnings for the three months ended September 30, 2015 decreased year-over-year due to lower levels of favorable reserve development, increased investments in and medical costs associated with advancing Medicare Star performance, as well as the impact of individual public exchange products. Operating earnings for the nine months ended September 30, 2015 increased as strong growth across the business along with improved medical cost management and increased productivity more than offset the items that resulted in the third quarter operating earnings decrease.
Optum
Total revenues and operating earnings increased for the three and nine months ended September 30, 2015 as each reporting segment increased revenues and earnings from operations by double-digit percentages as a result of the factors discussed below.
The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth during the three and nine months ended September 30, 2015 primarily due to growth in its health delivery businesses and the impact of acquisitions in patient care centers and population health management services. The operating margins for the three and nine months ended September 30, 2015 decreased from the prior year primarily due to investments made to develop future growth opportunities.
OptumInsight
Revenue, earnings from operations and operating margins at OptumInsight for the three and nine months ended September 30, 2015 increased primarily due to expansion and growth in care provider revenue management services, payment integrity and government exchange services.



28


OptumRx
Revenue and earnings from operations for the three and nine months ended September 30, 2015 increased due to the acquisition of Catamaran and strong organic growth. Operating margins for both the three and nine months ended September 30, 2015 decreased due to the inclusion of lower margin Catamaran business. For more information about Catamaran, see Note 2 in Notes to the Condensed Consolidated Financial Statements in Part I, Item 1 of this report.
LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Introduction
We manage our liquidity and financial position in the context of our overall business strategy. We continually forecast and manage our cash, investments, working capital balances and capital structure to meet the short-term and long-term obligations of our businesses while seeking to maintain liquidity and financial flexibility. Cash flows generated from operating activities are principally from earnings before noncash expenses.
Our regulated subsidiaries generate significant cash flows from operations and are subject to financial regulations and standards in their respective jurisdictions. These standards, among other things, require these subsidiaries to maintain specified levels of statutory capital, as defined by each jurisdiction, and restrict the timing and amount of dividends and other distributions that may be paid to their parent companies. In the United States, these regulations and standards are generally consistent with model regulations established by the National Association of Insurance Commissioners. These standards generally permit dividends to be paid from statutory unassigned surplus of the regulated subsidiary and are limited based on the regulated subsidiary’s level of statutory net income and statutory capital and surplus. These dividends are referred to as “ordinary dividends” and generally may be paid without prior regulatory approval. If the dividend, together with other dividends paid within the preceding twelve months, exceeds a specified statutory limit or is paid from sources other than earned surplus, the entire dividend is generally considered an “extraordinary dividend” and must receive prior regulatory approval.
For the nine months ended September 30, 2015 , our U.S. regulated subsidiaries paid their parent companies dividends of $3.5 billion, and we had approximately $1.1 billion in ordinary dividend capacity remaining for the year.
Our nonregulated businesses also generate cash flows from operations that are available for general corporate use. Cash flows generated by these entities, combined with dividends from our regulated entities and financing through the issuance of long-term debt as well as issuance of commercial paper or the ability to draw under our committed credit facilities, further strengthen our operating and financial flexibility. We use these cash flows to expand our businesses through acquisitions, reinvest in our businesses through capital expenditures, repay debt, and return capital to our shareholders through shareholder dividends and/or repurchases of our common stock, depending on market conditions.

29


Summary of our Major Sources and Uses of Cash and Cash Equivalents
Nine Months Ended September 30,
Increase/(Decrease)
(in millions)
2015
2014
2015 vs. 2014
Sources of cash:
Cash provided by operating activities
$
6,229

$
5,622

$
607

Issuances of commercial paper and long-term debt, net of repayments
14,231

543

13,688

Proceeds from common stock issuances
366

400

(34
)
Customer funds administered
119


119

Sales and maturities of investments, net of purchases

253

(253
)
Total sources of cash
20,945

6,818

Uses of cash:
Common stock repurchases
(1,130
)
(3,024
)
1,894

Cash paid for acquisitions, net of cash assumed
(16,183
)
(851
)
(15,332
)
Purchases of investments, net of sales and maturities
(114
)

(114
)
Purchases of property, equipment and capitalized software, net
(1,072
)
(1,121
)
49

Cash dividends paid
(1,310
)
(1,004
)
(306
)
Customer funds administered

(440
)
440

Other
(497
)
(424
)
(73
)
Total uses of cash
(20,306
)
(6,864
)
Effect of exchange rate changes on cash and cash equivalents
(151
)
3

(154
)
Net increase (decrease) in cash and cash equivalents
$
488

$
(43
)
$
531

2015 Cash Flows Compared to 2014 Cash Flows
Cash flows provided by operating activities in 2015 increased primarily due to improvement in net earnings and growth in risk-based products, which increased medical costs payable, partially offset by the increase in the third quarter payment of the 2015 Health Insurance Industry Tax and the first quarter 2015 payment of reinsurance program fees.
Other significant changes in sources or uses of cash year-over-year included increased cash paid for acquisitions and net debt issuances and decreased share repurchases, all due to the Catamaran acquisition.
Financial Condition
As of September 30, 2015 , our cash, cash equivalent and available-for-sale investment balances of $27.9 billion included $8.0 billion of cash and cash equivalents (of which $983 million was available for general corporate use), $18.4 billion of debt securities and $1.5 billion of investments in equity securities consisting of investments in non-U.S. dollar fixed-income funds; employee savings plan related investments; venture capital funds; and dividend paying stocks. Given the significant portion of our portfolio held in cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. The use of different market assumptions or valuation methodologies, especially those used in valuing our $456 million of available-for-sale Level 3 securities (those securities priced using significant unobservable inputs), may have an effect on the estimated fair values of our investments. Due to the subjective nature of these assumptions, the estimates may not be indicative of the actual exit price if we had sold the investment at the measurement date. Other sources of liquidity, primarily from operating cash flows and our commercial paper program, which is supported by our bank credit facilities, reduce the need to sell investments during adverse market conditions. See Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for further detail concerning our fair value measurements.
Our available-for-sale debt portfolio had a weighted-average duration of 3.4 years and a weighted-average credit rating of “AA” as of September 30, 2015 . When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.

30


Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Commercial Paper and Bank Credit Facilities. Our bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through third-party broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see Note 9 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Our bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 50%. As of September 30, 2015, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities was approximately 47%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, for example, to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. In July 2015, we issued debt to fund the acquisition of Catamaran. For more information on this debt issuance, see Note 9 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Credit Ratings. Our credit ratings as of September 30, 2015 , were as follows:
Moody’s
Standard & Poor’s
Fitch
A.M. Best
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Senior unsecured debt
A3
Negative
A+
Negative
A-
Negative
bbb+
Stable
Commercial paper
P-2
n/a
A-1
n/a
F1
n/a
AMB-2
n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. For example, a significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. We expect continued moderated share repurchase activity for the remainder of 2015 due to the acquisition of Catamaran. For more information on our share repurchase program, see Note 10 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Dividends. In June 2015 , our Board increased our quarterly cash dividend to shareholders to an annual dividend rate of $2.00 per share. For more information on our dividend, see Note 10 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2014 was disclosed in our 2014 10-K. During the nine months ended September 30, 2015 , there were no material changes to this previously disclosed information outside the ordinary course of business. However, we continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
RECENTLY ISSUED ACCOUNTING STANDARDS
In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)” as modified by ASU No. 2015-14, “Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date.” ASU 2014-09 will supersede existing revenue recognition standards with a single model unless those contracts are within the scope of other standards (e.g., an insurance entity’s insurance contracts). The revenue recognition principle in ASU 2014-09 is that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, new and enhanced disclosures will be required. Companies can adopt the new standard either using the full retrospective approach, a modified retrospective approach with practical expedients, or a cumulative effect upon adoption approach. ASU 2014-09 is effective for annual and interim reporting periods beginning after December 15, 2017. Early adoption at the original effective date, interim and annual periods beginning after December 15, 2016, will be permitted. We are currently evaluating the effect of the new revenue recognition guidance.

31


We have determined that there have been no other recently issued, but not yet adopted, accounting standards that will have a material impact on our Condensed Consolidated Financial Statements.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments, assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable, revenues, goodwill and intangible assets, investments, income taxes and contingent liabilities. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of our 2014 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in our 2014 10-K.
FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements within the meaning of the PSLRA. These statements are intended to take advantage of the “safe harbor” provisions of the PSLRA. Generally the words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “plan,” “project,” “should” and similar expressions identify forward-looking statements, which generally are not historical in nature. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. We caution that actual results could differ materially from those that management expects, depending on the outcome of certain factors.
Some factors that could cause actual results to differ materially from results discussed or implied in the forward-looking statements include: our ability to effectively estimate, price for and manage our medical costs, including the impact of any new coverage requirements; new laws or regulations, or changes in existing laws or regulations, or their enforcement or application, including increases in medical, administrative, technology or other costs or decreases in enrollment resulting from U.S., Brazilian and other jurisdictions regulations affecting the health care industry; assessments for insolvent payers under state guaranty fund laws; our ability to achieve improvement in CMS Star ratings and other quality scores that impact revenue; reductions in revenue or delays to cash flows received under Medicare, Medicaid and TRICARE programs, including sequestration and the effects of a prolonged U.S. government shutdown or debt ceiling constraints; changes in Medicare, including changes in payment methodology, the CMS Star ratings program or the application of risk adjustment data validation audits; our participation in federal and state health insurance exchanges which entail uncertainties associated with mix and volume of business; cyber-attacks or other privacy or data security incidents; failure to comply with privacy and data security regulations; regulatory and other risks and uncertainties of the pharmacy benefits management industry; competitive pressures, which could affect our ability to maintain or increase our market share; challenges to our public sector contract awards; our ability to execute contracts on competitive terms with physicians, hospitals and other service providers; failure to achieve targeted operating cost productivity improvements, including savings resulting from technology enhancement and administrative modernization; increases in costs and other liabilities associated with increased litigation, government investigations, audits or reviews; failure to manage successfully our strategic alliances or complete or receive anticipated benefits of acquisitions and other strategic transactions, including our acquisition of Catamaran; fluctuations in foreign currency exchange rates on our reported shareholders equity and results of operations; downgrades in our credit ratings; adverse economic conditions, including decreases in enrollment resulting from increases in the unemployment rate and commercial attrition; the performance of our investment portfolio; impairment of the value of our goodwill and intangible assets in connection with dispositions or if estimated future results do not adequately support goodwill and intangible assets recorded for our existing businesses or the businesses that we acquire; increases in health care costs resulting from large-scale medical emergencies; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; and our ability to obtain sufficient funds from our regulated subsidiaries or the debt or capital markets to fund our obligations, to maintain our debt to total capital ratio at targeted levels, to maintain our quarterly dividend payment cycle or to continue repurchasing shares of our common stock.
This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain risk factors that may affect our business operations, financial condition and results of operations, in our other periodic and current filings with the SEC, including our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Any or all forward-looking statements we make may turn out to be wrong, and can be affected by inaccurate

32


assumptions we might make or by known or unknown risks and uncertainties. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual future results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by applicable securities laws.
ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Our primary market risks are exposures to changes in interest rates that impact our investment income and interest expense and the fair value of certain of our fixed-rate investments and debt, as well as foreign currency exchange rate risk of the U.S. dollar primarily to the Brazilian real.
We manage exposure to market interest rates by diversifying investments across different fixed income market sectors and debt across maturities, as well as by endeavoring to match our floating-rate assets and liabilities over time, either directly or through the use of interest rate swap contracts. Unrealized gains and losses on investments in available-for-sale securities are reported in comprehensive income.
The following table summarizes the impact of hypothetical changes in market interest rates across the entire yield curve by 1% point or 2% points as of September 30, 2015 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
September 30, 2015
Increase (Decrease) in Market Interest Rate
Investment
Income Per
Annum (a)
Interest
Expense Per
Annum (a)
Fair Value of
Financial Assets (b)
Fair Value of
Financial Liabilities
2 %
$
198

$
238

$
(1,380
)
$
(3,351
)
1
99

119

(696
)
(1,813
)
(1)
(59
)
(23
)
634

2,121

(2)
nm

nm

1,013

4,487

nm = not meaningful
(a)
Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of September 30, 2015 , the assumed hypothetical change in interest rates does not reflect the full 100 basis point reduction in interest income or interest expense as the rate cannot fall below zero and thus the 200 basis point reduction is not meaningful.
(b)
As of September 30, 2015 , some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
We have an exposure to changes in the value of the Brazilian real to the U.S. dollar in translation of Amil’s operating results at the average exchange rate over the accounting period, and Amil’s assets and liabilities at the spot rate at the end of the accounting period. The gains or losses resulting from translating foreign assets and liabilities into U.S. dollars are included in shareholders’ equity and comprehensive income.
An appreciation of the U.S. dollar against the Brazilian real reduces the carrying value of the net assets denominated in Brazilian real. For example, as of September 30, 2015 , a hypothetical 10% and 25% increase in the value of the U.S. dollar against the Brazilian real would have caused a reduction in net assets of approximately $280 million and $620 million, respectively. We manage exposure to foreign currency risk by conducting our international business operations primarily in their functional currencies.
ITEM 4.
CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of September 30, 2015 . Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of September 30, 2015 .

33


CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended September 30, 2015 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
PART II. OTHER INFORMATION
ITEM 1.
LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to Note 12 of Notes to the Condensed Consolidated Financial Statements contained in Part I, Item 1 of this report.
ITEM 1A.
RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” of our 2014 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2014 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition and/or future results.
There have been no material changes to the risk factors disclosed in our 2014 10-K.
ITEM 2.    UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
Issuer Purchases of Equity Securities (a)
Third Quarter 2015
For the Month Ended
Total Number
of Shares
Purchased
Average Price
Paid per Share
Total Number of
Shares Purchased
as Part of Publicly
Announced Plans
or Programs
Maximum Number
of Shares That May
Yet Be Purchased
Under The Plans or
Programs
(in millions)
(in millions)
(in millions)
July 31, 2015

$


63

August 31, 2015
2

116

2

61

September 30, 2015



61

Total
2

$
116

2

(a)
In November 1997, our Board of Directors adopted a share repurchase program, which the Board evaluates periodically. In June 2014, the Board renewed our share repurchase program with an authorization to repurchase up to 100 million shares of our common stock in open market purchases or other types of transactions (including prepaid or structured repurchase programs). There is no established expiration date for the program.

ITEM 5.    OTHER INFORMATION
On November 5, 2015, we adopted an amendment (the “Amendment”) to the Amended and Restated UnitedHealth Group Incorporated 2008 Executive Incentive Plan which:
changed the change in control provision to a “double-trigger” provision requiring both a change in control and termination of employment in order for cash long-term incentive plan awards to be paid out; and
conformed the change in control definition to the definition in our equity award agreements , which included increasing from 20% to 50% the stock ownership threshold constituting a change in control and eliminating the Board’s ability to determine within its discretion whether a change in control has occurred.
The Amendment is attached hereto as Exhibit 10.3 and is incorporated herein by reference.
On November 5, 2015, we also adopted new forms of equity award agreements to be used for grants beginning in 2016 under the UnitedHealth Group Incorporated 2011 Stock Incentive Plan, as amended and restated in 2015 (the “2011 Plan”). The definition of “good reason” contained in each award agreement has been revised to delete as good reason triggers: (1) a diminution in budget responsibility, (2) a change in reporting relationship and (3) an office relocation of more than 25 miles. The performance-based restricted stock unit award agreement was further revised to include a “double-trigger” change in control provision requiring both a change in control and termination of employment for an award to vest in the event of a change in control.
The forms of stock option, restricted stock unit and performance-based restricted stock unit award agreements to be used for awards under the 2011 Plan beginning in 2016 are attached hereto as Exhibit 10.4, Exhibit 10.5 and Exhibit 10.6, respectively.

34


ITEM 6.
EXHIBITS**

The following exhibits are filed in response to Item 601 of Regulation S-K.
3.1

Certificate of Incorporation of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.1 to the Company's Registration Statement on Form 8-A/A filed on July 1, 2015)
3.2

Bylaws of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.2 to the Company's Registration Statement on Form 8-A/A filed on July 1, 2015)
4.1

Senior Indenture, dated as of November 15, 1998, between United HealthCare Corporation and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3/A, SEC File Number 333-66013, filed on January 11, 1999)
4.2

Amendment, dated as of November 6, 2000, to Senior Indenture, dated as of November 15, 1998, between UnitedHealth Group Incorporated and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Quarterly Report on Form 10-Q for the quarter ended September 30, 2001)
4.3

Instrument of Resignation, Appointment and Acceptance of Trustee, dated January 8, 2007, pursuant to the Senior Indenture, dated as of November 15, 1998, amended November 6, 2000, among UnitedHealth Group Incorporated, The Bank of New York and Wilmington Trust Company (incorporated by reference to Exhibit 4.3 to the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2007)
4.4

Indenture, dated as of February 4, 2008, between UnitedHealth Group Incorporated and U.S. Bank National Association (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3, SEC File Number 333-149031, filed on February 4, 2008)
10.1

Form of Indemnification Agreement (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on July 1, 2015)
*10.2

Sixth Amendment to UnitedHealth Group Executive Savings Plan (2004 Statement)
*10.3

Second Amendment, dated as of November 5, 2015, of Amended and Restated UnitedHealth Group Incorporated 2008 Executive Incentive Plan
*10.4

Form of Agreement for Non-Qualified Stock Option Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
*10.5

Form of Agreement for Restricted Stock Unit Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
*10.6

Form of Agreement for Performance-based Restricted Stock Unit Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
12.1

Computation of Ratio of Earnings to Fixed Charges
31.1

Certifications pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1

Certifications pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101

The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2015 filed on November 5, 2015, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
________________
*
Denotes management contracts and compensation plans in which certain directors and named executive officers participate and which are being filed pursuant to Item 601(b)(10)(iii)(A) of Regulation S-K.
**
Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.



35


SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
UNITEDHEALTH GROUP INCORPORATED
/s/    S TEPHEN J. H EMSLEY
Chief Executive Officer
(principal executive officer)
Dated:
November 5, 2015
Stephen J. Hemsley
/s/    D AVID S. W ICHMANN
President and Chief Financial Officer
(principal financial officer)
Dated:
November 5, 2015
David S. Wichmann
/ S /    T HOMAS E. R OOS
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:
November 5, 2015
Thomas E. Roos


36


EXHIBIT INDEX**
The following exhibits are filed in response to Item 601 of Regulation S-K.
3.1

Certificate of Incorporation of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.1 to the Company's Registration Statement on Form 8-A/A filed on July 1, 2015)
3.2

Bylaws of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.2 to the Company's Registration Statement on Form 8-A/A filed on July 1, 2015)
4.1

Senior Indenture, dated as of November 15, 1998, between United HealthCare Corporation and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3/A, SEC File Number 333-66013, filed on January 11, 1999)
4.2

Amendment, dated as of November 6, 2000, to Senior Indenture, dated as of November 15, 1998, between UnitedHealth Group Incorporated and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Quarterly Report on Form 10-Q for the quarter ended September 30, 2001)
4.3

Instrument of Resignation, Appointment and Acceptance of Trustee, dated January 8, 2007, pursuant to the Senior Indenture, dated as of November 15, 1998, amended November 6, 2000, among UnitedHealth Group Incorporated, The Bank of New York and Wilmington Trust Company (incorporated by reference to Exhibit 4.3 to the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2007)
4.4

Indenture, dated as of February 4, 2008, between UnitedHealth Group Incorporated and U.S. Bank National Association (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3, SEC File Number 333-149031, filed on February 4, 2008)
10.1

Form of Indemnification Agreement (incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed on July 1, 2015)
*10.2

Sixth Amendment to UnitedHealth Group Executive Savings Plan (2004 Statement)
*10.3

Second Amendment, dated as of November 5, 2015, of Amended and Restated UnitedHealth Group Incorporated 2008 Executive Incentive Plan
*10.4

Form of Agreement for Non-Qualified Stock Option Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
*10.5

Form of Agreement for Restricted Stock Unit Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
*10.6

Form of Agreement for Performance-based Restricted Stock Unit Award to Executives under UnitedHealth Group Incorporated’s 2011 Stock Incentive Plan, as amended and restated in 2015, for awards made after January 1, 2016
12.1

Computation of Ratio of Earnings to Fixed Charges
31.1

Certifications pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1

Certifications pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101

The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2015 filed on November 5, 2015, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
________________
*
Denotes management contracts and compensation plans in which certain directors and named executive officers participate and which are being filed pursuant to Item 601(b)(10)(iii)(A) of Regulation S-K.
**
Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.


37
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