United Healthcare 2015 Annual Report Download - page 5

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 and facilities. UnitedHealthcare Employer & Individual’s UnitedHealth
Premium®program is the longest-running physician quality and efficiency designation program in the industry,
making it easier for consumers to access high-quality, cost-efficient care. UnitedHealthcare Employer &
Individual has relationships with network care providers that integrate data and analytics, implement value-based
payments and care management programs, and enable us to jointly better manage health care across populations.
UnitedHealthcare Employer & Individual typically distributes its products through consultants or direct sales in
the larger employer and public sector segments. In the smaller group segment of the commercial marketplace,
UnitedHealthcare Employer & Individual’s distribution system consists primarily of direct sales and sales
through collaboration with brokers and agents. UnitedHealthcare Employer & Individual also distributes
products through wholesale agents or agencies that contract with health insurance carriers to distribute individual
or group benefits and provide other related services to their customers.
UnitedHealthcare Employer & Individual also distributes its products through professional employer
organizations, associations, private equity relationships and, increasingly, through both multi-carrier and its own
proprietary private exchange marketplaces. UnitedHealthcare Marketplace is a shopping platform for employers
seeking to offer their employees flexibility and a choice of UnitedHealthcare plans. UnitedHealthcare
Employer & Individual is also participating in select multi-plan exchanges that are structured to encourage
consumer choice. Direct-to-consumer sales are also supported by participation in multi-carrier health insurance
marketplaces for individuals and small groups through exchanges. In 2015, UnitedHealthcare Employer &
Individual participated in 23 individual and 12 small group state public exchanges and in 2016, will participate in
individual public exchange offerings in 34 states. The Company is evaluating its level of participation in
individual public exchange offerings for 2017. For more detail on our individual public exchange offerings, see
Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.”
UnitedHealthcare Employer & Individual’s diverse product portfolio offers a continuum of benefit designs, price
points and approaches to consumer engagement, which provides the flexibility to meet the needs of employers of
all sizes, as well as the needs of individuals shopping for health benefits coverage. Cost pressures are
accelerating demand for improved health care affordability and more coordinated care. UnitedHealthcare
Employer & Individual is responding to this demand with new network and contracting constructs (such as
performance incentives and benefit designs that direct more patients to higher-performing care providers),
alternative access to affordable and convenient care (such as through telehealth appointments with registered
nurses and physicians) and a new consumer-responsive service model called Advocate4Me.
UnitedHealthcare Employer & Individual offers its products through affiliates that are licensed as insurance
companies, health maintenance organizations (HMOs), or third-party administrators (TPAs). The market for
health benefit products is shifting, with benefit and network offerings shaped, at least in part, by the requirements
and effects of the Patient Protection and Affordable Care Act and a reconciliation measure, the Health Care and
Education Reconciliation Act of 2010 (together, Health Reform Legislation), increased employer focus on
quality and employee engagement and the urgent need to align the system around value.
Employers are seeking to offer comprehensive health benefits that improve the health and wellness of their
populations and as a result, lower overall health care costs, while improving employee satisfaction. By promoting
a healthy workforce, employers can maximize productivity and lower overall health care costs. UnitedHealthcare
Employer & Individual offers affordable products and actionable information to enable better health outcomes
and to help employers attract and retain talent. UnitedHealthcare Employer & Individual’s major product
families include:
Traditional Products. Traditional products include a full range of medical benefits and network options from
managed plans, such as Choice and Options PPO, to more traditional indemnity products. The plans offer a full
spectrum of covered services, including preventive care, direct access to specialists and catastrophic protection.
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