United Healthcare 2010 Annual Report Download - page 5

period. When providing administrative and other management services to customers that elect to self-fund the
health care costs of their employees and employees’ dependants, UnitedHealthcare Employer & Individual
receives a fixed service fee per individual served. These customers retain the risk of financing medical benefits
for their employees and employees’ dependants, while UnitedHealthcare Employer & Individual provides
coordination and facilitation of medical services, customer and health care professional services and access to a
contracted network of physicians, hospitals and other health care professionals. Large employer groups, such as
those serviced by UnitedHealthcare Employer & Individual National Accounts, typically use self-funded
arrangements. As of December 31, 2010, UnitedHealthcare Employer & Individual National Accounts served
372 large employer groups under these arrangements, including 144 of the Fortune 500 companies. Small
employer groups are more likely to purchase risk-based products because they are less willing or able to bear a
greater potential liability for health care expenditures. UnitedHealthcare Employer & Individual also offers a
variety of non-employer based insurance options for purchase by individuals, including students, which are
designed to meet the health coverage needs of these consumers and their families.
UnitedHealthcare Employer & Individual offers its products through affiliates that are licensed as insurance
companies, health maintenance organizations (HMOs), or third party administrators (TPAs). UnitedHealthcare
Employer & Individual’s product strategy centers on several principles: consumer choice, broad access to health
professionals, and use of data and science to promote better outcomes, quality service, transparency and
affordability. Integrated wellness programs and services help individuals make informed decisions, maintain
healthy lifestyles and optimize health outcomes by coordinating access to care services and providing
personalized, targeted education and information services.
Individuals served by UnitedHealthcare Employer & Individual have access to approximately 90% of the
physicians and other health care professionals and 96% of the hospitals through the UnitedHealth Group
networks. The consolidated purchasing capacity represented by the individuals UnitedHealth Group serves makes
it possible for UnitedHealthcare Employer & Individual to contract for cost-effective access to a large number of
conveniently located care professionals. Directly or through UnitedHealth Group’s family of companies,
UnitedHealthcare Employer & Individual offers:
• A comprehensive range of benefit plans integrating medical, ancillary and alternative care products so
customers can choose benefits that are right for them;
• Affordability across a broad set of price points and a wide product line, from offerings covering essential
needs to comprehensive benefit plans, all of which offer access to our broad-based proprietary network of
contracted physicians, hospitals and other health care professionals with economic benefits reflective of the
aggregate purchasing capacity of our organization;
• Innovative clinical programs that are built around an extensive clinical data set and principles of evidence-
based medicine;
• Consumer access to information about physician and hospital performance against quality and cost
efficiency criteria based on claims data assessment through the UnitedHealth Premium Designation Program
and the UnitedHealth Hospital Comparison Program;
• Physician and facility access to performance feedback information to support continuous quality
improvement;
• Care facilitation services that use several identification tools, including proprietary predictive technology to
identify individuals with significant gaps in care and unmet needs or risks for potential health problems, and
then facilitate appropriate interventions;
• Disease and condition management programs to help individuals address significant, complex disease states,
including disease-specific benefit offerings such as the Diabetes Health Plan; and
• Convenient self-service tools for health transactions and information.
3