UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________ 
Form 10-Q
__________________________________________________________ 
[X]QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED MARCH 31,SEPTEMBER 30, 2018
or
[ ]TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM _______ TO _______
Commission file number:File Number: 1-10864
__________________________________________________________ 
    uhglogo1a01a01a15.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware 41-1321939
(State or other jurisdiction of
incorporation or organization)
 
(I.R.S. Employer
Identification No.)
   
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota
 55343
(Address of principal executive offices) (Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
__________________________________________________________  
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes [X] No [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act (check one)
Large accelerated filer[X] Accelerated filer[ ] Non-accelerated filer (Do not check if a smaller reporting company)[ ]
Smaller reporting company[ ]    Emerging growth company[ ]
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. [ ]
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes [ ] No [X]
As of April 30,October 31, 2018, there were 960,981,242962,034,200 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.
     

UNITEDHEALTH GROUP
Table of Contents
 
   Page   Page
  
  
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  


PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data) March 31,
2018
 December 31,
2017
 September 30,
2018
 December 31,
2017
Assets        
Current assets:        
Cash and cash equivalents $18,243
 $11,981
 $10,263
 $11,981
Short-term investments 3,798
 3,509
 3,586
 3,509
Accounts receivable, net 11,512
 9,568
 10,992
 9,568
Other current receivables, net 6,778
 6,262
 7,270
 6,262
Assets under management 2,922
 3,101
 2,936
 3,101
Prepaid expenses and other current assets 5,100
 2,663
 3,707
 2,663
Total current assets 48,353
 37,084
 38,754
 37,084
Long-term investments 29,441
 28,341
 31,929
 28,341
Property, equipment and capitalized software, net 8,144
 7,013
 8,042
 7,013
Goodwill 56,850
 54,556
 58,703
 54,556
Other intangible assets, net 9,033
 8,489
 9,498
 8,489
Other assets 3,748
 3,575
 4,161
 3,575
Total assets $155,569
 $139,058
 $151,087
 $139,058
Liabilities, redeemable noncontrolling interests and equity        
Current liabilities:        
Medical costs payable $19,589
 $17,871
 $19,850
 $17,871
Accounts payable and accrued liabilities 18,210
 15,180
 18,991
 15,180
Commercial paper and current maturities of long-term debt 7,379
 2,857
 1,500
 2,857
Unearned revenues 7,683
 2,269
 2,388
 2,269
Other current liabilities 14,806
 12,286
 13,648
 12,286
Total current liabilities 67,667
 50,463
 56,377
 50,463
Long-term debt, less current maturities 28,206
 28,835
 32,053
 28,835
Deferred income taxes 2,213
 2,182
 2,434
 2,182
Other liabilities 5,557
 5,556
 5,858
 5,556
Total liabilities 103,643
 87,036
 96,722
 87,036
Commitments and contingencies (Note 6) 

 

Commitments and contingencies (Note 7) 

 

Redeemable noncontrolling interests 1,890
 2,189
 1,769
 2,189
Equity:        
Preferred stock, $0.001 par value - 10 shares authorized; no shares issued or outstanding 
 
 
 
Common stock, $0.01 par value - 3,000 shares authorized; 962 and 969 issued and outstanding 10
 10
 10
 10
Additional paid-in capital 
 1,703
 
 1,703
Retained earnings 50,494
 48,730
 54,386
 48,730
Accumulated other comprehensive loss (2,951) (2,667) (4,386) (2,667)
Nonredeemable noncontrolling interests 2,483
 2,057
 2,586
 2,057
Total equity 50,036
 49,833
 52,596
 49,833
Total liabilities, redeemable noncontrolling interests and equity $155,569
 $139,058
 $151,087
 $139,058

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
 Three Months Ended March 31, Three Months Ended September 30, 
Nine Months Ended
September 30,
(in millions, except per share data) 2018 2017 2018 2017 2018 2017
Revenues:            
Premiums $44,084
 $38,938
 $44,613
 $39,552
 $133,155
 $118,075
Products 6,702
 6,129
 7,344
 6,665
 21,050
 19,209
Services 4,104
 3,434
 4,217
 3,858
 12,590
 11,089
Investment and other income 298
 222
 382
 247
 1,035
 725
Total revenues 55,188
 48,723
 56,556
 50,322
 167,830
 149,098
Operating costs:            
Medical costs 35,863
 32,079
 36,158
 32,201
 108,448
 96,829
Operating costs 8,506
 7,022
 8,479
 7,387
 25,371
 21,737
Cost of products sold 6,184
 5,676
 6,718
 6,068
 19,373
 17,633
Depreciation and amortization 582
 533
 611
 578
 1,791
 1,667
Total operating costs 51,135
 45,310
 51,966
 46,234
 154,983
 137,866
Earnings from operations 4,053
 3,413
 4,590
 4,088
 12,847
 11,232
Interest expense (329) (283) (353) (294) (1,026) (878)
Earnings before income taxes 3,724
 3,130
 4,237
 3,794
 11,821
 10,354
Provision for income taxes (800) (939) (953) (1,233) (2,603) (3,252)
Net earnings 2,924
 2,191
 3,284
 2,561
 9,218
 7,102
Earnings attributable to noncontrolling interests (88) (19) (96) (76) (272) (161)
Net earnings attributable to UnitedHealth Group common shareholders $2,836
 $2,172
 $3,188
 $2,485
 $8,946
 $6,941
Earnings per share attributable to UnitedHealth Group common shareholders:            
Basic $2.94
 $2.28
 $3.31
 $2.57
 $9.29
 $7.22
Diluted $2.87
 $2.23
 $3.24
 $2.51
 $9.09
 $7.06
Basic weighted-average number of common shares outstanding 966
 954
 962
 968
 963
 962
Dilutive effect of common share equivalents 21
 21
 21
 21
 21
 21
Diluted weighted-average number of common shares outstanding 987
 975
 983
 989
 984
 983
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents 7
 9
 7
 1
 7
 6
Cash dividends declared per common share $0.750
 $0.625

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)

 Three Months Ended March 31, Three Months Ended September 30, Nine Months Ended September 30,
(in millions) 2018 2017 2018 2017 2018 2017
Net earnings $2,924
 $2,191
 $3,284
 $2,561
 $9,218
 $7,102
Other comprehensive (loss) income:            
Gross unrealized (losses) gains on investment securities during the period (378) 99
 (91) 44
 (512) 313
Income tax effect 86
 (32) 21
 (17) 117
 (111)
Total unrealized (losses) gains, net of tax (292) 67
 (70) 27
 (395) 202
Gross reclassification adjustment for net realized gains included in net earnings (19) (21) (3) (10) (58) (51)
Income tax effect 4
 8
 
 4
 13
 19
Total reclassification adjustment, net of tax (15) (13) (3) (6) (45) (32)
Total foreign currency translation (loss) gain (1) 180
Total foreign currency translation (losses) gains (233) 217
 (1,303) 158
Other comprehensive (loss) income (308) 234
 (306) 238
 (1,743) 328
Comprehensive income 2,616
 2,425
 2,978
 2,799
 7,475
 7,430
Comprehensive income attributable to noncontrolling interests (88) (19) (96) (76) (272) (161)
Comprehensive income attributable to UnitedHealth Group common shareholders $2,528
 $2,406
 $2,882
 $2,723
 $7,203
 $7,269

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
 Common Stock Additional Paid-In Capital Retained Earnings 
Accumulated Other Comprehensive (Loss)
Income
 Nonredeemable Noncontrolling Interests 
Total
Equity
 Common Stock Additional Paid-In Capital Retained Earnings 
Accumulated Other Comprehensive (Loss)
Income
 Nonredeemable Noncontrolling Interests 
Total
Equity
(in millions) Shares Amount Net Unrealized (Losses) Gains on Investments Foreign Currency Translation (Losses) Gains  Shares Amount Net Unrealized (Losses) Gains on Investments Foreign Currency Translation (Losses) Gains 
Balance at January 1, 2018 969
 $10
 $1,703
 $48,730
 $(13) $(2,654) $2,057
 $49,833
 969
 $10
 $1,703
 $48,730
 $(13) $(2,654) $2,057
 $49,833
Adjustment to adopt ASU 2016-01 
 
 
 (24) 24
 
 
 
       (24) 24
     
Net earnings       2,836
     53
 2,889
       8,946
     183
 9,129
Other comprehensive loss         (307) (1)   (308)         (440) (1,303)   (1,743)
Issuances of common stock,
and related tax effects
 5
 
 415
         415
 9
 
 761
         761
Share-based compensation     206
         206
     493
         493
Common share repurchases (12) 
 (2,324) (326)       (2,650) (16) 
 (2,838) (812)       (3,650)
Cash dividends paid on common shares       (722)       (722)
Cash dividends paid on common shares ($2.55 per share)       (2,454)       (2,454)
Redeemable noncontrolling interests fair value and other adjustments     (119)         (119)
Acquisition of nonredeemable noncontrolling interests             423
 423
             518
 518
Distribution to nonredeemable noncontrolling interests             (50) (50)             (172) (172)
Balance at March 31, 2018 962
 $10
 $
 $50,494
 $(296) $(2,655) $2,483
 $50,036
Balance at September 30, 2018 962
 $10
 $
 $54,386
 $(429) $(3,957) $2,586
 $52,596
                                
Balance at January 1, 2017 952
 $10
 $
 $40,945
 $(97) $(2,584) $(97) $38,177
 952
 $10
 $
 $40,945
 $(97) $(2,584) $(97) $38,177
Net earnings       2,172
     9
 2,181
       6,941
     120
 7,061
Other comprehensive income         54
 180
   234
         170
 158
   328
Issuances of common stock, and related tax effects 17
 
 1,923
         1,923
 24
 
 2,156
         2,156
Share-based compensation     189
         189
     447
         447
Common share repurchases (4) 
 (682) 
       (682) (7) 
 (1,173) 

       (1,173)
Cash dividends paid on common shares       (596)       (596)
Cash dividends paid on common shares ($2.125 per share)       (2,046)       (2,046)
Redeemable noncontrolling interests fair value and other adjustments     389
         389
     371
         371
Acquisition of nonredeemable noncontrolling interests             2,191
 2,191
             2,111
 2,111
Distribution to nonredeemable noncontrolling interests             (11) (11)             (122) (122)
Balance at March 31, 2017 965
 $10
 $1,819
 $42,521
 $(43) $(2,404) $2,092
 $43,995
Balance at September 30, 2017 969
 $10
 $1,801
 $45,840
 $73
 $(2,426) $2,012
 $47,310


See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
 Three Months Ended March 31, Nine Months Ended September 30,
(in millions) 2018 2017 2018 2017
Operating activities        
Net earnings $2,924
 $2,191
 $9,218
 $7,102
Noncash items:        
Depreciation and amortization 582
 533
 1,791
 1,667
Deferred income taxes (74) (89) 9
 (459)
Share-based compensation 208
 196
 512
 456
Other, net 27
 43
 (136) 168
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:        
Accounts receivable (1,579) (1,232) (984) (244)
Other assets (3,232) (998) (1,641) (763)
Medical costs payable 1,313
 1,024
 1,745
 1,305
Accounts payable and other liabilities 2,821
 292
 2,783
 2,283
Unearned revenues 5,379
 4,496
 20
 4,658
Cash flows from operating activities 8,369
 6,456
 13,317
 16,173
Investing activities        
Purchases of investments (3,891) (3,683) (11,316) (10,626)
Sales of investments 1,002
 1,018
 2,872
 2,809
Maturities of investments 1,504
 1,326
 4,715
 4,251
Cash paid for acquisitions, net of cash assumed (2,583) (468) (5,824) (908)
Purchases of property, equipment and capitalized software (477) (507) (1,505) (1,391)
Other, net (72) 25
 (187) (30)
Cash flows used for investing activities (4,517) (2,289) (11,245) (5,895)
Financing activities        
Common share repurchases (2,650) (682) (3,650) (1,173)
Cash dividends paid (722) (596) (2,454) (2,046)
Proceeds from common stock issuances 295
 270
 745
 604
Repayments of long-term debt (1,100) (1,392) (2,600) (2,867)
Proceeds from (repayments of) commercial paper, net 4,259
 (139)
Repayments of commercial paper, net (164) (3,352)
Proceeds from issuance of long-term debt 
 1,342
 3,964
 1,342
Customer funds administered 2,962
 3,217
 1,552
 3,659
Other, net (622) (495) (1,086) (624)
Cash flows from financing activities 2,422
 1,525
Cash flows used for financing activities (3,693) (4,457)
Effect of exchange rate changes on cash and cash equivalents (12) 20
 (97) 18
Increase in cash and cash equivalents 6,262
 5,712
(Decrease) increase in cash and cash equivalents (1,718) 5,839
Cash and cash equivalents, beginning of period 11,981
 10,430
 11,981
 10,430
Cash and cash equivalents, end of period $18,243
 $16,142
 $10,263
 $16,269
        
Supplemental schedule of noncash investing activities        
Common stock issued for acquisition $
 $1,860
 $
 $2,164

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1.    Basis of Presentation
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and the “Company”) is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through its diversified family of businesses, the Company leverages core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2017 as filed with the SEC (2017 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to medical costs payable, revenues, and goodwill and other intangible assets. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Recently Issued Accounting Standards
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2016-02, “Leases (Topic 842)” (ASU, as modified by ASUs 2018-01, 2018-10 and 2018-11 (collectively, ASU 2016-02). Under ASU 2016-02, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both finance and operating leases. For leases with a term of 12 months or less, an entity can elect to not recognize lease assets and lease liabilities and expense the lease over a straight-line basis for the term of the lease. ASU 2016-02 will require new disclosures that depict the amount, timing and uncertainty of cash flows pertaining to an entity’s leases. Companies are required tomay adopt the new standard using a modified retrospective approach or a cumulative effect upon adoption approach for the annual and interim periods beginning after December 15, 2018. Early adoption of ASU 2016-02 is permitted. When adopted, ASU 2016-02 will not have a material impact on the Company’s balance sheet, results of operations, equity or cash flows.
Recently Adopted Accounting Standards
In January 2016, the FASB issued ASU 2016-01, “Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (ASU 2016-01). Most notably, the new guidance requires that equity investments, with certain exemptions, be measured at fair value with changes in fair value recognized in net income as opposed to other comprehensive income. The Company adopted ASU 2016-01 on a prospective basis effective January 1, 2018, as required, and reclassified $24 million from accumulated other comprehensive income to retained earnings.
The Company has determined that there have been no other recently adopted or issued accounting standards that had, or will have, a material impact on its Condensed Consolidated Financial Statements.

2.    Investments
A summary of debt securities by major security type is as follows:
(in millions) 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
March 31, 2018        
September 30, 2018        
Debt securities - available-for-sale:                
U.S. government and agency obligations $2,939
 $1
 $(54) $2,886
 $3,291
 $
 $(76) $3,215
State and municipal obligations 7,190
 43
 (94) 7,139
 6,962
 30
 (112) 6,880
Corporate obligations 14,411
 15
 (167) 14,259
 15,561
 10
 (208) 15,363
U.S. agency mortgage-backed securities 4,423
 3
 (110) 4,316
 4,846
 1
 (171) 4,676
Non-U.S. agency mortgage-backed securities 1,162
 
 (20) 1,142
 1,329
 
 (30) 1,299
Total debt securities - available-for-sale 30,125
 62
 (445) 29,742
 31,989
 41
 (597) 31,433
Debt securities - held-to-maturity:                
U.S. government and agency obligations 249
 1
 (2) 248
 246
 1
 (3) 244
State and municipal obligations 2
 
 
 2
 11
 
 
 11
Corporate obligations 340
 
 
 340
 342
 
 
 342
Total debt securities - held-to-maturity 591
 1
 (2) 590
 599
 1
 (3) 597
Total debt securities $30,716
 $63
 $(447) $30,332
 $32,588
 $42
 $(600) $32,030
December 31, 2017                
Debt securities - available-for-sale:                
U.S. government and agency obligations $2,673
 $1
 $(30) $2,644
 $2,673
 $1
 $(30) $2,644
State and municipal obligations 7,596
 99
 (35) 7,660
 7,596
 99
 (35) 7,660
Corporate obligations 13,181
 57
 (44) 13,194
 13,181
 57
 (44) 13,194
U.S. agency mortgage-backed securities 3,942
 7
 (38) 3,911
 3,942
 7
 (38) 3,911
Non-U.S. agency mortgage-backed securities 1,018
 3
 (6) 1,015
 1,018
 3
 (6) 1,015
Total debt securities - available-for-sale 28,410
 167
 (153) 28,424
 28,410
 167
 (153) 28,424
Debt securities - held-to-maturity:                
U.S. government and agency obligations 254
 1
 (1) 254
 254
 1
 (1) 254
State and municipal obligations 2
 
 
 2
 2
 
 
 2
Corporate obligations 280
 
 
 280
 280
 
 
 280
Total debt securities - held-to-maturity 536
 1
 (1) 536
 536
 1
 (1) 536
Total debt securities $28,946
 $168
 $(154) $28,960
 $28,946
 $168
 $(154) $28,960
The Company held $1.9 billion and $2.0 billion of equity securities as of March 31,September 30, 2018 and December 31, 2017, respectively.2017. The Company’s investments in equity securities primarily consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments and dividend paying stocks, with readily determinable fair values.
Additionally, the Company’s investments included $959 million$1.5 billion and $898 million$0.9 billion of equity method investments in operating businesses in the health care sector as of March 31,September 30, 2018 and December 31, 2017, respectively.

The amortized cost and fair value of debt securities as of March 31,September 30, 2018,, by contractual maturity, were as follows:
 Available-for-Sale Held-to-Maturity Available-for-Sale Held-to-Maturity
(in millions) 
Amortized
Cost
 
Fair
Value
 Amortized
Cost
 Fair
Value
 
Amortized
Cost
 
Fair
Value
 Amortized
Cost
 Fair
Value
Due in one year or less $3,923
 $3,915
 $135
 $135
 $3,683
 $3,675
 $145
 $145
Due after one year through five years 11,400
 11,273
 202
 200
 12,362
 12,197
 180
 178
Due after five years through ten years 6,874
 6,766
 103
 103
 7,194
 7,041
 102
 101
Due after ten years 2,343
 2,330
 151
 152
 2,575
 2,545
 172
 173
U.S. agency mortgage-backed securities 4,423
 4,316
 
 
 4,846
 4,676
 
 
Non-U.S. agency mortgage-backed securities 1,162
 1,142
 
 
 1,329
 1,299
 
 
Total debt securities $30,125
 $29,742
 $591
 $590
 $31,989
 $31,433
 $599
 $597
The fair value of available-for-sale debt securities with gross unrealized losses by security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
 Less Than 12 Months 12 Months or Greater  Total Less Than 12 Months 12 Months or Greater  Total
(in millions) 
Fair
Value
 
Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 
Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
March 31, 2018            
September 30, 2018            
Debt securities - available-for-sale:                        
U.S. government and agency obligations $1,787
 $(25) $945
 $(29) $2,732
 $(54) $2,025
 $(33) $1,068
 $(43) $3,093
 $(76)
State and municipal obligations 3,958
 (66) 781
 (28) 4,739
 (94) 3,471
 (54) 1,596
 (58) 5,067
 (112)
Corporate obligations 9,998
 (129) 1,193
 (38) 11,191
 (167) 9,933
 (136) 2,334
 (72) 12,267
 (208)
U.S. agency mortgage-backed securities 2,775
 (61) 1,127
 (49) 3,902
 (110) 2,762
 (74) 1,811
 (97) 4,573
 (171)
Non-U.S. agency mortgage-backed securities 863
 (15) 136
 (5) 999
 (20) 956
 (19) 265
 (11) 1,221
 (30)
Total debt securities - available-for-sale $19,381
 $(296) $4,182
 $(149) $23,563
 $(445) $19,147
 $(316) $7,074
 $(281) $26,221
 $(597)
December 31, 2017                        
Debt securities - available-for-sale:                        
U.S. government and agency obligations $1,249
 $(8) $1,027
 $(22) $2,276
 $(30) $1,249
 $(8) $1,027
 $(22) $2,276
 $(30)
State and municipal obligations 2,599
 (21) 866
 (14) 3,465
 (35) 2,599
 (21) 866
 (14) 3,465
 (35)
Corporate obligations 5,901
 (23) 1,242
 (21) 7,143
 (44) 5,901
 (23) 1,242
 (21) 7,143
 (44)
U.S. agency mortgage-backed securities 1,657
 (12) 1,162
 (26) 2,819
 (38) 1,657
 (12) 1,162
 (26) 2,819
 (38)
Non-U.S. agency mortgage-backed securities 411
 (3) 144
 (3) 555
 (6) 411
 (3) 144
 (3) 555
 (6)
Total debt securities - available-for-sale $11,817
 $(67) $4,441
 $(86) $16,258
 $(153) $11,817
 $(67) $4,441
 $(86) $16,258
 $(153)
The Company’s unrealized losses from debt securities as of March 31,September 30, 2018 were generated from 18,00020,000 positions out of a total of 28,00029,000 positions. The Company believes that it will collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. At each reporting period, the Company evaluates securities for impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality and credit ratings of the issuers, noting no significant deterioration since purchase. As of March 31,September 30, 2018,, the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary.
3.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.

For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions) 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair and Carrying
Value
 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair and Carrying
Value
March 31, 2018        
September 30, 2018        
Cash and cash equivalents $16,249
 $1,994
 $
 $18,243
 $10,220
 $43
 $
 $10,263
Debt securities - available-for-sale:                
U.S. government and agency obligations 2,631
 255
 
 2,886
 2,928
 287
 
 3,215
State and municipal obligations 
 7,139
 
 7,139
 
 6,880
 
 6,880
Corporate obligations 50
 14,068
 141
 14,259
 41
 15,163
 159
 15,363
U.S. agency mortgage-backed securities 
 4,316
 
 4,316
 
 4,676
 
 4,676
Non-U.S. agency mortgage-backed securities 
 1,142
 
 1,142
 
 1,299
 
 1,299
Total debt securities - available-for-sale 2,681
 26,920
 141
 29,742
 2,969
 28,305
 159
 31,433
Equity securities 1,791
 13
 143
 1,947
 1,885
 13
 100
 1,998
Assets under management 950
 1,972
 
 2,922
 993
 1,939
 4
 2,936
Total assets at fair value
$21,671
 $30,899
 $284
 $52,854

$16,067
 $30,300
 $263
 $46,630
Percentage of total assets at fair value 41% 58% 1% 100% 34% 65% 1% 100%
December 31, 2017                
Cash and cash equivalents $11,718
 $263
 $
 $11,981
 $11,718
 $263
 $
 $11,981
Debt securities - available-for-sale:                
U.S. government and agency obligations 2,428
 216
 
 2,644
 2,428
 216
 
 2,644
State and municipal obligations 
 7,660
 
 7,660
 
 7,660
 
 7,660
Corporate obligations 65
 12,989
 140
 13,194
 65
 12,989
 140
 13,194
U.S. agency mortgage-backed securities 
 3,911
 
 3,911
 
 3,911
 
 3,911
Non-U.S. agency mortgage-backed securities 
 1,015
 
 1,015
 
 1,015
 
 1,015
Total debt securities - available-for-sale 2,493
 25,791
 140
 28,424
 2,493
 25,791
 140
 28,424
Equity securities 1,784
 14
 194
 1,992
 1,784
 14
 194
 1,992
Assets under management 1,117
 1,984
 
 3,101
 1,117
 1,984
 
 3,101
Total assets at fair value $17,112
 $28,052
 $334
 $45,498
 $17,112
 $28,052
 $334
 $45,498
Percentage of total assets at fair value 38% 61% 1% 100% 38% 61% 1% 100%
Transfers between levels, if any, are recorded as of the beginning of the reporting period in which the transfer occurs; there were no transfers between Levels 1, 2 or 3 of any financial assets or liabilities during the threenine months ended March 31,September 30, 2018 or 2017.

The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions) 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair
Value
 Total Carrying Value 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair
Value
 Total Carrying Value
March 31, 2018          
September 30, 2018          
Debt securities - held-to-maturity $260
 $66
 $264
 $590
 $591
 $257
 $71
 $269
 $597
 $599
Long-term debt and other financing obligations $
 $32,892
 $
 $32,892
 $31,162
 $
 $34,908
 $
 $34,908
 $33,533
December 31, 2017                    
Debt securities - held-to-maturity $267
 $4
 $265
 $536
 $536
 $267
 $4
 $265
 $536
 $536
Long-term debt and other financing obligations $
 $34,504
 $
 $34,504
 $31,542
 $
 $34,504
 $
 $34,504
 $31,542
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the threenine months ended March 31,September 30, 2018 or 2017.
4.    Medical Costs Payable
The following table shows the components of the change in medical costs payable for the threenine months ended March 31:September 30:
(in millions) 2018 2017 2018 2017
Medical costs payable, beginning of period $17,871
 $16,391
 $17,871
 $16,391
Acquisitions 211
 76
 333
 76
Reported medical costs:        
Current year 36,153
 32,529
 108,658
 97,519
Prior years (290) (450) (210) (690)
Total reported medical costs 35,863
 32,079
 108,448
 96,829
Medical payments:        
Payments for current year (21,237) (18,742) (90,348) (81,237)
Payments for prior years (13,119) (12,154) (16,454) (14,096)
Total medical payments (34,356) (30,896) (106,802) (95,333)
Medical costs payable, end of period $19,589
 $17,650
 $19,850
 $17,963
For the threenine months ended March 31,September 30, 2018, and 2017, the medical cost reserve development included no individual factors that were significant. For the nine months ended September 30, 2017, the medical cost reserve development was primarily driven by lower than expected health system utilization levels. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of $13.3$13.8 billion and $12.3 billion at March 31,September 30, 2018 and December 31, 2017, respectively.

5.    Commercial Paper and Long-Term Debt
Commercial paper and senior unsecured long-term debt consisted of the following:
 March 31, 2018 December 31, 2017 September 30, 2018 December 31, 2017
(in millions, except percentages) Par
Value
 
Carrying
Value
 
Fair
Value
 
Par
Value
 Carrying
Value
 
Fair
Value
 Par
Value
 Carrying
Value
 Fair
Value
 Par
Value
 Carrying
Value
 Fair
Value
Commercial paper $4,427
 $4,423
 $4,423
 $150
 $150
 $150
 $20
 $20
 $20
 $150
 $150
 $150
6.000% notes due February 2018 
 
 
 1,100
 1,101
 1,106
 
 
 
 1,100
 1,101
 1,106
1.900% notes due July 2018 1,500
 1,499
 1,498
 1,500
 1,499
 1,501
 
 
 
 1,500
 1,499
 1,501
1.700% notes due February 2019 750
 749
 744
 750
 749
 747
 750
 750
 747
 750
 749
 747
1.625% notes due March 2019 500
 501
 495
 500
 501
 497
 500
 500
 498
 500
 501
 497
2.300% notes due December 2019 500
 491
 495
 500
 495
 501
 500
 492
 496
 500
 495
 501
2.700% notes due July 2020 1,500
 1,497
 1,493
 1,500
 1,496
 1,517
 1,500
 1,497
 1,491
 1,500
 1,496
 1,517
Floating rate notes due October 2020 300
 299
 299
 300
 299
 300
 300
 299
 300
 300
 299
 300
3.875% notes due October 2020 450
 441
 459
 450
 446
 467
 450
 439
 456
 450
 446
 467
1.950% notes due October 2020 900
 896
 879
 900
 895
 892
 900
 897
 881
 900
 895
 892
4.700% notes due February 2021 400
 398
 418
 400
 403
 425
 400
 395
 412
 400
 403
 425
2.125% notes due March 2021 750
 747
 731
 750
 746
 744
 750
 747
 732
 750
 746
 744
Floating rate notes due June 2021 350
 349
 350
 
 
 
3.150% notes due June 2021 400
 398
 399
 
 
 
3.375% notes due November 2021 500
 485
 504
 500
 493
 516
 500
 481
 502
 500
 493
 516
2.875% notes due December 2021 750
 729
 743
 750
 741
 760
 750
 724
 741
 750
 741
 760
2.875% notes due March 2022 1,100
 1,037
 1,088
 1,100
 1,054
 1,114
 1,100
 1,031
 1,083
 1,100
 1,054
 1,114
3.350% notes due July 2022 1,000
 996
 1,005
 1,000
 996
 1,033
 1,000
 997
 999
 1,000
 996
 1,033
2.375% notes due October 2022 900
 893
 866
 900
 893
 891
 900
 894
 863
 900
 893
 891
0.000% notes due November 2022 15
 12
 12
 15
 12
 12
 15
 12
 12
 15
 12
 12
2.750% notes due February 2023 625
 594
 611
 625
 606
 626
 625
 588
 606
 625
 606
 626
2.875% notes due March 2023 750
 745
 738
 750
 762
 759
 750
 734
 731
 750
 762
 759
3.500% notes due June 2023 750
 746
 752
 
 
 
3.750% notes due July 2025 2,000
 1,988
 2,026
 2,000
 1,987
 2,108
 2,000
 1,989
 2,010
 2,000
 1,987
 2,108
3.100% notes due March 2026 1,000
 995
 969
 1,000
 995
 1,007
 1,000
 995
 961
 1,000
 995
 1,007
3.450% notes due January 2027 750
 745
 743
 750
 745
 776
 750
 745
 734
 750
 745
 776
3.375% notes due April 2027 625
 619
 615
 625
 618
 642
 625
 619
 607
 625
 618
 642
2.950% notes due October 2027 950
 937
 903
 950
 937
 947
 950
 938
 890
 950
 937
 947
3.850% notes due June 2028 1,150
 1,142
 1,153
 
 
 
4.625% notes due July 2035 1,000
 991
 1,094
 1,000
 991
 1,165
 1,000
 991
 1,064
 1,000
 991
 1,165
5.800% notes due March 2036 850
 838
 1,042
 850
 837
 1,105
 850
 838
 1,013
 850
 837
 1,105
6.500% notes due June 2037 500
 492
 660
 500
 491
 698
 500
 492
 640
 500
 491
 698
6.625% notes due November 2037 650
 641
 869
 650
 641
 923
 650
 641
 844
 650
 641
 923
6.875% notes due February 2038 1,100
 1,075
 1,511
 1,100
 1,075
 1,596
 1,100
 1,076
 1,467
 1,100
 1,075
 1,596
5.700% notes due October 2040 300
 296
 371
 300
 296
 389
 300
 296
 358
 300
 296
 389
5.950% notes due February 2041 350
 345
 443
 350
 345
 466
 350
 345
 428
 350
 345
 466
4.625% notes due November 2041 600
 588
 644
 600
 588
 685
 600
 588
 630
 600
 588
 685
4.375% notes due March 2042 502
 483
 524
 502
 483
 555
 502
 484
 510
 502
 483
 555
3.950% notes due October 2042 625
 607
 614
 625
 607
 650
 625
 607
 596
 625
 607
 650
4.250% notes due March 2043 750
 734
 771
 750
 734
 822
 750
 734
 749
 750
 734
 822
4.750% notes due July 2045 2,000
 1,972
 2,201
 2,000
 1,972
 2,362
 2,000
 1,972
 2,140
 2,000
 1,972
 2,362
4.200% notes due January 2047 750
 738
 759
 750
 738
 808
 750
 738
 743
 750
 738
 808
4.250% notes due April 2047 725
 717
 741
 725
 717
 798
 725
 717
 728
 725
 717
 798
3.750% notes due October 2047 950
 933
 895
 950
 933
 969
 950
 933
 883
 950
 933
 969
4.250% notes due June 2048 1,350
 1,329
 1,355
 
 
 
Total commercial paper and long-term debt $34,594
 $34,166
 $35,896
 $31,417
 $31,067
 $34,029
 $32,687
 $32,199
 $33,574
 $31,417
 $31,067
 $34,029
The Company’s long-term debt obligations included $1.4 billion and $625 million of other financing obligations, of which $207$230 million and $107 million were classified as current as of March 31,September 30, 2018 and December 31, 2017, respectively.

Commercial Paper and Bank Credit Facilities
Commercial paper consists of short-duration, senior unsecured debt privately placed on a discount basis through broker-dealers. As of March 31,September 30, 2018,, the Company’s outstanding commercial paper had a weighted-averageweighted average annual interest rate of 2.0%2.1%.

The Company has $3.0 billion five-year, $3.0 billion three-year and $4.0 billion 364-day revolving bank credit facilities with 26 banks, which mature in December 2022, December 2020 and December 2018, respectively. These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of March 31,September 30, 2018, no amounts had been drawn on any of the bank credit facilities. The annual interest rates, which are variable based on term, are calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. If amounts had been drawn on the bank credit facilities as of March 31,September 30, 2018, annual interest rates would have ranged from 2.7%3.1% to 3.3%3.4%.
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. The Company was in compliance with its debt covenants as of March 31,September 30, 2018.
6.    Shareholders' Equity
Share Repurchase Program
In June 2018, the Company’s Board of Directors renewed the Company’s share repurchase program with an authorization to repurchase up to 100 million shares of the Company’s common stock. The following table provides details of the Company’s share repurchase activity for the nine months endedSeptember 30, 2018:
(in millions, except per share data)  
Common share repurchases, shares 16
Common share repurchases, average price per share $232.61
Common share repurchases, aggregate cost $3,650
Board authorized shares remaining 98
Dividends
In June 2018, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to an annual dividend rate of $3.60 per share from $3.00 per share, which the Company had paid since June 2017. Declaration and payment of future quarterly dividends is at the discretion of the Board and may be adjusted as business needs or market conditions change.
The following table provides details of the Company’s 2018 dividend payments:
Payment Date Amount per Share Total Amount Paid
    (in millions)
March 20 $0.75
 $722
June 26 0.90
 866
September 18 0.90
 866
7.    Commitments and Contingencies
Legal Matters
Because of the nature of its businesses, the Company is frequently made party to a variety of legal actions and regulatory inquiries, including class actions and suits brought by members, care providers, consumer advocacy organizations, customers and regulators, relating to the Company’s businesses, including management and administration of health benefit plans and other services. These matters include medical malpractice, employment, intellectual property, antitrust, privacy and contract claims and claims related to health care benefits coverage and other business practices.
The Company records liabilities for its estimates of probable costs resulting from these matters where appropriate. Estimates of costs resulting from legal and regulatory matters involving the Company are inherently difficult to predict, particularly where the matters: involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or represent a shift in regulatory policy; involve a large number of claimants or regulatory bodies; are in the

early stages of the proceedings; or could result in a change in business practices. Accordingly, the Company is often unable to estimate the losses or ranges of losses for those matters where there is a reasonable possibility or it is probable that a loss may be incurred.
Government Investigations, Audits and Reviews
The Company has been involved or is currently involved in various governmental investigations, audits and reviews. These include routine, regular and special investigations, audits and reviews by the Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, the Brazilian national regulatory agency for private health insurance and plans (the Agência Nacional de Saúde Suplementar), state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice, the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the Brazilian federal revenue service (the Secretaria da Receita Federal), the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the Department of Justice (DOJ) announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges that the Company made improper risk adjustment submissions and violated the False Claims Act. On February 12, 2018, the court granted in part and denied in part the Company’s motion to dismiss. In May 2018, DOJ moved to dismiss the Company’s counterclaims, which were filed in March 2018, and moved for partial summary judgment. Those motions were argued in September 2018. The Company cannot reasonably estimate the outcome that may result from this matter given its procedural status.

7.8.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx. For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2017 10-K.
The following tables present reportable segment financial information:
   Optum       Optum    
(in millions) UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum 
Corporate and
Eliminations
 Consolidated UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum 
Corporate and
Eliminations
 Consolidated
Three Months Ended March 31, 2018                
Three Months Ended September 30, 2018                
Revenues - unaffiliated customers:                                
Premiums $43,237
 $847
 $
 $
 $
 $847
 $
 $44,084
 $43,628
 $985
 $
 $
 $
 $985
 $
 $44,613
Products 
 12
 23
 6,667
 
 6,702
 
 6,702
 
 13
 29
 7,302
 
 7,344
 
 7,344
Services 2,039
 1,188
 740
 137
 
 2,065
 
 4,104
 2,067
 1,196
 790
 164
 
 2,150
 
 4,217
Total revenues - unaffiliated customers 45,276
 2,047
 763
 6,804
 
 9,614
 
 54,890
 45,695
 2,194
 819
 7,466
 
 10,479
 
 56,174
Total revenues - affiliated customers 
 3,606
 1,304
 9,295
 (333) 13,872
 (13,872) 
 
 3,733
 1,431
 9,960
 (352) 14,772
 (14,772) 
Investment and other income 183
 106
 2
 7
 
 115
 
 298
 242
 125
 4
 11
 
 140
 
 382
Total revenues $45,459
 $5,759
 $2,069
 $16,106
 $(333) $23,601
 $(13,872) $55,188
 $45,937
 $6,052
 $2,254
 $17,437
 $(352) $25,391
 $(14,772) $56,556
Earnings from operations $2,400
 $488
 $395
 $770
 $
 $1,653
 $
 $4,053
 $2,559
 $622
 $534
 $875
 $
 $2,031
 $
 $4,590
Interest expense 
 
 
 
 
 
 (329) (329) 
 
 
 
 
 
 (353) (353)
Earnings before income taxes $2,400
 $488
 $395
 $770
 $
 $1,653
 $(329) $3,724
 $2,559
 $622
 $534
 $875
 $
 $2,031
 $(353) $4,237
Three Months Ended March 31, 2017                
Three Months Ended September 30, 2017                
Revenues - unaffiliated customers:                                
Premiums $38,053
 $885
 $
 $
 $
 $885
 $
 $38,938
 $38,576
 $976
 $
 $
 $
 $976
 $
 $39,552
Products 
 12
 21
 6,096
 
 6,129
 
 6,129
 
 10
 29
 6,626
 
 6,665
 
 6,665
Services 1,922
 721
 642
 149
 
 1,512
 
 3,434
 2,005
 1,040
 677
 136
 
 1,853
 
 3,858
Total revenues - unaffiliated customers 39,975
 1,618
 663
 6,245
 
 8,526
 
 48,501
 40,581
 2,026
 706
 6,762
 
 9,494
 
 50,075
Total revenues - affiliated customers 
 3,059
 1,179
 8,698
 (286) 12,650
 (12,650) 
 
 3,138
 1,297
 9,186
 (324) 13,297
 (13,297) 
Investment and other income 161
 56
 1
 4
 
 61
 
 222
 153
 88
 1
 5
 
 94
 
 247
Total revenues $40,136
 $4,733
 $1,843
 $14,947
 $(286) $21,237
 $(12,650) $48,723
 $40,734
 $5,252
 $2,004
 $15,953
 $(324) $22,885
 $(13,297) $50,322
Earnings from operations $2,134
 $332
 $294
 $653
 $
 $1,279
 $
 $3,413
 $2,391
 $513
 $414
 $770
 $
 $1,697
 $
 $4,088
Interest expense 
 
 
 
 
 
 (283) (283) 
 
 
 
 
 
 (294) (294)
Earnings before income taxes $2,134
 $332
 $294
 $653
 $
 $1,279
 $(283) $3,130
 $2,391
 $513
 $414
 $770
 $
 $1,697
 $(294) $3,794


    Optum    
(in millions) UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum 
Corporate and
Eliminations
 Consolidated
Nine Months Ended September 30, 2018                
Revenues - unaffiliated customers:                
Premiums $130,361
 $2,794
 $
 $
 $
 $2,794
 $
 $133,155
Products 
 37
 72
 20,941
 
 21,050
 
 21,050
Services 6,248
 3,587
 2,306
 449
 
 6,342
 
 12,590
Total revenues - unaffiliated customers 136,609
 6,418
 2,378
 21,390
 
 30,186
 
 166,795
Total revenues - affiliated customers 
 10,979
 4,115
 29,062
 (1,026) 43,130
 (43,130) 
Investment and other income 633
 355
 15
 32
 
 402
 
 1,035
Total revenues $137,242
 $17,752
 $6,508
 $50,484
 $(1,026) $73,718
 $(43,130) $167,830
Earnings from operations $7,316
 $1,680
 $1,382
 $2,469
 $
 $5,531
 $
 $12,847
Interest expense 
 
 
 
 
 
 (1,026) (1,026)
Earnings before income taxes $7,316
 $1,680
 $1,382
 $2,469
 $
 $5,531
 $(1,026) $11,821
Nine Months Ended September 30, 2017                
Revenues - unaffiliated customers:                
Premiums $115,295
 $2,780
 $
 $
 $
 $2,780
 $
 $118,075
Products 
 33
 69
 19,107
 
 19,209
 
 19,209
Services 5,885
 2,769
 2,011
 424
 
 5,204
 
 11,089
Total revenues - unaffiliated customers 121,180
 5,582
 2,080
 19,531
 
 27,193
 
 148,373
Total revenues - affiliated customers 
 9,294
 3,757
 27,196
 (894) 39,353
 (39,353) 
Investment and other income 478
 231
 3
 13
 
 247
 
 725
Total revenues $121,658
 $15,107
 $5,840
 $46,740
 $(894) $66,793
 $(39,353) $149,098
Earnings from operations $6,736
 $1,267
 $1,080
 $2,149
 $
 $4,496
 $
 $11,232
Interest expense 
 
 
 
 
 
 (878) (878)
Earnings before income taxes $6,736
 $1,267
 $1,080
 $2,149
 $
 $4,496
 $(878) $10,354


ITEM 2.MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion should be read together with the accompanying Condensed Consolidated Financial Statements and Notes and with our 2017 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 2017 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a diversified health care company dedicated to helping people live healthier lives and helping make the health system work better for everyone. Through our diversified family of businesses, we leverage core competencies in data and health information; advanced technology; and clinical expertise to help meet the demands of the health system. These core competencies are deployed within our two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K and additional information on our segments can be found in this Item 2 and in Note 78 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the United States, South American and certain other international health markets. In the United States, health care spending has grown consistently for many years and comprises approximately 19%18% of gross domestic product. We expect overall spending on health care to continue to grow in the future due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macro-economic conditions and regulatory changes, which have impacted and could further impact our results of operations.
Pricing Trends. To price our health care benefit products, we start with our view of expected future costs, including theany impact offrom the Health Insurance Industry Tax. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations, including minimum medical loss ratio (MLR) thresholds. We will continue seeking to balance growth and profitability across all of these dimensions.
The commercial risk market remains highly competitive in both the small group and large group segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs amid reform changes. In 2019, there will be a one year moratorium on the collection of the Health Insurance Industry Tax. Pricing for contracts that cover some portion of calendar year 2019 will reflect the impact of the moratorium.
Medicare Advantage funding continuesGovernment programs in the public and senior sector tend to be pressured, as discussed below in “Regulatory Trendsreceive lower rates of increase than the commercial market due to governmental budget pressures and Uncertainties.”intrinsically lower cost trends.
Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, health system utilization and prescription drug costs. We endeavor to mitigate those increases by engaging physicians and consumers with information and helping them make clinically sound choices, with the objective of helping them achieve high quality, affordable care.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of theregulatory trends and uncertainties related to Medicare Advantage rates.uncertainties. For additional information regarding regulatory trends and uncertainties, see Part I, Item 1 “Business - Government Regulation,” Part 1, Item 1A, “Risk Factors” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2017 10-K.

Medicare Advantage Rates. Final 2019 Medicare Advantage rates resulted in an increase in industry base rates of approximately 3.4%, short of the industry forward medical cost trend, which creates continued pressure in the Medicare Advantage program. The impact of this funding shortfall in Medicare Advantage is partially mitigated by reductions in provider payments for those care providers with rates indexed to Medicare Advantage revenues or Medicare fee-for-service payment rates. These factors can affect our plan benefit designs, pricing, growth prospects and earnings expectations for our Medicare Advantage plans.
The Tax Cut and Jobs Act (Tax Reform). Tax Reform was enacted by the U.S federal government in December 2017, changing existing federal tax law, including reducing the U.S. corporate income tax rate. With theThe impact of Tax Reform is partially offset by the return of the nondeductible Health Insurance Industry Tax we expect that our effective tax rate in 2018 will be approximately 24%.2018.
Health Insurance Industry Tax. After a moratorium in 2017, the industry-wide amount of the Health Insurance Industry Tax in 2018 will beis $14.3 billion, and we expectwith our portion to be approximately $2.8being $2.6 billion. The return of the tax impacts year over yearyear-over-year comparability of our financial statements, including revenue,revenues, the medical care ratio (MCR), operating cost ratio and effective tax rate. A one year moratorium on the collection of the Health Insurance Industry Tax will occur in 2019.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select firstthird quarter 2018 year-over-year operating comparisons to firstthird quarter 2017 and other 2018 significant items.
Consolidated revenues grew 13%12%, UnitedHealthcare revenues grew 13% and Optum revenues grew 11%.
UnitedHealthcare served 465,00075,000 fewer people primarily as a result of completion of its commitment to the 2.9 million people under the TRICARE military health care program, partially offset by the addition of 22.2 million people through acquisition and the remainder from organic growth.
Earnings from operations increased 19%12%, including increases of 12%7% at UnitedHealthcare and 29%20% at Optum.
Due primarily to the impact of Tax Reform, our effective income tax rate decreased 850 basis10 percentage points to 21.5%22.5%.
Diluted earnings per common share increased 29%.
Cash flows from operations for the nine months ended were $8.4 billion, aided by the March receipt of our April CMS premium payment of $5.1$13.3 billion.

RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data) Three Months Ended March 31, Increase/(Decrease) Three Months Ended September 30, Increase/(Decrease) Nine Months Ended September 30, Increase/(Decrease)
2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017
Revenues:                        
Premiums $44,084
 $38,938
 $5,146
 13% $44,613
 $39,552
 $5,061
 13% $133,155
 $118,075
 $15,080
 13%
Products 6,702
 6,129
 573
 9
 7,344
 6,665
 679
 10
 21,050
 19,209
 1,841
 10
Services 4,104
 3,434
 670
 20
 4,217
 3,858
 359
 9
 12,590
 11,089
 1,501
 14
Investment and other income 298
 222
 76
 34
 382
 247
 135
 55
 1,035
 725
 310
 43
Total revenues 55,188
 48,723
 6,465
 13
 56,556
 50,322
 6,234
 12
 167,830
 149,098
 18,732
 13
Operating costs:                        
Medical costs 35,863
 32,079
 3,784
 12
 36,158
 32,201
 3,957
 12
 108,448
 96,829
 11,619
 12
Operating costs 8,506
 7,022
 1,484
 21
 8,479
 7,387
 1,092
 15
 25,371
 21,737
 3,634
 17
Cost of products sold 6,184
 5,676
 508
 9
 6,718
 6,068
 650
 11
 19,373
 17,633
 1,740
 10
Depreciation and amortization 582
 533
 49
 9
 611
 578
 33
 6
 1,791
 1,667
 124
 7
Total operating costs 51,135
 45,310
 5,825
 13
 51,966
 46,234
 5,732
 12
 154,983
 137,866
 17,117
 12
Earnings from operations 4,053
 3,413
 640
 19
 4,590
 4,088
 502
 12
 12,847
 11,232
 1,615
 14
Interest expense (329) (283) (46) 16
 (353) (294) (59) 20
 (1,026) (878) (148) 17
Earnings before income taxes 3,724
 3,130
 594
 19
 4,237
 3,794
 443
 12
 11,821
 10,354
 1,467
 14
Provision for income taxes (800) (939) 139
 (15) (953) (1,233) 280
 (23) (2,603) (3,252) 649
 (20)
Net earnings 2,924
 2,191
 733
 33
 3,284
 2,561
 723
 28
 9,218
 7,102
 2,116
 30
Earnings attributable to noncontrolling interests (88) (19) (69) 363
 (96) (76) (20) 26
 (272) (161) (111) 69
Net earnings attributable to UnitedHealth Group common shareholders $2,836
 $2,172
 $664
 31 % $3,188
 $2,485
 $703
 28 % $8,946
 $6,941
 $2,005
 29 %
Diluted earnings per share attributable to UnitedHealth Group common shareholders $2.87
 $2.23
 $0.64
 29 % $3.24
 $2.51
 $0.73
 29 % $9.09
 $7.06
 $2.03
 29 %
Medical care ratio (a) 81.4% 82.4% (1.0)%   81.0% 81.4% (0.4)%   81.4% 82.0% (0.6)%  
Operating cost ratio 15.4
 14.4
 1.0
   15.0
 14.7
 0.3
   15.1
 14.6
 0.5
  
Operating margin 7.3
 7.0
 0.3
   8.1
 8.1
 
   7.7
 7.5
 0.2
  
Tax rate 21.5
 30.0
 (8.5)   22.5
 32.5
 (10.0)   22.0
 31.4
 (9.4)  
Net earnings margin (b) 5.1
 4.5
 0.6
   5.6
 4.9
 0.7
   5.3
 4.7
 0.6
  
Return on equity (c) 23.8% 21.7% 2.1 %   25.9% 22.5% 3.4 %   24.6% 22.0% 2.6 %  
                   
(a)Medical care ratio is calculated as medical costs divided by premium revenue.
(b)Net earnings margin attributable to UnitedHealth Group shareholders.
(c)Return on equity is calculated as annualized net earnings divided by average equity. Average equity is calculated using the equity balance at the end of the preceding year and the equity balances at the end of each of the quarters in the year presented.
2018 RESULTS OF OPERATIONS COMPARED TO 2017 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenue
The increase in revenue was primarily driven by the increase in the number of individuals served through risk-based products across our UnitedHealthcare benefits businesses, pricing trends, including for the return of the Health Insurance Industry Tax in 2018, and growth across the Optum business.business, primarily due to expansion in care delivery, pharmacy care services, and outsourcing and advisory services.
Medical Costs and MCR
Medical costs increased due to growth in people served through risk-based products and medical cost trends. The MCR decreased due to the revenue effects of the Health Insurance Industry Tax, partiallywhich more than offset by elevated flu-related illness costs.business mix changes and lower favorable reserve development.
Income Tax Rate
Our effective tax rate decreased due to the impact of Tax Reform, which was partially offset by the return of the nondeductible Health Insurance Industry Tax.

Reportable Segments
See Note 78 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information on our segments. The following table presents a summary of the reportable segment financial information:
 Three Months Ended March 31, Increase/(Decrease) Three Months Ended September 30, Increase/(Decrease) Nine Months Ended September 30, Increase/(Decrease)
(in millions, except percentages) 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017
Revenues                        
UnitedHealthcare $45,459
 $40,136
 $5,323
 13% $45,937
 $40,734
 $5,203
 13% $137,242
 $121,658
 $15,584
 13%
OptumHealth 5,759
 4,733
 1,026
 22
 6,052
 5,252
 800
 15
 17,752
 15,107
 2,645
 18
OptumInsight 2,069
 1,843
 226
 12
 2,254
 2,004
 250
 12
 6,508
 5,840
 668
 11
OptumRx 16,106
 14,947
 1,159
 8
 17,437
 15,953
 1,484
 9
 50,484
 46,740
 3,744
 8
Optum eliminations (333) (286) (47) 16
 (352) (324) (28) 9
 (1,026) (894) (132) 15
Optum 23,601
 21,237
 2,364
 11
 25,391
 22,885
 2,506
 11
 73,718
 66,793
 6,925
 10
Eliminations (13,872) (12,650) (1,222) 10
 (14,772) (13,297) (1,475) 11
 (43,130) (39,353) (3,777) 10
Consolidated revenues $55,188
 $48,723
 $6,465
 13% $56,556
 $50,322
 $6,234
 12% $167,830
 $149,098
 $18,732
 13%
Earnings from operations                        
UnitedHealthcare $2,400
 $2,134
 $266
 12% $2,559
 $2,391
 $168
 7% $7,316
 $6,736
 $580
 9%
OptumHealth 488
 332
 156
 47
 622
 513
 109
 21
 1,680
 1,267
 413
 33
OptumInsight 395
 294
 101
 34
 534
 414
 120
 29
 1,382
 1,080
 302
 28
OptumRx 770
 653
 117
 18
 875
 770
 105
 14
 2,469
 2,149
 320
 15
Optum 1,653
 1,279
 374
 29
 2,031
 1,697
 334
 20
 5,531
 4,496
 1,035
 23
Consolidated earnings from operations $4,053
 $3,413
 $640
 19% $4,590
 $4,088
 $502
 12% $12,847
 $11,232
 $1,615
 14%
Operating margin                        
UnitedHealthcare 5.3% 5.3% %   5.6% 5.9% (0.3)%   5.3% 5.5% (0.2)%  
OptumHealth 8.5
 7.0
 1.5
   10.3
 9.8
 0.5
   9.5
 8.4
 1.1
  
OptumInsight 19.1
 16.0
 3.1
   23.7
 20.7
 3.0
   21.2
 18.5
 2.7
  
OptumRx 4.8
 4.4
 0.4
   5.0
 4.8
 0.2
   4.9
 4.6
 0.3
  
Optum 7.0
 6.0
 1.0
   8.0
 7.4
 0.6
   7.5
 6.7
 0.8
  
Consolidated operating margin 7.3% 7.0% 0.3%   8.1% 8.1%  %   7.7% 7.5% 0.2 %  
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended March 31, Increase/(Decrease) Three Months Ended September 30, Increase/(Decrease) Nine Months Ended September 30, Increase/(Decrease)
(in millions, except percentages) 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017
UnitedHealthcare Employer & Individual $13,414
 $12,739
 $675
 5% $13,734
 $13,054
 $680
 5% $40,856
 $38,759
 $2,097
 5%
UnitedHealthcare Medicare & Retirement 18,925
 16,552
 2,373
 14
 18,789
 16,306
 2,483
 15
 56,573
 49,605
 6,968
 14
UnitedHealthcare Community & State 10,671
 8,949
 1,722
 19
 11,054
 9,378
 1,676
 18
 32,471
 27,505
 4,966
 18
UnitedHealthcare Global 2,449
 1,896
 553
 29
 2,360
 1,996
 364
 18
 7,342
 5,789
 1,553
 27
Total UnitedHealthcare revenues $45,459
 $40,136
 $5,323
 13% $45,937
 $40,734
 $5,203
 13% $137,242
 $121,658
 $15,584
 13%

The following table summarizes the number of individuals served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
 March 31, Increase/(Decrease) September 30, Increase/(Decrease)
(in thousands, except percentages) 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017
Commercial group:                
Risk-based 7,860
 7,695
 165
 2 % 7,955
 7,805
 150
 2 %
Fee-based 18,475
 19,155
 (680) (4) 18,365
 18,610
 (245) (1)
Total commercial group 26,335
 26,850
 (515) (2) 26,320
 26,415
 (95) 
Individual 475
 585
 (110) (19) 495
 515
 (20) (4)
Fee-based TRICARE 
 2,860
 (2,860) (100) 
 2,855
 (2,855) (100)
Total commercial 26,810
 30,295
 (3,485) (12) 26,815
 29,785
 (2,970) (10)
Medicare Advantage 4,760
 4,305
 455
 11
 4,915
 4,390
 525
 12
Medicaid 6,695
 6,200
 495
 8
 6,630
 6,375
 255
 4
Medicare Supplement (Standardized) 4,490
 4,350
 140
 3
 4,540
 4,415
 125
 3
Total public and senior 15,945
 14,855
 1,090
 7
 16,085
 15,180
 905
 6
Total UnitedHealthcare - domestic medical 42,755
 45,150
 (2,395) (5) 42,900
 44,965
 (2,065) (5)
International 6,095
 4,165
 1,930
 46
 6,070
 4,080
 1,990
 49
Total UnitedHealthcare - medical 48,850
 49,315
 (465) (1)% 48,970
 49,045
 (75)  %
Supplemental Data:                
Medicare Part D stand-alone 4,770
 4,955
 (185) (4)% 4,725
 4,945
 (220) (4)%
Broad-based growth, primarily in services to small groups, resulted in theThe overall increase in people served through risk-based benefit plans in the commercial group market.market was driven by broad-based growth, primarily in services to small groups. Fee-based commercial group business declined primarily due to the non-renewal of one public sector customer in the third quarter of 2017.attrition at certain large commercial accounts. Medicare Advantage increased year-over-year due to growth in people served through individual and employer-sponsored group Medicare Advantage plans. Medicaid growth was driven by the combination of new state-based awards and growth in established programs. Medicare Supplement growth reflected strong customer retention and new sales. International growth was primarily driven by an acquisition in the first quarter.
UnitedHealthcare’s revenue and earnings from operations increased due to growth in the number of individuals served across its risk-based businesses, a higher revenue membership mix, rate increases for underlying medical cost trends and the impact of the return of the Health Insurance Industry Tax. Earnings from operations increased, as the operating margin remained consistent.
Optum
Total revenues and earnings from operations increased as each segment reported increased revenues and earnings from operations as a result of productivity and overall cost management initiatives in addition to the factors discussed below.
The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth primarily due to organic and acquisition-related growth in care delivery and behavioral health, digital customerconsumer engagement and health financial services.
OptumInsight
Revenue and earnings from operations at OptumInsight increased primarily due to organic and acquisition-related growth in payer technology and servicesbusiness process outsourcing and care provider advisory services.
OptumRx
Revenue and earnings from operations at OptumRx increased primarily due to customergrowth in specialty pharmacy, home delivery services, and overall prescription growth. OptumRx fulfilled 332331 million and 322321 million adjusted scripts, in the firstthird quarters of 2018 and 2017, respectively.

LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Summary of our Major Sources and Uses of Cash and Cash Equivalents
 Three Months Ended March 31, Increase/(Decrease) Nine Months Ended September 30, Increase/(Decrease)
(in millions) 2018 2017 2018 vs. 2017 2018 2017 2018 vs. 2017
Sources of cash:            
Cash provided by operating activities $8,369
 $6,456
 $1,913
 $13,317
 $16,173
 $(2,856)
Issuances of commercial paper and long-term debt, net of repayments 3,159
 
 3,159
 1,200
 
 1,200
Proceeds from common stock issuances 295
 270
 25
 745
 604
 141
Customer funds administered 2,962
 3,217
 (255) 1,552
 3,659
 (2,107)
Other 
 25
 (25)
Total sources of cash 14,785
 9,968
   16,814
 20,436
  
Uses of cash:            
Common stock repurchases (2,650) (682) (1,968) (3,650) (1,173) (2,477)
Cash paid for acquisitions, net of cash assumed (2,583) (468) (2,115) (5,824) (908) (4,916)
Purchases of investments, net of sales and maturities (1,385) (1,339) (46) (3,729) (3,566) (163)
Repayments of commercial paper and long-term debt, net of issuances 
 (189) 189
 
 (4,877) 4,877
Purchases of property, equipment and capitalized software (477) (507) 30
 (1,505) (1,391) (114)
Cash dividends paid (722) (596) (126) (2,454) (2,046) (408)
Other (694) (495) (199) (1,273) (654) (619)
Total uses of cash (8,511) (4,276)   (18,435) (14,615)  
Effect of exchange rate changes on cash and cash equivalents (12) 20
 (32) (97) 18
 (115)
Net increase in cash and cash equivalents $6,262
 $5,712
 $550
Net (decrease) increase in cash and cash equivalents $(1,718) $5,839
 $(7,557)
2018 Cash Flows Compared to 2017 Cash Flows
IncreasedDecreased cash flows provided by operating activities were primarily driven by the increasea decrease in unearned revenues due to the increase in the MarchSeptember 2017 receipt of our AprilOctober CMS premium payment of $5.1$4.6 billion, compared to $4.4 billion, for 2018 and 2017, respectively,offset by higher net earnings, and the year-over-year impact of the return of the Health Insurance Industry Tax. In October 2018, we paid our portion of the 2018 Health Insurance Industry Tax of $2.6 billion.
Other significant changes in sources or uses of cash year-over-year included net issuances of debt in 2018 compared to net repayments in 2017, an increase in cash paid for acquisitions, andincreased share repurchases partially offset by net issuancesand a decrease in customer funds administered primarily due to the September 2017 receipt of commercial paper in 2018.our October CMS payment.
Financial Condition
As of March 31,September 30, 2018, our cash, cash equivalent, available-for-sale debt securities and equity securities balances of $50$44 billion included $18approximately $10 billion of cash and cash equivalents (of which $1$0.9 billion was available for general corporate use), $30$31 billion of debt securities and $2 billion of investments in equity securities. Given the significant portion of our portfolio held in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt portfolio had a weighted-average duration of 3.23.3 years and a weighted-average credit rating of “Double A” as of March 31,September 30, 2018. When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Commercial Paper and Bank Credit Facilities. Our revolving bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through third-party broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.

Our revolving bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. As of March 31,September 30, 2018, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 40%37%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, such as to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. For more information on our long-term debt, see Note 5 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Credit Ratings. Our credit ratings as of March 31,September 30, 2018 were as follows:
  
Moody’s S&P Global Fitch A.M. Best
 Ratings Outlook Ratings Outlook Ratings Outlook Ratings Outlook
Senior unsecured debtA3 Stable A+ Stable A- Stable bbb+A- Stable
Commercial paperP-2 n/a A-1 n/a F1 n/a AMB-2AMB-1 n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. For example, a significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. During the three months ended March 31, 2018, we repurchased 12 million shares at an average price of $228.16 per share. As of March 31,September 30, 2018, we had Board authorization to purchase up to an additional 3198 million shares of our common stock. For more information on our share repurchase program, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Dividends. OurIn June 2018, our Board increased our quarterly cash dividend to shareholders reflectsto an annual dividend rate of $3.00$3.60 per share. For more information on our dividend, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
For additional liquidity discussion, see Note 10 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2017 was disclosed in our 2017 10-K. During the threenine months ended March 31,September 30, 2018, there were no material changes to this previously disclosed information outside the ordinary course of business. However, we continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
RECENTLY ISSUED ACCOUNTING STANDARDS
See Note 1 of Notes to the Condensed Consolidated Financial Statements in Part I, Item 1 of this report for a discussion of new accounting pronouncements that affect us.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments, assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates, and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable, revenues, and goodwill and other intangible assets. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2017 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in our 2017 10-K.

FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements within the meaning of the PSLRA. These statements are intended to take advantage of the “safe harbor” provisions of the PSLRA. Generally the words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements, which generally are not historical in nature. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. We caution that actual results could differ materially from those that management expects, depending on the outcome of certain factors.
Some factors that could cause actual results to differ materially from results discussed or implied in the forward-looking statements include: our ability to effectively estimate, price for and manage our medical costs, including the impact of any new coverage requirements; new laws or regulations, or changes in existing laws or regulations, or their enforcement or application, including increases in medical, administrative, technology or other costs or decreases in enrollment resulting from U.S., South American and other jurisdictions’ regulations affecting the health care industry; the outcome of the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in CMS star ratings and other quality scores that impact revenue; reductions in revenue or delays to cash flows received under Medicare, Medicaid and other government programs, including the effects of a prolonged U.S. government shutdown or debt ceiling constraints; changes in Medicare, including changes in payment methodology, the CMS star ratings program or the application of risk adjustment data validation audits; cyber-attacks or other privacy or data security incidents; failure to comply with privacy and data security regulations; regulatory and other risks and uncertainties of the pharmacy benefits management industry; competitive pressures, which could affect our ability to maintain or increase our market share; changes in or challenges to our public sector contract awards; our ability to execute contracts on competitive terms with physicians, hospitals and other service providers; failure to achieve targeted operating cost productivity improvements, including savings resulting from technology enhancement and administrative modernization; increases in costs and other liabilities associated with increased litigation, government investigations, audits or reviews; failure to manage successfully our strategic alliances or complete or receive anticipated benefits of acquisitions and other strategic transactions, fluctuations in foreign currency exchange rates on our reported shareholders’ equity and results of operations; downgrades in our credit ratings; the performance of our investment portfolio; impairment of the value of our goodwill and intangible assets if estimated future results do not adequately support goodwill and intangible assets recorded for our existing businesses or the businesses that we acquire; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; and our ability to obtain sufficient funds from our regulated subsidiaries or the debt or capital markets to fund our obligations, to maintain our debt to total capital ratio at targeted levels, to maintain our quarterly dividend payment cycle or to continue repurchasing shares of our common stock.
This list of important factors is not intended to be exhaustive. We discuss certain of these matters more fully, as well as certain risk factors that may affect our business operations, financial condition and results of operations, in our other periodic and current filings with the SEC, including our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K. Any or all forward-looking statements we make may turn out to be wrong, and can be affected by inaccurate assumptions we might make or by known or unknown risks and uncertainties. By their nature, forward-looking statements are not guarantees of future performance or results and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Actual future results may vary materially from expectations expressed or implied in this document or any of our prior communications. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made. We do not undertake to update or revise any forward-looking statements, except as required by applicable securities laws.
ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We manage exposure to market interest rates by diversifying investments across different fixed-income market sectors and debt across maturities, as well as by endeavoring to match our floating-rate assets and liabilities over time, either directly or through the use of interest rate swap contracts. Unrealized gains and losses on investments in available-for-sale debt securities are reported in comprehensive income.

The following table summarizes the impact of hypothetical changes in market interest rates across the entire yield curve by 1% point or 2% points as of March 31,September 30, 2018 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
 March 31, 2018 September 30, 2018
Increase (Decrease) in Market Interest Rate 
Investment
Income Per
Annum (a)
 
Interest
Expense Per
Annum (a)
 Fair Value of
Financial Assets (b)
 
Fair Value of
Financial Liabilities
 
Investment
Income Per
Annum (a)
 
Interest
Expense Per
Annum
 Fair Value of
Financial Assets (b)
 
Fair Value of
Financial Liabilities
2 % $426
 $262
 $(2,037) $(4,148) $261
 $187
 $(2,192) $(4,652)
1 213
 131
 (1,035) (2,241) 131
 94
 (1,118) (2,557)
(1) (213) (131) 1,021
 2,654
 (131) (94) 1,109
 2,814
(2) (340) (205) 1,980
 5,817
 (254) (187) 2,167
 6,283
                 
(a)Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of March 31,September 30, 2018, the assumed hypothetical change in interest rates does not reflect the full 200 basis point reduction in interest expenseinvestment income as the rate cannot fall below zero.
(b)
As of March 31,September 30, 2018, some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
ITEM 4.    CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this quarterly report on Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of March 31,September 30, 2018. Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of March 31,September 30, 2018.
CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended March 31,September 30, 2018 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

PART II. OTHER INFORMATION
ITEM 1.LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to Note 67 of Notes to the Condensed Consolidated Financial Statements contained in Part I, Item 1 of this report.
ITEM 1A.RISK FACTORS
ITEM 1A.    RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” of our 2017 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2017 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or future results.
There have been no material changes to the risk factors disclosed in our 2017 10-K.
ITEM 2.UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
In November 1997, our Board of Directors adopted a share repurchase program, which the Board evaluates periodically. There is no established expiration date for the program. During the firstthird quarter 2018, we repurchased approximately 122 million shares at an average price of $228.16$259.78 per share. As of March 31,September 30, 2018, we had Board authorization to purchase up to 3198 million shares of our common stock.


ITEM 6.EXHIBITS*

The following exhibits are filed or incorporated by reference herein in response to Item 601 of Regulation S-K. The Company files Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q and Current Reports on Form 8-K pursuant to the Securities Exchange Act of 1934 under Commission File No. 1-10864.

 

 
4.1
 Senior Indenture, dated as of November 15, 1998, between United HealthCare Corporation and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3/A, SEC File Number 333-66013, filed on January 11, 1999)

 

 

 


 

 
101
 The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended March 31,September 30, 2018 filed on May 7,November 8, 2018, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
 ________________
* Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.


SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
UNITEDHEALTH GROUP INCORPORATED
 
/s/ DAVID S. WICHMANN
 Chief Executive Officer
(principal executive officer)
Dated:May 7,November 8, 2018
David S. Wichmann    
   
/s/ JOHN F. REX
 
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:May 7,November 8, 2018
John F. Rex    
   
/s/S/ THOMAS E. ROOS
 
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:May 7,November 8, 2018
Thomas E. Roos    


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