UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________ 
Form 10-Q
__________________________________________________________ 
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, 2020
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: 1-10864
__________________________________________________________ 
unh-20200930_g1.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware41-1321939
(State or other jurisdiction of

incorporation or organization)
(I.R.S. Employer

Identification No.)
UnitedHealth Group Center55343
9900 Bren Road East
Minnetonka,Minnesota
(Address of principal executive offices)(Zip Code)
(952) (952) 936-1300
(Registrant’s telephone number, including area code)
_________________________________________________________  
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $.01 par valueUNHNYSE
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 No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted 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 such files).    Yes  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
Large accelerated filerAccelerated filerNon-accelerated filer
Smaller reporting companyEmerging 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 
As of AprilOctober 30, 2020, there were 948,379,502948,820,710 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.




UNITEDHEALTH GROUP
Table of Contents
 

    Page
     
 
  
  
  
  
  
  
  
  
  
  
  
  
  
 






PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data) March 31,
2020
 December 31,
2019
Assets    
Current assets:    
Cash and cash equivalents $21,569
 $10,985
Short-term investments 2,876
 3,260
Accounts receivable, net 14,613
 11,822
Other current receivables, net 10,275
 9,640
Assets under management 2,866
 3,076
Prepaid expenses and other current assets 6,608
 3,851
Total current assets 58,807
 42,634
Long-term investments 36,578
 37,209
Property, equipment and capitalized software, net 8,173
 8,704
Goodwill 65,302
 65,659
Other intangible assets, net 10,199
 10,349
Other assets 10,008
 9,334
Total assets $189,067
 $173,889
Liabilities, redeemable noncontrolling interests and equity    
Current liabilities:    
Medical costs payable $22,772
 $21,690
Accounts payable and accrued liabilities 22,845
 19,005
Short-term borrowings and current maturities of long-term debt 15,828
 3,870
Unearned revenues 2,509
 2,622
Other current liabilities 14,652
 14,595
Total current liabilities 78,606
 61,782
Long-term debt, less current maturities 35,779
 36,808
Deferred income taxes 3,030
 2,993
Other liabilities 10,048
 10,144
Total liabilities 127,463
 111,727
Commitments and contingencies (Note 6) 


 


Redeemable noncontrolling interests 1,741
 1,726
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; 947 and 948 issued and outstanding 10
 9
Additional paid-in capital 
 7
Retained earnings 62,327
 61,178
Accumulated other comprehensive loss (5,360) (3,578)
Nonredeemable noncontrolling interests 2,886
 2,820
Total equity 59,863
 60,436
Total liabilities, redeemable noncontrolling interests and equity $189,067
 $173,889

(in millions, except per share data)September 30,
2020
December 31,
2019
Assets
Current assets:
Cash and cash equivalents$17,550 $10,985 
Short-term investments3,259 3,260 
Accounts receivable, net12,171 11,822 
Other current receivables, net13,231 9,640 
Assets under management3,788 3,076 
Prepaid expenses and other current assets4,822 3,851 
Total current assets54,821 42,634 
Long-term investments39,184 37,209 
Property, equipment and capitalized software, net8,151 8,704 
Goodwill68,088 65,659 
Other intangible assets, net10,373 10,349 
Other assets10,352 9,334 
Total assets$190,969 $173,889 
Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable$21,167 $21,690 
Accounts payable and accrued liabilities21,173 19,005 
Short-term borrowings and current maturities of long-term debt3,899 3,870 
Unearned revenues2,391 2,622 
Other current liabilities17,967 14,595 
Total current liabilities66,597 61,782 
Long-term debt, less current maturities39,895 36,808 
Deferred income taxes3,340 2,993 
Other liabilities11,186 10,144 
Total liabilities121,018 111,727 
Commitments and contingencies (Note 7)
Redeemable noncontrolling interests1,847 1,726 
Equity:
Preferred stock, $0.001 par value - 10 shares authorized; 0 shares issued or outstanding
Common stock, $0.01 par value - 3,000 shares authorized; 949 and 948 issued and outstanding10 
Additional paid-in capital
Retained earnings69,715 61,178 
Accumulated other comprehensive loss(4,494)(3,578)
Nonredeemable noncontrolling interests2,873 2,820 
Total equity68,104 60,436 
Total liabilities, redeemable noncontrolling interests and equity$190,969 $173,889 

1

UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
  Three Months Ended March 31,
(in millions, except per share data) 2020 2019
Revenues:    
Premiums $50,640
 $47,513
Products 8,431
 8,072
Services 4,985
 4,318
Investment and other income 365
 405
Total revenues 64,421
 60,308
Operating costs:    
Medical costs 41,000
 38,939
Operating costs 10,015
 8,517
Cost of products sold 7,687
 7,381
Depreciation and amortization 723
 639
Total operating costs 59,425
 55,476
Earnings from operations 4,996
 4,832
Interest expense (437) (400)
Earnings before income taxes 4,559
 4,432
Provision for income taxes (1,094) (875)
Net earnings 3,465
 3,557
Earnings attributable to noncontrolling interests (83) (90)
Net earnings attributable to UnitedHealth Group common shareholders $3,382
 $3,467
Earnings per share attributable to UnitedHealth Group common shareholders:    
Basic $3.56
 $3.62
Diluted $3.52
 $3.56
Basic weighted-average number of common shares outstanding 949
 958
Dilutive effect of common share equivalents 13
 17
Diluted weighted-average number of common shares outstanding 962
 975
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents 10
 8

 Three Months Ended
September 30,
Nine Months Ended
September 30,
(in millions, except per share data)2020201920202019
Revenues:
Premiums$50,863 $47,397 $150,897 $142,074 
Products8,777 7,546 25,455 23,971 
Services5,124 4,942 14,265 13,756 
Investment and other income351 466 1,057 1,453 
Total revenues65,115 60,351 191,674 181,254 
Operating costs:
Medical costs41,636 39,041 117,314 117,164 
Operating costs10,174 8,960 30,190 25,892 
Cost of products sold7,935 6,627 23,123 21,606 
Depreciation and amortization719 709 2,159 2,002 
Total operating costs60,464 55,337 172,786 166,664 
Earnings from operations4,651 5,014 18,888 14,590 
Interest expense(395)(449)(1,262)(1,267)
Earnings before income taxes4,256 4,565 17,626 13,323 
Provision for income taxes(1,000)(936)(4,209)(2,752)
Net earnings3,256 3,629 13,417 10,571 
Earnings attributable to noncontrolling interests(84)(91)(226)(273)
Net earnings attributable to UnitedHealth Group common shareholders$3,172 $3,538 $13,191 $10,298 
Earnings per share attributable to UnitedHealth Group common shareholders:
Basic$3.34 $3.73 $13.90 $10.82 
Diluted$3.30 $3.67 $13.73 $10.65 
Basic weighted-average number of common shares outstanding950 949 949 952 
Dilutive effect of common share equivalents12 14 12 15 
Diluted weighted-average number of common shares outstanding962 963 961 967 
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents12 10 

2

UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)

  Three Months Ended March 31,
(in millions) 2020 2019
Net earnings $3,465
 $3,557
Other comprehensive (loss) income:    
Gross unrealized (losses) gains on investment securities during the period (349) 520
Income tax effect 80
 (119)
Total unrealized (losses) gains, net of tax (269) 401
Gross reclassification adjustment for net realized (gains) losses included in net earnings (18) 4
Income tax effect 4
 (1)
Total reclassification adjustment, net of tax (14) 3
Total foreign currency translation losses (1,499) (2)
Other comprehensive (loss) income (1,782) 402
Comprehensive income 1,683
 3,959
Comprehensive income attributable to noncontrolling interests (83) (90)
Comprehensive income attributable to UnitedHealth Group common shareholders $1,600
 $3,869

 Three Months Ended September 30,Nine Months Ended September 30,
(in millions)2020201920202019
Net earnings$3,256 $3,629 $13,417 $10,571 
Other comprehensive income (loss):
Gross unrealized gains on investment securities during the period148 230 919 1,243 
Income tax effect(37)(53)(214)(285)
Total unrealized gains, net of tax111 177 705 958 
Gross reclassification adjustment for net realized gains included in net earnings(21)(69)(50)(70)
Income tax effect16 12 16 
Total reclassification adjustment, net of tax(16)(53)(38)(54)
Total foreign currency translation losses(39)(560)(1,583)(453)
Other comprehensive income (loss)56 (436)(916)451 
Comprehensive income3,312 3,193 12,501 11,022 
Comprehensive income attributable to noncontrolling interests(84)(91)(226)(273)
Comprehensive income attributable to UnitedHealth Group common shareholders$3,228 $3,102 $12,275 $10,749 

3


UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common StockAdditional Paid-In CapitalRetained EarningsAccumulated Other Comprehensive
Income (Loss)
Nonredeemable Noncontrolling InterestsTotal
Equity
Three months ended September 30,
(in millions)
Three months ended September 30,
(in millions)
SharesAmountNet Unrealized Gains on InvestmentsForeign Currency Translation Losses
Balance at June 30, 2020Balance at June 30, 2020950 $10 $388 $67,776 $1,161 $(5,711)$2,891 $66,515 
Net earningsNet earnings3,172 62 3,234 
Other comprehensive income (loss)Other comprehensive income (loss)95 (39)56 
Issuances of common stock, and related tax effectsIssuances of common stock, and related tax effects321 321 
Share-based compensationShare-based compensation131 131 
Common share repurchasesCommon share repurchases(3)(805)(45)(850)
Cash dividends paid on common shares ($1.25 per share)Cash dividends paid on common shares ($1.25 per share)(1,188)(1,188)
Redeemable noncontrolling interests fair value and other adjustmentsRedeemable noncontrolling interests fair value and other adjustments(35)(35)
Acquisition and other adjustments of nonredeemable noncontrolling interestsAcquisition and other adjustments of nonredeemable noncontrolling interests(8)(8)
Distribution to nonredeemable noncontrolling interestsDistribution to nonredeemable noncontrolling interests(72)(72)
Balance at September 30, 2020Balance at September 30, 2020949 $10 $$69,715 $1,256 $(5,750)$2,873 $68,104 
 Common Stock Additional Paid-In Capital Retained Earnings 
Accumulated Other Comprehensive
Income (Loss)
 Nonredeemable Noncontrolling Interests 
Total
Equity
 Shares Amount Net Unrealized Gains (Losses) on Investments Foreign Currency Translation Losses 
Balance at January 1, 2020 948
 $9
 $7
 $61,178
 $589
 $(4,167) $2,820
 $60,436
Adjustment to adopt ASU 2016-13       (28)       (28)
Balance at June 30, 2019Balance at June 30, 2019948 $$$56,367 $516 $(3,789)$2,751 $55,854 
Net earnings       3,382
     59
 3,441
Net earnings3,538 82 3,620 
Other comprehensive (loss) income         (283) (1,499)   (1,782)
Other comprehensive income (loss)Other comprehensive income (loss)124 (560)(436)
Issuances of common stock,
and related tax effects
 5
 1
 320
         321
Issuances of common stock, and related tax effects277 277 
Share-based compensation     234
         234
Share-based compensation130 130 
Common share repurchases (6) 
 (510) (1,181)       (1,691)Common share repurchases(3)(415)(185)(600)
Cash dividends paid on common shares ($1.08 per share)       (1,024)       (1,024)Cash dividends paid on common shares ($1.08 per share)(1,024)(1,024)
Redeemable noncontrolling interests fair value and other adjustments     (51)         (51)Redeemable noncontrolling interests fair value and other adjustments
Acquisition and other adjustments of nonredeemable noncontrolling interests             50
 50
Acquisition and other adjustments of nonredeemable noncontrolling interests(7)(7)
Distribution to nonredeemable noncontrolling interests             (43) (43)Distribution to nonredeemable noncontrolling interests(66)(66)
Balance at March 31, 2020 947
 $10
 $
 $62,327
 $306
 $(5,666) $2,886
 $59,863
                
Balance at January 1, 2019 960
 $10
 $
 $55,846
 $(264) $(3,896) $2,623
 $54,319
Adjustment to adopt ASU 2016-02       (13)     (5) (18)
Net earnings       3,467
     60
 3,527
Other comprehensive income (loss)         404
 (2)   402
Issuances of common stock, and related tax effects 5
 
 56
         56
Share-based compensation     239
         239
Common share repurchases (12) 
 (34) (2,968)       (3,002)
Cash dividends paid on common shares ($0.90 per share)       (860)       (860)
Redeemable noncontrolling interests fair value and other adjustments     (152)         (152)
Acquisition and other adjustments of nonredeemable noncontrolling interests     (109)       132
 23
Distribution to nonredeemable noncontrolling interests             (83) (83)
Balance at March 31, 2019 953
 $10
 $
 $55,472
 $140
 $(3,898) $2,727
 $54,451
Balance at September 30, 2019Balance at September 30, 2019947 $$$58,696 $640 $(4,349)$2,760 $57,756 

4

UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
Common StockAdditional Paid-In CapitalRetained EarningsAccumulated Other Comprehensive
Income (Loss)
Nonredeemable Noncontrolling InterestsTotal
Equity
Nine months ended September 30,
(in millions)
SharesAmountNet Unrealized Gains (Losses) on InvestmentsForeign Currency Translation Losses
Balance at January 1, 2020948 $$$61,178 $589 $(4,167)$2,820 $60,436 
Adjustment to adopt ASU 2016-13(28)(28)
Net earnings13,191 159 13,350 
Other comprehensive income (loss)667 (1,583)(916)
Issuances of common stock, and related tax effects10 928 929 
Share-based compensation509 509 
Common share repurchases(9)(1,315)(1,226)(2,541)
Cash dividends paid on common shares ($3.58 per share)(3,400)(3,400)
Redeemable noncontrolling interests fair value and other adjustments(129)(129)
Acquisition and other adjustments of nonredeemable noncontrolling interests42 42 
Distribution to nonredeemable noncontrolling interests(148)(148)
Balance at September 30, 2020949 $10 $$69,715 $1,256 $(5,750)$2,873 $68,104 
Balance at January 1, 2019960 $10 $$55,846 $(264)$(3,896)$2,623 $54,319 
Adjustment to adopt ASU 2016-02(13)(5)(18)
Net earnings10,298 196 10,494 
Other comprehensive income (loss)904 (453)451 
Issuances of common stock, and related tax effects438 438 
Share-based compensation521 521 
Common share repurchases(21)(1)(573)(4,527)(5,101)
Cash dividends paid on common shares ($3.06 per share)(2,908)(2,908)
Redeemable noncontrolling interests fair value and other adjustments(277)(277)
Acquisition and other adjustments of nonredeemable noncontrolling interests(109)157 48 
Distribution to nonredeemable noncontrolling interests(211)(211)
Balance at September 30, 2019947 $$$58,696 $640 $(4,349)$2,760 $57,756 
5

UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
  Three Months Ended March 31,
(in millions) 2020 2019
Operating activities    
Net earnings $3,465
 $3,557
Noncash items:    
Depreciation and amortization 723
 639
Deferred income taxes 202
 134
Share-based compensation 231
 243
Other, net 45
 42
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:    
Accounts receivable (2,652) (1,421)
Other assets (4,249) (1,495)
Medical costs payable 1,120
 1,125
Accounts payable and other liabilities 4,137
 318
Unearned revenues (79) 92
Cash flows from operating activities 2,943

3,234
Investing activities    
Purchases of investments (3,866) (3,540)
Sales of investments 2,170
 1,510
Maturities of investments 1,726
 1,711
Cash paid for acquisitions, net of cash assumed (929) (689)
Purchases of property, equipment and capitalized software (469) (562)
Other, net (165) 154
Cash flows used for investing activities (1,533) (1,416)
Financing activities    
Common share repurchases (1,691) (3,002)
Cash dividends paid (1,024) (860)
Proceeds from common stock issuances 557
 323
Repayments of long-term debt 
 (1,250)
Proceeds from short-term borrowings, net 10,797
 3,101
Customer funds administered 1,062
 1,784
Other, net (398) (368)
Cash flows from (used for) financing activities 9,303
 (272)
Effect of exchange rate changes on cash and cash equivalents (129) (5)
Increase in cash and cash equivalents 10,584
 1,541
Cash and cash equivalents, beginning of period 10,985
 10,866
Cash and cash equivalents, end of period $21,569
 $12,407
     

 Nine Months Ended September 30,
(in millions)20202019
Operating activities
Net earnings$13,417 $10,571 
Noncash items:
Depreciation and amortization2,159 2,002 
Deferred income taxes119 177 
Share-based compensation527 525 
Other, net48 (181)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable(194)957 
Other assets(2,697)(2,181)
Medical costs payable(615)223 
Accounts payable and other liabilities3,441 105 
Unearned revenues(132)60 
Cash flows from operating activities16,073 12,258 
Investing activities
Purchases of investments(11,570)(13,386)
Sales of investments4,887 6,198 
Maturities of investments5,297 5,160 
Cash paid for acquisitions, net of cash assumed(4,326)(8,200)
Purchases of property, equipment and capitalized software(1,477)(1,421)
Other, net(165)338 
Cash flows used for investing activities(7,354)(11,311)
Financing activities
Common share repurchases(2,541)(5,101)
Cash dividends paid(3,400)(2,908)
Proceeds from common stock issuances1,206 740 
Repayments of long-term debt(1,500)(1,250)
(Repayments of) proceeds from short-term borrowings, net(423)3,998 
Proceeds from issuance of long-term debt4,864 5,444 
Customer funds administered249 420 
Other, net(449)(756)
Cash flows (used for) from financing activities(1,994)587 
Effect of exchange rate changes on cash and cash equivalents(160)(37)
Increase in cash and cash equivalents6,565 1,497 
Cash and cash equivalents, beginning of period10,985 10,866 
Cash and cash equivalents, end of period$17,550 $12,363 

6

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;information, advanced technology;technology and clinical expertise. 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 and Supplementary Data” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 as filed with the SEC (2019 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 include medical costs payable and goodwill. 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.
Revenue from Products
For the quarterthree and nine months ended March 31,September 30, 2020, the Company recognized revenue and cost of products sold for retail pharmacy co-payments related to its OptumRx business. Revenue recognized in prior periods related to retail pharmacy transactions excludes the member’s applicable co-payment. There was no impact on earnings from operations, net earnings, earnings per share or total equity.
Recently Adopted Accounting Standards
In June 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2016-13, “Financial Instruments - Credit Losses (Topic 326)” (ASU 2016-13). ASU 2016-13 requires the use of the current expected credit loss impairment model to develop an estimate of expected credit losses for certain financial assets. ASU 2016-13 also requires expected credit losses on available-for-sale debt securities to be recognized through an allowance for credit losses and revises certain disclosure requirements. The Company adopted ASU 2016-13 on January 1, 2020 using a cumulative effect upon adoption approach. The adoption of ASU 2016-13 was immaterial to the Company’s consolidated balance sheet, results of operations, equity and cash flows.
Under the current expected credit loss impairment model, the Company evaluates an available-for-sale debt security for credit-related impairment by considering the present value of expected cash flows relative to a security’s amortized cost, the extent to which fair value is less than amortized cost, the financial condition and near-term prospects of the issuer and specific events or circumstances that may influence the operations of the issuer. Credit-related impairments are recorded as an allowance, with an offset to investment and other income. Non-credit related impairments are recorded through other comprehensive income. If the Company intends to sell an impaired security, or will likely be required to sell a security before recovery of the entire amortized cost, the entire impairment is included in net 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.

7

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
March 31, 2020        
Debt securities - available-for-sale:        
U.S. government and agency obligations $3,146
 $183
 $(1) $3,328
State and municipal obligations 5,724
 214
 (20) 5,918
Corporate obligations 17,923
 182
 (411) 17,694
U.S. agency mortgage-backed securities 6,508
 260
 
 6,768
Non-U.S. agency mortgage-backed securities 1,932
 28
 (36) 1,924
Total debt securities - available-for-sale 35,233
 867
 (468) 35,632
Debt securities - held-to-maturity:        
U.S. government and agency obligations 410
 9
 
 419
State and municipal obligations 31
 2
 
 33
Corporate obligations 284
 
 (1) 283
Total debt securities - held-to-maturity 725
 11
 (1) 735
Total debt securities $35,958
 $878
 $(469) $36,367
December 31, 2019        
Debt securities - available-for-sale:        
U.S. government and agency obligations $3,502
 $55
 $(4) $3,553
State and municipal obligations 5,680
 251
 (5) 5,926
Corporate obligations 17,910
 343
 (11) 18,242
U.S. agency mortgage-backed securities 6,425
 109
 (6) 6,528
Non-U.S. agency mortgage-backed securities 1,811
 37
 (3) 1,845
Total debt securities - available-for-sale 35,328
 795
 (29) 36,094
Debt securities - held-to-maturity:        
U.S. government and agency obligations 402
 2
 
 404
State and municipal obligations 32
 2
 
 34
Corporate obligations 538
 
 (1) 537
Total debt securities - held-to-maturity 972
 4
 (1) 975
Total debt securities $36,300
 $799
 $(30) $37,069

(in millions)Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
September 30, 2020
Debt securities - available-for-sale:
U.S. government and agency obligations$3,374 $160 $$3,534 
State and municipal obligations6,311 377 (4)6,684 
Corporate obligations18,461 778 (35)19,204 
U.S. agency mortgage-backed securities6,523 270 (3)6,790 
Non-U.S. agency mortgage-backed securities2,033 98 (6)2,125 
Total debt securities - available-for-sale36,702 1,683 (48)38,337 
Debt securities - held-to-maturity:
U.S. government and agency obligations422 429 
State and municipal obligations31 33 
Corporate obligations245 246 
Total debt securities - held-to-maturity698 10 708 
Total debt securities$37,400 $1,693 $(48)$39,045 
December 31, 2019
Debt securities - available-for-sale:
U.S. government and agency obligations$3,502 $55 $(4)$3,553 
State and municipal obligations5,680 251 (5)5,926 
Corporate obligations17,910 343 (11)18,242 
U.S. agency mortgage-backed securities6,425 109 (6)6,528 
Non-U.S. agency mortgage-backed securities1,811 37 (3)1,845 
Total debt securities - available-for-sale35,328 795 (29)36,094 
Debt securities - held-to-maturity:
U.S. government and agency obligations402 404 
State and municipal obligations32 34 
Corporate obligations538 (1)537 
Total debt securities - held-to-maturity972 (1)975 
Total debt securities$36,300 $799 $(30)$37,069 
The Company held $1.7$2.1 billion and $2.0 billion of equity securities as of March 31,September 30, 2020 and December 31, 2019, respectively. The Company’s investments in equity securities primarily consist of employee savings plan related investments and shares of Brazilian real denominated fixed-income funds with readily determinable fair values. Additionally, the Company’s investments included $1.3 billion and $1.4 billion of equity method investments in operating businesses in the health care sector as of March 31,September 30, 2020 and December 31, 2019.2019, respectively. The allowance for credit losses on held-to-maturity securities at March 31,September 30, 2020 was not material.

8

The amortized cost and fair value of debt securities as of March 31,September 30, 2020, by contractual maturity, were as follows:
  Available-for-Sale Held-to-Maturity
(in millions) 
Amortized
Cost
 
Fair
Value
 Amortized
Cost
 Fair
Value
Due in one year or less $3,010
 $3,011
 $319
 $320
Due after one year through five years 11,565
 11,604
 352
 359
Due after five years through ten years 8,563
 8,669
 28
 28
Due after ten years 3,655
 3,656
 26
 28
U.S. agency mortgage-backed securities 6,508
 6,768
 
 
Non-U.S. agency mortgage-backed securities 1,932
 1,924
 
 
Total debt securities $35,233
 $35,632
 $725
 $735

Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less$3,388 $3,407 $400 $401 
Due after one year through five years11,253 11,678 246 252 
Due after five years through ten years9,179 9,826 30 31 
Due after ten years4,326 4,511 22 24 
U.S. agency mortgage-backed securities6,523 6,790 — — 
Non-U.S. agency mortgage-backed securities2,033 2,125 — — 
Total debt securities$36,702 $38,337 $698 $708 
The fair value of available-for-sale debt securities with gross unrealized losses by major 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
(in millions) 
Fair
Value
 
Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
March 31, 2020            
Debt securities - available-for-sale:            
U.S. government and agency obligations $56
 $(1) $
 $
 $56
 $(1)
State and municipal obligations 810
 (20) 
 
 810
 (20)
Corporate obligations 9,294
 (382) 391
 (29) 9,685
 (411)
Non-U.S. agency mortgage-backed securities 841
 (33) 30
 (3) 871
 (36)
Total debt securities - available-for-sale $11,001
 $(436) $421
 $(32) $11,422
 $(468)
December 31, 2019            
Debt securities - available-for-sale:            
U.S. government and agency obligations $616
 $(4) $
 $
 $616
 $(4)
State and municipal obligations 440
 (5) 
 
 440
 (5)
Corporate obligations 1,903
 (7) 740
 (4) 2,643
 (11)
U.S. agency mortgage-backed securities 657
 (3) 333
 (3) 990
 (6)
Non-U.S. agency mortgage-backed securities 406
 (3) 
 
 406
 (3)
Total debt securities - available-for-sale $4,022
 $(22) $1,073
 $(7) $5,095
 $(29)

 Less Than 12 Months12 Months or Greater Total
(in millions)Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
September 30, 2020
Debt securities - available-for-sale:
State and municipal obligations$366 $(4)$$$366 $(4)
Corporate obligations2,314 (30)400 (5)2,714 (35)
U.S. agency mortgage-backed securities687 (3)687 (3)
Non-U.S. agency mortgage-backed securities278 (3)55 (3)333 (6)
Total debt securities - available-for-sale$3,645 $(40)$455 $(8)$4,100 $(48)
December 31, 2019
Debt securities - available-for-sale:
U.S. government and agency obligations$616 $(4)$$$616 $(4)
State and municipal obligations440 (5)440 (5)
Corporate obligations1,903 (7)740 (4)2,643 (11)
U.S. agency mortgage-backed securities657 (3)333 (3)990 (6)
Non-U.S. agency mortgage-backed securities406 (3)406 (3)
Total debt securities - available-for-sale$4,022 $(22)$1,073 $(7)$5,095 $(29)
The Company’s unrealized losses from debt securities as of March 31,September 30, 2020 were generated from approximately 10,0003,000 positions out of a total of 32,00034,000 positions. The Company believes that it will collect the timely 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 that impacted our assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers, and the potential economic impacts of COVID-19 on the issuers, noting no significant credit deterioration since purchase. As of March 31,September 30, 2020, the Company did not have the intent to sell any of the available-for-sale debt securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities at March 31,September 30, 2020 was not material.

9

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 and Supplementary Data” in the 2019 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
March 31, 2020        
Cash and cash equivalents $21,450
 $119
 $
 $21,569
Debt securities - available-for-sale:        
U.S. government and agency obligations 3,143
 185
 
 3,328
State and municipal obligations 
 5,918
 
 5,918
Corporate obligations 59
 17,385
 250
 17,694
U.S. agency mortgage-backed securities 
 6,768
 
 6,768
Non-U.S. agency mortgage-backed securities 
 1,924
 
 1,924
Total debt securities - available-for-sale 3,202
 32,180
 250
 35,632
Equity securities 1,394
 19
 
 1,413
Assets under management 937
 1,890
 39
 2,866
Total assets at fair value
$26,983
 $34,208
 $289
 $61,480
Percentage of total assets at fair value 44% 56% % 100%
December 31, 2019        
Cash and cash equivalents $10,837
 $148
 $
 $10,985
Debt securities - available-for-sale:        
U.S. government and agency obligations 3,369
 184
 
 3,553
State and municipal obligations 
 5,926
 
 5,926
Corporate obligations 70
 17,923
 249
 18,242
U.S. agency mortgage-backed securities 
 6,528
 
 6,528
Non-U.S. agency mortgage-backed securities 
 1,845
 
 1,845
Total debt securities - available-for-sale 3,439
 32,406
 249
 36,094
Equity securities 1,734
 22
 
 1,756
Assets under management 1,123
 1,918
 35
 3,076
Total assets at fair value $17,133
 $34,494
 $284
 $51,911
Percentage of total assets at fair value 33% 66% 1% 100%

(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair and Carrying
Value
September 30, 2020
Cash and cash equivalents$17,472 $78 $$17,550 
Debt securities - available-for-sale:
U.S. government and agency obligations3,336 198 3,534 
State and municipal obligations6,684 6,684 
Corporate obligations44 18,881 279 19,204 
U.S. agency mortgage-backed securities6,790 6,790 
Non-U.S. agency mortgage-backed securities2,125 2,125 
Total debt securities - available-for-sale3,380 34,678 279 38,337 
Equity securities1,593 30 1,623 
Assets under management1,690 2,050 48 3,788 
Total assets at fair value$24,135 $36,836 $327 $61,298 
Percentage of total assets at fair value39 %60 %%100 %
December 31, 2019
Cash and cash equivalents$10,837 $148 $$10,985 
Debt securities - available-for-sale:
U.S. government and agency obligations3,369 184 3,553 
State and municipal obligations5,926 5,926 
Corporate obligations70 17,923 249 18,242 
U.S. agency mortgage-backed securities6,528 6,528 
Non-U.S. agency mortgage-backed securities1,845 1,845 
Total debt securities - available-for-sale3,439 32,406 249 36,094 
Equity securities1,734 22 1,756 
Assets under management1,123 1,918 35 3,076 
Total assets at fair value$17,133 $34,494 $284 $51,911 
Percentage of total assets at fair value33 %66 %%100 %
There were no0 transfers in or out of Level 3 financial assets or liabilities during the threenine months ended March 31,September 30, 2020 or 2019.

10

Table of Contents
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
March 31, 2020          
Debt securities - held-to-maturity $556
 $91
 $88
 $735
 $725
Long-term debt and other financing obligations $
 $45,272
 $
 $45,272
 $40,394
December 31, 2019          
Debt securities - held-to-maturity $541
 $181
 $253
 $975
 $972
Long-term debt and other financing obligations $
 $45,078
 $
 $45,078
 $40,278

(in millions)Quoted Prices
in Active
Markets
(Level 1)
Other
Observable
Inputs
(Level 2)
Unobservable
Inputs
(Level 3)
Total
Fair
Value
Total Carrying Value
September 30, 2020
Debt securities - held-to-maturity$531 $99 $78 $708 $698 
Long-term debt and other financing obligations$$51,785 $$51,785 $43,794 
December 31, 2019
Debt securities - held-to-maturity$541 $181 $253 $975 $972 
Long-term debt and other financing obligations$$45,078 $$45,078 $40,278 
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 no0 significant fair value adjustments for these assets and liabilities recorded during either the threenine months ended March 31,September 30, 2020 or 2019.2019.
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) 2020 2019
Medical costs payable, beginning of period $21,690
 $19,891
Acquisitions 
 35
Reported medical costs:    
Current year 41,580
 39,239
Prior years (580) (300)
Total reported medical costs 41,000
 38,939
Medical payments:    
Payments for current year (23,471) (22,973)
Payments for prior years (16,447) (14,753)
Total medical payments (39,918) (37,726)
Medical costs payable, end of period $22,772
 $21,139

(in millions)20202019
Medical costs payable, beginning of period$21,690 $19,891 
Acquisitions186 868 
Reported medical costs:
Current year118,114 117,624 
Prior years(800)(460)
Total reported medical costs117,314 117,164 
Medical payments:
Payments for current year(98,548)(99,487)
Payments for prior years(19,475)(17,497)
Total medical payments(118,023)(116,984)
Medical costs payable, end of period$21,167 $20,939 
For the threenine months ended March 31,September 30, 2020, prior years medical cost reserve development was primarily driven by lower than expected health system utilization. For the threenine months ended March 31,September 30, 2019, the prior years medical cost reserve development included no individual factors that were significant. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of $14.3$14.7 billion and $13.8 billion at March 31,September 30, 2020 and December 31, 2019, respectively.

11

Table of Contents
5.    Short-Term Borrowings and Long-Term Debt
Short-term borrowings and senior unsecured long-term debt consisted of the following:
 March 31, 2020 December 31, 2019 September 30, 2020December 31, 2019
(in millions, except percentages) Par Value Carrying Value Fair Value Par Value Carrying Value Fair Value(in millions, except percentages)Par ValueCarrying ValueFair ValuePar ValueCarrying ValueFair Value
Commercial paper $1,214
 $1,213
 $1,213
 $400
 $400
 $400
Commercial paper$$$$400 $400 $400 
Bank credit facilities 10,000
 10,000
 10,000
 
 
 
2.700% notes due July 2020 1,500
 1,500
 1,500
 1,500
 1,499
 1,506
2.700% notes due July 20201,500 1,499 1,506 
Floating rate notes due October 2020 300
 300
 296
 300
 300
 300
Floating rate notes due October 2020300 300 300 300 300 300 
3.875% notes due October 2020 450
 452
 452
 450
 450
 455
3.875% notes due October 2020450 450 451 450 450 455 
1.950% notes due October 2020 900
 899
 900
 900
 899
 900
1.950% notes due October 2020900 900 901 900 899 900 
4.700% notes due February 2021 400
 406
 407
 400
 403
 410
4.700% notes due February 2021400 403 402 400 403 410 
2.125% notes due March 2021 750
 749
 750
 750
 749
 753
2.125% notes due March 2021750 749 756 750 749 753 
Floating rate notes due June 2021 350
 349
 347
 350
 349
 350
Floating rate notes due June 2021350 350 351 350 349 350 
3.150% notes due June 2021 400
 399
 406
 400
 399
 407
3.150% notes due June 2021400 400 408 400 399 407 
3.375% notes due November 2021 500
 510
 512
 500
 501
 512
3.375% notes due November 2021500 509 513 500 501 512 
2.875% notes due December 2021 750
 768
 764
 750
 753
 765
2.875% notes due December 2021750 765 774 750 753 765 
2.875% notes due March 2022 1,100
 1,114
 1,130
 1,100
 1,087
 1,121
2.875% notes due March 20221,100 1,115 1,133 1,100 1,087 1,121 
3.350% notes due July 2022 1,000
 998
 1,034
 1,000
 998
 1,036
3.350% notes due July 20221,000 998 1,054 1,000 998 1,036 
2.375% notes due October 2022 900
 896
 912
 900
 896
 911
2.375% notes due October 2022900 897 937 900 896 911 
0.000% notes due November 2022 15
 13
 14
 15
 13
 14
0.000% notes due November 202215 13 14 15 13 14 
2.750% notes due February 2023 625
 646
 640
 625
 624
 638
2.750% notes due February 2023625 646 656 625 624 638 
2.875% notes due March 2023 750
 797
 777
 750
 770
 770
2.875% notes due March 2023750 793 794 750 770 770 
3.500% notes due June 2023 750
 747
 788
 750
 747
 786
3.500% notes due June 2023750 748 811 750 747 786 
3.500% notes due February 2024 750
 746
 794
 750
 746
 792
3.500% notes due February 2024750 746 825 750 746 792 
2.375% notes due August 2024 750
 747
 767
 750
 747
 760
2.375% notes due August 2024750 747 799 750 747 760 
3.750% notes due July 2025 2,000
 1,991
 2,161
 2,000
 1,990
 2,161
3.750% notes due July 20252,000 1,992 2,283 2,000 1,990 2,161 
3.700% notes due December 2025 300
 298
 323
 300
 298
 325
3.700% notes due December 2025300 298 343 300 298 325 
1.250% notes due January 20261.250% notes due January 2026500 496 513 
3.100% notes due March 2026 1,000
 996
 1,056
 1,000
 996
 1,048
3.100% notes due March 20261,000 996 1,118 1,000 996 1,048 
3.450% notes due January 2027 750
 746
 804
 750
 746
 804
3.450% notes due January 2027750 746 853 750 746 804 
3.375% notes due April 2027 625
 620
 668
 625
 620
 667
3.375% notes due April 2027625 620 713 625 620 667 
2.950% notes due October 2027 950
 939
 992
 950
 939
 988
2.950% notes due October 2027950 940 1,060 950 939 988 
3.850% notes due June 2028 1,150
 1,143
 1,281
 1,150
 1,142
 1,269
3.850% notes due June 20281,150 1,143 1,357 1,150 1,142 1,269 
3.875% notes due December 2028 850
 843
 953
 850
 843
 941
3.875% notes due December 2028850 843 1,010 850 843 941 
2.875% notes due August 2029 1,000
 1,104
 1,047
 1,000
 993
 1,029
2.875% notes due August 20291,000 1,104 1,115 1,000 993 1,029 
2.000% notes due May 20302.000% notes due May 20301,250 1,233 1,310 
4.625% notes due July 2035 1,000
 992
 1,190
 1,000
 992
 1,215
4.625% notes due July 20351,000 992 1,317 1,000 992 1,215 
5.800% notes due March 2036 850
 838
 1,107
 850
 838
 1,129
5.800% notes due March 2036850 839 1,231 850 838 1,129 
6.500% notes due June 2037 500
 492
 691
 500
 492
 712
6.500% notes due June 2037500 492 778 500 492 712 
6.625% notes due November 2037 650
 641
 910
 650
 641
 940
6.625% notes due November 2037650 641 1,027 650 641 940 
6.875% notes due February 2038 1,100
 1,077
 1,613
 1,100
 1,076
 1,631
6.875% notes due February 20381,100 1,077 1,772 1,100 1,076 1,631 
3.500% notes due August 2039 1,250
 1,241
 1,348
 1,250
 1,241
 1,313
3.500% notes due August 20391,250 1,241 1,436 1,250 1,241 1,313 
2.750% notes due May 20402.750% notes due May 20401,000 964 1,057 
5.700% notes due October 2040 300
 296
 405
 300
 296
 396
5.700% notes due October 2040300 296 438 300 296 396 
5.950% notes due February 2041 350
 345
 484
 350
 345
 475
5.950% notes due February 2041350 346 525 350 345 475 
4.625% notes due November 2041 600
 589
 742
 600
 589
 716
4.625% notes due November 2041600 589 787 600 589 716 
4.375% notes due March 2042 502
 484
 601
 502
 484
 580
4.375% notes due March 2042502 485 639 502 484 580 
3.950% notes due October 2042 625
 608
 711
 625
 607
 688
3.950% notes due October 2042625 608 760 625 607 688 
4.250% notes due March 2043 750
 735
 885
 750
 735
 856
4.250% notes due March 2043750 735 949 750 735 856 
4.750% notes due July 2045 2,000
 1,973
 2,547
 2,000
 1,973
 2,463
4.750% notes due July 20452,000 1,973 2,730 2,000 1,973 2,463 
4.200% notes due January 2047 750
 738
 881
 750
 738
 861
4.200% notes due January 2047750 738 950 750 738 861 
4.250% notes due April 2047 725
 717
 853
 725
 717
 839
4.250% notes due April 2047725 717 923 725 717 839 
3.750% notes due October 2047 950
 934
 1,050
 950
 934
 1,023
3.750% notes due October 2047950 934 1,130 950 934 1,023 
4.250% notes due June 2048 1,350
 1,330
 1,592
 1,350
 1,330
 1,569
4.250% notes due June 20481,350 1,330 1,721 1,350 1,330 1,569 
4.450% notes due December 2048 1,100
 1,086
 1,333
 1,100
 1,086
 1,316
4.450% notes due December 20481,100 1,086 1,457 1,100 1,086 1,316 
3.700% notes due August 2049 1,250
 1,235
 1,385
 1,250
 1,235
 1,344
3.700% notes due August 20491,250 1,235 1,496 1,250 1,235 1,344 
2.900% notes due May 20502.900% notes due May 20501,250 1,208 1,318 
3.875% notes due August 2059 1,250
 1,229
 1,372
 1,250
 1,228
 1,350
3.875% notes due August 20591,250 1,228 1,529 1,250 1,228 1,350 
3.125% notes due May 20603.125% notes due May 20601,000 968 1,073 
Total short-term borrowings and long-term debt $50,631
 $50,509
 $55,388
 $39,817
 $39,474
 $44,234
Total short-term borrowings and long-term debt$42,917 $42,662 $50,597 $39,817 $39,474 $44,234 


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The Company’s long-term debt obligations also included $1.1 billion and $1.2 billion of other financing obligations, of which $309$347 million and $322 million were classified as current as of March 31,September 30, 2020 and December 31, 2019, 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, 2020, the Company’s outstanding commercial paper had a weighted average annual interest rate of 2.4%.
The Company has $4.4 billion five-year, $4.4 billion three-year and $3.8 billion 364-day revolving bank credit facilities with 25 banks, which mature in December 2024, December 2022 and December 2020, respectively. These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of September 30, 2020, 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. AsIf amounts had been drawn on the bank credit facilities as of March 31,September 30, 2020, the Company had drawn $1.8 billion, $4.4 billion and $3.8 billion at annual interest rates of 1.6%, 1.6% and 1.7% on its $4.4 billion five-year, $4.4 billion three-year and $3.8 billion 364-day revolving bank credit facilities, respectively.would have ranged from 0.8% to 1%.
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain adefined debt to debt-plus-shareholders’ equity ratio of not more than 60%. The Company was in compliance with its debt covenants as of March 31,September 30, 2020.
6.    Dividends
In June 2020, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders to an annual rate of $5.00 compared to $4.32 per share, which the Company had paid since June 2019. 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 2020 dividend payments:
Payment DateAmount per ShareTotal Amount Paid
(in millions)
March 24$1.08 $1,024 
June 301.25 1,188 
September 221.25 1,188 
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, 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 U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Similarly, our international businesses are also subject to investigations, audits and reviews by applicable foreign governments, including South American and other non-U.S. governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including
13

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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. In March 2019, the court denied the government’s motion for partial summary judgment and dismissed the

Company’s counterclaims without prejudice. 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 4 reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx. OptumRx. For more information on the Company’s segments see Part I, Item I, “Business” and Note 14 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2019 10-K.
The following tables present reportable segment financial information:
  Optum  
(in millions)UnitedHealthcareOptumHealthOptumInsightOptumRxOptum EliminationsOptumCorporate and
Eliminations
Consolidated
Three Months Ended September 30, 2020
Revenues - unaffiliated customers:
Premiums$48,121 $2,742 $$$$2,742 $$50,863 
Products10 34 8,733 8,777 8,777 
Services2,075 1,834 974 241 3,049 5,124 
Total revenues - unaffiliated customers50,196 4,586 1,008 8,974 14,568 64,764 
Total revenues - affiliated customers5,748 1,755 13,102 (424)20,181 (20,181)
Investment and other income177 165 174 351 
Total revenues$50,373 $10,499 $2,767 $22,081 $(424)$34,923 $(20,181)$65,115 
Earnings from operations$2,068 $835 $785 $963 $$2,583 $$4,651 
Interest expense(395)(395)
Earnings before income taxes$2,068 $835 $785 $963 $$2,583 $(395)$4,256 
Three Months Ended September 30, 2019
Revenues - unaffiliated customers:
Premiums$45,557 $1,840 $$$$1,840 $$47,397 
Products29 7,511 7,546 7,546 
Services2,274 1,487 988 193 2,668 4,942 
Total revenues - unaffiliated customers47,831 3,333 1,017 7,704 12,054 59,885 
Total revenues - affiliated customers4,630 1,594 10,734 (441)16,517 (16,517)
Investment and other income274 170 16 192 466 
Total revenues$48,105 $8,133 $2,617 $18,454 $(441)$28,763 $(16,517)$60,351 
Earnings from operations$2,655 $748 $632 $979 $$2,359 $$5,014 
Interest expense(449)(449)
Earnings before income taxes$2,655 $748 $632 $979 $$2,359 $(449)$4,565 
    Optum    
(in millions) UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum Corporate and
Eliminations
 Consolidated
Three Months Ended March 31, 2020                
Revenues - unaffiliated customers:                
Premiums $48,593
 $2,047
 $
 $
 $
 $2,047
 $
 $50,640
Products 
 9
 29
 8,393
 
 8,431
 
 8,431
Services 2,278
 1,548
 891
 268
 
 2,707
 
 4,985
Total revenues - unaffiliated customers 50,871
 3,604
 920
 8,661
 
 13,185
 
 64,056
Total revenues - affiliated customers 
 5,452
 1,562
 12,876
 (404) 19,486
 (19,486) 
Investment and other income 197
 136
 12
 20
 
 168
 
 365
Total revenues $51,068
 $9,192
 $2,494
 $21,557
 $(404) $32,839
 $(19,486) $64,421
Earnings from operations $2,888
 $712
 $536
 $860
 $
 $2,108
 $
 $4,996
Interest expense 
 
 
 
 
 
 (437) (437)
Earnings before income taxes $2,888
 $712
 $536
 $860
 $
 $2,108
 $(437) $4,559
Three Months Ended March 31, 2019                
Revenues - unaffiliated customers:                
Premiums $46,501
 $1,012
 $
 $
 $
 $1,012
 $
 $47,513
Products 
 8
 23
 8,041
 
 8,072
 
 8,072
Services 2,141
 1,274
 754
 149
 
 2,177
 
 4,318
Total revenues - unaffiliated customers 48,642
 2,294
 777
 8,190
 
 11,261
 
 59,903
Total revenues - affiliated customers 
 4,287
 1,407
 9,613
 (359) 14,948
 (14,948) 
Investment and other income 254
 132
 5
 14
 
 151
 
 405
Total revenues $48,896
 $6,713
 $2,189
 $17,817
 $(359) $26,360
 $(14,948) $60,308
Earnings from operations $2,954
 $626
 $432
 $820
 $
 $1,878
 $
 $4,832
Interest expense 
 
 
 
 
 
 (400) (400)
Earnings before income taxes $2,954
 $626
 $432
 $820
 $
 $1,878
 $(400) $4,432
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Optum
(in millions)UnitedHealthcareOptumHealthOptumInsightOptumRxOptum EliminationsOptumCorporate and EliminationsConsolidated
Nine Months Ended September 30, 2020
Revenues - unaffiliated customers:
Premiums$143,753 $7,144 $$$$7,144 $$150,897 
Products26 90 25,339 25,455 25,455 
Services6,248 4,607 2,629 781 8,017 14,265 
Total revenues - unaffiliated customers150,001 11,777 2,719 26,120 40,616 190,617 
Total revenues - affiliated customers16,623 5,140 38,843 (1,275)59,331 (59,331)
Investment and other income547 430 34 46 510 1,057 
Total revenues$150,548 $28,830 $7,893 $65,009 $(1,275)$100,457 $(59,331)$191,674 
Earnings from operations$11,963 $2,388 $1,882 $2,655 $$6,925 $$18,888 
Interest expense(1,262)(1,262)
Earnings before income taxes$11,963 $2,388 $1,882 $2,655 $$6,925 $(1,262)$17,626 
Nine Months Ended September 30, 2019
Revenues - unaffiliated customers:
Premiums$138,088 $3,986 $$$$3,986 $$142,074 
Products23 74 23,874 23,971 23,971 
Services6,603 4,131 2,532 490 7,153 13,756 
Total revenues - unaffiliated customers144,691 8,140 2,606 24,364 35,110 179,801 
Total revenues - affiliated customers13,366 4,522 30,786 (1,181)47,493 (47,493)
Investment and other income904 488 17 44 549 1,453 
Total revenues$145,595 $21,994 $7,145 $55,194 $(1,181)$83,152 $(47,493)$181,254 
Earnings from operations$8,251 $2,062 $1,589 $2,688 $$6,339 $$14,590 
Interest expense(1,267)(1,267)
Earnings before income taxes$8,251 $2,062 $1,589 $2,688 $$6,339 $(1,267)$13,323 
15

ITEM 2.MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
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 2019 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements and Supplementary Data” 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 2019 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,information; advanced technology,technology; and clinical expertise, focused on improving health outcomes, lowering health care costs and creating a better experience for patients, their caregivers and physicians. 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 2019 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.
COVID-19 Trends and Uncertainties
The COVID-19 pandemic is rapidly evolvingcontinues to evolve and the ultimate impact on our business, results of operations, financial condition and cash flows isremains uncertain and difficult to predict. For additional information regarding risksDuring the second quarter, the global health system experienced unprecedented levels of care deferral, which impacted all of our businesses. As the pandemic advanced, access to and uncertainties relatingdemand for care was most constrained from mid-March through April, began to COVID-19, seeRisk Factorsrecover in Part II, Item 1AMay and June and restored to near normal seasonal levels in the third quarter. The temporary deferral of this report.care may cause care patterns to moderately exceed normal baselines in future periods as utilization of health system capacity continues to increase. From time to time, health system capacity may be subject to possible increased volatility due to the pandemic. Specific trends and uncertainties related to our two business platforms are as follows:
UnitedHealthcare.WeWe have expanded benefit coverage in areas such as COVID-19 testingcare and treatment,testing, telemedicine, and pharmacy benefits; provided customers assistance in the form of co-pay waivers and premium forgiveness; offered additional enrollment opportunities to those who previously declined employer-sponsored offerings; extended certain premium payment terms for customers experiencing financial hardship; simplified administrative practices; and began acceleratingaccelerated payments to care providers, all with the aim of assisting our customers, providers and members in addressing the COVID-19 crisis. Potential economic costs, including costTemporary care deferrals significantly impacted UnitedHealthcare’s results of operations for the nine months ended September 30, 2020, contributing to a lower medical care ratio and losshigher operating earnings than in previous periods. For the three months ended September 30, 2020, the impact of commercial membership due to higher rates of unemployment, may initially betemporary care deferrals was more than offset by temporary deferrals of electiveCOVID-19 related care and increased membershiptesting, the significant financial assistance we continued to provide our customers and broader economic impacts. Enrollment in Medicaid and individual programs. Following the crisis,our commercial products declined primarily due to employer actions.
Increased consumer demand for care, ispotentially even higher acuity care, along with continued COVID-19 care and testing costs are expected to return, resultingresult in potentially increased future medical costs. DependingDisrupted care patterns, as a result of the pandemic, may temporarily affect the ability to obtain complete member health status information, impacting future revenue in businesses that utilize risk adjustment methodologies. The ultimate overall impact is uncertain and dependent on the future pacing and intensity of the virus, as well aspandemic, the duration of policies and initiatives to address COVID-19, such as stay-at-home and social distancing guidelines,the ultimate impact is uncertain.progress of an uncertain economic recovery.

16

Optum. The reductiontemporary deferral of elective and routine procedurescare also impactsmeaningfully impacted the Optum business.businesses for the nine months ended September 30, 2020. For example, mostour fee-for-service care delivery business, such as traditional procedure work at our ambulatory surgery centers, has been postponed,was negatively impacted, while our capitatedrisk-based care delivery business performance reflected lower demand for care. Our OptumInsight and OptumRx volume-based businesses were negatively impacted by the lower level of care encounters which took place, as well as by broader economic factors, contributing to lower managed services and prescription volume. As the health system continues to return to normal seasonally adjusted levels of care, we have experienced lower care demand.seen business activity approach more normal levels. COVID-19 will also continue to influence customer and consumer behavior, both during and after the pandemic, which could impact how care is delivered and the manner in which consumers wish to receive their prescription drugs or infusion services. The impact of COVID-19 on our care provider and payer clients could impact the volume and types of services that Optum provides, as well as the pacing of potential new business opportunities. As a result of the dynamic situation and broad-reaching impact to the health system, the ultimate impact of COVID-19 on our Optum businesses is uncertain.

Business Trends
Our businesses participate in the United States, South American and certain other international health markets. Overall spending on health care is impacted by inflation; utilization; medical technology and pharmaceutical advancement; regulatory requirements; demographic trends in the populationpopulation; 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, such as the economic impact of COVID-19, and regulatory changes, which could impact our results of operations, including our continued efforts to control health care costs.
Pricing TrendsTrends.. To price our health care benefit products, we start with our view of expected future costs, including any impactpotential impacts from COVID-19 and the Health Insurance 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 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. Pricing for contracts that cover some portion of calendar year 2021 will reflect the permanent repeal of the Health Insurance Tax.
Government programs in the public and senior sector tend to receive lower rates of increase than the commercial market due to governmental budget pressures and lower cost trends.
Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, health system utilization and prescription drug costs. COVID-19 care and testing costs and certain of our customer assistance initiatives have also impacted medical cost trends in the current year and may continue in future years. 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. The uncertain impact of COVID-19 may impact our ability to estimate medical costs payable, which could result in increased variability to medical cost reserve development in future periods.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of regulatory trends and uncertainties. For additional information regarding regulatory trends and uncertainties, see Part I, Item 1 “Business - Government Regulation,” Part 1, Item 1A, “Risk Factors,” Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2019 10-K and “Risk Factors” in Part II, Item 1A of this report.
Medicare Advantage Rates.Final 2021 Medicare Advantage rates resulted in an increase in industry base rates of approximately 1.7%, short of the industry forward medical cost trend, creating continued pressure in the Medicare Advantage program.
Affordable Care Act (ACA) Tax. After a moratorium in 2019, the industry-wide amount of the Health Insurance Tax for 2020, which is primarily borne by customers, is $15.5 billion, with our portion being approximately $3.0 billion. The return of the tax impacts year-over-year comparability of our financial statements, including revenues, operating costs, medical care ratio (MCR), operating cost ratio, effective tax rate and cash flows from operations. The ACA Tax was permanently repealed by Congress, effective January 1, 2021.
17


SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select firstthird quarter 2020 year-over-year operating comparisons to firstthird quarter 2019.2019, which were significantly impacted by the effects of COVID-19 on the health system.
Consolidated revenues grew 7%8%, UnitedHealthcare revenues grew 4%5% and Optum revenues grew 25%21%.
UnitedHealthcare served 670,000635,000 fewer people domestically primarily due to increased unemployment and expected attrition in commercial group and the proactive withdrawal from a Medicaid market.benefits.
Consolidated earnings from operations increased 3%decreased 7%, including a decrease of 2%22% at UnitedHealthcare andprimarily due to COVID-19 impacts, partially offset by an increase of 12%9% at Optum.
Diluted earnings per common share decreased 1% to $3.52.$3.30.
Cash flows from operations for the threenine months ended March 31,September 30, 2020 were $2.9$16.1 billion.
Return on equity was 23.6%19.7%.

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 September 30,Increase/(Decrease)Nine Months Ended
September 30,
Increase/(Decrease)
202020192020 vs. 2019202020192020 vs. 2019
Revenues:
Premiums$50,863 $47,397 $3,466 %$150,897 $142,074 $8,823 %
Products8,777 7,546 1,231 16 25,455 23,971 1,484 
Services5,124 4,942 182 14,265 13,756 509 
Investment and other income351 466 (115)(25)1,057 1,453 (396)(27)
Total revenues65,115 60,351 4,764 191,674 181,254 10,420 
Operating costs:
Medical costs41,636 39,041 2,595 117,314 117,164 150 — 
Operating costs10,174 8,960 1,214 14 30,190 25,892 4,298 17 
Cost of products sold7,935 6,627 1,308 20 23,123 21,606 1,517 
Depreciation and amortization719 709 10 2,159 2,002 157 
Total operating costs60,464 55,337 5,127 172,786 166,664 6,122 
Earnings from operations4,651 5,014 (363)(7)18,888 14,590 4,298 29 
Interest expense(395)(449)54 (12)(1,262)(1,267)— 
Earnings before income taxes4,256 4,565 (309)(7)17,626 13,323 4,303 32 
Provision for income taxes(1,000)(936)(64)(4,209)(2,752)(1,457)53 
Net earnings3,256 3,629 (373)(10)13,417 10,571 2,846 27 
Earnings attributable to noncontrolling interests(84)(91)(8)(226)(273)47 (17)
Net earnings attributable to UnitedHealth Group common shareholders$3,172 $3,538 $(366)(10)%$13,191 $10,298 $2,893 28 %
Diluted earnings per share attributable to UnitedHealth Group common shareholders$3.30 $3.67 $(0.37)(10)%$13.73 $10.65 $3.08 29 %
Medical care ratio (a)81.9 %82.4 %(0.5)%77.7 %82.5 %(4.8)%
Operating cost ratio15.6 14.8 0.8 15.8 14.3 1.5 
Operating margin7.1 8.3 (1.2)9.9 8.0 1.9 
Tax rate23.5 20.5 3.0 23.9 20.7 3.2 
Net earnings margin (b)4.9 5.9 (1.0)6.9 5.7 1.2 
Return on equity (c)19.7 %26.2 %(6.5)%28.9 %26.0 %2.9 %
(a)
(in millions, except percentages and per share data) Three Months Ended March 31, Increase/(Decrease)
 2020 2019 2020 vs. 2019
Revenues:        
Premiums $50,640
 $47,513
 $3,127
 7 %
Products 8,431
 8,072
 359
 4
Services 4,985
 4,318
 667
 15
Investment and other income 365
 405
 (40) (10)
Total revenues 64,421
 60,308
 4,113
 7
Operating costs:     

 

Medical costs 41,000
 38,939
 2,061
 5
Operating costs 10,015
 8,517
 1,498
 18
Cost of products sold 7,687
 7,381
 306
 4
Depreciation and amortization 723
 639
 84
 13
Total operating costs 59,425
 55,476
 3,949
 7
Earnings from operations 4,996
 4,832
 164
 3
Interest expense (437) (400) (37) 9
Earnings before income taxes 4,559
 4,432
 127
 3
Provision for income taxes (1,094) (875) (219) 25
Net earnings 3,465
 3,557
 (92) (3)
Earnings attributable to noncontrolling interests (83) (90) 7
 (8)
Net earnings attributable to UnitedHealth Group common shareholders $3,382
 $3,467
 $(85) (2)%
Diluted earnings per share attributable to UnitedHealth Group common shareholders $3.52
 $3.56
 $(0.04) (1)%
Medical care ratio (a) 81.0% 82.0% (1.0)% 

Operating cost ratio 15.5
 14.1
 1.4
 

Operating margin 7.8
 8.0
 (0.2) 

Tax rate 24.0
 19.7
 4.3
 

Net earnings margin (b) 5.2
 5.7
 (0.5) 

Return on equity (c) 23.6% 26.8% (3.2)% 

Medical care ratio is calculated as medical costs divided by premium revenue.
(b)Net earnings margin attributable to UnitedHealth Group shareholders.
(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 attributable to UnitedHealth Group common shareholders divided by average shareholders’ equity. Average shareholders’ equity is calculated using the shareholders’ equity balance at the end of the preceding year and the shareholders’ equity balances at the end of each of the quarters in the year presented.
(c)Return on equity is calculated as annualized net earnings attributable to UnitedHealth Group common shareholders divided by average shareholders’ equity. Average shareholders’ equity is calculated using the shareholders’ equity balance at the end of the preceding year and the shareholders’ equity balances at the end of each of the quarters in the year presented.
18

2020 RESULTS OF OPERATIONS COMPARED TO 2019 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenue
The increases in revenue were primarily driven by the increase in the number of individuals served through Medicare Advantage;Advantage and Medicaid; pricing trends; and acquisitionorganic and organicacquisition growth across the Optum business, primarily due to expansion in pharmacy care services and care delivery. The increases were partially offset by decreased individuals served through our commercial and Global benefits businesses and certain customer assistance programs. For the nine months ended September 30, 2020, revenues were also negatively impacted by decreases in our fee-for-service care delivery and other volume-based businesses, primarily as a result of the impacts of COVID-19 on the economy.
Medical Costs and MCR
Medical costs increased due toas a result of growth in people served through Medicare Advantage and Medicaid, medical cost trends and calendar day impacts,COVID-19 care and testing costs, partially offset by decreased people served in Medicaid due to a proactive market withdrawalcommercial and increased prior year favorable medical cost development. TheGlobal and modestly lower care patterns. For the nine months ended September 30, 2020, the MCR decreased primarily due to the temporary deferral of care and the revenue effects of the return of the Health Insurance Tax, partially offset by calendar day impacts.COVID-19 care and testing costs and customer assistance measures.
Operating Cost Ratio
The operating cost ratio increased primarily due to the impact of the return of the Health Insurance Tax and changes in business mix, partially offset by effective operating cost management.

mix.
Income Tax Rate
Our effective tax rate increased primarily due to the impact of the return of the nondeductible Health Insurance Tax.

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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. We utilize various metrics to evaluate and manage our reportable segments, including individuals served by UnitedHealthcare by major market segment and funding arrangement, people served by OptumHealth and adjusted scripts for OptumRx. These metrics are the main drivers of revenue, earnings and cash flows at each business. The metrics also allow management and investors to evaluate and understand business mix, customer penetration and pricing trends when comparing the metrics to revenue by segment.
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) 2020 2019 2020 vs. 2019(in millions, except percentages)202020192020 vs. 2019202020192020 vs. 2019
Revenues        Revenues
UnitedHealthcare $51,068
 $48,896
 $2,172
 4 %UnitedHealthcare$50,373 $48,105 $2,268 %$150,548 $145,595 $4,953 %
OptumHealth 9,192
 6,713
 2,479
 37
OptumHealth10,499 8,133 2,366 29 28,830 21,994 6,836 31 
OptumInsight 2,494
 2,189
 305
 14
OptumInsight2,767 2,617 150 7,893 7,145 748 10 
OptumRx 21,557
 17,817
 3,740
 21
OptumRx22,081 18,454 3,627 20 65,009 55,194 9,815 18 
Optum eliminations (404) (359) (45) 13
Optum eliminations(424)(441)17 (4)(1,275)(1,181)(94)
Optum 32,839
 26,360
 6,479
 25
Optum34,923 28,763 6,160 21 100,457 83,152 17,305 21 
Eliminations (19,486) (14,948) (4,538) 30
Eliminations(20,181)(16,517)(3,664)22 (59,331)(47,493)(11,838)25 
Consolidated revenues $64,421
 $60,308
 $4,113
 7 %Consolidated revenues$65,115 $60,351 $4,764 %$191,674 $181,254 $10,420 %
Earnings from operations        Earnings from operations
UnitedHealthcare $2,888
 $2,954
 $(66) (2)%UnitedHealthcare$2,068 $2,655 $(587)(22)%$11,963 $8,251 $3,712 45 %
OptumHealth 712
 626
 86
 14
OptumHealth835 748 87 12 2,388 2,062 326 16 
OptumInsight 536
 432
 104
 24
OptumInsight785 632 153 24 1,882 1,589 293 18 
OptumRx 860
 820
 40
 5
OptumRx963 979 (16)(2)2,655 2,688 (33)(1)
Optum 2,108
 1,878
 230
 12
Optum2,583 2,359 224 6,925 6,339 586 
Consolidated earnings from operations $4,996
 $4,832
 $164
 3 %Consolidated earnings from operations$4,651 $5,014 $(363)(7)%$18,888 $14,590 $4,298 29 %
Operating margin        Operating margin
UnitedHealthcare 5.7% 6.0% (0.3)%  UnitedHealthcare4.1 %5.5 %(1.4)%7.9 %5.7 %2.2 %
OptumHealth 7.7
 9.3
 (1.6)  OptumHealth8.0 9.2 (1.2)8.3 9.4 (1.1)
OptumInsight 21.5
 19.7
 1.8
  OptumInsight28.4 24.1 4.3 23.8 22.2 1.6 
OptumRx 4.0
 4.6
 (0.6)  OptumRx4.4 5.3 (0.9)4.1 4.9 (0.8)
Optum 6.4
 7.1
 (0.7)  Optum7.4 8.2 (0.8)6.9 7.6 (0.7)
Consolidated operating margin 7.8% 8.0% (0.2)%  Consolidated operating margin7.1 %8.3 %(1.2)%9.9 %8.0 %1.9 %
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended September 30,Increase/(Decrease)Nine Months Ended September 30,Increase/(Decrease)
(in millions, except percentages)202020192020 vs. 2019202020192020 vs. 2019
UnitedHealthcare Employer & Individual$14,081 $14,291 $(210)(1)%$41,324 $42,407 $(1,083)(3)%
UnitedHealthcare Medicare & Retirement22,606 20,698 1,908 68,613 62,649 5,964 10 
UnitedHealthcare Community & State11,820 10,670 1,150 11 34,796 33,038 1,758 
UnitedHealthcare Global1,866 2,446 (580)(24)5,815 7,501 (1,686)(22)
Total UnitedHealthcare revenues$50,373 $48,105 $2,268 %$150,548 $145,595 $4,953 %
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  Three Months Ended March 31, Increase/(Decrease)
(in millions, except percentages) 2020 2019 2020 vs. 2019
UnitedHealthcare Employer & Individual $14,280
 $14,084
 $196
 1 %
UnitedHealthcare Medicare & Retirement 23,152
 21,096
 2,056
 10
UnitedHealthcare Community & State 11,453
 11,182
 271
 2
UnitedHealthcare Global 2,183
 2,534
 (351) (14)
Total UnitedHealthcare revenues $51,068
 $48,896
 $2,172
 4 %

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) 2020 2019 2020 vs. 2019(in thousands, except percentages)202020192020 vs. 2019
Commercial:        Commercial:
Risk-based 8,215
 8,340
 (125) (1)%Risk-based7,950 8,605 (655)(8)%
Fee-based 18,825
 19,175
 (350) (2)Fee-based18,400 19,230 (830)(4)
Total commercial 27,040
 27,515
 (475) (2)Total commercial26,350 27,835 (1,485)(5)
Medicare Advantage 5,575
 5,165
 410
 8
Medicare Advantage5,670 5,230 440 
Medicaid 5,880
 6,425
 (545) (8)Medicaid6,435 5,965 470 
Medicare Supplement (Standardized) 4,440
 4,500
 (60) (1)Medicare Supplement (Standardized)4,450 4,510 (60)(1)
Total public and senior 15,895
 16,090
 (195) (1)Total public and senior16,555 15,705 850 
Total UnitedHealthcare - domestic medical 42,935
 43,605
 (670) (2)Total UnitedHealthcare - domestic medical42,905 43,540 (635)(1)
International 5,605
 6,125
 (520) (8)
GlobalGlobal5,285 5,845 (560)(10)
Total UnitedHealthcare - medical 48,540
 49,730
 (1,190) (2)%Total UnitedHealthcare - medical48,190 49,385 (1,195)(2)%
Supplemental Data:        Supplemental Data:
Medicare Part D stand-alone 4,150
 4,480
 (330) (7)%Medicare Part D stand-alone4,075 4,415 (340)(8)%
Fee-based and risk-based commercial business decreased primarily due to increased unemployment and expected attrition. Medicare Advantage increased due to growth in people served through individual Medicare Advantage plans. The decreaseincrease in people served through Medicaid was primarily driven by the proactive withdrawal from a market as well as by states managing eligibility, partially offset by increaseseasing redetermination requirements due to COVID-19 and growth in people served via Dual Special Needs Plans. The decrease in people served internationallyby UnitedHealthcare Global is a result of our continued affordability efforts, underwriting discipline and underwriting discipline.increased unemployment.
UnitedHealthcare’s revenue increased due to growth in the number of individuals served through Medicare Advantage and Medicaid, a greater mix of people with higher acuity needs and the return of the Health Insurance Tax, partially offset by a decrease in the number of individuals served through the commercial and Medicaid businesses. EarningsGlobal businesses and foreign currency impacts. For the three months ended September 30, 2020, earnings from operations decreased primarily due to direct COVID-19 care and testing costs, our customer assistance measures as well as broader economic effects, partially offset by modestly lower care patterns. For the nine months ended September 30, 2020, earnings from operations increased due to the deferral of care caused by COVID-19 on the health system and the factors impacting revenue, partially offset by the return of the Health Insurance Tax, COVID-19 care and calendar day impacts, partially offset by the factors impacting revenue.testing costs, customer assistance programs and broader economic effects.
Optum
Total revenues and earnings from operations increased as each segment reported increased revenues and earningsrevenue growth. Earnings from operations as a result of productivityincreased due to growth at OptumHealth and overall cost management initiatives in addition to the factors discussed below.OptumInsight.
The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth increased primarily due to acquisitions and organic growth and acquisitions in risk-based care delivery. For the nine months ended September 30, 2020, reduced care volumes in fee-for-service arrangements as a result of COVID-19, partially offset the increases in revenues and earnings. OptumHealth served approximately 9698 million people as of March 31,September 30, 2020 compared to 9395 million people as of March 31,September 30, 2019.
OptumInsight
Revenue and earnings from operations at OptumInsight increased primarily due to organic growth in technology and acquisitionsmanaged services, partially offset by decreased activity levels in managed services.volume-based services due to the impact of COVID-19 on payer and care provider clients.

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OptumRx
Revenue at OptumRx and the corresponding eliminations increased due to the inclusion of retail pharmacy co-payments. See Note 1 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for further detail. Revenue at OptumRx also increased due to organic and acquisition growth in specialty pharmacy and new client wins, partially offset by an expected large client transition.transition and lower script volumes driven by COVID-19 related care deferral, primarily related to first fill script volumes. Earnings from operations increaseddecreased primarily due to COVID-19 impacts, partially offset by improved supply chain management. OptumRx fulfilled 339325 million adjusted scripts in both the first quarterthird quarters of 2020 and 2019, with organic growth in adjusted scripts being offset by the expected large client transition.

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) 2020 2019 2020 vs. 2019(in millions)202020192020 vs. 2019
Sources of cash:      Sources of cash:
Cash provided by operating activities $2,943
 $3,234
 $(291)Cash provided by operating activities$16,073 $12,258 $3,815 
Issuances of short-term borrowings and long-term debt, net of repayments 10,797
 1,851
 8,946
Issuances of short-term borrowings and long-term debt, net of repayments2,941 8,192 (5,251)
Proceeds from common stock issuances 557
 323
 234
Proceeds from common stock issuances1,206 740 466 
Customer funds administered 1,062
 1,784
 (722)Customer funds administered249 420 (171)
Sales and maturities of investments, net of purchases 30
 
 30
OtherOther— 338 (338)
Total sources of cash 15,389
 7,192
  Total sources of cash20,469 21,948 
Uses of cash:      Uses of cash:
Common stock repurchases (1,691) (3,002) 1,311
Common stock repurchases(2,541)(5,101)2,560 
Cash paid for acquisitions, net of cash assumed (929) (689) (240)Cash paid for acquisitions, net of cash assumed(4,326)(8,200)3,874 
Purchases of investments, net of sales and maturities 
 (319) 319
Purchases of investments, net of sales and maturities(1,386)(2,028)642 
Purchases of property, equipment and capitalized software (469) (562) 93
Purchases of property, equipment and capitalized software(1,477)(1,421)(56)
Cash dividends paid (1,024) (860) (164)Cash dividends paid(3,400)(2,908)(492)
Other (563) (214) (349)Other(614)(756)142 
Total uses of cash (4,676) (5,646)  Total uses of cash(13,744)(20,414)
Effect of exchange rate changes on cash and cash equivalents (129) (5) (124)Effect of exchange rate changes on cash and cash equivalents(160)(37)(123)
Net increase in cash and cash equivalents $10,584
 $1,541
 $9,043
Net increase in cash and cash equivalents$6,565 $1,497 $5,068 
2020 Cash Flows Compared to 2019 Cash Flows
DecreasedIncreased cash flows provided by operating activities were primarily driven by changesincreased net earnings as a result of the temporary deferral of care experienced at our benefits businesses related to COVID-19, partially offset by the payment of the Health Insurance Tax in working capital accounts.the third quarter. Other significant changes in sources or uses of cash year-over-year included increased short-term borrowings and decreased cash paid for acquisitions, common stock repurchases and net purchases of investments, partially offset by a decrease in customer funds administered.decreased issuances of long-term debt.
Financial Condition
As of March 31,September 30, 2020, our cash, cash equivalent, available-for-sale debt securities and equity securities balances of $58.9$58.0 billion included approximately $21.6$17.6 billion of cash and cash equivalents (of which $10.9$2.9 billion was available for general corporate use), $35.6$38.3 billion of debt securities and $1.7$2.1 billion of investments in equity securities. Cash available for general corporate use was intentionally higher than previous periods as a prudent response to more volatile financial markets. 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 3.53.6 years and a weighted-average credit rating of “Double A” as of March 31,September 30, 2020. 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.
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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 independent 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 60%. As of March 31,September 30, 2020, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 44%38%.

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, 2020 were as follows:
  
Moody’sS&P GlobalFitchA.M. Best
RatingsOutlookRatingsOutlookRatingsOutlookRatingsOutlook
Senior unsecured debtA3StableA+StableAStableA-Positive
Commercial paperP-2n/aA-1n/aF1n/aAMB-1n/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, including the impacts of COVID-19 and related governmental market stabilization programs. 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 threenine months ended March 31,September 30, 2020, we repurchased 69 million shares at an average price of $271.32$281.37 per share. As of March 31,September 30, 2020, we had Board authorization to purchase up to 6663 million shares of our common stock.
Dividends. OurIn June 2020, the Company’s Board of Directors increased the Company’s quarterly cash dividend to shareholders reflectsto an annual dividend rate of $5.00 compared to $4.32 per share. For more information on our dividend, see Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part 1, 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 Supplementary Data” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 2019 10-K.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2019 was disclosed in our 2019 10-K. During the threenine months ended March 31,September 30, 2020, 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.

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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 and goodwill. 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 2019 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 and Supplementary Data” in our 2019 10-K.

FORWARD-LOOKING STATEMENTS
The statements, estimates, projections, guidance or outlook contained in this document include “forward-looking” statements which are intended to take advantage of the “safe harbor” provisions of the federal securities law. The words “believe,” “expect,” “intend,” “estimate,” “anticipate,” “forecast,” “outlook,” “plan,” “project,” “should” and similar expressions identify forward-looking statements. These statements may contain information about financial prospects, economic conditions and trends and involve risks and uncertainties. Actual results could differ materially from those that management expects, depending on the outcome of certain factors including: risks associated with public health crises, large-scale medical emergencies and pandemics, such as the COVID-19 pandemic; our ability to effectively estimate, price for and manage medical costs; new or changes in existing health care laws or regulations, or their enforcement or application; the DOJ’s legal action relating to the risk adjustment submission matter; our ability to maintain and achieve improvement in quality scores impacting revenue; reductions in revenue or delays to cash flows received under government programs; changes in Medicare, the CMS star ratings program or the application of risk adjustment data validation audits; failure to maintain effective and efficient information systems or if our technology products do not operate as intended; cyber-attacks, other privacy/data security incidents, or our failure to comply with related regulations; risks and uncertainties associated with the pharmacy benefits management industry; competitive pressures; changes in or challenges to our public sector contract awards; our ability to contract on competitive terms with physicians, hospitals and other service providers; failure to achieve targeted operating cost productivity improvements; increases in costs and other liabilities associated with litigation, government investigations, audits or reviews; failure to manage successfully our strategic alliances or complete or receive anticipated benefits of strategic transactions; fluctuations in foreign currency exchange rates; downgrades in our credit ratings; our investment portfolio performance; impairment of our goodwill and intangible assets; and our ability to obtain sufficient funds from our regulated subsidiaries or from external financings to fund our obligations, maintain our debt to total capital ratio at targeted levels, maintain our quarterly dividend payment cycle, or continue repurchasing shares of our common stock. This above list is not exhaustive. We discuss these matters, and certain risks that may affect our business operations, financial condition and results of operations more fully in our filings with the SEC, including our reports on Forms 10-K, 10-Q and 8-K. 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 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 law.
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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, 2020 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
September 30, 2020
Increase (Decrease) in Market Interest RateInvestment
Income Per
Annum (a)
Interest
Expense Per
Annum (a)
Fair Value of
Financial Assets (b)
Fair Value of
Financial Liabilities
2 %$412 $176 $(2,847)$(8,464)
1206 88 (1,412)(4,609)
(1)(62)(13)636 4,792 
(2)(62)(13)675 6,424 
(a)Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of September 30, 2020, the assumed hypothetical change in interest rates does not reflect the full 100 and 200 basis point reduction in interest income or interest expense, as the rates are assumed not to fall below zero.
(b)As of September 30, 2020, some of our investments had interest rates below 1% so the assumed hypothetical change in the fair value of investments does not reflect the full 100 and 200 basis point reduction.
  March 31, 2020
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
2 % $491
 $404
 $(2,514) $(6,673)
1 246
 202
 (1,250) (3,628)
(1) (160) (202) 784
 3,735
(2) (160) (267) 877
 4,694

(a)Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of March 31, 2020, the assumed hypothetical change in interest rates does not reflect the full 100 and 200 basis point reduction in interest income or the full 200 basis point reduction in interest expense, as the rate cannot fall below zero.

(b)As of March 31, 2020, 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 100 and 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, 2020. 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, 2020.
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, 2020 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
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.
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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 2019 10-K and Part II, Item 1A, “Risk Factors” of our 10-Q for the quarterly period ended March 31, 2020 (“2020 First Quarter 10-Q”), which could materially affect our business, financial condition or future results. The risks described in our 2019 10-K and in this Item 1A,2020 First Quarter 10-Q, 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 other material changes to the risk factors as disclosed in our 2019 10-K except that we have added the following risk factor to provide details on our risks associated with COVID-19:and 2020 First Quarter 10-Q.
We are subject to risks associated with public health crises, large-scale medical emergencies and pandemics, such as the COVID-19 pandemic, which could have a material adverse effect on our business, results of operations, financial condition and financial performance.
The rapidly developing COVID-19 global health crisis is having major impacts on health systems, businesses, governments and customer and consumer activities. UnitedHealth Group continues to mobilize the full strength of its resources to deliver the best care for patients, support for its members and care provider partners, and deliver innovative solutions and support for the communities we serve and the entire health system. The impact to our business is primarily dependent upon the ultimate pacing, intensity and duration of the crisis, factors which we cannot predict at this time. These factors will drive the related treatment, testing, coverage and other services we provide for the people we serve. The health system has recently experienced deferrals of elective care, which impacts both the UnitedHealthcare and Optum businesses through decreased utilization of health care services. As the crisis abates, we may experience an increase in medical care costs as people seek care which was deferred during the pandemic and individuals with chronic conditions may require additional care needs resulting from missed treatments. There can be no assurance that the premiums and fees we charge will be sufficient to cover the medical and administrative costs associated with COVID-19. In addition, we may experience reduced demand for certain services Optum provides to care providers and health plans as a result of reduced clinical and claims activity and changes in business priorities resulting from COVID-19. We cannot at this time measure the impact or duration of changing customer, consumer and member behavior to our overall business.
Governmental policies and initiatives to address COVID-19 have resulted in our customers having to close or severely curtail their operations. Among other impacts, we may experience loss of commercial membership due to customer reductions in workforce and an adverse impact on the timing and collectability of premium payments. In addition, governments have modified, and may continue to modify, regulatory standards around various aspects of health care in response to COVID-19,

and these rapidly changing standards may create challenges for us to ensure timely compliance and meet various contractual obligations.
Disruptions in public and private infrastructure, including supply chains providing medical supplies and pharmaceutical products, could adversely disrupt our business operations. Additionally, the enactment of emergency powers by governments could disrupt our business operations, including restricting pharmaceuticals or other supplies, and could increase the risk of shortages of necessary items.
We have transitioned a significant number of our team members to at-home work environments in an effort to mitigate the spread of COVID-19. This transition may increase our operating costs and effectiveness, including our ability to maintain service levels and ratings, and exacerbate certain risks to our business, including demand for information technology resources, increased vulnerabilities to cybersecurity attacks, and increased risk of unauthorized dissemination of sensitive personal information or proprietary or confidential information about us, our customers or our members.
The COVID-19 crisis has also adversely impacted global access to capital and caused significant volatility in financial markets. Significant deterioration of the U.S. and global economies could have a significant adverse impact on our investment income, the value of our investments, or future liquidity needs.
Because of the unknown pacing, intensity and duration of this pandemic, we cannot predict the impact of its ultimate disruption to business activities, its employment and economic effects, its near and long-term impacts on the patterns of care and services across the healthcare system, or the ultimate resulting impact on our business, results of operations, financial position or cash flows.
ITEM 2.UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
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 2020, we repurchased approximately 63 million shares at an average price of $271.32$303.76 per share. As of March 31,September 30, 2020, we had Board authorization to purchase up to 6663 million shares of our common stock.

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ITEM 6.EXHIBITS*

Table of Contents
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.








101.INS
XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCH
Inline XBRL Taxonomy Extension Schema Document.
101.CAL
Inline XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEF
Inline XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB
Inline XBRL Taxonomy Extension Label Linkbase Document.
101.PRE
Inline XBRL Taxonomy Extension Presentation Linkbase Document.
104
Cover Page Interactive Data File (formatted as Inline XBRL and embedded within Exhibit 101).
 ________________
*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.

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Table of Contents
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 6,November 2, 2020
David S. Wichmann
/s/ JOHN F. REX
Executive Vice President and

Chief Financial Officer
(principal financial officer)
Dated:May 6,November 2, 2020
John F. Rex
/s/ THOMAS E. ROOS
Senior Vice President and

Chief Accounting Officer
(principal accounting officer)
Dated:May 6,November 2, 2020
Thomas E. Roos


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