UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
__________________________________________________________ 
Form 10-Q
__________________________________________________________ 
[X]QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED MARCH 31, 20172018
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
__________________________________________________________ 
    uhglogo1a01a01a12.jpg
UnitedHealth Group Incorporated
(Exact name of registrant as specified in its charter)
 __________________________________________________________ 
Delaware 41-1321939
(State or other jurisdiction of
incorporation or organization)
 
(I.R.S. Employer
Identification No.)
   
UnitedHealth Group Center
9900 Bren Road East
Minnetonka, Minnesota
 55343
(Address of principal executive offices) (Zip Code)
(952) 936-1300
(Registrant’s telephone number, including area code)
__________________________________________________________  
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes [X] No [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, 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:Act (check one)
Large accelerated filer[X] Accelerated filer[ ] Non-accelerated filer (Do not check if a smaller reporting company)[ ]
Smaller reporting company[ ] Emerging growth company[ ]
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. [ ]
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes [ ] No [X]
As of April 28, 2017,30, 2018, there were 963,661,565960,981,242 shares of the registrant’s Common Stock, $.01 par value per share, issued and outstanding.
     

UNITEDHEALTH GROUP
Table of Contents
 
   Page   Page
  
  
 
  
  
  
  
  
  
  
  
  
  
  
  
  
  




PART I
ITEM 1.    FINANCIAL STATEMENTS
UnitedHealth Group
Condensed Consolidated Balance Sheets
(Unaudited)
(in millions, except per share data) March 31,
2017
 December 31,
2016
 March 31,
2018
 December 31,
2017
Assets        
Current assets:        
Cash and cash equivalents $16,142
 $10,430
 $18,243
 $11,981
Short-term investments 3,210
 2,845
 3,798
 3,509
Accounts receivable, net 9,595
 8,152
 11,512
 9,568
Other current receivables, net 6,609
 7,499
 6,778
 6,262
Assets under management 2,886
 3,105
 2,922
 3,101
Prepaid expenses and other current assets 2,547
 1,848
 5,100
 2,663
Total current assets 40,989
 33,879
 48,353
 37,084
Long-term investments 25,760
 23,868
 29,441
 28,341
Property, equipment and capitalized software, net 6,329
 5,901
 8,144
 7,013
Goodwill 52,376
 47,584
 56,850
 54,556
Other intangible assets, net 8,618
 8,541
 9,033
 8,489
Other assets 3,085
 3,037
 3,748
 3,575
Total assets $137,157
 $122,810
 $155,569
 $139,058
Liabilities, redeemable noncontrolling interests and equity        
Current liabilities:        
Medical costs payable $17,650
 $16,391
 $19,589
 $17,871
Accounts payable and accrued liabilities 13,473
 13,361
 18,210
 15,180
Commercial paper and current maturities of long-term debt 7,747
 7,193
 7,379
 2,857
Unearned revenues 6,475
 1,968
 7,683
 2,269
Other current liabilities 12,198
 10,339
 14,806
 12,286
Total current liabilities 57,543
 49,252
 67,667
 50,463
Long-term debt, less current maturities 26,154
 25,777
 28,206
 28,835
Future policy benefits 2,519
 2,524
Deferred income taxes 2,894
 2,761
 2,213
 2,182
Other liabilities 2,385
 2,307
 5,557
 5,556
Total liabilities 91,495
 82,621
 103,643
 87,036
Commitments and contingencies (Note 7) 

 

Commitments and contingencies (Note 6) 

 

Redeemable noncontrolling interests 1,667
 2,012
 1,890
 2,189
Equity:        
Preferred stock, $0.001 par value - 10 shares authorized; no shares issued or outstanding 
 
 
 
Common stock, $0.01 par value - 3,000 shares authorized; 965 and 952 issued and outstanding 10
 10
Common stock, $0.01 par value - 3,000 shares authorized; 962 and 969 issued and outstanding 10
 10
Additional paid-in capital 1,819
 
 
 1,703
Retained earnings 42,521
 40,945
 50,494
 48,730
Accumulated other comprehensive loss (2,447) (2,681) (2,951) (2,667)
Nonredeemable noncontrolling interest 2,092
 (97)
Nonredeemable noncontrolling interests 2,483
 2,057
Total equity 43,995
 38,177
 50,036
 49,833
Total liabilities, redeemable noncontrolling interests and equity $137,157
 $122,810
 $155,569
 $139,058

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Operations
(Unaudited)
 Three Months Ended March 31, Three Months Ended March 31,
(in millions, except per share data) 2017 2016 2018 2017
Revenues:        
Premiums $38,938
 $34,811
 $44,084
 $38,938
Products 6,129
 6,393
 6,702
 6,129
Services 3,434
 3,140
 4,104
 3,434
Investment and other income 222
 183
 298
 222
Total revenues 48,723
 44,527
 55,188
 48,723
Operating costs:        
Medical costs 32,079
 28,430
 35,863
 32,079
Operating costs 7,022
 6,758
 8,506
 7,022
Cost of products sold 5,676
 5,877
 6,184
 5,676
Depreciation and amortization 533
 502
 582
 533
Total operating costs 45,310
 41,567
 51,135
 45,310
Earnings from operations 3,413
 2,960
 4,053
 3,413
Interest expense (283) (259) (329) (283)
Earnings before income taxes 3,130
 2,701
 3,724
 3,130
Provision for income taxes (939) (1,074) (800) (939)
Net earnings 2,191
 1,627
 2,924
 2,191
Earnings attributable to noncontrolling interests (19) (16) (88) (19)
Net earnings attributable to UnitedHealth Group common shareholders $2,172
 $1,611
 $2,836
 $2,172
Earnings per share attributable to UnitedHealth Group common shareholders:        
Basic $2.28
 $1.69
 $2.94
 $2.28
Diluted $2.23
 $1.67
 $2.87
 $2.23
Basic weighted-average number of common shares outstanding 954
 953
 966
 954
Dilutive effect of common share equivalents 21
 14
 21
 21
Diluted weighted-average number of common shares outstanding 975
 967
 987
 975
Anti-dilutive shares excluded from the calculation of dilutive effect of common share equivalents 9
 7
 7
 9
Cash dividends declared per common share $0.625
 $0.500
 $0.750
 $0.625

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)

 Three Months Ended March 31, Three Months Ended March 31,
(in millions) 2017 2016 2018 2017
Net earnings $2,191
 $1,627
 $2,924
 $2,191
Other comprehensive income:    
Gross unrealized gains on investment securities during the period 99
 260
Other comprehensive (loss) income:    
Gross unrealized (losses) gains on investment securities during the period (378) 99
Income tax effect (32) (96) 86
 (32)
Total unrealized gains, net of tax 67
 164
Total unrealized (losses) gains, net of tax (292) 67
Gross reclassification adjustment for net realized gains included in net earnings (21) (35) (19) (21)
Income tax effect 8
 13
 4
 8
Total reclassification adjustment, net of tax (13) (22) (15) (13)
Total foreign currency translation gains 180
 388
Other comprehensive income 234
 530
Total foreign currency translation (loss) gain (1) 180
Other comprehensive (loss) income (308) 234
Comprehensive income 2,425
 2,157
 2,616
 2,425
Comprehensive income attributable to noncontrolling interests (19) (16) (88) (19)
Comprehensive income attributable to UnitedHealth Group common shareholders $2,406
 $2,141
 $2,528
 $2,406

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Changes in Equity
(Unaudited)
 Common Stock Additional Paid-In Capital Retained Earnings 
Accumulated Other Comprehensive (Loss)
Income
 Nonredeemable Noncontrolling Interest 
Total
Equity
 Common Stock Additional Paid-In Capital Retained Earnings 
Accumulated Other Comprehensive (Loss)
Income
 Nonredeemable Noncontrolling Interests 
Total
Equity
(in millions) Shares Amount Net Unrealized (Losses) Gains on Investments Foreign Currency Translation (Losses) Gains  Shares Amount Net Unrealized (Losses) Gains on Investments Foreign Currency Translation (Losses) Gains 
Balance at January 1, 2018 969
 $10
 $1,703
 $48,730
 $(13) $(2,654) $2,057
 $49,833
Adjustment to adopt ASU 2016-01 
 
 
 (24) 24
 
 
 
Net earnings       2,836
     53
 2,889
Other comprehensive loss         (307) (1)   (308)
Issuances of common stock,
and related tax effects
 5
 
 415
         415
Share-based compensation     206
         206
Common share repurchases (12) 
 (2,324) (326)       (2,650)
Cash dividends paid on common shares       (722)       (722)
Acquisition of nonredeemable noncontrolling interests             423
 423
Distribution to nonredeemable noncontrolling interests             (50) (50)
Balance at March 31, 2018 962
 $10
 $
 $50,494
 $(296) $(2,655) $2,483
 $50,036
                
Balance at January 1, 2017 952
 $10
 $
 $40,945
 $(97) $(2,584) $(97) $38,177
 952
 $10
 $
 $40,945
 $(97) $(2,584) $(97) $38,177
Net earnings       2,172
     9
 2,181
       2,172
     9
 2,181
Other comprehensive income         54
 180
   234
         54
 180
   234
Issuances of common stock,
and related tax effects
 17
 
 1,923
         1,923
 17
 
 1,923
         1,923
Share-based compensation     189
         189
     189
         189
Common share repurchases (4) 
 (682) 
       (682) (4) 
 (682) 
       (682)
Cash dividends paid on common shares       (596)       (596)       (596)       (596)
Redeemable noncontrolling interests fair value and other adjustments     389
         389
     389
         389
Acquisition of nonredeemable noncontrolling interest             2,191
 2,191
Distribution to nonredeemable noncontrolling interest             (11) (11)
Acquisition of nonredeemable noncontrolling interests             2,191
 2,191
Distribution to nonredeemable noncontrolling interests             (11) (11)
Balance at March 31, 2017 965
 $10
 $1,819
 $42,521
 $(43) $(2,404) $2,092
 $43,995
 965
 $10
 $1,819
 $42,521
 $(43) $(2,404) $2,092
 $43,995
                
Balance at January 1, 2016 953
 $10
 $29
 $37,125
 $56
 $(3,390) $(105) $33,725
Adjustment to adopt ASU 2016-09       28
       28
Net earnings       1,611
     11
 1,622
Other comprehensive income         142
 388
   530
Issuances of common stock,
and related tax effects
 5
 
 56
         56
Share-based compensation     150
         150
Common share repurchases (4) 
 (176) (324)       (500)
Cash dividends paid on common shares       (477)       (477)
Redeemable noncontrolling interests fair value and other adjustments     (59)         (59)
Distribution to nonredeemable noncontrolling interest             (8) (8)
Balance at March 31, 2016 954
 $10
 $
 $37,963
 $198
 $(3,002) $(102) $35,067


See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Condensed Consolidated Statements of Cash Flows
(Unaudited)
 Three Months Ended March 31, Three Months Ended March 31,
(in millions) 2017 2016 2018 2017
Operating activities        
Net earnings $2,191
 $1,627
 $2,924
 $2,191
Noncash items:        
Depreciation and amortization 533
 502
 582
 533
Deferred income taxes (89) 145
 (74) (89)
Share-based compensation 196
 157
 208
 196
Other, net 43
 6
 27
 43
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:        
Accounts receivable (1,232) (1,110) (1,579) (1,232)
Other assets (998) (2,162) (3,232) (998)
Medical costs payable 1,024
 1,368
 1,313
 1,024
Accounts payable and other liabilities 292
 2,036
 2,821
 292
Unearned revenues 4,496
 (251) 5,379
 4,496
Cash flows from operating activities 6,456
 2,318
 8,369
 6,456
Investing activities        
Purchases of investments (3,683) (5,173) (3,891) (3,683)
Sales of investments 1,018
 2,122
 1,002
 1,018
Maturities of investments 1,326
 978
 1,504
 1,326
Cash paid for acquisitions, net of cash assumed (468) (1,697) (2,583) (468)
Purchases of property, equipment and capitalized software (507) (425) (477) (507)
Other, net 25
 14
 (72) 25
Cash flows used for investing activities (2,289) (4,181) (4,517) (2,289)
Financing activities        
Common share repurchases (682) (500) (2,650) (682)
Cash dividends paid (596) (477) (722) (596)
Proceeds from common stock issuances 270
 198
 295
 270
Repayments of long-term debt (1,100) (1,392)
Proceeds from (repayments of) commercial paper, net 4,259
 (139)
Proceeds from issuance of long-term debt 1,342
 2,485
 
 1,342
Repayments of long-term debt (1,392) (601)
Repayments of commercial paper, net (139) (285)
Customer funds administered 3,217
 1,067
 2,962
 3,217
Other, net (495) (385) (622) (495)
Cash flows from financing activities 1,525
 1,502
 2,422
 1,525
Effect of exchange rate changes on cash and cash equivalents 20
 34
 (12) 20
Increase (decrease) in cash and cash equivalents 5,712
 (327)
Increase in cash and cash equivalents 6,262
 5,712
Cash and cash equivalents, beginning of period 10,430
 10,923
 11,981
 10,430
Cash and cash equivalents, end of period $16,142
 $10,596
 $18,243
 $16,142
        
Supplemental Schedule of Noncash Investing Activities    
Supplemental schedule of noncash investing activities    
Common stock issued for acquisition $1,860
 $
 $
 $1,860

See Notes to the Condensed Consolidated Financial Statements

UnitedHealth Group
Notes to the Condensed Consolidated Financial Statements
(Unaudited)
1. Basis of Presentation and Significant Accounting Policies
UnitedHealth Group Incorporated (individually and together with its subsidiaries, “UnitedHealth Group” and “the Company”the “Company”) is a diversified health and well-beingcare company dedicated to helping people live healthier lives and helping to make the health system work better for everyone. Through its diversified family of businesses, the Company leverages core competencies in data and health information; advanced enabling technology; health care data, information and intelligence; and clinical care management and coordinationexpertise to help meet the demands of the health system. These core competencies are deployed within the Company’s two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
The Company has prepared the Condensed Consolidated Financial Statements according to U.S. Generally Accepted Accounting Principles (GAAP) and has included the accounts of UnitedHealth Group and its subsidiaries. The year-end condensed consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission (SEC), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited Consolidated Financial Statements. Therefore, these Condensed Consolidated Financial Statements should be read together with the Consolidated Financial Statements and the Notes included in Part II, Item 8, “Financial Statements” in the Company’s Annual Report on Form 10-K for the year ended December 31, 20162017 as filed with the SEC (2016(2017 10-K). The accompanying Condensed Consolidated Financial Statements include all normal recurring adjustments necessary to present the interim financial statements fairly.
Use of Estimates
These Condensed Consolidated Financial Statements include certain amounts based on the Company’s best estimates and judgments. The Company’s most significant estimates relate to estimates and judgments for medical costs payable, and revenues, valuation and impairment analysis of goodwill and other intangible assets and valuations of certain investments.assets. Certain of these estimates require the application of complex assumptions and judgments, often because they involve matters that are inherently uncertain and will likely change in subsequent periods. The impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.
Revenues
The Company’s revenues include premium, product, and service revenues. Service revenues include net patient service revenues that are recorded based upon established billing rates, less allowances for contractual adjustments, and are recognized as services are provided. For more information about the Company’s revenues, see Notes 2 and 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2016 10-K. See Note 8 for disaggregation of revenue by segment and type.
As of March 31, 2017, accounts receivables related to products and services were $3.3 billion. For the three months ended March 31, 2017, the Company had no material bad-debt expense and there were no material contract assets, contract liabilities or deferred contract costsrecorded on the Condensed Consolidated Balance Sheet as of March 31, 2017.
For the three months ended March 31, 2017, revenue recognized from performance obligations related to prior periods (for example, due to changes in transaction price), was not material.
Revenue expected to be recognized in any future year related to remaining performance obligations, excluding revenue pertaining to contracts that have an original expected duration of one year or less, contracts where revenue is recognized as invoiced and contracts with variable consideration related to undelivered performance obligations, is not material.
Health Insurance Industry Tax
The Patient Protection and Affordable Care Act (ACA) included an annual, nondeductible insurance industry tax (Health Insurance Industry Tax) to be levied proportionally across the insurance industry for risk-based health insurance products. A provision in the 2016 Federal Budget imposed a one year moratorium for 2017 on the collection of the Health Insurance Industry Tax. The Company has experienced a lower effective income tax rate in 2017 as compared to 2016 primarily due to the moratorium.
The remainder of the accounting policies disclosed in Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2016 10-K remain unchanged.

Recently Issued Accounting Standards
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standard Update (ASU) No. 2016-02, “Leases (Topic 842)” (ASU 2016-02). Under ASU 2016-02, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both finance and operating leases. For leases with a term of 12 months or less, an entity can elect to not recognize lease assets and lease liabilities and expense the lease over a straight-line basis for the term of the lease. ASU 2016-02 will require new disclosures that depict the amount, timing and uncertainty of cash flows pertaining to an entity’s leases. Companies are required to adopt the new standard using a modified retrospective approach for annual and interim periods beginning after December 15, 2018. Early adoption of ASU 2016-02 is permitted. When adopted, the Company does not expect ASU 2016-02 towill not have a material impact on itsthe Company’s balance sheet, results of operations, equity or cash flows. The impact of ASU 2016-02 on the Company’s consolidated financial position will be based on leases outstanding at the time of adoption.
Recently Adopted Accounting Standards
In January 2016, the FASB issued ASU 2016-01, “Financial Instruments - Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities” (ASU 2016-01). TheMost notably, the new guidance changes the current accounting related to (i) the classification and measurement of certain equity investments, (ii) the presentation of changes in the fair value of financial liabilities measured under the fair value option that are due to instrument-specific credit risk, and (iii) certain disclosures associated with the fair value of financial instruments. Most notably, ASU 2016-01 requires that equity investments, with certain exemptions, be measured at fair value with changes in fair value recognized in net income as opposed to other comprehensive income. The new guidance is effective for annual and interim reporting periods beginning after December 15, 2017. As of March 31, 2017, based on equity securities held, the Company does not expectadopted ASU 2016-01 to haveon a material impact on its consolidated financial position, results of operations, equity or cash flows. The Company will continue to evaluate any changes in its mix of investments or market conditions and the related impact of ASU 2016-01.
Recently Adopted Accounting Standards
In May 2014, the FASB issued ASU No. 2014-09, “Revenue from Contracts with Customers (Topic 606)” as modified by subsequently issued ASUs 2015-14, 2016-08, 2016-10, 2016-12 and 2016-20 (collectively ASU 2014-09). ASU 2014-09 superseded existing revenue recognition standards with a single model unless those contracts are within the scope of other standards (e.g., an insurance entity’s insurance contracts). The revenue recognition principle in ASU 2014-09 is that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The Company early adopted the new standardprospective basis effective January 1, 2017,2018, as allowed, using the modified retrospective approach. A significant majority of the Company’s revenues are not subjectrequired, and reclassified $24 million from accumulated other comprehensive income to the new guidance. The adoption of ASU 2014-09 did not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows as of the adoption date or for the three months ended March 31, 2017. The Company has included the disclosures required by ASU 2014-09 above.retained earnings.
The Company has determined that there have been no other recently adopted or issued accounting standards that had, or will have, a material impact on its Condensed Consolidated Financial Statements.

2.    Investments
A summary of short-term and long-term investmentsdebt securities by major security type is as follows:
(in millions) 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
 
Amortized
Cost
 
Gross
Unrealized
Gains
 
Gross
Unrealized
Losses
 
Fair
Value
March 31, 2017        
March 31, 2018        
Debt securities - available-for-sale:                
U.S. government and agency obligations $2,529
 $2
 $(28) $2,503
 $2,939
 $1
 $(54) $2,886
State and municipal obligations 7,020
 64
 (64) 7,020
 7,190
 43
 (94) 7,139
Corporate obligations 11,879
 48
 (46) 11,881
 14,411
 15
 (167) 14,259
U.S. agency mortgage-backed securities 3,345
 7
 (44) 3,308
 4,423
 3
 (110) 4,316
Non-U.S. agency mortgage-backed securities 999
 2
 (10) 991
 1,162
 
 (20) 1,142
Total debt securities - available-for-sale 25,772
 123
 (192) 25,703
 30,125
 62
 (445) 29,742
Equity securities 2,120
 43
 (42) 2,121
Debt securities - held-to-maturity:                
U.S. government and agency obligations 259
 1
 
 260
 249
 1
 (2) 248
State and municipal obligations 5
 
 
 5
 2
 
 
 2
Corporate obligations 288
 
 
 288
 340
 
 
 340
Total debt securities - held-to-maturity 552
 1
 
 553
 591
 1
 (2) 590
Total investments $28,444
 $167
 $(234) $28,377
December 31, 2016        
Total debt securities $30,716
 $63
 $(447) $30,332
December 31, 2017        
Debt securities - available-for-sale:                
U.S. government and agency obligations $2,294
 $1
 $(31) $2,264
 $2,673
 $1
 $(30) $2,644
State and municipal obligations 7,120
 40
 (101) 7,059
 7,596
 99
 (35) 7,660
Corporate obligations 10,944
 41
 (58) 10,927
 13,181
 57
 (44) 13,194
U.S. agency mortgage-backed securities 2,963
 7
 (43) 2,927
 3,942
 7
 (38) 3,911
Non-U.S. agency mortgage-backed securities 1,009
 3
 (10) 1,002
 1,018
 3
 (6) 1,015
Total debt securities - available-for-sale 24,330
 92
 (243) 24,179
 28,410
 167
 (153) 28,424
Equity securities 2,036
 52
 (47) 2,041
Debt securities - held-to-maturity:                
U.S. government and agency obligations 250
 1
 
 251
 254
 1
 (1) 254
State and municipal obligations 5
 
 
 5
 2
 
 
 2
Corporate obligations 238
 
 
 238
 280
 
 
 280
Total debt securities - held-to-maturity 493
 1
 
 494
 536
 1
 (1) 536
Total investments $26,859
 $145
 $(290) $26,714
Total debt securities $28,946
 $168
 $(154) $28,960
The Company held $1.9 billion and $2.0 billion of equity securities as of March 31, 2018 and December 31, 2017, respectively. The Company’s investments in equity securities primarily consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments and dividend paying stocks, with readily determinable fair values.
Additionally, the Company’s investments included $959 million and $898 million of equity method investments in operating businesses in the health care sector as of March 31, 2018 and December 31, 2017, respectively.

The amortized cost and fair value of debt securities as of March 31, 20172018, by contractual maturity, were as follows:
 Available-for-Sale Held-to-Maturity Available-for-Sale Held-to-Maturity
(in millions) 
Amortized
Cost
 
Fair
Value
 Amortized
Cost
 Fair
Value
 
Amortized
Cost
 
Fair
Value
 Amortized
Cost
 Fair
Value
Due in one year or less $3,291
 $3,293
 $191
 $191
 $3,923
 $3,915
 $135
 $135
Due after one year through five years 10,041
 10,049
 111
 111
 11,400
 11,273
 202
 200
Due after five years through ten years 6,090
 6,069
 120
 120
 6,874
 6,766
 103
 103
Due after ten years 2,006
 1,993
 130
 131
 2,343
 2,330
 151
 152
U.S. agency mortgage-backed securities 3,345
 3,308
 
 
 4,423
 4,316
 
 
Non-U.S. agency mortgage-backed securities 999
 991
 
 
 1,162
 1,142
 
 
Total debt securities $25,772
 $25,703
 $552
 $553
 $30,125
 $29,742
 $591
 $590
The fair value of available-for-sale investmentsdebt 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 Less Than 12 Months 12 Months or Greater  Total
(in millions) 
Fair
Value
 
Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 
Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
 
Fair
Value
 Gross
Unrealized
Losses
March 31, 2017            
March 31, 2018            
Debt securities - available-for-sale:                        
U.S. government and agency obligations $2,077
 $(28) $
 $
 $2,077
 $(28) $1,787
 $(25) $945
 $(29) $2,732
 $(54)
State and municipal obligations 3,187
 (64) 
 
 3,187
 (64) 3,958
 (66) 781
 (28) 4,739
 (94)
Corporate obligations 4,567
 (44) 81
 (2) 4,648
 (46) 9,998
 (129) 1,193
 (38) 11,191
 (167)
U.S. agency mortgage-backed securities 2,406
 (41) 76
 (3) 2,482
 (44) 2,775
 (61) 1,127
 (49) 3,902
 (110)
Non-U.S. agency mortgage-backed securities 616
 (8) 47
 (2) 663
 (10) 863
 (15) 136
 (5) 999
 (20)
Total debt securities - available-for-sale $12,853
 $(185) $204
 $(7) $13,057
 $(192) $19,381
 $(296) $4,182
 $(149) $23,563
 $(445)
Equity securities $75
 $(4) $101
 $(38) $176
 $(42)
December 31, 2016            
December 31, 2017            
Debt securities - available-for-sale:                        
U.S. government and agency obligations $1,794
 $(31) $
 $
 $1,794
 $(31) $1,249
 $(8) $1,027
 $(22) $2,276
 $(30)
State and municipal obligations 4,376
 (101) 
 
 4,376
 (101) 2,599
 (21) 866
 (14) 3,465
 (35)
Corporate obligations 5,128
 (56) 137
 (2) 5,265
 (58) 5,901
 (23) 1,242
 (21) 7,143
 (44)
U.S. agency mortgage-backed securities 2,247
 (40) 79
 (3) 2,326
 (43) 1,657
 (12) 1,162
 (26) 2,819
 (38)
Non-U.S. agency mortgage-backed securities 544
 (7) 97
 (3) 641
 (10) 411
 (3) 144
 (3) 555
 (6)
Total debt securities - available-for-sale $14,089
 $(235) $313
 $(8) $14,402
 $(243) $11,817
 $(67) $4,441
 $(86) $16,258
 $(153)
Equity securities $93
 $(5) $91
 $(42) $184
 $(47)
The Company’s unrealized losses from alldebt securities as of March 31, 20172018 were generated from more than 10,00018,000 positions out of a total of 27,00028,000 positions. The Company believes that it will collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. At each reporting period, the Company evaluates securities for impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the underlying credit quality and credit ratings of the issuers, noting no significant deterioration since purchase. As of March 31, 20172018, the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary.
The Company’s investments in equity securities consist of investments in Brazilian real denominated fixed-income funds, employee savings plan related investments, venture capital funds, and dividend paying stocks. The Company evaluated its investments in equity securities for severity and duration of unrealized loss, overall market volatility and other market factors. Additionally, as of March 31, 2017, the Company’s investments included $594 million in equity method investments that were obtained as part of a 2017 acquisition.
3.    Fair Value
Certain assets and liabilities are measured at fair value in the Condensed Consolidated Financial Statements or have fair values disclosed in the Notes to the Condensed Consolidated Financial Statements. These assets and liabilities are classified into one of three levels of a hierarchy defined by GAAP.

For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 4 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 20162017 10-K.

The following table presents a summary of fair value measurements by level and carrying values for items measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions) 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair and Carrying
Value
 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair and Carrying
Value
March 31, 2017        
March 31, 2018        
Cash and cash equivalents $16,101
 $41
 $
 $16,142
 $16,249
 $1,994
 $
 $18,243
Debt securities - available-for-sale:                
U.S. government and agency obligations 2,220
 283
 
 2,503
 2,631
 255
 
 2,886
State and municipal obligations 
 7,020
 
 7,020
 
 7,139
 
 7,139
Corporate obligations 26
 11,744
 111
 11,881
 50
 14,068
 141
 14,259
U.S. agency mortgage-backed securities 
 3,308
 
 3,308
 
 4,316
 
 4,316
Non-U.S. agency mortgage-backed securities 
 991
 
 991
 
 1,142
 
 1,142
Total debt securities - available-for-sale 2,246
 23,346
 111
 25,703
 2,681
 26,920
 141
 29,742
Equity securities 1,666
 12
 443
 2,121
 1,791
 13
 143
 1,947
Assets under management 888
 1,998
 
 2,886
 950
 1,972
 
 2,922
Interest rate swap assets 
 45
 
 45
Total assets at fair value
$20,901
 $25,442
 $554
 $46,897

$21,671
 $30,899
 $284
 $52,854
Percentage of total assets at fair value 45% 54% 1% 100% 41% 58% 1% 100%
Interest rate swap liabilities $
 $19
 $
 $19
December 31, 2016        
December 31, 2017        
Cash and cash equivalents $10,386
 $44
 $
 $10,430
 $11,718
 $263
 $
 $11,981
Debt securities - available-for-sale:                
U.S. government and agency obligations 2,017
 247
 
 2,264
 2,428
 216
 
 2,644
State and municipal obligations 
 7,059
 
 7,059
 
 7,660
 
 7,660
Corporate obligations 21
 10,804
 102
 10,927
 65
 12,989
 140
 13,194
U.S. agency mortgage-backed securities 
 2,927
 
 2,927
 
 3,911
 
 3,911
Non-U.S. agency mortgage-backed securities 
 1,002
 
 1,002
 
 1,015
 
 1,015
Total debt securities - available-for-sale 2,038
 22,039
 102
 24,179
 2,493
 25,791
 140
 28,424
Equity securities 1,591
 13
 437
 2,041
 1,784
 14
 194
 1,992
Assets under management 1,064
 2,041
 
 3,105
 1,117
 1,984
 
 3,101
Interest rate swap assets 
 55
 
 55
Total assets at fair value $15,079
 $24,192
 $539
 $39,810
 $17,112
 $28,052
 $334
 $45,498
Percentage of total assets at fair value 38% 61% 1% 100% 38% 61% 1% 100%
Interest rate swap liabilities $
 $14
 $
 $14
Transfers between levels, if any, are recorded as of the beginning of the reporting period in which the transfer occurs; there were no transfers between Levels 1, 2 or 3 of any financial assets or liabilities during the three months ended March 31, 20172018 or 2016.2017.

The following table presents a summary of fair value measurements by level and carrying values for certain financial instruments not measured at fair value on a recurring basis in the Condensed Consolidated Balance Sheets:
(in millions) 
Quoted Prices
in Active
Markets
(Level 1)
 
Other
Observable
Inputs
(Level 2)
 
Unobservable
Inputs
(Level 3)
 
Total
Fair
Value
 Total Carrying Value
March 31, 2017          
Debt securities - held-to-maturity:          
U.S. government and agency obligations $257
 $3
 $
 $260
 $259
State and municipal obligations 
 
 5
 5
 5
Corporate obligations 18
 2
 268
 288
 288
Total debt securities - held-to-maturity $275
 $5
 $273
 $553
 $552
Other assets $
 $468
 $
 $468
 $465
Long-term debt and other financing obligations $
 $32,489
 $
 $32,489
 $30,399
December 31, 2016          
Debt securities - held-to-maturity:          
U.S. government and agency obligations $251
 $
 $
 $251
 $250
State and municipal obligations 
 
 5
 5
 5
Corporate obligations 20
 8
 210
 238
 238
Total debt securities - held-to-maturity $271
 $8
 $215
 $494
 $493
Other assets $
 $476
 $
 $476
 $471
Long-term debt and other financing obligations $
 $31,295
 $
 $31,295
 $29,337
(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, 2018          
Debt securities - held-to-maturity $260
 $66
 $264
 $590
 $591
Long-term debt and other financing obligations $
 $32,892
 $
 $32,892
 $31,162
December 31, 2017          
Debt securities - held-to-maturity $267
 $4
 $265
 $536
 $536
Long-term debt and other financing obligations $
 $34,504
 $
 $34,504
 $31,542
Nonfinancial assets and liabilities or financial assets and liabilities that are measured at fair value on a nonrecurring basis are subject to fair value adjustments only in certain circumstances, such as when the Company records an impairment. There were no significant fair value adjustments for these assets and liabilities recorded during the three months ended March 31, 20172018 or 20162017.
4.    Other Current Receivables
The Company’s pharmacy care services businesses contract with pharmaceutical manufacturers, some of which provide rebates based on use of the manufacturers’ products by the Company’s clients. As of March 31, 2017 and December 31, 2016, total pharmaceutical manufacturer rebates receivable included in other receivables in the Condensed Consolidated Balance Sheets amounted to $4.0 billion and $3.3 billion, respectively. See Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 2016 10-K for more information on the Company’s pharmaceutical manufacturer rebates.
5.    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) 2017 2016 2018 2017
Medical costs payable, beginning of period $16,391
 $14,330
 $17,871
 $16,391
Acquisitions 76
 
 211
 76
Reported medical costs:        
Current year 32,529
 28,790
 36,153
 32,529
Prior years (450) (360) (290) (450)
Total reported medical costs 32,079
 28,430
 35,863
 32,079
Medical payments:        
Payments for current year (18,742) (15,797) (21,237) (18,742)
Payments for prior years (12,154) (11,140) (13,119) (12,154)
Total medical payments (30,896) (26,937) (34,356) (30,896)
Medical costs payable, end of period $17,650
 $15,823
 $19,589
 $17,650
For the three months ended March 31, 20172018 and 20162017, the medical cost reserve development included no individual factors that were material.significant. Medical costs payable included reserves for claims incurred by insured customers but not yet reported to the Company of $12.5$13.3 billion and $11.6$12.3 billion at March 31, 20172018 and December 31, 2016,2017, respectively.

6.5.     Commercial Paper and Long-Term Debt
Commercial paper and senior unsecured long-term debt consisted of the following:
 March 31, 2017 December 31, 2016 March 31, 2018 December 31, 2017
(in millions, except percentages) Par
Value
 
Carrying
Value
 
Fair
Value
 
Par
Value
 Carrying
Value
 
Fair
Value
 Par
Value
 
Carrying
Value
 
Fair
Value
 
Par
Value
 Carrying
Value
 
Fair
Value
Commercial paper $3,502
 $3,502
 $3,502
 $3,633
 $3,633
 $3,633
 $4,427
 $4,423
 $4,423
 $150
 $150
 $150
Floating rate notes due January 2017 
 
 
 750
 750
 750
6.000% notes due June 2017 441
 443
 445
 441
 446
 450
1.450% notes due July 2017 750
 750
 751
 750
 750
 751
1.400% notes due October 2017 625
 625
 625
 625
 624
 626
6.000% notes due November 2017 156
 158
 161
 156
 159
 163
1.400% notes due December 2017 750
 750
 750
 750
 751
 750
6.000% notes due February 2018 1,100
 1,106
 1,142
 1,100
 1,107
 1,153
 
 
 
 1,100
 1,101
 1,106
1.900% notes due July 2018 1,500
 1,497
 1,507
 1,500
 1,496
 1,507
 1,500
 1,499
 1,498
 1,500
 1,499
 1,501
1.700% notes due February 2019 750
 748
 750
 750
 748
 748
 750
 749
 744
 750
 749
 747
1.625% notes due March 2019 500
 501
 498
 500
 501
 498
 500
 501
 495
 500
 501
 497
2.300% notes due December 2019 500
 497
 505
 500
 498
 504
 500
 491
 495
 500
 495
 501
2.700% notes due July 2020 1,500
 1,495
 1,530
 1,500
 1,495
 1,523
 1,500
 1,497
 1,493
 1,500
 1,496
 1,517
Floating rate notes due October 2020 300
 299
 299
 300
 299
 300
3.875% notes due October 2020 450
 449
 475
 450
 450
 474
 450
 441
 459
 450
 446
 467
1.950% notes due October 2020 900
 896
 879
 900
 895
 892
4.700% notes due February 2021 400
 407
 433
 400
 409
 433
 400
 398
 418
 400
 403
 425
2.125% notes due March 2021 750
 746
 744
 750
 745
 741
 750
 747
 731
 750
 746
 744
3.375% notes due November 2021 500
 496
 520
 500
 497
 519
 500
 485
 504
 500
 493
 516
2.875% notes due December 2021 750
 746
 765
 750
 748
 760
 750
 729
 743
 750
 741
 760
2.875% notes due March 2022 1,100
 1,056
 1,122
 1,100
 1,057
 1,114
 1,100
 1,037
 1,088
 1,100
 1,054
 1,114
3.350% notes due July 2022 1,000
 995
 1,035
 1,000
 995
 1,030
 1,000
 996
 1,005
 1,000
 996
 1,033
2.375% notes due October 2022 900
 893
 866
 900
 893
 891
0.000% notes due November 2022 15
 11
 12
 15
 11
 12
 15
 12
 12
 15
 12
 12
2.750% notes due February 2023 625
 608
 623
 625
 609
 622
 625
 594
 611
 625
 606
 626
2.875% notes due March 2023 750
 768
 752
 750
 771
 753
 750
 745
 738
 750
 762
 759
3.750% notes due July 2025 2,000
 1,986
 2,089
 2,000
 1,986
 2,070
 2,000
 1,988
 2,026
 2,000
 1,987
 2,108
3.100% notes due March 2026 1,000
 994
 992
 1,000
 994
 986
 1,000
 995
 969
 1,000
 995
 1,007
3.450% notes due January 2027 750
 745
 761
 750
 745
 762
 750
 745
 743
 750
 745
 776
3.375% notes due April 2027 625
 618
 629
 
 
 
 625
 619
 615
 625
 618
 642
2.950% notes due October 2027 950
 937
 903
 950
 937
 947
4.625% notes due July 2035 1,000
 991
 1,090
 1,000
 991
 1,090
 1,000
 991
 1,094
 1,000
 991
 1,165
5.800% notes due March 2036 850
 837
 1,048
 850
 837
 1,034
 850
 838
 1,042
 850
 837
 1,105
6.500% notes due June 2037 500
 491
 655
 500
 491
 643
 500
 492
 660
 500
 491
 698
6.625% notes due November 2037 650
 640
 865
 650
 640
 850
 650
 641
 869
 650
 641
 923
6.875% notes due February 2038 1,100
 1,075
 1,495
 1,100
 1,075
 1,497
 1,100
 1,075
 1,511
 1,100
 1,075
 1,596
5.700% notes due October 2040 300
 296
 365
 300
 296
 366
 300
 296
 371
 300
 296
 389
5.950% notes due February 2041 350
 345
 441
 350
 345
 437
 350
 345
 443
 350
 345
 466
4.625% notes due November 2041 600
 588
 637
 600
 588
 634
 600
 588
 644
 600
 588
 685
4.375% notes due March 2042 502
 483
 520
 502
 483
 509
 502
 483
 524
 502
 483
 555
3.950% notes due October 2042 625
 606
 608
 625
 606
 609
 625
 607
 614
 625
 607
 650
4.250% notes due March 2043 750
 734
 764
 750
 734
 765
 750
 734
 771
 750
 734
 822
4.750% notes due July 2045 2,000
 1,972
 2,192
 2,000
 1,972
 2,203
 2,000
 1,972
 2,201
 2,000
 1,972
 2,362
4.200% notes due January 2047 750
 738
 762
 750
 737
 759
 750
 738
 759
 750
 738
 808
4.250% notes due April 2047 725
 717
 740
 
 
 
 725
 717
 741
 725
 717
 798
3.750% notes due October 2047 950
 933
 895
 950
 933
 969
Total commercial paper and long-term debt $33,491
 $33,210
 $35,300
 $33,022
 $32,770
 $34,728
 $34,594
 $34,166
 $35,896
 $31,417
 $31,067
 $34,029
During the first quarter of 2017, the Company assumed $926 million in debt of an acquired company, of which $642 million was repaid in the first quarter. The Company repaid the remainder of the acquired debt in the second quarter of 2017. The Company’s long-term debt obligations also included $407 million$1.4 billion and $200$625 million of other financing obligations, of which $129$207 million and $80$107 million were classified as current as of March 31, 20172018 and December 31, 2016,2017, respectively.

Commercial Paper and Bank Credit Facilities
Commercial paper consists of short-duration, senior unsecured debt privately placed on a discount basis through broker-dealers. As of March 31, 20172018, the Company’s outstanding commercial paper had a weighted-average annual interest rate of 1.1%2.0%.

The Company has $3.0 billion five-year, $2.0$3.0 billion three-year and $1.0$4.0 billion 364-day revolving bank credit facilities with 2326 banks, which mature in December 2021,2022, December 20192020 and December 2017,2018, respectively. These facilities provide liquidity support for the Company’s commercial paper program and are available for general corporate purposes. As of March 31, 2017,2018, no amounts had been drawn on any of the bank credit facilities. The annual interest rates, which are variable based on term, are calculated based on the London Interbank Offered Rate (LIBOR) plus a credit spread based on the Company’s senior unsecured credit ratings. If amounts had been drawn on the bank credit facilities as of March 31, 2017,2018, annual interest rates would have ranged from 1.8%2.7% to 2.3%3.3%.
Debt Covenants
The Company’s bank credit facilities contain various covenants, including covenants requiring the Company to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. The Company was in compliance with its debt covenants as of March 31, 2017.2018.
7.6.    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.
Litigation Matters
California Claims Processing Matter.On January 25, 2008, the California Department of Insurance (CDI) issued an Order to Show Cause to PacifiCare Life and Health Insurance Company, a subsidiary of the Company, alleging violations of certain insurance statutes and regulations related to an alleged failure to include certain language in standard claims correspondence, timeliness and accuracy of claims processing, interest payments, care provider contract implementation, care provider dispute resolution and other related matters. Although the Company believes that CDI had never before issued a fine in excess of $8 million, CDI advocated a fine of approximately $325 million in this matter. The matter was the subject of an administrative hearing before a California administrative law judge beginning in December 2009, and in August 2013, the administrative law judge issued a nonbinding proposed decision recommending a fine of $11.5 million. The California Insurance Commissioner rejected the administrative law judge’s recommendation and on June 9, 2014, issued his own decision imposing a fine of approximately $174 million. On July 10, 2014, the Company filed a lawsuit in California state court challenging the Commissioner’s decision. On September 8, 2015, in the first phase of that lawsuit, the California state court issued an order invalidating certain of the regulations the Commissioner had relied upon in issuing his decision and penalty. In March 2017, the court entered a tentative ruling reversing all of the penalties imposed and remanding certain further issues to the Commissioner. A final order is expected later this year. The Company cannot reasonably estimate the range of loss, if any, that may result from this matter given the procedural status of the dispute, the wide range of possible outcomes, the legal issues presented (including the legal basis for the majority of the alleged violations), the inherent difficulty in predicting a regulatory fine in the event of a remand, and the various remedies and levels of judicial review that remain available to the Company.
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 CMS,Centers for Medicare and Medicaid Services (CMS), state insurance and health and welfare departments, the Brazilian national regulatory agency for private health insurance and plans (the Agência Nacional de Saúde Suplementar), state attorneys general, the Office of the Inspector General, the Office of Personnel Management, the Office of

Civil Rights, the Government Accountability Office, the Federal Trade Commission, U.S. Congressional committees, the U.S. Department of Justice, the SEC, the Internal Revenue Service, the U.S. Drug Enforcement Administration, the Brazilian federal revenue service (the Secretaria da Receita Federal), the U.S. Department of Labor, the Federal Deposit Insurance Corporation, the Defense Contract Audit Agency and other governmental authorities. Certain of the Company’s businesses have been reviewed or are currently under review, including for, among other matters, compliance with coding and other requirements under the Medicare risk-adjustment model. CMS has selected certain of the Company’s local plans for risk adjustment data validation (RADV) audits to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans.
On February 14, 2017, the Department of Justice (DOJ) announced its decision to pursue certain claims within a lawsuit initially asserted against the Company and filed under seal by a whistleblower in 2011. The whistleblower’s complaint, which was unsealed on February 15, 2017, alleges that the Company along with a number of other Medicare Advantage plans, made improper risk adjustment submissions and violated the False Claims Act. On March 24, 2017, DOJ intervenedFebruary 12, 2018, the court granted in a separate lawsuit initially asserted againstpart and denied in part the Company and filed by a whistleblower in 2009 concerning risk adjustment submissions by Medicare Advantage plans. Both cases are now pending in the U.S. District Court for the Central District of California. DOJ filed its complaint in one case on May 1, 2017, and has been orderedCompany’s motion to file its complaint in the other case by May 16, 2017.dismiss. The Company cannot reasonably estimate the outcome that may result from these mattersthis matter given their current posture.its procedural status.

8.7.    Segment Financial Information
The Company’s four reportable segments are UnitedHealthcare, OptumHealth, OptumInsight and OptumRx. For more information on the Company’s segments see Part I, Item I, “Business” and Note 13 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in the 20162017 10-K.
As of March 31, 2017, OptumHealth’s total assets were $24.7 billion as compared to $18.7 billion as of December 31, 2016. The increase was due to an acquisition completed during the three months ended March 31, 2017. Goodwill at the OptumHealth reportable segment increased during the first quarter of 2017 by $4.6 billion.
The following tables present reportable segment financial information:
   Optum       Optum    
(in millions) UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum 
Corporate and
Eliminations
 Consolidated UnitedHealthcare OptumHealth OptumInsight OptumRx Optum Eliminations Optum 
Corporate and
Eliminations
 Consolidated
Three Months Ended March 31, 2017                
Revenues - external customers:                
Three Months Ended March 31, 2018                
Revenues - unaffiliated customers:                
Premiums $38,053
 $885
 $
 $
 $
 $885
 $
 $38,938
 $43,237
 $847
 $
 $
 $
 $847
 $
 $44,084
Products 
 12
 21
 6,096
 
 6,129
 
 6,129
 
 12
 23
 6,667
 
 6,702
 
 6,702
Services 1,922
 721
 642
 149
 
 1,512
 
 3,434
 2,039
 1,188
 740
 137
 
 2,065
 
 4,104
Total revenues - external customers 39,975
 1,618
 663
 6,245
 
 8,526
 
 48,501
Total revenues - intersegment 
 3,059
 1,179
 8,698
 (286) 12,650
 (12,650) 
Total revenues - unaffiliated customers 45,276
 2,047
 763
 6,804
 
 9,614
 
 54,890
Total revenues - affiliated customers 
 3,606
 1,304
 9,295
 (333) 13,872
 (13,872) 
Investment and other income 161
 56
 1
 4
 
 61
 
 222
 183
 106
 2
 7
 
 115
 
 298
Total revenues $40,136
 $4,733
 $1,843
 $14,947
 $(286) $21,237
 $(12,650) $48,723
 $45,459
 $5,759
 $2,069
 $16,106
 $(333) $23,601
 $(13,872) $55,188
Earnings from operations $2,134
 $332
 $294
 $653
 $
 $1,279
 $
 $3,413
 $2,400
 $488
 $395
 $770
 $
 $1,653
 $
 $4,053
Interest expense 
 
 
 
 
 
 (283) (283) 
 
 
 
 
 
 (329) (329)
Earnings before income taxes $2,134
 $332
 $294
 $653
 $
 $1,279
 $(283) $3,130
 $2,400
 $488
 $395
 $770
 $
 $1,653
 $(329) $3,724
Three Months Ended March 31, 2016                
Revenues - external customers:                
Three Months Ended March 31, 2017                
Revenues - unaffiliated customers:                
Premiums $33,963
 $848
 $
 $
 $
 $848
 $
 $34,811
 $38,053
 $885
 $
 $
 $
 $885
 $
 $38,938
Products 
 13
 20
 6,360
 
 6,393
 
 6,393
 
 12
 21
 6,096
 
 6,129
 
 6,129
Services 1,796
 612
 606
 126
 
 1,344
 
 3,140
 1,922
 721
 642
 149
 
 1,512
 
 3,434
Total revenues - external customers 35,759
 1,473
 626
 6,486
 
 8,585
 
 44,344
Total revenues - intersegment 
 2,485
 1,041
 7,785
 (254) 11,057
 (11,057) 
Total revenues - unaffiliated customers 39,975
 1,618
 663
 6,245
 
 8,526
 
 48,501
Total revenues - affiliated customers 
 3,059
 1,179
 8,698
 (286) 12,650
 (12,650) 
Investment and other income 141
 40
 
 2
 
 42
 
 183
 161
 56
 1
 4
 
 61
 
 222
Total revenues $35,900
 $3,998
 $1,667
 $14,273
 $(254) $19,684
 $(11,057) $44,527
 $40,136
 $4,733
 $1,843
 $14,947
 $(286) $21,237
 $(12,650) $48,723
Earnings from operations $1,854
 $300
 $246
 $560
 $
 $1,106
 $
 $2,960
 $2,134
 $332
 $294
 $653
 $
 $1,279
 $
 $3,413
Interest expense 
 
 
 
 
 
 (259) (259) 
 
 
 
 
 
 (283) (283)
Earnings before income taxes $1,854
 $300
 $246
 $560
 $
 $1,106
 $(259) $2,701
 $2,134
 $332
 $294
 $653
 $
 $1,279
 $(283) $3,130

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 20162017 10-K, including the Consolidated Financial Statements and Notes in Part II, Item 8, “Financial Statements” in that report. Unless the context indicates otherwise, references to the terms “UnitedHealth Group,” “we,” “our” or “us” used throughout this Management’s Discussion and Analysis of Financial Condition and Results of Operations refer to UnitedHealth Group Incorporated and its consolidated subsidiaries.
Readers are cautioned that the statements, estimates, projections or outlook contained in this Management's Discussion and Analysis of Financial Condition and Results of Operations, including discussions regarding financial prospects, economic conditions, trends and uncertainties contained in this Item 2, may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA). These forward-looking statements involve risks and uncertainties that may cause our actual results to differ materially from the results discussed or implied in the forward-looking statements. A description of some of the risks and uncertainties is set forth in Part I, Item 1A, “Risk Factors” in our 20162017 10-K and in the discussion below.
EXECUTIVE OVERVIEW
General
UnitedHealth Group is a diversified health and well-beingcare company dedicated to helping people live healthier lives and helping to make the health system work better for everyone. Through our diversified family of businesses, we leverage core competencies in data and health information; advanced enabling technology; health care data; information and intelligence; and clinical care management and coordinationexpertise to help meet the demands of the health system. These core competencies are deployed within our two distinct, but strategically aligned, business platforms: health benefits operating under UnitedHealthcare and health services operating under Optum.
Further information on our business is presented in Part I, Item 1, “Business” and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 20162017 10-K and additional information on our segments can be found in this Item 2 and in Note 87 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, BrazilianSouth American and certain other international health markets. In the United States, health care spending has grown consistently for many years and comprises approximately 18%19% of gross domestic product. We expect overall spending on health care to continue to grow in the future due to inflation, medical technology and pharmaceutical advancement, regulatory requirements, demographic trends in the population and national interest in health and well-being. The rate of market growth may be affected by a variety of factors, including macro-economic conditions and regulatory changes, which have impacted and could further impact our results of operations.
Pricing Trends. To price our health care benefit products, we start with our view of expected future costs.costs, including the impact of the Health Insurance Industry Tax. We frequently evaluate and adjust our approach in each of the local markets we serve, considering all relevant factors, such as product positioning, price competitiveness and environmental, competitive, legislative and regulatory considerations.considerations, including minimum medical loss ratio (MLR) thresholds. We will continue seeking to balance growth and profitability across all of these dimensions.
The commercial risk market remains highly competitive in both the small group and large group segments. We expect broad-based competition to continue as the industry adapts to individual and employer needs amid reform changes. A provision in the 2016 Federal Budget imposedIn 2019 there will be a one year moratorium for 2017 on the collection of the Health Insurance Industry Tax. Pricing for contracts that cover some portion of calendar year 20182019 will reflect the impact of the returning Health Insurance Industry Tax.moratorium.
Medicare Advantage funding continues to be pressured, as discussed below in “Regulatory Trends and Uncertainties.”
Medical Cost Trends. Our medical cost trends primarily relate to changes in unit costs, health system utilization and prescription drug costs. We endeavor to mitigate those increases by engaging physicians and consumers with medical management. Our 2017 management activities include managing costs across all health care categories, including specialty pharmacy spending, as new therapies are introduced atinformation and helping them make clinically sound choices, with the objective of helping them achieve high costs and older drugs experience price increases.quality, affordable care.
Regulatory Trends and Uncertainties
Following is a summary of management’s view of the trends and uncertainties related to Medicare Advantage rates. For additional information regarding the ACA and other regulatory trends and uncertainties, see Part I, Item 1 “Business - Government Regulation”,Regulation,” Item 1A, “Risk Factors”, and Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our 20162017 10-K.

Medicare Advantage Rates. Final 20182019 Medicare Advantage rates resulted in an increase in industry base rates of approximately 0.45%3.4%, well short of the industry forward medical cost trend, of 3%, which creates continued pressure in the Medicare Advantage program. The impact of this funding shortfall in Medicare Advantage is partially mitigated by reductions in provider payments for those care providers with rates indexed to Medicare Advantage revenues or Medicare fee-for-service payment rates. These factors can affect our plan benefit designs, pricing, growth prospects and earnings expectations for our Medicare Advantage plans.
As providedThe Tax Cut and Jobs Act (Tax Reform). Tax Reform was enacted by the U.S federal government in December 2017, changing existing federal tax law, including reducing the ACA,U.S. corporate income tax rate. With the impact of Tax Reform, partially offset by the return of the nondeductible Health Insurance Industry Tax, we expect that our Medicare Advantage rates are currently enhanced by CMS quality bonuseseffective tax rate in certain counties based on our local plans’ Star ratings. The level of Star ratings from CMS, based upon specified clinical and operational performance standards,2018 will impact future quality bonuses. In addition, Star ratings affectbe approximately 24%.
Health Insurance Industry Tax. After a moratorium in 2017, the industry-wide amount of savings a plan can usethe Health Insurance Industry Tax in 2018 will be $14.3 billion and we expect our portion to offer supplemental benefits, which ultimately may affectbe approximately $2.8 billion. The return of the plan’s membership and revenue. For the 2017 paymenttax impacts year approximately 80%over year comparability of our Medicare Advantage members arefinancial statements, including revenue, medical care ratio (MCR), operating cost ratio and effective tax rate. A one year moratorium on the collection of the Health Insurance Industry Tax will occur in plans rated four stars or higher. We expect at least 85% of our Medicare Advantage members will be in plans rated four stars or higher for payment year 2018. We continue to dedicate substantial resources to advance our quality scores and Star ratings to strengthen our local market programs and further improve our performance.2019.

SELECTED OPERATING PERFORMANCE AND OTHER SIGNIFICANT ITEMS
The following summarizes select first quarter 20172018 year-over-year operating comparisons to first quarter 20162017 and other 20172018 significant items.
Consolidated revenues grew 9%13%, UnitedHealthcare revenues grew 12%13% and Optum revenues grew 8%11%.
UnitedHealthcare grewserved 465,000 fewer people as a result of completion of its commitment to serve an additional 1.6the 2.9 million people.people under the TRICARE military health care program, partially offset by the addition of 2 million people through acquisition and the remainder from organic growth.
Earnings from operations increased 15%19%, including increases of 15%12% at UnitedHealthcare and 16%29% at Optum.
TheDue primarily to the impact of Tax Reform, our effective income tax rate decreased 980850 basis points to 30.0%21.5%.
Diluted earnings per common share increased 34%29%.
Cash flows from operations were $6.5$8.4 billion, aided by the March 2017 receipt of our April CMS premium payment of $4.4$5.1 billion.

RESULTS SUMMARY
The following table summarizes our consolidated results of operations and other financial information:
(in millions, except percentages and per share data) Three Months Ended March 31, Increase/(Decrease) Three Months Ended March 31, Increase/(Decrease)
2017 2016 2017 vs. 2016 2018 2017 2018 vs. 2017
Revenues:                
Premiums $38,938
 $34,811
 $4,127
 12% $44,084
 $38,938
 $5,146
 13%
Products 6,129
 6,393
 (264) (4) 6,702
 6,129
 573
 9
Services 3,434
 3,140
 294
 9
 4,104
 3,434
 670
 20
Investment and other income 222
 183
 39
 21
 298
 222
 76
 34
Total revenues 48,723
 44,527
 4,196
 9
 55,188
 48,723
 6,465
 13
Operating costs:                
Medical costs 32,079
 28,430
 3,649
 13
 35,863
 32,079
 3,784
 12
Operating costs 7,022
 6,758
 264
 4
 8,506
 7,022
 1,484
 21
Cost of products sold 5,676
 5,877
 (201) (3) 6,184
 5,676
 508
 9
Depreciation and amortization 533
 502
 31
 6
 582
 533
 49
 9
Total operating costs 45,310
 41,567
 3,743
 9
 51,135
 45,310
 5,825
 13
Earnings from operations 3,413
 2,960
 453
 15
 4,053
 3,413
 640
 19
Interest expense (283) (259) (24) 9
 (329) (283) (46) 16
Earnings before income taxes 3,130
 2,701
 429
 16
 3,724
 3,130
 594
 19
Provision for income taxes (939) (1,074) 135
 (13) (800) (939) 139
 (15)
Net earnings 2,191
 1,627
 564
 35
 2,924
 2,191
 733
 33
Earnings attributable to noncontrolling interests (19) (16) (3) 19 % (88) (19) (69) 363
Net earnings attributable to UnitedHealth Group common shareholders $2,172
 $1,611
 $561
 35 % $2,836
 $2,172
 $664
 31 %
Diluted earnings per share attributable to UnitedHealth Group common shareholders $2.23
 $1.67
 $0.56
 34 % $2.87
 $2.23
 $0.64
 29 %
Medical care ratio (a) 82.4% 81.7% 0.7 %   81.4% 82.4% (1.0)%  
Operating cost ratio 14.4
 15.2
 (0.8)   15.4
 14.4
 1.0
  
Operating margin 7.0
 6.6
 0.4
   7.3
 7.0
 0.3
  
Tax rate 30.0
 39.8
 (9.8)   21.5
 30.0
 (8.5)  
Net earnings margin (b) 4.5
 3.6
 0.9
   5.1
 4.5
 0.6
  
Return on equity (c) 21.7% 18.7% 3.0 %   23.8% 21.7% 2.1 %  
                   
(a)Medical care ratio is calculated as medical costs divided by premium revenue.
(b)Net earnings margin attributable to UnitedHealth Group shareholders.
(c)Return on equity is calculated as annualized net earnings divided by average equity. Average equity is calculated using the equity balance at the end of the preceding year and the equity balances at the end of each of the quarters in the year presented.

20172018 RESULTS OF OPERATIONS COMPARED TO 20162017 RESULTS OF OPERATIONS
Consolidated Financial Results
RevenuesRevenue
The increase in revenues wererevenue was primarily driven by organic growththe increase in the number of individuals served through risk-based products across our UnitedHealthcare benefits businesses, pricing trends, including for the return of the Health Insurance Industry Tax in 2018, and growth across all of Optum’s businesses. This increase was partially offset by revenue decreasesthe Optum business.
Medical Costs and MCR
Medical costs increased due to withdrawals of individual ACA-compliantgrowth in people served through risk-based products inand medical cost trends. The MCR decreased due to the individual market and therevenue effects of the Health Insurance Industry Tax moratorium.
Medical Costs and Medical Care Ratio (MCR)
Medical costs increased due to risk-based membership growth and medical cost trends. The MCR increase was due to the effects of the Health Insurance Industry Tax moratoriumpartially offset primarily by the reduction of individual ACA business.elevated flu-related illness costs.
Income Tax Rate
Our effective tax rate decreased primarily due to the impact of Tax Reform, which was partially offset by the return of the nondeductible Health Insurance Industry Tax moratorium as well as higher excess tax benefits resulting from an increase in share-based payment activity.Tax.

Reportable Segments
See Note 87 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report for more information on our segments. The following table presents a summary of the reportable segment financial information:
 Three Months Ended March 31, Increase/(Decrease) Three Months Ended March 31, Increase/(Decrease)
(in millions, except percentages) 2017 2016 2017 vs. 2016 2018 2017 2018 vs. 2017
Revenues                
UnitedHealthcare $40,136
 $35,900
 $4,236
 12% $45,459
 $40,136
 $5,323
 13%
OptumHealth 4,733
 3,998
 735
 18
 5,759
 4,733
 1,026
 22
OptumInsight 1,843
 1,667
 176
 11
 2,069
 1,843
 226
 12
OptumRx 14,947
 14,273
 674
 5
 16,106
 14,947
 1,159
 8
Optum eliminations (286) (254) (32) 13
 (333) (286) (47) 16
Optum 21,237
 19,684
 1,553
 8
 23,601
 21,237
 2,364
 11
Eliminations (12,650) (11,057) (1,593) 14
 (13,872) (12,650) (1,222) 10
Consolidated revenues $48,723
 $44,527
 $4,196
 9% $55,188
 $48,723
 $6,465
 13%
Earnings from operations                
UnitedHealthcare $2,134
 $1,854
 $280
 15% $2,400
 $2,134
 $266
 12%
OptumHealth 332
 300
 32
 11
 488
 332
 156
 47
OptumInsight 294
 246
 48
 20
 395
 294
 101
 34
OptumRx 653
 560
 93
 17
 770
 653
 117
 18
Optum 1,279
 1,106
 173
 16
 1,653
 1,279
 374
 29
Consolidated earnings from operations $3,413
 $2,960
 $453
 15% $4,053
 $3,413
 $640
 19%
Operating margin                
UnitedHealthcare 5.3% 5.2% 0.1 %   5.3% 5.3% %  
OptumHealth 7.0
 7.5
 (0.5)   8.5
 7.0
 1.5
  
OptumInsight 16.0
 14.8
 1.2
   19.1
 16.0
 3.1
  
OptumRx 4.4
 3.9
 0.5
   4.8
 4.4
 0.4
  
Optum 6.0
 5.6
 0.4
   7.0
 6.0
 1.0
  
Consolidated operating margin 7.0% 6.6% 0.4 %   7.3% 7.0% 0.3%  
UnitedHealthcare
The following table summarizes UnitedHealthcare revenues by business:
 Three Months Ended March 31, Increase/(Decrease) Three Months Ended March 31, Increase/(Decrease)
(in millions, except percentages) 2017 2016 2017 vs. 2016 2018 2017 2018 vs. 2017
UnitedHealthcare Employer & Individual $12,739
 $12,820
 $(81) (1)% $13,414
 $12,739
 $675
 5%
UnitedHealthcare Medicare & Retirement 16,552
 14,065
 2,487
 18
 18,925
 16,552
 2,373
 14
UnitedHealthcare Community & State 8,949
 7,728
 1,221
 16
 10,671
 8,949
 1,722
 19
UnitedHealthcare Global 1,896
 1,287
 609
 47
 2,449
 1,896
 553
 29
Total UnitedHealthcare revenues $40,136
 $35,900
 $4,236
 12 % $45,459
 $40,136
 $5,323
 13%

The following table summarizes the number of individuals served by our UnitedHealthcare businesses, by major market segment and funding arrangement:
 March 31, Increase/(Decrease) March 31, Increase/(Decrease)
(in thousands, except percentages) 2017 2016 2017 vs. 2016 2018 2017 2018 vs. 2017
Commercial group:                
Risk-based 7,695
 7,115
 580
 8 % 7,860
 7,695
 165
 2 %
Fee-based 19,155
 18,945
 210
 1
 18,475
 19,155
 (680) (4)
Total commercial group 26,850
 26,060
 790
 3
 26,335
 26,850
 (515) (2)
Individual 585
 1,485
 (900) (61) 475
 585
 (110) (19)
Fee-based TRICARE 2,860
 2,880
 (20) (1) 
 2,860
 (2,860) (100)
Total commercial 30,295
 30,425
 (130) 
 26,810
 30,295
 (3,485) (12)
Medicare Advantage 4,305
 3,530
 775
 22
 4,760
 4,305
 455
 11
Medicaid 6,200
 5,450
 750
 14
 6,695
 6,200
 495
 8
Medicare Supplement (Standardized) 4,350
 4,200
 150
 4
 4,490
 4,350
 140
 3
Total public and senior 14,855
 13,180
 1,675
 13
 15,945
 14,855
 1,090
 7
Total UnitedHealthcare - domestic medical 45,150
 43,605
 1,545
 4
 42,755
 45,150
 (2,395) (5)
International 4,165
 4,065
 100
 2
 6,095
 4,165
 1,930
 46
Total UnitedHealthcare - medical 49,315
 47,670
 1,645
 3 % 48,850
 49,315
 (465) (1)%
Supplemental Data:                
Medicare Part D stand-alone 4,955
 4,990
 (35) (1)% 4,770
 4,955
 (185) (4)%
GrowthBroad-based growth, primarily in services to small groups, ledresulted in the overall increase in people served through risk-based benefit plans in the commercial group market. Membership in individual decreasedFee-based commercial group business declined primarily due to our reduced participationthe non-renewal of one public sector customer in ACA-compliant products inthe third quarter of 2017. Medicare Advantage increased year-over-year due to growth in people served through individual and employer-sponsored group Medicare Advantage plans. Medicaid growth was driven by the combination of new state-based awards and growth in established programs. Medicare Supplement growth reflected strong customer retention and new sales. International growth was driven by an acquisition in the first quarter.
UnitedHealthcare’s revenue increases wereincreased due to growth in the number of individuals served across its risk-based businesses, and pricerate increases for underlying medical cost trends which were partially offset by the reduction of people served in ACA-compliant individual products and the impact of the return of the Health Insurance Industry Tax moratorium.
The increase in UnitedHealthcare’sTax. Earnings from operations increased, as the operating earnings was led by diversified growth and increased operating margin. The results for first quarter of 2016 included ACA-compliant losses in individual products.margin remained consistent.
Optum
Total revenues and operating earnings from operations increased as each segment reported increased revenues and earnings from operations as a result of productivity and overall cost management initiatives in addition to the factors discussed below.

The results by segment were as follows:
OptumHealth
Revenue and earnings from operations increased at OptumHealth primarily due to organic and acquisition-related growth in care delivery and behavioral, servicesdigital customer engagement and health financial services.
OptumInsight
Revenue and earnings from operations at OptumInsight increased primarily due to organic and acquisition-related growth in revenue management services, business processpayer technology and services and technologycare provider advisory services.
OptumRx
Revenue and earnings from operations at OptumRx increased primarily due to client and consumer expansion.customer growth. OptumRx fulfilled 332 million and 322 million adjusted scripts, in the first quarterquarters of 2018 and 2017, compared to 307 million in 2016.respectively.

LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
Liquidity
Summary of our Major Sources and Uses of Cash and Cash Equivalents
 Three Months Ended March 31, Increase/(Decrease) Three Months Ended March 31, Increase/(Decrease)
(in millions) 2017 2016 2017 vs. 2016 2018 2017 2018 vs. 2017
Sources of cash:            
Cash provided by operating activities $6,456
 $2,318
 $4,138
 $8,369
 $6,456
 $1,913
Issuances of commercial paper and long-term debt, net of repayments 
 1,599
 (1,599) 3,159
 
 3,159
Proceeds from common stock issuances 270
 198
 72
 295
 270
 25
Customer funds administered 3,217
 1,067
 2,150
 2,962
 3,217
 (255)
Other 25
 14
 11
 
 25
 (25)
Total sources of cash 9,968
 5,196
   14,785
 9,968
  
Uses of cash:            
Common stock repurchases (682) (500) (182) (2,650) (682) (1,968)
Cash paid for acquisitions, net of cash assumed (468) (1,697) 1,229
 (2,583) (468) (2,115)
Purchases of investments, net of sales and maturities (1,339) (2,073) 734
 (1,385) (1,339) (46)
Repayments of commercial paper and long-term debt, net of issuances (189) 
 (189) 
 (189) 189
Purchases of property, equipment and capitalized software (507) (425) (82) (477) (507) 30
Cash dividends paid (596) (477) (119) (722) (596) (126)
Other (495) (385) (110) (694) (495) (199)
Total uses of cash (4,276) (5,557)   (8,511) (4,276)  
Effect of exchange rate changes on cash and cash equivalents 20
 34
 (14) (12) 20
 (32)
Net increase (decrease) in cash and cash equivalents $5,712
 $(327) $6,039
Net increase in cash and cash equivalents $6,262
 $5,712
 $550
20172018 Cash Flows Compared to 20162017 Cash Flows
Increased cash flows provided by operating activities were primarily driven by the increase in unearned revenues, due to the increase in the March 2017 receipt of our April CMS premium payment of $5.1 billion compared to $4.4 billion, for 2018 and 2017, respectively, higher net earnings, partially offset byand the year-over-year impact of the return of the Health Insurance Industry Tax and the impact of discontinuing many ACA-compliant products.Tax.
Other significant changes in sources or uses of cash year-over-year included increased customer funds administered primarily due to the March receipt of our April CMS premium payment, decreasedan increase in cash paid for acquisitions and net purchases of investments,share repurchases, partially offset by 2017 net repaymentsissuances of debt compared to 2016 proceeds from debt issuances.commercial paper in 2018.
Financial Condition
As of March 31, 2017,2018, our cash, cash equivalent, available-for-sale debt securities and available-for-sale investmentequity securities balances of $44.0$50 billion included $16.1$18 billion of cash and cash equivalents (of which approximately $700 million$1 billion was available for general corporate use), $25.7$30 billion of debt securities and $2.1$2 billion of investments in equity securities. Given the significant portion of our portfolio held

in cash and cash equivalents, we do not anticipate fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position. Our available-for-sale debt portfolio had a weighted-average duration of 3.53.2 years and a weighted-average credit rating of “AA”“Double A” as of March 31, 2017.2018. When multiple credit ratings are available for an individual security, the average of the available ratings is used to determine the weighted-average credit rating.
Capital Resources and Uses of Liquidity
In addition to cash flows from operations and cash and cash equivalent balances available for general corporate use, our capital resources and uses of liquidity are as follows:
Commercial Paper and Bank Credit Facilities. Our revolving bank credit facilities provide liquidity support for our commercial paper borrowing program, which facilitates the private placement of unsecured debt through third-party broker-dealers, and are available for general corporate purposes. For more information on our commercial paper and bank credit facilities, see Note 65 of Notes to the Condensed Consolidated Financial Statements included in Part I, Item 1 of this report.

Our revolving bank credit facilities contain various covenants, including covenants requiring us to maintain a defined debt to debt-plus-shareholders’ equity ratio of not more than 55%. As of March 31, 2017,2018, our debt to debt-plus-shareholders’ equity ratio, as defined and calculated under the credit facilities, was approximately 42%40%.
Long-Term Debt. Periodically, we access capital markets and issue long-term debt for general corporate purposes, for example,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 65 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, 20172018 were as follows:
  
Moody’s Standard & Poor’sS&P Global Fitch A.M. Best
 Ratings Outlook Ratings Outlook Ratings Outlook Ratings Outlook
Senior unsecured debtA3 NegativeStable A+ NegativeStable A- NegativeStable bbb+ Stable
Commercial paperP-2 n/a A-1 n/a F1 n/a AMB-2 n/a
The availability of financing in the form of debt or equity is influenced by many factors, including our profitability, operating cash flows, debt levels, credit ratings, debt covenants and other contractual restrictions, regulatory requirements and economic and market conditions. For example, a significant downgrade in our credit ratings or adverse conditions in the capital markets may increase the cost of borrowing for us or limit our access to capital.
Share Repurchase Program. During the three months ended March 31, 2017,2018, we repurchased 412 million shares at an average price of $160.72$228.16 per share. As of March 31, 2017,2018, we had Board authorization to purchase up to an additional 4731 million shares of our common stock.
Dividends.Our quarterly cash dividend to shareholders reflects an annual dividend rate of $2.50$3.00 per share.
For additional liquidity discussion, see Note 10 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 20162017 10-K.
CONTRACTUAL OBLIGATIONS AND COMMITMENTS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 20162017 was disclosed in our 20162017 10-K. During the three months ended March 31, 2017,2018, there were no material changes to this previously disclosed information outside the ordinary course of business. However, we continually evaluate opportunities to expand our operations, including through internal development of new products, programs and technology applications and acquisitions.
RECENTLY ISSUED ACCOUNTING STANDARDS
See Note 1 of Notes to the Condensed Consolidated Financial Statements in Part I, Item 1 of this report for a discussion of new accounting pronouncements that affect us.
CRITICAL ACCOUNTING ESTIMATES
In preparing our Condensed Consolidated Financial Statements, we are required to make judgments, assumptions and estimates, which we believe are reasonable and prudent based on the available facts and circumstances. These judgments,

assumptions and estimates affect certain of our revenues and expenses and their related balance sheet accounts and disclosure of our contingent liabilities. We base our assumptions and estimates primarily on historical experience and consider known and projected trends. On an ongoing basis, we re-evaluate our selection of assumptions and the method of calculating our estimates. Actual results, however, may materially differ from our calculated estimates, and this difference would be reported in our current operations.
Our critical accounting estimates include medical costs payable, revenues, and goodwill and other intangible assets and valuations of certain investments.assets. For a detailed description of our critical accounting estimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in Part II, Item 7 in our 20162017 10-K. For a detailed discussion of our significant accounting policies, see Note 2 of Notes to the Consolidated Financial Statements in Part II, Item 8, “Financial Statements” in our 20162017 10-K.

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

ITEM 3.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We manage exposure to market interest rates by diversifying investments across different fixed incomefixed-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 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, 20172018 on our investment income and interest expense per annum, and the fair value of our investments and debt (in millions, except percentages):
 March 31, 2017 March 31, 2018
Increase (Decrease) in Market Interest Rate 
Investment
Income Per
Annum (a)
 
Interest
Expense Per
Annum (a)
 
Fair Value of
Financial Assets (b)
 
Fair Value of
Financial Liabilities
 
Investment
Income Per
Annum (a)
 
Interest
Expense Per
Annum (a)
 Fair Value of
Financial Assets (b)
 
Fair Value of
Financial Liabilities
2 % $378
 $234
 $(1,811) $(3,926) $426
 $262
 $(2,037) $(4,148)
1 189
 117
 (924) (2,110) 213
 131
 (1,035) (2,241)
(1) (167) (115) 902
 2,573
 (213) (131) 1,021
 2,654
(2) nm
 nm
 1,566
 5,530
 (340) (205) 1,980
 5,817
                 
nm = not meaningful
(a)
Given the low absolute level of short-term market rates on our floating-rate assets and liabilities as of March 31, 2017,2018, the assumed hypothetical change in interest rates does not reflect the full 100200 basis point reduction in interest income or interest expense as the rate cannot fall below zero and thus the 200 basis point reduction is not meaningful.
zero.
(b)
As of March 31, 20172018, some of our investments had interest rates below 2% so the assumed hypothetical change in the fair value of investments does not reflect the full 200 basis point reduction.
ITEM 4.    CONTROLS AND PROCEDURES
EVALUATION OF DISCLOSURE CONTROLS AND PROCEDURES
We maintain disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934 (Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms; and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
In connection with the filing of this quarterly report on Form 10-Q, management evaluated, under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of March 31, 2017.2018. Based upon that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of March 31, 2017.2018.
CHANGES IN INTERNAL CONTROL OVER FINANCIAL REPORTING
There have been no changes in our internal control over financial reporting during the quarter ended March 31, 20172018 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 76 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 20162017 10-K, which could materially affect our business, financial condition or future results. The risks described in our 20162017 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 and/or future results.
There have been no material changes to the risk factors disclosed in our 20162017 10-K.

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 first quarter 2017,2018, we repurchased approximately 412 million shares at an average price of $160.72$228.16 per share. As of March 31, 2017,2018, we had Board authorization to purchase up to 4731 million shares of our common stock.


ITEM 6.EXHIBITS**

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

 

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

 

 

 
*10.1
 Summary of Non-Management Director Compensation, effective as of October 1, 2016
12.1

 

 
101
 The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended March 31, 20172018 filed on May 8, 2017,7, 2018, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
 ________________
*Denotes management contracts and compensation plans in which certain directors and named executive officers participate and which are being filed pursuant to Item 601(b)(10)(iii)(A) of Regulation S-K.
** Pursuant to Item 601(b)(4)(iii) of Regulation S-K, copies of instruments defining the rights of certain holders of long-term debt are not filed. The Company will furnish copies thereof to the SEC upon request.


SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
UNITEDHEALTH GROUP INCORPORATED
 
/s/ SDTEPHENAVID J. HS. WEMSLEYICHMANN
 Chief Executive Officer
(principal executive officer)
Dated:May 8, 20177, 2018
Stephen J. HemsleyDavid S. Wichmann    
   
/s/ JOHN F. REX
 
Executive Vice President and
Chief Financial Officer
(principal financial officer)
Dated:May 8, 20177, 2018
John F. Rex    
   
/S/ THOMAS E. ROOS
 
Senior Vice President and
Chief Accounting Officer
(principal accounting officer)
Dated:May 8, 20177, 2018
Thomas E. Roos    


EXHIBIT INDEX**

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.
25
3.1
Certificate of Incorporation of UnitedHealth Group Incorporated (incorporated by reference to Exhibit 3.1 to the Company's Registration Statement on Form 8-A/A filed on July 1, 2015)
3.2
Bylaws of UnitedHealth Group Incorporated, effective February 9, 2016 (incorporated by reference to Exhibit 3.1 to the Company's Current Report on Form 8-K filed on February 12, 2016)
4.1
Senior Indenture, dated as of November 15, 1998, between United HealthCare Corporation and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3/A, SEC File Number 333-66013, filed on January 11, 1999)
4.2
Amendment, dated as of November 6, 2000, to Senior Indenture, dated as of November 15, 1998, between UnitedHealth Group Incorporated and The Bank of New York (incorporated by reference to Exhibit 4.1 to the Company's Quarterly Report on Form 10-Q for the quarter ended September 30, 2001)
4.3
Instrument of Resignation, Appointment and Acceptance of Trustee, dated January 8, 2007, pursuant to the Senior Indenture, dated as of November 15, 1998, amended November 6, 2000, among UnitedHealth Group Incorporated, The Bank of New York and Wilmington Trust Company (incorporated by reference to Exhibit 4.3 to the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2007)
4.4
Indenture, dated as of February 4, 2008, between UnitedHealth Group Incorporated and U.S. Bank National Association (incorporated by reference to Exhibit 4.1 to the Company's Registration Statement on Form S-3, SEC File Number 333-149031, filed on February 4, 2008)
*10.1
Summary of Non-Management Director Compensation, effective as of October 1, 2016
12.1
Computation of Ratio of Earnings to Fixed Charges
31.1
Certifications pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
32.1
Certifications pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101
The following materials from UnitedHealth Group Incorporated’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2017 filed on May 8, 2017, formatted in XBRL (eXtensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations, (iii) Condensed Consolidated Statements of Comprehensive Income, (iv) Condensed Consolidated Statements of Changes in Equity, (v) Condensed Consolidated Statements of Cash Flows, and (vi) Notes to the Condensed Consolidated Financial Statements.
 ________________
*Denotes management contracts and compensation plans in which certain directors and named executive officers participate and which are being filed pursuant to Item 601(b)(10)(iii)(A) of Regulation S-K.
**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.


26