United Healthcare 2011 Annual Report Download - page 5

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costs by using formulary programs to drive better unit costs, encouraging consumers to use drugs that offer better value and
outcomes, and through physician and consumer programs that support the appropriate use of drugs based on clinical evidence.
In addition, UnitedHealthcare Employer & Individual also offers a comprehensive range of dental, vision, life, and disability
product offerings delivered through an integrated approach that enhances efficiency and effectiveness and includes a network of
nearly 35,000 vision professionals in private and retail settings, and more than 180,000 dental providers.
UnitedHealthcare Employer & Individual's distribution system consists primarily of producers (i.e., brokers and agents) and
direct and internet sales in the individual market, producers in the small employer group market, and producers and other
consultant-based or direct sales for large employer and public sector groups. UnitedHealthcare Employer & Individual's direct
distribution efforts are generally limited to the individual market, portions of the large employer group and public sector
markets, and cross-selling of specialty products to existing customers. UnitedHealthcare Employer & Individual offers its
products through affiliates that are licensed as insurance companies, health maintenance organizations (HMOs), or third party
administrators (TPAs).
UnitedHealthcare Medicare & Retirement
UnitedHealthcare Medicare & Retirement provides health and well-being services to individuals age 50 and older, addressing
their unique needs for preventive and acute health care services as well as for services dealing with chronic disease and other
specialized issues for older individuals. UnitedHealthcare Medicare & Retirement is fully dedicated to serving this growing
senior market segment, providing products and services in all 50 states, the District of Columbia, and most U.S. territories.
UnitedHealthcare Medicare & Retirement offers a wide spectrum of Medicare products, including Medicare Advantage plans,
Medicare Part D prescription drug coverage, and Medigap products that supplement traditional fee-for-service coverage, which
may be sold to individuals or on a group basis. Premium revenues from the Centers for Medicare & Medicaid Services (CMS)
represented 28% of our total consolidated revenues for the year ended December 31, 2011, most of which were generated by
UnitedHealthcare Medicare & Retirement under a number of contracts.
UnitedHealthcare Medicare & Retirement has extensive distribution capabilities and experience, including direct marketing to
consumers on behalf of its key clients: AARP, the nation's largest membership organization dedicated to the needs of people age
50 and over; state and U.S. government agencies; and employer groups. UnitedHealthcare Medicare & Retirement also has
distinct pricing, underwriting, clinical program management and marketing capabilities dedicated to risk-based health products
and services in the senior and geriatric markets.
Medicare Advantage. UnitedHealthcare Medicare & Retirement provides health care coverage for seniors and other eligible
Medicare beneficiaries primarily through the Medicare Advantage program administered by CMS, including Medicare
Advantage HMO plans, preferred provider organization (PPO) plans, Special Needs Plans, Point-of-Service (POS) plans and
Private-Fee-for-Service plans. Under the Medicare Advantage programs, UnitedHealthcare Medicare & Retirement provides
health insurance coverage in exchange for a fixed monthly premium per member from CMS. Premium amounts vary based on
the geographic areas in which members reside; demographic factors such as age, gender, and institutionalized status; and the
health status of the individual. UnitedHealthcare Medicare & Retirement also provides complete, individualized care planning
and care benefits for retirees, aging, disabled and chronically ill individuals, serving individuals enrolled in Medicare
Advantage products in 30 states and in the District of Columbia in long-term care settings including nursing homes,
community-based settings and private homes. In addition, UnitedHealthcare Medicare & Retirement offers innovative care
management and clinical programs, integrating federal, state and personal funding through a continuum of products from
Medicare Advantage and Special Needs Plans to hospice care. For high-risk patients in certain care settings and programs,
UnitedHealthcare Medicare & Retirement uses proprietary, automated medical record software that enables clinical care teams
to capture and track patient data and clinical encounters, creating a comprehensive set of care information that bridges across
home, hospital and nursing home care settings. UnitedHealthcare Medicare & Retirement had approximately 2.2 million
members enrolled in its Medicare Advantage products as of December 31, 2011. Proprietary predictive modeling tools help
identify members at high risk and allow care managers to proactively outreach to members to create individualized care plans
and help members obtain the right care, in the right place, at the right time.
Prescription Drug Benefit (Part D). UnitedHealthcare Medicare & Retirement provides the Medicare prescription drug benefit
(Part D) to beneficiaries throughout the United States and its territories. UnitedHealthcare Medicare & Retirement provides Part
D drug coverage through its Medicare Advantage program and stand-alone Part D plans. As of December 31, 2011,
UnitedHealthcare Medicare & Retirement had enrolled 7.1 million members in the Part D program, including 4.9 million
members in the stand-alone Part D plans and 2.2 million members in its Medicare Advantage plans incorporating Part D
coverage.
Medicare Supplement. In association with AARP, UnitedHealthcare Medicare & Retirement provides a range of Medicare
supplement and hospital indemnity insurance offerings through insurance company affiliates to 3.8 million AARP members.
Additional UnitedHealthcare Medicare & Retirement services include a nurse health line service, a lower cost Medicare
supplement offering that provides consumers with a national hospital network, 24-hour access to health care information, and