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UNITEDHEALTH GROUP INC - Quarter Report: 2022 March (Form 10-Q)


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, 2022
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-20220331_g1.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware 41-1321939
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)
UnitedHealth Group Center 55343
9900 Bren Road East
Minnetonka,
Minnesota
(Address of principal executive offices) (Zip Code)
(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 valueUNHNew York Stock Exchange
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 filer
Non-accelerated filer
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes No 
As of April 29, 2022, there were 938,171,603 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.



UNITEDHEALTH GROUP
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PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data)March 31,
2022
December 31,
2021
Assets
Current assets:
Cash and cash equivalents$25,482 $21,375 
Short-term investments2,914 2,532 
Accounts receivable, net18,871 14,216 
Other current receivables, net11,994 13,866 
Assets under management4,155 4,449 
Prepaid expenses and other current assets5,613 5,320 
Total current assets69,029 61,758 
Long-term investments42,353 43,114 
Property, equipment and capitalized software, net
9,183 8,969 
Goodwill77,548 75,795 
Other intangible assets, net9,918 10,044 
Other assets13,207 12,526 
Total assets$221,238 $212,206 
Liabilities, redeemable noncontrolling interests and equity
Current liabilities:
Medical costs payable$28,676 $24,483 
Accounts payable and accrued liabilities25,058 24,643 
Short-term borrowings and current maturities of long-term debt6,697 3,620 
Unearned revenues2,675 2,571 
Other current liabilities25,064 22,975 
Total current liabilities88,170 78,292 
Long-term debt, less current maturities40,796 42,383 
Deferred income taxes2,954 3,265 
Other liabilities11,671 11,787 
Total liabilities143,591 135,727 
Commitments and contingencies (Note 5)
Redeemable noncontrolling interests1,519 1,434 
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; 939 and 941 issued and outstanding
10 10 
Retained earnings78,782 77,134 
Accumulated other comprehensive loss(6,026)(5,384)
Nonredeemable noncontrolling interests
3,362 3,285 
Total equity76,128 75,045 
Total liabilities, redeemable noncontrolling interests and equity$221,238 $212,206 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
 Three Months Ended March 31,
(in millions, except per share data)20222021
Revenues:
Premiums$64,070 $55,486 
Products9,340 8,340 
Services6,372 5,918 
Investment and other income367 452 
Total revenues80,149 70,196 
Operating costs:
Medical costs52,523 44,904 
Operating costs11,401 10,223 
Cost of products sold8,487 7,572 
Depreciation and amortization788 758 
Total operating costs73,199 63,457 
Earnings from operations6,950 6,739 
Interest expense(433)(397)
Earnings before income taxes6,517 6,342 
Provision for income taxes(1,369)(1,364)
Net earnings5,148 4,978 
Earnings attributable to noncontrolling interests(121)(116)
Net earnings attributable to UnitedHealth Group common shareholders
$5,027 $4,862 
Earnings per share attributable to UnitedHealth Group common shareholders:
Basic
$5.34 $5.14 
Diluted
$5.27 $5.08 
Basic weighted-average number of common shares outstanding941 945 
Dilutive effect of common share equivalents13 12 
Diluted weighted-average number of common shares outstanding
954 957 
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
 Three Months Ended March 31,
(in millions)20222021
Net earnings$5,148 $4,978 
Other comprehensive loss:
Gross unrealized losses on investment securities during the period(2,023)(764)
Income tax effect465 174 
Total unrealized losses, net of tax(1,558)(590)
Gross reclassification adjustment for net realized gains included in net earnings
(3)(7)
Income tax effect
Total reclassification adjustment, net of tax
(2)(5)
Total foreign currency translation gains (losses)918 (417)
Other comprehensive loss(642)(1,012)
Comprehensive income4,506 3,966 
Comprehensive income attributable to noncontrolling interests(121)(116)
Comprehensive income attributable to UnitedHealth Group common shareholders
$4,385 $3,850 
See Notes to the Condensed Consolidated Financial Statements
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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 March 31,
(in millions)
SharesAmountNet Unrealized Gains (losses) on InvestmentsForeign Currency Translation (Losses) Gains
Balance at January 1, 2022941 $10 $— $77,134 $423 $(5,807)$3,285 $75,045 
Net earnings
5,027 88 5,115 
Other comprehensive (loss) income(1,560)918 (642)
Issuances of common stock, and related tax effects
— 333 333 
Share-based compensation
282 282 
Common share repurchases(5)— (484)(2,016)(2,500)
Cash dividends paid on common shares ($1.45 per share)
(1,363)(1,363)
Redeemable noncontrolling interests fair value and other adjustments
(131)(131)
Acquisition and other adjustments of nonredeemable noncontrolling interests
91 91 
Distribution to nonredeemable noncontrolling interests
(102)(102)
Balance at March 31, 2022939 $10 $— $78,782 $(1,137)$(4,889)$3,362 $76,128 
Balance at January 1, 2021946 $10 $— $69,295 $1,336 $(5,150)$2,837 $68,328 
Net earnings
4,862 80 4,942 
Other comprehensive loss(595)(417)(1,012)
Issuances of common stock, and related tax effects
— 256 256 
Share-based compensation
242 242 
Common share repurchases(5)— — (1,650)(1,650)
Cash dividends paid on common shares ($1.25 per share)
(1,181)(1,181)
Redeemable noncontrolling interests fair value and other adjustments
(498)(106)(604)
Acquisition and other adjustments of nonredeemable noncontrolling interests
66 66 
Distribution to nonredeemable noncontrolling interests
(74)(74)
Balance at March 31, 2021944 $10 $— $71,220 $741 $(5,567)$2,909 $69,313 
See Notes to the Condensed Consolidated Financial Statements
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UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
 Three Months Ended March 31,
(in millions)20222021
Operating activities
Net earnings$5,148 $4,978 
Noncash items:
Depreciation and amortization788 758 
Deferred income taxes161 341 
Share-based compensation299 256 
Other, net17 (55)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable(4,521)(2,895)
Other assets(1,089)(955)
Medical costs payable3,849 2,968 
Accounts payable and other liabilities589 870 
Unearned revenues78 (261)
Cash flows from operating activities5,319 6,005 
Investing activities
Purchases of investments(4,982)(4,612)
Sales of investments1,591 643 
Maturities of investments1,759 2,255 
Cash paid for acquisitions, net of cash assumed(1,231)(1,193)
Purchases of property, equipment and capitalized software(555)(568)
Other, net(255)(232)
Cash flows used for investing activities(3,673)(3,707)
Financing activities
Common share repurchases(2,500)(1,650)
Cash dividends paid(1,363)(1,181)
Proceeds from common stock issuances551 436 
Repayments of long-term debt(1,100)(1,150)
Proceeds from short-term borrowings, net3,148 4,057 
Customer funds administered5,120 2,131 
Other, net(1,552)(1,856)
Cash flows from financing activities2,304 787 
Effect of exchange rate changes on cash and cash equivalents157 (51)
Increase in cash and cash equivalents4,107 3,034 
Cash and cash equivalents, beginning of period21,375 16,921 
Cash and cash equivalents, end of period$25,482 $19,955 
See Notes to the Condensed Consolidated Financial Statements
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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 health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. Our two distinct, yet complementary business platforms — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations the Company is privileged to serve.
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, 2021 as filed with the SEC (2021 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to estimates and judgments for 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.
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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, 2022
Debt securities - available-for-sale:
U.S. government and agency obligations$3,507 $$(140)$3,371 
State and municipal obligations7,022 57 (224)6,855 
Corporate obligations21,669 55 (811)20,913 
U.S. agency mortgage-backed securities6,210 (316)5,901 
Non-U.S. agency mortgage-backed securities2,913 (112)2,803 
Total debt securities - available-for-sale41,321 125 (1,603)39,843 
Debt securities - held-to-maturity:
U.S. government and agency obligations510 (9)502 
State and municipal obligations29 — — 29 
Corporate obligations87 — — 87 
Total debt securities - held-to-maturity626 (9)618 
Total debt securities$41,947 $126 $(1,612)$40,461 
December 31, 2021
Debt securities - available-for-sale:
U.S. government and agency obligations$3,206 $23 $(31)$3,198 
State and municipal obligations6,829 297 (20)7,106 
Corporate obligations20,947 372 (145)21,174 
U.S. agency mortgage-backed securities5,868 88 (55)5,901 
Non-U.S. agency mortgage-backed securities2,819 42 (23)2,838 
Total debt securities - available-for-sale39,669 822 (274)40,217 
Debt securities - held-to-maturity:
U.S. government and agency obligations511 (2)511 
State and municipal obligations30 — 32 
Corporate obligations100 — — 100 
Total debt securities - held-to-maturity641 (2)643 
Total debt securities$40,310 $826 $(276)$40,860 
The Company held $3.5 billion of equity securities as of both March 31, 2022 and December 31, 2021. The Company’s investments in equity securities primarily consist of employee savings plan related investments, other venture investments and shares of Brazilian real denominated fixed-income funds with readily determinable fair values. Additionally, the Company’s investments included $1.3 billion of equity method investments in operating businesses in the health care sector, as of both March 31, 2022 and December 31, 2021. The allowance for credit losses on held-to-maturity securities at March 31, 2022 and December 31, 2021 was not material.
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The amortized cost and fair value of debt securities as of March 31, 2022, by contractual maturity, were as follows:
Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost
Fair
Value
Amortized
Cost
Fair
Value
Due in one year or less$2,987 $2,986 $217 $217 
Due after one year through five years12,900 12,608 355 347 
Due after five years through ten years12,055 11,461 29 29 
Due after ten years4,256 4,084 25 25 
U.S. agency mortgage-backed securities6,210 5,901 — — 
Non-U.S. agency mortgage-backed securities2,913 2,803 — — 
Total debt securities$41,321 $39,843 $626 $618 
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 Months12 Months or Greater Total
(in millions)Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
Fair
Value
Gross
Unrealized
Losses
March 31, 2022
Debt securities - available-for-sale:
U.S. government and agency obligations
$2,485 $(96)$451 $(44)$2,936 $(140)
State and municipal obligations3,568 (204)218 (20)3,786 (224)
Corporate obligations14,237 (603)2,049 (208)16,286 (811)
U.S. agency mortgage-backed securities4,192 (201)1,225 (115)5,417 (316)
Non-U.S. agency mortgage-backed securities
2,097 (78)348 (34)2,445 (112)
Total debt securities - available-for-sale$26,579 $(1,182)$4,291 $(421)$30,870 $(1,603)
December 31, 2021
Debt securities - available-for-sale:
U.S. government and agency obligations
$1,976 $(18)$249 $(13)$2,225 $(31)
State and municipal obligations1,386 (19)31 (1)$1,417 $(20)
Corporate obligations9,357 (130)376 (15)$9,733 $(145)
U.S. agency mortgage-backed securities3,078 (52)116 (3)$3,194 $(55)
Non-U.S. agency mortgage-backed securities
1,321 (18)114 (5)$1,435 $(23)
Total debt securities - available-for-sale$17,118 $(237)$886 $(37)$18,004 $(274)
The Company’s unrealized losses from debt securities as of March 31, 2022 were generated from approximately 27,000 positions out of a total of 39,000 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 caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities that impacted the Company’s 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, noting no significant credit deterioration since purchase. As of March 31, 2022, 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, 2022 and December 31, 2021 was not material.
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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 2021 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, 2022
Cash and cash equivalents$25,382 $100 $— $25,482 
Debt securities - available-for-sale:
U.S. government and agency obligations3,214 157 — 3,371 
State and municipal obligations— 6,855 — 6,855 
Corporate obligations36 20,670 207 20,913 
U.S. agency mortgage-backed securities— 5,901 — 5,901 
Non-U.S. agency mortgage-backed securities— 2,803 — 2,803 
Total debt securities - available-for-sale3,250 36,386 207 39,843 
Equity securities2,036 20 68 2,124 
Assets under management 1,727 2,333 95 4,155 
Total assets at fair value$32,395 $38,839 $370 $71,604 
Percentage of total assets at fair value45 %54 %%100 %
December 31, 2021
Cash and cash equivalents$21,359 $16 $— $21,375 
Debt securities - available-for-sale:
U.S. government and agency obligations3,017 181 — 3,198 
State and municipal obligations— 7,106 — 7,106 
Corporate obligations40 20,916 218 21,174 
U.S. agency mortgage-backed securities— 5,901 — 5,901 
Non-U.S. agency mortgage-backed securities— 2,838 — 2,838 
Total debt securities - available-for-sale3,057 36,942 218 40,217 
Equity securities2,090 23 64 2,177 
Assets under management 1,972 2,376 101 4,449 
Total assets at fair value$28,478 $39,357 $383 $68,218 
Percentage of total assets at fair value42 %57 %%100 %
There were no transfers in or out of Level 3 financial assets or liabilities during the three months ended March 31, 2022 or 2021.
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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, 2022
Debt securities - held-to-maturity$525 $86 $$618 $626 
Long-term debt and other financing obligations$— $46,686 $— $46,686 $43,344 
December 31, 2021
Debt securities - held-to-maturity$534 $102 $$643 $641 
Long-term debt and other financing obligations$— $52,583 $— $52,583 $46,003 
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during either the three months ended March 31, 2022 or 2021.
4.    Medical Costs Payable
The following table shows the components of the change in medical costs payable for the three months ended March 31:
(in millions)20222021
Medical costs payable, beginning of period$24,483 $21,872 
Acquisitions12 
Reported medical costs:
Current year52,813 45,914 
Prior years(290)(1,010)
Total reported medical costs52,523 44,904 
Medical payments:
Payments for current year
(29,589)(25,960)
Payments for prior years(18,749)(15,995)
Total medical payments(48,338)(41,955)
Medical costs payable, end of period$28,676 $24,833 
For the three months ended March 31, 2022, prior years medical cost reserve development included no individual factors that were significant. For the three months ended March 31, 2021, prior years’ medical cost reserve development was primarily driven by lower than expected health system utilization and the uncertainty of care patterns due to the disruption of the health care system caused by COVID-19. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of $19.5 billion and $17.1 billion at March 31, 2022 and December 31, 2021, respectively.
5.    Commitments and Contingencies
Pending Acquisitions
As of March 31, 2022, the Company has entered into agreements to acquire companies in the health care sector, most notably Change Healthcare (NASDAQ: CHNG) and LHC Group, Inc. (NASDAQ: LHCG), subject to regulatory approval and other customary closing conditions. The total anticipated capital required for these acquisitions, excluding associated disposition proceeds and the payoff of acquired indebtedness, is approximately $15 billion.
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.
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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 for Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the DOJ, 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 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 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 Medicare 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, the 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.
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6.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, Optum Health, Optum Insight and Optum Rx. For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements and Supplementary Data” in the 2021 10-K.
On January 1, 2022, the Company realigned its operating segments to combine UnitedHealthcare Global and UnitedHealthcare Employer & Individual. The realignment had no impact on the Company’s reportable segments.
The following tables present reportable segment financial information:
  Optum  
(in millions)UnitedHealthcareOptum HealthOptum InsightOptum RxOptum EliminationsOptumCorporate and
Eliminations
Consolidated
Three Months Ended March 31, 2022
Revenues - unaffiliated customers:
Premiums$59,937 $4,133 $— $— $— $4,133 $— $64,070 
Products— 40 9,294 — 9,340 — 9,340 
Services2,515 2,558 974 325 — 3,857 — 6,372 
Total revenues - unaffiliated customers
62,452 6,697 1,014 9,619 — 17,330 — 79,782 
Total revenues - affiliated customers
— 9,829 2,138 14,291 (553)25,705 (25,705)— 
Investment and other income
143 156 67 — 224 — 367 
Total revenues$62,595 $16,682 $3,219 $23,911 $(553)$43,259 $(25,705)$80,149 
Earnings from operations$3,798 $1,366 $847 $939 $— $3,152 $— $6,950 
Interest expense— — — — — — (433)(433)
Earnings before income taxes
$3,798 $1,366 $847 $939 $— $3,152 $(433)$6,517 
Three Months Ended March 31, 2021
Revenues - unaffiliated customers:
Premiums$52,558 $2,928 $— $— $— $2,928 $— $55,486 
Products— 37 8,295 — 8,340 — 8,340 
Services2,350 2,336 961 271 — 3,568 — 5,918 
Total revenues - unaffiliated customers
54,908 5,272 998 8,566 — 14,836 — 69,744 
Total revenues - affiliated customers
— 6,952 1,821 13,004 (475)21,302 (21,302)— 
Investment and other income
206 179 33 34 — 246 — 452 
Total revenues$55,114 $12,403 $2,852 $21,604 $(475)$36,384 $(21,302)$70,196 
Earnings from operations$4,108 $962 $779 $890 $— $2,631 $— $6,739 
Interest expense— — — — — — (397)(397)
Earnings before income taxes
$4,108 $962 $779 $890 $— $2,631 $(397)$6,342 

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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 2021 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,” the “Company,” “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 2021 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group Incorporated is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. Our two distinct, yet complementary business platforms — Optum and UnitedHealthcare — are working to help build a modern, high-performing health system through improved access, affordability, outcomes and experiences for the individuals and organizations we are privileged to serve.
We have four reportable segments across our two business platforms, Optum and UnitedHealthcare:
Optum Health;
Optum Insight;
Optum Rx; and
UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State.
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 2021 10-K and additional information on our segments, including the realignment of our UnitedHealthcare operating segments to combine UnitedHealthcare Global and UnitedHealthcare Employer and Individual, can be found in this Item 2 and in Note 6 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.
Business Trends
Our businesses participate in the United States, South America 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 population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macroeconomic 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 Trends. To price our health care benefit products, we start with our view of expected future costs, including any potential impacts from COVID-19. 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 and similar revenue adjustments. We will continue seeking to balance growth and profitability across all these dimensions.
The commercial risk market remains highly competitive in the small group, large group and individual segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs.
Government programs in the community 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 related care and testing costs as well as the deferral of care have also impacted medical cost trends in the current year and may continue in future years. Future medical cost trends may be impacted by increased consumer
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demand for care, potentially even higher acuity care, due to the temporary deferral of care since the onset of the pandemic. 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 continued uncertain impact of COVID-19 may impact our ability to estimate medical costs payable, which has resulted in, and could result in, increased variability to medical cost reserve development.
COVID-19 Trends and Uncertainties
The COVID-19 pandemic continues to evolve and the ultimate impact on our business, results of operations, financial condition and cash flows remains uncertain. During the three months ended March 31, 2022, overall care was near normal baseline levels. COVID-19 treatment and testing costs continue to be mitigated by the temporary deferral of care, both varying with COVID-19 incidence rates. In future periods, care patterns may moderately exceed normal baselines as previously deferred care is obtained. Though not yet experienced, acuity may temporarily rise due to missed regular care.
COVID-19 may continue to influence customer and consumer behavior, which could impact how and where care is delivered, benefit product designs, and the manner in which consumers wish to receive their prescription drugs or infusion services. Disrupted care patterns, as a result of the pandemic, have affected and may continue to temporarily affect the ability to obtain complete member health status information, impacting revenue in businesses utilizing risk adjustment methodologies.
The ultimate overall impact is uncertain and dependent on the future pacing, intensity and duration of the pandemic, the severity of new variants of the COVID-19 virus, the effectiveness and extent of administration of vaccination and treatments and general economic uncertainty.
SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select first quarter 2022 year-over-year operating comparisons to first quarter 2021 and other financial results.
Consolidated revenues grew 14%, UnitedHealthcare revenues grew 14% and Optum revenues grew 19%.
UnitedHealthcare served nearly 1.5 million more people, led by growth in community and senior programs.
Consolidated earnings from operations of $7.0 billion compared to $6.7 billion last year, included growth of 20% at Optum, partially offset by a decrease of 8% at UnitedHealthcare.
Diluted earnings per common share were $5.27.
Cash flows from operations for the three months ended March 31, 2022 were $5.3 billion.
Return on equity was 27.8%.
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RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data)Three Months Ended March 31,Increase/(Decrease)
202220212022 vs. 2021
Revenues:
Premiums$64,070 $55,486 $8,584 15 %
Products9,340 8,340 1,000 12 
Services6,372 5,918 454 
Investment and other income
367 452 (85)(19)
Total revenues80,149 70,196 9,953 14 
Operating costs:
Medical costs52,523 44,904 7,619 17 
Operating costs11,401 10,223 1,178 12 
Cost of products sold8,487 7,572 915 12 
Depreciation and amortization
788 758 30 
Total operating costs73,199 63,457 9,742 15 
Earnings from operations6,950 6,739 211 
Interest expense(433)(397)(36)
Earnings before income taxes6,517 6,342 175 
Provision for income taxes(1,369)(1,364)(5)— 
Net earnings5,148 4,978 170 
Earnings attributable to noncontrolling interests
(121)(116)(5)
Net earnings attributable to UnitedHealth Group common shareholders
$5,027 $4,862 $165 %
Diluted earnings per share attributable to UnitedHealth Group common shareholders
$5.27 $5.08 $0.19 %
Medical care ratio (a)82.0 %80.9 %1.1 %
Operating cost ratio14.2 14.6 (0.4)
Operating margin8.7 9.6 (0.9)
Tax rate21.0 21.5 (0.5)
Net earnings margin (b)6.3 6.9 (0.6)
Return on equity (c)27.8 %29.5 %(1.7)%
(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.
2022 RESULTS OF OPERATIONS COMPARED TO 2021 RESULTS OF OPERATIONS
Consolidated Financial Results
Revenues
The increases in revenues were primarily driven by growth in the number of people served through Medicare Advantage, Medicaid and commercial offerings; pricing trends; and growth across the Optum businesses.
Medical Costs and MCR
Medical costs and MCR increased as a result of business mix and decreased favorable development. Medical costs also increased due to growth in people served through Medicare Advantage, Medicaid and commercial offerings.
Operating Cost Ratio
The operating cost ratio decreased primarily due to COVID-19 related revenue effects, operating efficiency gains and business mix.
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Reportable Segments
See Note 6 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 people served by UnitedHealthcare by major market segment and funding arrangement, people served by Optum Health and adjusted scripts for Optum Rx. 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, including the mix of care delivered through value-based care models at Optum Health, level and scope of services provided to people 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)
(in millions, except percentages)202220212022 vs. 2021
Revenues
UnitedHealthcare$62,595 $55,114 $7,481 14 %
Optum Health16,682 12,403 4,279 34 
Optum Insight3,219 2,852 367 13 
Optum Rx23,911 21,604 2,307 11 
Optum eliminations(553)(475)(78)16 
Optum
43,259 36,384 6,875 19 
Eliminations(25,705)(21,302)(4,403)21 
Consolidated revenues$80,149 $70,196 $9,953 14 %
Earnings from operations
UnitedHealthcare$3,798 $4,108 $(310)(8)%
Optum Health1,366 962 404 42 
Optum Insight847 779 68 
Optum Rx939 890 49 
Optum
3,152 2,631 521 20 
Consolidated earnings from operations
$6,950 $6,739 $211 %
Operating margin
UnitedHealthcare6.1 %7.5 %(1.4)%
Optum Health8.2 7.8 0.4 
Optum Insight26.3 27.3 (1.0)
Optum Rx3.9 4.1 (0.2)
Optum
7.3 7.2 0.1 
Consolidated operating margin8.7 %9.6 %(0.9)%
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended March 31,Increase/(Decrease)
(in millions, except percentages)202220212022 vs. 2021
UnitedHealthcare Employer & Individual - Domestic$15,822 $14,632 $1,190 %
UnitedHealthcare Employer & Individual - Global (a)2,133 2,035 98 %
UnitedHealthcare Employer & Individual - Total (a)17,955 16,667 1,288 %
UnitedHealthcare Medicare & Retirement
29,100 25,474 3,626 14 
UnitedHealthcare Community & State
15,540 12,973 2,567 20 
Total UnitedHealthcare revenues$62,595 $55,114 $7,481 14 %
(a)On January 1, 2022, we realigned our operating segments to combine UnitedHealthcare Global and UnitedHealthcare Employer & Individual.
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The following table summarizes the number of people served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
March 31,Increase/(Decrease)
(in thousands, except percentages)202220212022 vs. 2021
Commercial - domestic:
Risk-based7,950 7,860 90 %
Fee-based18,460 18,455 — 
Total commercial - domestic26,410 26,315 95 — 
Medicare Advantage6,890 6,335 555 
Medicaid7,810 6,975 835 12 
Medicare Supplement (Standardized)4,355 4,390 (35)(1)
Total community and senior19,055 17,700 1,355 
Total UnitedHealthcare - domestic medical45,465 44,015 1,450 
Commercial - global5,500 5,460 40 
Total UnitedHealthcare - medical50,965 49,475 1,490 %
Supplemental Data:
Medicare Part D stand-alone3,360 3,795 (435)(11)%
Commercial business increased due to growth in risk-based offerings. Medicare Advantage increased due to growth in people served through individual and group Medicare Advantage plans. The increase in people served through Medicaid was primarily driven by states continuing to ease redetermination requirements due to COVID-19, new state-based awards and growth in people served through Dual Special Needs Plans.
UnitedHealthcare’s revenues increased due to growth in the number of individuals served through Medicare Advantage and Medicaid, including a greater mix of people with higher acuity needs, and an increase in the number of individuals served through commercial benefits. Earnings from operations declined primarily due to decreased favorable development partially offset by the factors impacting revenue and COVID-19 impacts.
Optum
Total revenues and earnings from operations increased due to growth across the Optum businesses. The results by segment were as follows:
Optum Health
Revenues at Optum Health increased primarily due to organic growth in value-based care arrangements and acquisitions. Earnings from operations increased due to organic growth in value-based care arrangements, COVID-19 effects and cost management initiatives. Optum Health served approximately 100 million people as of March 31, 2022 compared to 99 million people as of March 31, 2021.
Optum Insight
Revenues and earnings from operations at Optum Insight increased due to growth in managed services and technology, with managed services growth driven by higher payer volumes and new health system partnerships.
Optum Rx
Revenues and earnings from operations at Optum Rx increased due to higher script volumes from growth in people served, increased utilization and organic growth in pharmacy care services, including community-behavioral, specialty pharmacy and e-commerce services. Earnings from operations also increased as a result of continued supply chain management initiatives. Optum Rx fulfilled 352 million and 329 million adjusted scripts in the first quarters of 2022 and 2021, respectively.
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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)
(in millions)202220212022 vs. 2021
Sources of cash:
Cash provided by operating activities$5,319 $6,005 $(686)
Issuances of short-term borrowings and long-term debt, net of repayments
2,048 2,907 (859)
Proceeds from common stock issuances551 436 115 
Customer funds administered
5,120 2,131 2,989 
Total sources of cash13,038 11,479 
Uses of cash:
Common stock repurchases(2,500)(1,650)(850)
Cash paid for acquisitions, net of cash assumed
(1,231)(1,193)(38)
Purchases of investments, net of sales and maturities (1,632)(1,714)82 
Purchases of property, equipment and capitalized software
(555)(568)13 
Cash dividends paid
(1,363)(1,181)(182)
Other(1,807)(2,088)281 
Total uses of cash(9,088)(8,394)
Effect of exchange rate changes on cash and cash equivalents
157 (51)208 
Net increase in cash and cash equivalents$4,107 $3,034 $1,073 
2022 Cash Flows Compared to 2021 Cash Flows
Decreased cash flows provided by operating activities were primarily driven by changes in working capital accounts. Other significant changes in sources or uses of cash year-over-year included increased customer funds administered, partially offset by increased share repurchases and decreased net issuances of short-term borrowings and long-term debt.
Financial Condition
As of March 31, 2022, our cash, cash equivalent, available-for-sale debt securities and equity securities balances of $68.8 billion included approximately $25.5 billion of cash and cash equivalents (of which $2.5 billion was available for general corporate use), $39.8 billion of debt securities and $3.5 billion of investments in equity securities. Given the significant portion of our portfolio held in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt securities portfolio had a weighted-average duration of 4.1 years and a weighted-average credit rating of “Double A” as of March 31, 2022. When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Cash Requirements. A summary of our cash requirements as of December 31, 2021 was disclosed in Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 2021 10-K. During the three months ended March 31, 2022, there were no material changes to this previously disclosed information outside the ordinary course of business. We believe our capital resources are sufficient to meet future, short-term and long-term, liquidity needs. We continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
Short-Term Borrowings. 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 8 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements and Supplementary Data” in our 2021 10-K.
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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, 2022, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 37%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, such as, to meet our working capital requirements, to refinance debt, to finance acquisitions or for share repurchases. For more information on our long-term debt, see Note 8 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements and Supplementary Data” in our 2021 10-K.
Credit Ratings. Our credit ratings as of March 31, 2022 were as follows:
  
Moody’sS&P GlobalFitchA.M. Best
 RatingsOutlookRatingsOutlookRatingsOutlookRatingsOutlook
Senior unsecured debt
A3StableA+StableAStableAStable
Commercial paperP-2n/aA-1n/aF1n/aAMB-1+n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. A significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. During the three months ended March 31, 2022, we repurchased approximately 5 million shares at an average price of $485.12 per share. As of March 31, 2022, we had Board authorization to purchase up to 40 million shares of our common stock.
Dividends. Our quarterly cash dividend to shareholders reflects an annual dividend rate of $5.80 per share.
Pending Acquisitions. As of March 31, 2022, we have entered into agreements to acquire companies in the health care sector, most notably Change Healthcare (NASDAQ: CHNG) and LHC Group, Inc. (NASDAQ: LHCG), subject to regulatory approval and other customary closing conditions. The total anticipated capital required for these acquisitions, excluding associated disposition proceeds and the payoff of acquired indebtedness, is approximately $15 billion.
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 2021 10-K.
RECENTLY ISSUED ACCOUNTING STANDARDS
There are no recently issued accounting standards that are expected to have a material impact on our Condensed Consolidated Financial Statements.
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 2021 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 2021 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
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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; cyberattacks, other privacy/data security incidents, or our failure to comply with related regulations; failure to protect proprietary rights to our databases, software and related products; risks and uncertainties associated with our businesses providing pharmacy care services; competitive pressures, including our ability to develop and deliver innovative products to health care payers and expand access to virtual care; changes in or challenges to our public sector contract awards; failure to develop and maintain satisfactory relationships with health care payers, physicians, hospitals and other service providers; failure to attract, develop, retain, and manage the succession of key employees and executives; the impact of potential changes in tax laws and regulations (including any increase in the U.S. income tax rate applicable to corporations); 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.
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 matching a portion of our floating-rate assets and liabilities, 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, 2022 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
March 31, 2022
Increase (Decrease) in Market Interest RateInvestment
Income Per
Annum
Interest
Expense Per
Annum
Fair Value of
Financial Assets
Fair Value of
Financial Liabilities
2 %$578 $202 $(3,090)$(7,429)
1289 101 (1,586)(4,041)
(1)(92)(46)1,650 4,857 
(2)(92)(46)3,280 10,710 
Note: Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of March 31, 2022, 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. As of March 31, 2022, some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
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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, 2022. 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, 2022.
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, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
PART II. OTHER INFORMATION
ITEM 1.    LEGAL PROCEEDINGS
A description of our legal proceedings is included in and incorporated by reference to Note 5 of Notes to the Condensed Consolidated Financial Statements contained in Part I, Item 1 of this report.
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 2021 10-K, which could materially affect our business, financial condition or future results. The risks described in our 2021 10-K are not the only risks facing us. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or future results.
There have been no material changes to the risk factors as disclosed in our 2021 10-K.
ITEM 2.    UNREGISTERED SALE OF EQUITY SECURITIES AND USE OF PROCEEDS
Issuer Purchases of Equity Securities (a)
First Quarter 2022
For the Month EndedTotal Number of Shares PurchasedAverage Price Paid Per ShareTotal Number of Shares Purchased as Part of Publicly Announced Plans or ProgramsMaximum Number of Shares That May Yet Be Purchased Under The Plans or Programs
(in millions)(in millions)(in millions)
January 31, 20221$472.20 144
February 28, 20221474.86 143
March 31, 20223494.10 340
Total5$485.12 5
(a)    In November 1997, our Board of Directors adopted a share repurchase program, which the Board evaluates periodically. In June 2018, the Board renewed our share repurchase program with an authorization to repurchase up to 100 million shares of our common stock in open market purchases or other types of transactions (including prepaid or structured repurchase programs). There is no established expiration date for the program.
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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.INSXBRL 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.SCHInline XBRL Taxonomy Extension Schema Document.
101.CALInline XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEFInline XBRL Taxonomy Extension Definition Linkbase Document.
101.LABInline XBRL Taxonomy Extension Label Linkbase Document.
101.PREInline 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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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/ ANDREW P. WITTY
Chief Executive Officer
(principal executive officer)
Dated:May 4, 2022
Andrew P. Witty  
/s/ JOHN F. REX
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:May 4, 2022
John F. Rex  
/s/ THOMAS E. ROOS
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:May 4, 2022
Thomas E. Roos  
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