United Healthcare 2015 Annual Report Download - page 4

UnitedHealthcare
Through its health benefits offerings, UnitedHealthcare is enabling better health, helping to control rising health
care costs and creating a better health care experience for its customers. UnitedHealthcare’s market position is
built on:
• a national scale;
• strong local market relationships;
• the breadth of product offerings, which are responsive to many distinct market segments in health care;
• service and advanced technology;
• competitive medical and operating cost positions;
• effective clinical engagement;
• extensive expertise in distinct market segments; and
• innovation for customers and consumers.
UnitedHealthcare utilizes Optum’s capabilities to help coordinate patient care, improve affordability of medical
care, analyze cost trends, manage pharmacy benefits, work with care providers more effectively and create a
simpler consumer experience.
In the United States, UnitedHealthcare arranges for discounted access to care through networks that include
1 million physicians and other health care professionals and approximately 6,000 hospitals and other facilities.
UnitedHealthcare is subject to extensive government regulation. See further discussion of our regulatory
environment below under “Government Regulation” and in Part II, Item 7, “Management’s Discussion and
Analysis of Financial Condition and Results of Operations.”
UnitedHealthcare Employer & Individual
UnitedHealthcare Employer & Individual offers an array of consumer-oriented health benefit plans and services
nationwide for large national employers, public sector employers, mid-sized employers, small businesses,
individuals and military service members in the TRICARE west region. UnitedHealthcare Employer &
Individual provides access to medical services for approximately 30 million people on behalf of our customers
and alliance partners. This includes more than 190,000 employer customers across all 50 states. Large employer
groups typically use self-funded arrangements where UnitedHealthcare Employer & Individual earns a service
fee. Smaller employer groups and individuals are more likely to purchase risk-based products because they are
less willing or unable to bear a greater potential liability for health care expenditures.
Through its risk-based product offerings, UnitedHealthcare Employer & Individual assumes the risk of both
medical and administrative costs for its customers in return for a monthly premium, which is typically a fixed
rate per individual served for a one-year period. When providing administrative and other management services
to customers that elect to self-fund the health care costs of their employees and employees’ dependents,
UnitedHealthcare Employer & Individual receives a fixed monthly service fee per individual served. These
customers retain the risk of financing medical benefits for their employees and employees’ dependents, while
UnitedHealthcare Employer & Individual provides services such as coordination and facilitation of medical and
related services to customers, consumers and health care professionals, administration of transaction processing
and access to a contracted network of physicians, hospitals and other health care professionals, including dental
and vision. UnitedHealthcare Employer & Individual also offers a variety of insurance options for purchase by
individuals, including students, which are designed to meet the health coverage needs of these consumers and
their families.
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