United Healthcare 2015 Annual Report Download - page 17

of medicine laws that prohibit specific types of entities from practicing medicine or employing physicians to
practice medicine. Moreover, some states prohibit certain entities from sharing in the fees or revenues of a
professional practice (fee-splitting). These prohibitions may be statutory or regulatory, or may be imposed
through judicial or regulatory interpretation. The laws, regulations and interpretations in certain states have been
subject to limited judicial and regulatory interpretation and are subject to change.
Consumer Protection Laws. Certain of our businesses participate in direct-to-consumer activities and are subject
to regulations applicable to on-line communications and other general consumer protection laws and regulations.
Banking Regulation
Optum Bank is subject to regulation by federal banking regulators, including the Federal Deposit Insurance
Corporation, which performs annual examinations to ensure that the bank is operating in accordance with federal
safety and soundness requirements, and the Consumer Financial Protection Bureau, which may perform periodic
examinations to ensure that the bank is in compliance with applicable consumer protection statutes, regulations
and agency guidelines. Optum Bank is also subject to supervision and regulation by the Utah State Department of
Financial Institutions, which carries out annual examinations to ensure that the bank is operating in accordance
with state safety and soundness requirements and performs periodic examinations of the bank’s compliance with
applicable state banking statutes, regulations and agency guidelines. In the event of unfavorable examination
results from any of these agencies, the bank could become subject to increased operational expenses and capital
requirements, enhanced governmental oversight and monetary penalties.
International Regulation
Certain of our businesses operate internationally and are subject to regulation in the jurisdictions in which they
are organized or conduct business. These regulatory regimes vary from jurisdiction to jurisdiction. In addition,
our non-U.S. businesses and operations are subject to U.S. laws that regulate the conduct and activities of U.S.-
based businesses operating abroad, such as the Foreign Corrupt Practices Act (FCPA), which prohibits offering,
promising, providing or authorizing others to give anything of value to a foreign government official to obtain or
retain business or otherwise secure a business advantage.
COMPETITION
As a diversified health and well-being services company, we operate in highly competitive markets. Our
competitors include managed health care companies, insurance companies, HMOs, TPAs and business services
outsourcing companies, health care professionals that have formed networks to contract directly with employers
or with CMS, specialty benefit providers, government entities, disease management companies and various
health information and consulting companies. For our UnitedHealthcare businesses, our competitors include
Aetna Inc., Anthem, Inc., Centene Corporation, Cigna Corporation, Health Net, Inc., Humana Inc., Kaiser
Permanente, numerous for-profit and not-for-profit organizations operating under licenses from the Blue Cross
Blue Shield Association and, with respect to our Brazilian operations, several established competitors in Brazil
and other enterprises that serve more limited geographic areas. For our OptumRx businesses, our competitors
include CVS Health Corporation, Express Scripts, Inc. and Prime Therapeutics LLC. New entrants into the
markets in which we compete, as well as consolidation within these markets, also contribute to a competitive
environment. We compete on the basis of the sales, marketing and pricing of our products and services; product
innovation; consumer engagement and satisfaction; the level and quality of products and services; care delivery;
network and clinical management capabilities; market share; product distribution systems; efficiency of
administration operations; financial strength; and marketplace reputation. If we fail to compete effectively to
maintain or increase our market share, including by maintaining or increasing enrollments in businesses
providing health benefits, our results of operations, financial position and cash flows could be materially and
adversely affected. See Part I, Item 1A, “Risk Factors,” for additional discussion of our risks related to
competition.
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