UNH 10-Q Quarterly Report Sept. 30, 2018 | Alphaminr
UNITEDHEALTH GROUP INC

UNH 10-Q Quarter ended Sept. 30, 2018

UNITEDHEALTH GROUP INC
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10-Q 1 unh201893010-q.htm 10-Q Document
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________
Form 10-Q
__________________________________________________________
[X]
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED SEPTEMBER 30, 2018
or
[ ]
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM _______ TO _______
Commission File Number: 1-10864
__________________________________________________________
uhglogo1a01a01a15.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
__________________________________________________________
Delaware
41-1321939
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota
55343
(Address of principal executive offices)
(Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
__________________________________________________________
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes [X] No [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act
Large accelerated filer
[X]
Accelerated filer
[ ]
Non-accelerated filer
[ ]
Smaller reporting company
[ ]
Emerging growth company
[ ]
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. [ ]
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes [ ] No [X]
As of October 31, 2018, there were 962,034,200 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.

UNITEDHEALTH GROUP
Table of Contents
Page




PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)
September 30,
2018
December 31,
2017
Assets
Current assets:
Cash and cash equivalents
$
10,263

$
11,981

Short-term investments
3,586

3,509

Accounts receivable, net
10,992

9,568

Other current receivables, net
7,270

6,262

Assets under management
2,936

3,101

Prepaid expenses and other current assets
3,707

2,663

Total current assets
38,754

37,084

Long-term investments
31,929

28,341

Property, equipment and capitalized software, net
8,042

7,013

Goodwill
58,703

54,556

Other intangible assets, net
9,498

8,489

Other assets
4,161

3,575

Total assets
$
151,087

$
139,058

Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable
$
19,850

$
17,871

Accounts payable and accrued liabilities
18,991

15,180

Commercial paper and current maturities of long-term debt
1,500

2,857

Unearned revenues
2,388

2,269

Other current liabilities
13,648

12,286

Total current liabilities
56,377

50,463

Long-term debt, less current maturities
32,053

28,835

Deferred income taxes
2,434

2,182

Other liabilities
5,858

5,556

Total liabilities
96,722

87,036

Commitments and contingencies (Note 7)




Redeemable noncontrolling interests
1,769

2,189

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


Common stock, $0.01 par value - 3,000 shares authorized; 962 and 969 issued and outstanding
10

10

Additional paid-in capital

1,703

Retained earnings
54,386

48,730

Accumulated other comprehensive loss
(4,386
)
(2,667
)
Nonredeemable noncontrolling interests
2,586

2,057

Total equity
52,596

49,833

Total liabilities, redeemable noncontrolling interests and equity
$
151,087

$
139,058



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)
2018
2017
2018
2017
Revenues:
Premiums
$
44,613

$
39,552

$
133,155

$
118,075

Products
7,344

6,665

21,050

19,209

Services
4,217

3,858

12,590

11,089

Investment and other income
382

247

1,035

725

Total revenues
56,556

50,322

167,830

149,098

Operating costs:
Medical costs
36,158

32,201

108,448

96,829

Operating costs
8,479

7,387

25,371

21,737

Cost of products sold
6,718

6,068

19,373

17,633

Depreciation and amortization
611

578

1,791

1,667

Total operating costs
51,966

46,234

154,983

137,866

Earnings from operations
4,590

4,088

12,847

11,232

Interest expense
(353
)
(294
)
(1,026
)
(878
)
Earnings before income taxes
4,237

3,794

11,821

10,354

Provision for income taxes
(953
)
(1,233
)
(2,603
)
(3,252
)
Net earnings
3,284

2,561

9,218

7,102

Earnings attributable to noncontrolling interests
(96
)
(76
)
(272
)
(161
)
Net earnings attributable to UnitedHealth Group common shareholders
$
3,188

$
2,485

$
8,946

$
6,941

Earnings per share attributable to UnitedHealth Group common shareholders:
Basic
$
3.31

$
2.57

$
9.29

$
7.22

Diluted
$
3.24

$
2.51

$
9.09

$
7.06

Basic weighted-average number of common shares outstanding
962

968

963

962

Dilutive effect of common share equivalents
21

21

21

21

Diluted weighted-average number of common shares outstanding
983

989

984

983

Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents
7

1

7

6



2



UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)

Three Months Ended September 30,
Nine Months Ended September 30,
(in millions)
2018
2017
2018
2017
Net earnings
$
3,284

$
2,561

$
9,218

$
7,102

Other comprehensive (loss) income:
Gross unrealized (losses) gains on investment securities during the period
(91
)
44

(512
)
313

Income tax effect
21

(17
)
117

(111
)
Total unrealized (losses) gains, net of tax
(70
)
27

(395
)
202

Gross reclassification adjustment for net realized gains included in net earnings
(3
)
(10
)
(58
)
(51
)
Income tax effect

4

13

19

Total reclassification adjustment, net of tax
(3
)
(6
)
(45
)
(32
)
Total foreign currency translation (losses) gains
(233
)
217

(1,303
)
158

Other comprehensive (loss) income
(306
)
238

(1,743
)
328

Comprehensive income
2,978

2,799

7,475

7,430

Comprehensive income attributable to noncontrolling interests
(96
)
(76
)
(272
)
(161
)
Comprehensive income attributable to UnitedHealth Group common shareholders
$
2,882

$
2,723

$
7,203

$
7,269



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 Interests
Total
Equity
(in millions)
Shares
Amount
Net Unrealized (Losses) Gains on Investments
Foreign Currency Translation (Losses) Gains
Balance at January 1, 2018
969

$
10

$
1,703

$
48,730

$
(13
)
$
(2,654
)
$
2,057

$
49,833

Adjustment to adopt ASU 2016-01
(24
)
24


Net earnings
8,946

183

9,129

Other comprehensive loss
(440
)
(1,303
)
(1,743
)
Issuances of common stock,
and related tax effects
9


761

761

Share-based compensation
493

493

Common share repurchases
(16
)

(2,838
)
(812
)
(3,650
)
Cash dividends paid on common shares ($2.55 per share)
(2,454
)
(2,454
)
Redeemable noncontrolling interests fair value and other adjustments
(119
)
(119
)
Acquisition of nonredeemable noncontrolling interests
518

518

Distribution to nonredeemable noncontrolling interests
(172
)
(172
)
Balance at September 30, 2018
962

$
10

$

$
54,386

$
(429
)
$
(3,957
)
$
2,586

$
52,596

Balance at January 1, 2017
952

$
10

$

$
40,945

$
(97
)
$
(2,584
)
$
(97
)
$
38,177

Net earnings
6,941

120

7,061

Other comprehensive income
170

158

328

Issuances of common stock, and related tax effects
24


2,156

2,156

Share-based compensation
447

447

Common share repurchases
(7
)

(1,173
)


(1,173
)
Cash dividends paid on common shares ($2.125 per share)
(2,046
)
(2,046
)
Redeemable noncontrolling interests fair value and other adjustments
371

371

Acquisition of nonredeemable noncontrolling interests
2,111

2,111

Distribution to nonredeemable noncontrolling interests
(122
)
(122
)
Balance at September 30, 2017
969

$
10

$
1,801

$
45,840

$
73

$
(2,426
)
$
2,012

$
47,310




4


UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Nine Months Ended September 30,
(in millions)
2018
2017
Operating activities
Net earnings
$
9,218

$
7,102

Noncash items:
Depreciation and amortization
1,791

1,667

Deferred income taxes
9

(459
)
Share-based compensation
512

456

Other, net
(136
)
168

Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable
(984
)
(244
)
Other assets
(1,641
)
(763
)
Medical costs payable
1,745

1,305

Accounts payable and other liabilities
2,783

2,283

Unearned revenues
20

4,658

Cash flows from operating activities
13,317

16,173

Investing activities
Purchases of investments
(11,316
)
(10,626
)
Sales of investments
2,872

2,809

Maturities of investments
4,715

4,251

Cash paid for acquisitions, net of cash assumed
(5,824
)
(908
)
Purchases of property, equipment and capitalized software
(1,505
)
(1,391
)
Other, net
(187
)
(30
)
Cash flows used for investing activities
(11,245
)
(5,895
)
Financing activities
Common share repurchases
(3,650
)
(1,173
)
Cash dividends paid
(2,454
)
(2,046
)
Proceeds from common stock issuances
745

604

Repayments of long-term debt
(2,600
)
(2,867
)
Repayments of commercial paper, net
(164
)
(3,352
)
Proceeds from issuance of long-term debt
3,964

1,342

Customer funds administered
1,552

3,659

Other, net
(1,086
)
(624
)
Cash flows used for financing activities
(3,693
)
(4,457
)
Effect of exchange rate changes on cash and cash equivalents
(97
)
18

(Decrease) increase in cash and cash equivalents
(1,718
)
5,839

Cash and cash equivalents, beginning of period
11,981

10,430

Cash and cash equivalents, end of period
$
10,263

$
16,269

Supplemental schedule of noncash investing activities
Common stock issued for acquisition
$

$
2,164



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 care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through its diversified family of businesses, the Company leverages core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 as filed with the SEC ( 2017 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to medical costs payable, revenues, and goodwill and other intangible assets. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Recently Issued Accounting Standards
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2016-02, “Leases (Topic 842)”, as modified by ASUs 2018-01, 2018-10 and 2018-11 (collectively, ASU 2016-02). Under ASU 2016-02, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both finance and operating leases. For leases with a term of 12 months or less, an entity can elect to not recognize lease assets and lease liabilities and expense the lease over a straight-line basis for the term of the lease. ASU 2016-02 will require new disclosures that depict the amount, timing and uncertainty of cash flows pertaining to an entity’s leases. Companies may adopt the new standard using a modified retrospective approach or a cumulative effect upon adoption approach for the annual and interim periods beginning after December 15, 2018. Early adoption of ASU 2016-02 is permitted. When adopted, ASU 2016-02 will not have a material impact on the Company’s balance sheet, results of operations, equity or cash flows.
Recently Adopted Accounting Standards
In January 2016, the FASB issued ASU 2016-01, “Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (ASU 2016-01). Most notably, the new guidance requires that equity investments, with certain exemptions, be measured at fair value with changes in fair value recognized in net income as opposed to other comprehensive income. The Company adopted ASU 2016-01 on a prospective basis effective January 1, 2018, as required, and reclassified $24 million from accumulated other comprehensive income to retained earnings.
The Company has determined that there have been no other recently adopted or issued accounting standards that had, or will have, a material impact on its Condensed Consolidated Financial Statements.

6


2.    Investments
A summary of debt securities by major security type is as follows:
(in millions)
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2018
Debt securities - available-for-sale:
U.S. government and agency obligations
$
3,291

$

$
(76
)
$
3,215

State and municipal obligations
6,962

30

(112
)
6,880

Corporate obligations
15,561

10

(208
)
15,363

U.S. agency mortgage-backed securities
4,846

1

(171
)
4,676

Non-U.S. agency mortgage-backed securities
1,329


(30
)
1,299

Total debt securities - available-for-sale
31,989

41

(597
)
31,433

Debt securities - held-to-maturity:
U.S. government and agency obligations
246

1

(3
)
244

State and municipal obligations
11



11

Corporate obligations
342



342

Total debt securities - held-to-maturity
599

1

(3
)
597

Total debt securities
$
32,588

$
42

$
(600
)
$
32,030

December 31, 2017
Debt securities - available-for-sale:
U.S. government and agency obligations
$
2,673

$
1

$
(30
)
$
2,644

State and municipal obligations
7,596

99

(35
)
7,660

Corporate obligations
13,181

57

(44
)
13,194

U.S. agency mortgage-backed securities
3,942

7

(38
)
3,911

Non-U.S. agency mortgage-backed securities
1,018

3

(6
)
1,015

Total debt securities - available-for-sale
28,410

167

(153
)
28,424

Debt securities - held-to-maturity:
U.S. government and agency obligations
254

1

(1
)
254

State and municipal obligations
2



2

Corporate obligations
280



280

Total debt securities - held-to-maturity
536

1

(1
)
536

Total debt securities
$
28,946

$
168

$
(154
)
$
28,960

The Company held $2.0 billion of equity securities as of September 30, 2018 and December 31, 2017. The Company’s investments in equity securities primarily consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments and dividend paying stocks, with readily determinable fair values.
Additionally, the Company’s investments included $ 1.5 billion and $0.9 billion of equity method investments in operating businesses in the health care sector as of September 30, 2018 and December 31, 2017, respectively.

7


The amortized cost and fair value of debt securities as of September 30, 2018 , by contractual maturity, were as follows:
Available-for-Sale
Held-to-Maturity
(in millions)
Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less
$
3,683

$
3,675

$
145

$
145

Due after one year through five years
12,362

12,197

180

178

Due after five years through ten years
7,194

7,041

102

101

Due after ten years
2,575

2,545

172

173

U.S. agency mortgage-backed securities
4,846

4,676



Non-U.S. agency mortgage-backed securities
1,329

1,299



Total debt securities
$
31,989

$
31,433

$
599

$
597

The fair value of available-for-sale debt securities with gross unrealized losses by security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
Less Than 12 Months
12 Months or Greater
Total
(in millions)
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
September 30, 2018
Debt securities - available-for-sale:
U.S. government and agency obligations
$
2,025

$
(33
)
$
1,068

$
(43
)
$
3,093

$
(76
)
State and municipal obligations
3,471

(54
)
1,596

(58
)
5,067

(112
)
Corporate obligations
9,933

(136
)
2,334

(72
)
12,267

(208
)
U.S. agency mortgage-backed securities
2,762

(74
)
1,811

(97
)
4,573

(171
)
Non-U.S. agency mortgage-backed securities
956

(19
)
265

(11
)
1,221

(30
)
Total debt securities - available-for-sale
$
19,147

$
(316
)
$
7,074

$
(281
)
$
26,221

$
(597
)
December 31, 2017
Debt securities - available-for-sale:
U.S. government and agency obligations
$
1,249

$
(8
)
$
1,027

$
(22
)
$
2,276

$
(30
)
State and municipal obligations
2,599

(21
)
866

(14
)
3,465

(35
)
Corporate obligations
5,901

(23
)
1,242

(21
)
7,143

(44
)
U.S. agency mortgage-backed securities
1,657

(12
)
1,162

(26
)
2,819

(38
)
Non-U.S. agency mortgage-backed securities
411

(3
)
144

(3
)
555

(6
)
Total debt securities - available-for-sale
$
11,817

$
(67
)
$
4,441

$
(86
)
$
16,258

$
(153
)
The Company’s unrealized losses from debt securities as of September 30, 2018 were generated from 20,000 positions out of a total of 29,000 positions. The Company believes that it will collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. At each reporting period, the Company evaluates securities for impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality and credit ratings of the issuers, noting no significant deterioration since purchase. As of September 30, 2018 , the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary.
3.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.

8


For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
September 30, 2018
Cash and cash equivalents
$
10,220

$
43

$

$
10,263

Debt securities - available-for-sale:
U.S. government and agency obligations
2,928

287


3,215

State and municipal obligations

6,880


6,880

Corporate obligations
41

15,163

159

15,363

U.S. agency mortgage-backed securities

4,676


4,676

Non-U.S. agency mortgage-backed securities

1,299


1,299

Total debt securities - available-for-sale
2,969

28,305

159

31,433

Equity securities
1,885

13

100

1,998

Assets under management
993

1,939

4

2,936

Total assets at fair value

$
16,067

$
30,300

$
263

$
46,630

Percentage of total assets at fair value
34
%
65
%
1
%
100
%
December 31, 2017
Cash and cash equivalents
$
11,718

$
263

$

$
11,981

Debt securities - available-for-sale:
U.S. government and agency obligations
2,428

216


2,644

State and municipal obligations

7,660


7,660

Corporate obligations
65

12,989

140

13,194

U.S. agency mortgage-backed securities

3,911


3,911

Non-U.S. agency mortgage-backed securities

1,015


1,015

Total debt securities - available-for-sale
2,493

25,791

140

28,424

Equity securities
1,784

14

194

1,992

Assets under management
1,117

1,984


3,101

Total assets at fair value
$
17,112

$
28,052

$
334

$
45,498

Percentage of total assets at fair value
38
%
61
%
1
%
100
%
Transfers between levels, if any, are recorded as of the beginning of the reporting period in which the transfer occurs; there were no transfers between Levels 1, 2 or 3 of any financial assets during the nine months ended September 30, 2018 or 2017 .

9


The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions)
Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
September 30, 2018
Debt securities - held-to-maturity
$
257

$
71

$
269

$
597

$
599

Long-term debt and other financing obligations
$

$
34,908

$

$
34,908

$
33,533

December 31, 2017
Debt securities - held-to-maturity
$
267

$
4

$
265

$
536

$
536

Long-term debt and other financing obligations
$

$
34,504

$

$
34,504

$
31,542

Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the nine months ended September 30, 2018 or 2017 .
4.    Medical Costs Payable
The following table shows the components of the change in medical costs payable for the nine months ended September 30:
(in millions)
2018
2017
Medical costs payable, beginning of period
$
17,871

$
16,391

Acquisitions
333

76

Reported medical costs:
Current year
108,658

97,519

Prior years
(210
)
(690
)
Total reported medical costs
108,448

96,829

Medical payments:
Payments for current year
(90,348
)
(81,237
)
Payments for prior years
(16,454
)
(14,096
)
Total medical payments
(106,802
)
(95,333
)
Medical costs payable, end of period
$
19,850

$
17,963

For the nine months ended September 30, 2018 , the medical cost reserve development included no individual factors that were significant. For the nine months ended September 30, 2017, the medical cost reserve development was primarily driven by lower than expected health system utilization levels. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of $13.8 billion and $12.3 billion at September 30, 2018 and December 31, 2017, respectively.

10


5.    Commercial Paper and Long-Term Debt
Commercial paper and senior unsecured long-term debt consisted of the following:
September 30, 2018
December 31, 2017
(in millions, except percentages)
Par
Value
Carrying
Value
Fair
Value
Par
Value
Carrying
Value
Fair
Value
Commercial paper
$
20

$
20

$
20

$
150

$
150

$
150

6.000% notes due February 2018



1,100

1,101

1,106

1.900% notes due July 2018



1,500

1,499

1,501

1.700% notes due February 2019
750

750

747

750

749

747

1.625% notes due March 2019
500

500

498

500

501

497

2.300% notes due December 2019
500

492

496

500

495

501

2.700% notes due July 2020
1,500

1,497

1,491

1,500

1,496

1,517

Floating rate notes due October 2020
300

299

300

300

299

300

3.875% notes due October 2020
450

439

456

450

446

467

1.950% notes due October 2020
900

897

881

900

895

892

4.700% notes due February 2021
400

395

412

400

403

425

2.125% notes due March 2021
750

747

732

750

746

744

Floating rate notes due June 2021
350

349

350




3.150% notes due June 2021
400

398

399




3.375% notes due November 2021
500

481

502

500

493

516

2.875% notes due December 2021
750

724

741

750

741

760

2.875% notes due March 2022
1,100

1,031

1,083

1,100

1,054

1,114

3.350% notes due July 2022
1,000

997

999

1,000

996

1,033

2.375% notes due October 2022
900

894

863

900

893

891

0.000% notes due November 2022
15

12

12

15

12

12

2.750% notes due February 2023
625

588

606

625

606

626

2.875% notes due March 2023
750

734

731

750

762

759

3.500% notes due June 2023
750

746

752




3.750% notes due July 2025
2,000

1,989

2,010

2,000

1,987

2,108

3.100% notes due March 2026
1,000

995

961

1,000

995

1,007

3.450% notes due January 2027
750

745

734

750

745

776

3.375% notes due April 2027
625

619

607

625

618

642

2.950% notes due October 2027
950

938

890

950

937

947

3.850% notes due June 2028
1,150

1,142

1,153




4.625% notes due July 2035
1,000

991

1,064

1,000

991

1,165

5.800% notes due March 2036
850

838

1,013

850

837

1,105

6.500% notes due June 2037
500

492

640

500

491

698

6.625% notes due November 2037
650

641

844

650

641

923

6.875% notes due February 2038
1,100

1,076

1,467

1,100

1,075

1,596

5.700% notes due October 2040
300

296

358

300

296

389

5.950% notes due February 2041
350

345

428

350

345

466

4.625% notes due November 2041
600

588

630

600

588

685

4.375% notes due March 2042
502

484

510

502

483

555

3.950% notes due October 2042
625

607

596

625

607

650

4.250% notes due March 2043
750

734

749

750

734

822

4.750% notes due July 2045
2,000

1,972

2,140

2,000

1,972

2,362

4.200% notes due January 2047
750

738

743

750

738

808

4.250% notes due April 2047
725

717

728

725

717

798

3.750% notes due October 2047
950

933

883

950

933

969

4.250% notes due June 2048
1,350

1,329

1,355




Total commercial paper and long-term debt
$
32,687

$
32,199

$
33,574

$
31,417

$
31,067

$
34,029

The Company’s long-term debt obligations included $ 1.4 billion and $625 million of other financing obligations, of which $230 million and $107 million were classified as current as of September 30, 2018 and December 31, 2017 , respectively.

11


Commercial Paper and Bank Credit Facilities
Commercial paper consists of short-duration, senior unsecured debt privately placed on a discount basis through broker-dealers. As of September 30, 2018 , the Company’s outstanding commercial paper had a weighted average annual interest rate of 2.1% .
The Company has $3.0 billion five-year, $3.0 billion three-year and $4.0 billion 364-day revolving bank credit facilities with 26 banks, which mature in December 2022 , December 2020 and December 2018, respectively. These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of September 30, 2018 , no amounts had been drawn on any of the bank credit facilities. The annual interest rates, which are variable based on term, are calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. If amounts had been drawn on the bank credit facilities as of September 30, 2018 , annual interest rates would have ranged from 3.1% to 3.4% .
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55% . The Company was in compliance with its debt covenants as of September 30, 2018 .
6.    Shareholders' Equity
Share Repurchase Program
In June 2018, the Company’s Board of Directors renewed the Company’s share repurchase program with an authorization to repurchase up to 100 million shares of the Company’s common stock. The following table provides details of the Company’s share repurchase activity for the nine months ended September 30, 2018 :
(in millions, except per share data)
Common share repurchases, shares
16

Common share repurchases, average price per share
$
232.61

Common share repurchases, aggregate cost
$
3,650

Board authorized shares remaining
98

Dividends
In June 2018, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to an annual dividend rate of $ 3.60 per share from $ 3.00 per share, which the Company had paid since June 2017. Declaration and payment of future quarterly dividends is at the discretion of the Board and may be adjusted as business needs or market conditions change.
The following table provides details of the Company’s 2018 dividend payments:
Payment Date
Amount per Share
Total Amount Paid
(in millions)
March 20
$
0.75

$
722

June 26
0.90

866

September 18
0.90

866

7.    Commitments and Contingencies
Legal Matters
Because of the nature of its businesses, the Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the

12


early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable that a loss may be incurred.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by the Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, the Brazilian national regulatory agency for private health insurance and plans (the Agência Nacional de Saúde Suplementar), state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice, the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the Brazilian federal revenue service (the Secretaria da Receita Federal), the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the Department of Justice (DOJ) announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges that the Company made improper risk adjustment submissions and violated the False Claims Act. On February 12, 2018, the court granted in part and denied in part the Company’s motion to dismiss. In May 2018, DOJ moved to dismiss the Company’s counterclaims, which were filed in March 2018, and moved for partial summary judgment. Those motions were argued in September 2018. The Company cannot reasonably estimate the outcome that may result from this matter given its procedural status.

13


8.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx . For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following tables present reportable segment financial information:
Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Three Months Ended September 30, 2018
Revenues - unaffiliated customers:
Premiums
$
43,628

$
985

$

$

$

$
985

$

$
44,613

Products

13

29

7,302


7,344


7,344

Services
2,067

1,196

790

164


2,150


4,217

Total revenues - unaffiliated customers
45,695

2,194

819

7,466


10,479


56,174

Total revenues - affiliated customers

3,733

1,431

9,960

(352
)
14,772

(14,772
)

Investment and other income
242

125

4

11


140


382

Total revenues
$
45,937

$
6,052

$
2,254

$
17,437

$
(352
)
$
25,391

$
(14,772
)
$
56,556

Earnings from operations
$
2,559

$
622

$
534

$
875

$

$
2,031

$

$
4,590

Interest expense






(353
)
(353
)
Earnings before income taxes
$
2,559

$
622

$
534

$
875

$

$
2,031

$
(353
)
$
4,237

Three Months Ended September 30, 2017
Revenues - unaffiliated customers:
Premiums
$
38,576

$
976

$

$

$

$
976

$

$
39,552

Products

10

29

6,626


6,665


6,665

Services
2,005

1,040

677

136


1,853


3,858

Total revenues - unaffiliated customers
40,581

2,026

706

6,762


9,494


50,075

Total revenues - affiliated customers

3,138

1,297

9,186

(324
)
13,297

(13,297
)

Investment and other income
153

88

1

5


94


247

Total revenues
$
40,734

$
5,252

$
2,004

$
15,953

$
(324
)
$
22,885

$
(13,297
)
$
50,322

Earnings from operations
$
2,391

$
513

$
414

$
770

$

$
1,697

$

$
4,088

Interest expense






(294
)
(294
)
Earnings before income taxes
$
2,391

$
513

$
414

$
770

$

$
1,697

$
(294
)
$
3,794



14


Optum
(in millions)
UnitedHealthcare
OptumHealth
OptumInsight
OptumRx
Optum Eliminations
Optum
Corporate and
Eliminations
Consolidated
Nine Months Ended September 30, 2018
Revenues - unaffiliated customers:
Premiums
$
130,361

$
2,794

$

$

$

$
2,794

$

$
133,155

Products

37

72

20,941


21,050


21,050

Services
6,248

3,587

2,306

449


6,342


12,590

Total revenues - unaffiliated customers
136,609

6,418

2,378

21,390


30,186


166,795

Total revenues - affiliated customers

10,979

4,115

29,062

(1,026
)
43,130

(43,130
)

Investment and other income
633

355

15

32


402


1,035

Total revenues
$
137,242

$
17,752

$
6,508

$
50,484

$
(1,026
)
$
73,718

$
(43,130
)
$
167,830

Earnings from operations
$
7,316

$
1,680

$
1,382

$
2,469

$

$
5,531

$

$
12,847

Interest expense






(1,026
)
(1,026
)
Earnings before income taxes
$
7,316

$
1,680

$
1,382

$
2,469

$

$
5,531

$
(1,026
)
$
11,821

Nine Months Ended September 30, 2017
Revenues - unaffiliated customers:
Premiums
$
115,295

$
2,780

$

$

$

$
2,780

$

$
118,075

Products

33

69

19,107


19,209


19,209

Services
5,885

2,769

2,011

424


5,204


11,089

Total revenues - unaffiliated customers
121,180

5,582

2,080

19,531


27,193


148,373

Total revenues - affiliated customers

9,294

3,757

27,196

(894
)
39,353

(39,353
)

Investment and other income
478

231

3

13


247


725

Total revenues
$
121,658

$
15,107

$
5,840

$
46,740

$
(894
)
$
66,793

$
(39,353
)
$
149,098

Earnings from operations
$
6,736

$
1,267

$
1,080

$
2,149

$

$
4,496

$

$
11,232

Interest expense






(878
)
(878
)
Earnings before income taxes
$
6,736

$
1,267

$
1,080

$
2,149

$

$
4,496

$
(878
)
$
10,354



15


ITEM 2.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2017 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2017 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through our diversified family of businesses, we leverage core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within our two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K and additional information on our segments can be found in this Item 2 and in Note 8 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the United States, South American and certain other international health markets. In the United States, health care spending has grown consistently for many years and comprises approximately 18% of gross domestic product. We expect overall spending on health care to continue to grow in the future due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macro-economic conditions and regulatory changes, which have impacted and could further impact our results of operations.
Pricing Trends . To price our health care benefit products, we start with our view of expected future costs, including any impact from the Health Insurance Industry Tax. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations, including minimum medical loss ratio (MLR) thresholds. We will continue seeking to balance growth and profitability across all of these dimensions.
The commercial risk market remains highly competitive in both the small group and large group segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs amid reform changes. In 2019, there will be a one year moratorium on the collection of the Health Insurance Industry Tax. Pricing for contracts that cover some portion of calendar year 2019 will reflect the impact of the moratorium.
Government programs in the public and senior sector tend to receive lower rates of increase than the commercial market due to governmental budget pressures and intrinsically lower cost trends.
Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, health system utilization and prescription drug costs. We endeavor to mitigate those increases by engaging physicians and consumers with information and helping them make clinically sound choices, with the objective of helping them achieve high quality, affordable care.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of regulatory trends and uncertainties. For additional information regarding regulatory trends and uncertainties, see Part I, Item 1 “Business - Government Regulation,” Part 1, Item 1A, “Risk Factors” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K.

16


Medicare Advantage Rates. Final 2019 Medicare Advantage rates resulted in an increase in industry base rates of approximately 3.4%, short of the industry forward medical cost trend, which creates continued pressure in the Medicare Advantage program.
The Tax Cut and Jobs Act (Tax Reform). Tax Reform was enacted by the U.S federal government in December 2017, changing existing federal tax law, including reducing the U.S. corporate income tax rate. The impact of Tax Reform is partially offset by the return of the nondeductible Health Insurance Industry Tax in 2018.
Health Insurance Industry Tax. After a moratorium in 2017, the industry-wide amount of the Health Insurance Industry Tax in 2018 is $14.3 billion, with our portion being $2.6 billion. The return of the tax impacts year-over-year comparability of our financial statements, including revenues, the medical care ratio (MCR), operating cost ratio and effective tax rate. A one year moratorium on the collection of the Health Insurance Industry Tax will occur in 2019.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select third quarter 2018 year-over-year operating comparisons to third quarter 2017 and other 2018 significant items.
Consolidated revenues grew 12% , UnitedHealthcare revenues grew 13% and Optum revenues grew 11% .
UnitedHealthcare served 75,000 fewer people primarily as a result of completion of its commitment to the 2.9 million people under the TRICARE military health care program, partially offset by the addition of 2.2 million people through acquisition and the remainder from organic growth.
Earnings from operations increased 12% , including increases of 7% at UnitedHealthcare and 20% at Optum.
Due primarily to the impact of Tax Reform, our effective income tax rate decreased 10 percentage points to 22.5% .
Diluted earnings per common share increased 29% .
Cash flows from operations for the nine months ended were $13.3 billion .

17


RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
Revenues:
Premiums
$
44,613

$
39,552

$
5,061

13
%
$
133,155

$
118,075

$
15,080

13
%
Products
7,344

6,665

679

10

21,050

19,209

1,841

10

Services
4,217

3,858

359

9

12,590

11,089

1,501

14

Investment and other income
382

247

135

55

1,035

725

310

43

Total revenues
56,556

50,322

6,234

12

167,830

149,098

18,732

13

Operating costs:
Medical costs
36,158

32,201

3,957

12

108,448

96,829

11,619

12

Operating costs
8,479

7,387

1,092

15

25,371

21,737

3,634

17

Cost of products sold
6,718

6,068

650

11

19,373

17,633

1,740

10

Depreciation and amortization
611

578

33

6

1,791

1,667

124

7

Total operating costs
51,966

46,234

5,732

12

154,983

137,866

17,117

12

Earnings from operations
4,590

4,088

502

12

12,847

11,232

1,615

14

Interest expense
(353
)
(294
)
(59
)
20

(1,026
)
(878
)
(148
)
17

Earnings before income taxes
4,237

3,794

443

12

11,821

10,354

1,467

14

Provision for income taxes
(953
)
(1,233
)
280

(23
)
(2,603
)
(3,252
)
649

(20
)
Net earnings
3,284

2,561

723

28

9,218

7,102

2,116

30

Earnings attributable to noncontrolling interests
(96
)
(76
)
(20
)
26

(272
)
(161
)
(111
)
69

Net earnings attributable to UnitedHealth Group common shareholders
$
3,188

$
2,485

$
703

28
%
$
8,946

$
6,941

$
2,005

29
%
Diluted earnings per share attributable to UnitedHealth Group common shareholders
$
3.24

$
2.51

$
0.73

29
%
$
9.09

$
7.06

$
2.03

29
%
Medical care ratio (a)
81.0
%
81.4
%
(0.4
)%
81.4
%
82.0
%
(0.6
)%
Operating cost ratio
15.0

14.7

0.3

15.1

14.6

0.5

Operating margin
8.1

8.1


7.7

7.5

0.2

Tax rate
22.5

32.5

(10.0
)
22.0

31.4

(9.4
)
Net earnings margin (b)
5.6

4.9

0.7

5.3

4.7

0.6

Return on equity (c)
25.9
%
22.5
%
3.4
%
24.6
%
22.0
%
2.6
%
(a)
Medical care ratio is calculated as medical costs divided by premium revenue.
(b)
Net earnings margin attributable to UnitedHealth Group shareholders.
(c)
Return on equity is calculated as annualized net earnings divided by average equity. Average equity is calculated using the equity balance at the end of the preceding year and the equity balances at the end of each of the quarters in the year presented.
2018 RESULTS OF OPERATIONS COMPARED TO 2017 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenue
The increase in revenue was primarily driven by the increase in the number of individuals served through risk-based products across our UnitedHealthcare benefits businesses, pricing trends, including for the return of the Health Insurance Industry Tax in 2018, and growth across the Optum business, primarily due to expansion in care delivery, pharmacy care services, and outsourcing and advisory services.
Medical Costs and MCR
Medical costs increased due to growth in people served through risk-based products and medical cost trends. The MCR decreased due to the revenue effects of the Health Insurance Industry Tax, which more than offset business mix changes and lower favorable reserve development.
Income Tax Rate
Our effective tax rate decreased due to the impact of Tax Reform, which was partially offset by the return of the nondeductible Health Insurance Industry Tax.

18


Reportable Segments
See Note 8 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information on our segments. The following table presents a summary of the reportable segment financial information:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
Revenues
UnitedHealthcare
$
45,937

$
40,734

$
5,203

13
%
$
137,242

$
121,658

$
15,584

13
%
OptumHealth
6,052

5,252

800

15

17,752

15,107

2,645

18

OptumInsight
2,254

2,004

250

12

6,508

5,840

668

11

OptumRx
17,437

15,953

1,484

9

50,484

46,740

3,744

8

Optum eliminations
(352
)
(324
)
(28
)
9

(1,026
)
(894
)
(132
)
15

Optum
25,391

22,885

2,506

11

73,718

66,793

6,925

10

Eliminations
(14,772
)
(13,297
)
(1,475
)
11

(43,130
)
(39,353
)
(3,777
)
10

Consolidated revenues
$
56,556

$
50,322

$
6,234

12
%
$
167,830

$
149,098

$
18,732

13
%
Earnings from operations
UnitedHealthcare
$
2,559

$
2,391

$
168

7
%
$
7,316

$
6,736

$
580

9
%
OptumHealth
622

513

109

21

1,680

1,267

413

33

OptumInsight
534

414

120

29

1,382

1,080

302

28

OptumRx
875

770

105

14

2,469

2,149

320

15

Optum
2,031

1,697

334

20

5,531

4,496

1,035

23

Consolidated earnings from operations
$
4,590

$
4,088

$
502

12
%
$
12,847

$
11,232

$
1,615

14
%
Operating margin
UnitedHealthcare
5.6
%
5.9
%
(0.3
)%
5.3
%
5.5
%
(0.2
)%
OptumHealth
10.3

9.8

0.5

9.5

8.4

1.1

OptumInsight
23.7

20.7

3.0

21.2

18.5

2.7

OptumRx
5.0

4.8

0.2

4.9

4.6

0.3

Optum
8.0

7.4

0.6

7.5

6.7

0.8

Consolidated operating margin
8.1
%
8.1
%
%
7.7
%
7.5
%
0.2
%
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
Three Months Ended September 30,
Increase/(Decrease)
Nine Months Ended September 30,
Increase/(Decrease)
(in millions, except percentages)
2018
2017
2018 vs. 2017
2018
2017
2018 vs. 2017
UnitedHealthcare Employer & Individual
$
13,734

$
13,054

$
680

5
%
$
40,856

$
38,759

$
2,097

5
%
UnitedHealthcare Medicare & Retirement
18,789

16,306

2,483

15

56,573

49,605

6,968

14

UnitedHealthcare Community & State
11,054

9,378

1,676

18

32,471

27,505

4,966

18

UnitedHealthcare Global
2,360

1,996

364

18

7,342

5,789

1,553

27

Total UnitedHealthcare revenues
$
45,937

$
40,734

$
5,203

13
%
$
137,242

$
121,658

$
15,584

13
%

19


The following table summarizes the number of individuals served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
September 30,
Increase/(Decrease)
(in thousands, except percentages)
2018
2017
2018 vs. 2017
Commercial group:
Risk-based
7,955

7,805

150

2
%
Fee-based
18,365

18,610

(245
)
(1
)
Total commercial group
26,320

26,415

(95
)

Individual
495

515

(20
)
(4
)
Fee-based TRICARE

2,855

(2,855
)
(100
)
Total commercial
26,815

29,785

(2,970
)
(10
)
Medicare Advantage
4,915

4,390

525

12

Medicaid
6,630

6,375

255

4

Medicare Supplement (Standardized)
4,540

4,415

125

3

Total public and senior
16,085

15,180

905

6

Total UnitedHealthcare - domestic medical
42,900

44,965

(2,065
)
(5
)
International
6,070

4,080

1,990

49

Total UnitedHealthcare - medical
48,970

49,045

(75
)
%
Supplemental Data:
Medicare Part D stand-alone
4,725

4,945

(220
)
(4
)%
The overall increase in people served through risk-based benefit plans in the commercial group market was driven by broad-based growth, primarily in services to small groups. Fee-based commercial group business declined primarily due to attrition at certain large commercial accounts. Medicare Advantage increased year-over-year due to growth in people served through individual and employer-sponsored group Medicare Advantage plans. Medicaid growth was driven by the combination of new state-based awards and growth in established programs. Medicare Supplement growth reflected strong customer retention and new sales. International growth was primarily driven by an acquisition in the first quarter.
UnitedHealthcare’s revenue and earnings from operations increased due to growth in the number of individuals served across its risk-based businesses, a higher revenue membership mix, rate increases for underlying medical cost trends and the impact of the return of the Health Insurance Industry Tax.
Optum
Total revenues and earnings from operations increased as each segment reported increased revenues and earnings from operations as a result of productivity and overall cost management initiatives in addition to the factors discussed below.
The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth primarily due to organic and acquisition-related growth in care delivery and behavioral health, digital consumer engagement and health financial services.
OptumInsight
Revenue and earnings from operations at OptumInsight increased primarily due to organic and acquisition-related growth in business process outsourcing and care provider advisory services.
OptumRx
Revenue and earnings from operations at OptumRx increased primarily due to growth in specialty pharmacy, home delivery services, and overall prescription growth. OptumRx fulfilled 331 million and 321 million adjusted scripts, in the third quarters of 2018 and 2017, respectively.

20


LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Summary of our Major Sources and Uses of Cash and Cash Equivalents
Nine Months Ended September 30,
Increase/(Decrease)
(in millions)
2018
2017
2018 vs. 2017
Sources of cash:
Cash provided by operating activities
$
13,317

$
16,173

$
(2,856
)
Issuances of commercial paper and long-term debt, net of repayments
1,200


1,200

Proceeds from common stock issuances
745

604

141

Customer funds administered
1,552

3,659

(2,107
)
Total sources of cash
16,814

20,436

Uses of cash:
Common stock repurchases
(3,650
)
(1,173
)
(2,477
)
Cash paid for acquisitions, net of cash assumed
(5,824
)
(908
)
(4,916
)
Purchases of investments, net of sales and maturities
(3,729
)
(3,566
)
(163
)
Repayments of commercial paper and long-term debt, net of issuances

(4,877
)
4,877

Purchases of property, equipment and capitalized software
(1,505
)
(1,391
)
(114
)
Cash dividends paid
(2,454
)
(2,046
)
(408
)
Other
(1,273
)
(654
)
(619
)
Total uses of cash
(18,435
)
(14,615
)
Effect of exchange rate changes on cash and cash equivalents
(97
)
18

(115
)
Net (decrease) increase in cash and cash equivalents
$
(1,718
)
$
5,839

$
(7,557
)
2018 Cash Flows Compared to 2017 Cash Flows
Decreased cash flows provided by operating activities were primarily driven by a decrease in unearned revenues due to the September 2017 receipt of our October CMS premium payment of $4.6 billion, offset by higher net earnings, and the year-over-year impact of the return of the Health Insurance Industry Tax. In October 2018, we paid our portion of the 2018 Health Insurance Industry Tax of $2.6 billion.
Other significant changes in sources or uses of cash year-over-year included net issuances of debt in 2018 compared to net repayments in 2017, an increase in cash paid for acquisitions, increased share repurchases and a decrease in customer funds administered primarily due to the September 2017 receipt of our October CMS payment.
Financial Condition
As of September 30, 2018 , our cash, cash equivalent, available-for-sale debt securities and equity securities balances of $44 billion included approximately $10 billion of cash and cash equivalents (of which $0.9 billion was available for general corporate use), $31 billion of debt securities and $2 billion of investments in equity securities. Given the significant portion of our portfolio held in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt portfolio had a weighted-average duration of 3.3 years and a weighted-average credit rating of “Double A” as of September 30, 2018 . When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Commercial Paper and Bank Credit Facilities. Our revolving bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through third-party broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.

21


Our revolving bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. As of September 30, 2018 , our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 37%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, such as to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. For more information on our long-term debt, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Credit Ratings. Our credit ratings as of September 30, 2018 were as follows:
Moody’s
S&P Global
Fitch
A.M. Best
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Ratings
Outlook
Senior unsecured debt
A3
Stable
A+
Stable
A-
Stable
A-
Stable
Commercial paper
P-2
n/a
A-1
n/a
F1
n/a
AMB-1
n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. For example, a significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. As of September 30, 2018 , we had Board authorization to purchase up to 98 million shares of our common stock. For more information on our share repurchase program, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Dividends. In June 2018, our Board increased our quarterly cash dividend to shareholders to an annual dividend rate of $ 3.60 per share. For more information on our dividend, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
For additional liquidity discussion, see Note 10 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2017 was disclosed in our 2017 10-K. During the nine months ended September 30, 2018 , there were no material changes to this previously disclosed information outside the ordinary course of business. However, we continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
RECENTLY ISSUED ACCOUNTING STANDARDS
See Note 1 of Notes to the Condensed Consolidated Financial Statements in Part I, Item 1 of this report for a discussion of new accounting pronouncements that affect us.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments, assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates, and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable, revenues, and goodwill and other intangible assets. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in our 2017 10-K.

22


FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements within the meaning of the PSLRA. These statements are intended to take advantage of the “safe harbor” provisions of the PSLRA. Generally the words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements, which generally are not historical in nature. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. We caution that actual results could differ materially from those that management expects, depending on the outcome of certain factors.
Some factors that could cause actual results to differ materially from results discussed or implied in the forward-looking statements include: our ability to effectively estimate, price for and manage our medical costs, including the impact of any new coverage requirements; new laws or regulations, or changes in existing laws or regulations, or their enforcement or application, including increases in medical, administrative, technology or other costs or decreases in enrollment resulting from U.S., South American and other jurisdictions’ regulations affecting the health care industry; the outcome of the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in CMS star ratings and other quality scores that impact revenue; reductions in revenue or delays to cash flows received under Medicare, Medicaid and other government programs, including the effects of a prolonged U.S. government shutdown or debt ceiling constraints; changes in Medicare, including changes in payment methodology, the CMS star ratings program or the application of risk adjustment data validation audits; cyber-attacks or other privacy or data security incidents; failure to comply with privacy and data security regulations; regulatory and other risks and uncertainties of the pharmacy benefits management industry; competitive pressures, which could affect our ability to maintain or increase our market share; changes in or challenges to our public sector contract awards; our ability to execute contracts on competitive terms with physicians, hospitals and other service providers; failure to achieve targeted operating cost productivity improvements, including savings resulting from technology enhancement and administrative modernization; increases in costs and other liabilities associated with increased litigation, government investigations, audits or reviews; failure to manage successfully our strategic alliances or complete or receive anticipated benefits of acquisitions and other strategic transactions, fluctuations in foreign currency exchange rates on our reported shareholders’ equity and results of operations; downgrades in our credit ratings; the performance of our investment portfolio; impairment of the value of our goodwill and intangible assets if estimated future results do not adequately support goodwill and intangible assets recorded for our existing businesses or the businesses that we acquire; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; and our ability to obtain sufficient funds from our regulated subsidiaries or the debt or capital markets to fund our obligations, to maintain our debt to total capital ratio at targeted levels, to maintain our quarterly dividend payment cycle or to continue repurchasing shares of our common stock.
This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain risk factors that may affect our business operations, financial condition and results of operations, in our other periodic and current filings with the SEC, including our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Any or all forward-looking statements we make may turn out to be wrong, and can be affected by inaccurate assumptions we might make or by known or unknown risks and uncertainties. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual future results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by applicable securities laws.
ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We manage exposure to market interest rates by diversifying investments across different fixed-income market sectors and debt across maturities, as well as by endeavoring to match our floating-rate assets and liabilities over time, either directly or through the use of interest rate swap contracts. Unrealized gains and losses on investments in available-for-sale debt securities are reported in comprehensive income.

23


The following table summarizes the impact of hypothetical changes in market interest rates across the entire yield curve by 1% point or 2% points as of September 30, 2018 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
September 30, 2018
Increase (Decrease) in Market Interest Rate
Investment
Income Per
Annum (a)
Interest
Expense Per
Annum
Fair Value of
Financial Assets (b)
Fair Value of
Financial Liabilities
2 %
$
261

$
187

$
(2,192
)
$
(4,652
)
1
131

94

(1,118
)
(2,557
)
(1)
(131
)
(94
)
1,109

2,814

(2)
(254
)
(187
)
2,167

6,283

(a)
Given the low absolute level of short-term market rates on our floating-rate assets as of September 30, 2018 , the assumed hypothetical change in interest rates does not reflect the full 200 basis point reduction in investment income as the rate cannot fall below zero.
(b)
As of September 30, 2018 , some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
ITEM 4.    CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this quarterly report on Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of September 30, 2018 . Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of September 30, 2018 .
CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended September 30, 2018 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

24


PART II. OTHER INFORMATION
ITEM 1.
LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to Note 7 of Notes to the Condensed Consolidated Financial Statements contained in Part I, Item 1 of this report.
ITEM 1A.    RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” of our 2017 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2017 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or future results.
There have been no material changes to the risk factors disclosed in our 2017 10-K.
ITEM 2.
UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
In November 1997, our Board of Directors adopted a share repurchase program, which the Board evaluates periodically. There is no established expiration date for the program. During the third quarter 2018, we repurchased approximately 2 million shares at an average price of $259.78 per share. As of September 30, 2018, we had Board authorization to purchase up to 98 million shares of our common stock.

25


ITEM 6.
EXHIBITS*
The following exhibits are filed or incorporated by reference herein in response to Item 601 of Regulation S-K. The Company files Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q and Current Reports on Form 8-K pursuant to the Securities Exchange Act of 1934 under Commission File No. 1-10864.


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)





101

The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2018 filed on November 8, 2018, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
________________
*
Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.


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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
UNITEDHEALTH GROUP INCORPORATED
/s/ D AVID S. W ICHMANN
Chief Executive Officer
(principal executive officer)
Dated:
November 8, 2018
David S. Wichmann
/s/ J OHN F. R EX
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:
November 8, 2018
John F. Rex
/s/ T HOMAS E. R OOS
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:
November 8, 2018
Thomas E. Roos


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TABLE OF CONTENTS
Part IprintItem 1. Financial StatementsprintItem 2. Management S Discussion and Analysis Of Financial Condition and Results Of OperationsprintItem 3. Quantitative and Qualitative Disclosures About Market RiskprintItem 4. Controls and ProceduresprintPart II. Other InformationprintItem 1. Legal ProceedingsprintItem 1A. Risk FactorsprintItem 2. Unregistered Sale Of Equity Securities and Use Of ProceedsprintItem 6. Exhibits*print

Exhibits

3.1 Certificate of Incorporation of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.1 to the Companys Registration Statement on Form 8-A/A filed on July 1, 2015) 3.2 Bylaws of UnitedHealth Group Incorporated, effective August 15, 2017 (incorporated by reference to Exhibit 3.1 to the Companys Current Report on Form 8-K filed on August 16, 2017) 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 Companys 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 Companys Quarterly Report on Form 10-Q for the quarter ended June30, 2007) 4.4 Indenture, dated as of February4,2008, between UnitedHealth Group Incorporated and U.S. Bank National Association (incorporated by reference to Exhibit 4.1 to the Companys Registration Statement on Form S-3, SEC File Number 333-149031, filed on February4, 2008) 31.1 Certifications pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 32.1 Certifications pursuant to Section 906 of the Sarbanes-Oxley Act of 2002