Full year 2009 Health Benefits revenues increased $5.5 billion or 7 percent year-over-year to $81.3 billion. The revenue advance was driven by growth of nearly 1.1 million people served across the public and senior markets and rate increases reflecting underlying medical cost trends, offset by a decrease of 1.7 million people served in the commercial benefits market, reflecting the significant decline in U.S. employment in 2009. Fourth quarter 2009 Health Benefits revenues of $20.2 billion grew 6 percent year-over-year. Health Benefits earnings from operations for the full year decreased $280 million year-over-year to $4.8 billion; fourth quarter earnings from operations were $1.15 billion. The full year operating margin declined 80 basis points year-over-year to 5.9 percent, reflecting lower investment income, growth in lower margin public and senior markets businesses, and elevated medical costs related to the H1N1 virus, partially offset by improvements in operating efficiency. For similar reasons, the fourth quarter 2009 operating margin of 5.7 percent decreased 90 basis points year-over-year. Fourth quarter results for UnitedHealthcare included net enrollment decreases of 45,000 people in risk-based benefit plans and 85,000 people in fee-based programs. Absent employment attrition at continuing clients, the business would have posted net growth of 40,000 people in total in the fourth quarter. On a full year basis, attrition contributed 55 percent of the net decrease of 1.7 million people. Full year UnitedHealthcare revenues of $40.8 billion decreased $1.0 billion or 2 percent year-over-year and fourth quarter 2009 revenues decreased $401 million or 4 percent year-over-year. UnitedHealthcare ™s 2009 medical care ratio of 84.0 percent increased 50 basis points from 83.5 percent in 2008, largely due to elevated medical costs related to the H1N1 virus and a higher proportion of participants receiving care under unemployment-related benefit continuation programs due to an increased level of national unemployment. For similar reasons, as well as the increasing mix of high deductible policy business (which tends to generate seasonally higher medical costs), the fourth quarter 2009 medical care ratio increased 190 basis points year-over-year to 85.8 percent. The fourth quarter ratio was slightly better than expected due to the decreasing prevalence of H1N1 during the course of the quarter. Full year Ovations revenues of $32.1 billion grew $4.1 billion or 15 percent year-over-year in 2009. This strong growth included notable revenue advances in the Medicare Advantage, Medicare Supplement and Part D Prescription Drug businesses. Fourth quarter revenues were $7.8 billion, up $934 million or 14 percent year-over-year. In Medicare Advantage, the Company brought its services to nearly 300,000 more seniors in 2009, an increase of 20 percent, including growth of 20,000 people in the fourth quarter. Growth in active Medicare Supplement products continued, with the number of seniors served in this product family increasing by 140,000 or 6 percent in 2009, including 20,000 people in the fourth quarter. At December 31, 2009, approximately 4.3 million people participated in the Company ™s stand-alone Part D Prescription Drug plans, including growth of 240,000 people in 2009. In total, the Company brought services to 675,000 additional seniors in 2009, reflecting its commitments to market-responsive product designs, local market engagement and overall customer value. AmeriChoice full year revenues of $8.4 billion increased $2.4 billion or 40 percent year-over-year, driven by strong organic growth as well as the full year benefit of a mid-2008 acquisition. Fourth quarter 2009 revenues of $2.3 billion grew $584 million organically or 34 percent year-over-year. During 2009 risk-based Medicaid programs grew by 565,000 people, including 105,000 in the fourth quarter, to a total of 2.9 million people. This organic growth of 24 percent in 2009 was driven by continued geographic market expansion and an overall increase in Medicaid program participation due to the economic downturn. Growth highlights in 2009 included expanding to Hawaii and completing program implementations in Connecticut, Tennessee and New Mexico. Most recently, the Mississippi Division of Medicaid awarded AmeriChoice the opportunity to provide benefits and services to approximately 30,000 women, children and disabled people, beginning in third quarter 2010.

Through its Health Services businesses, the Company provides consumer services, software, pharmaceutical and specialty benefit management, financial capabilities, data and analytics, consulting and other services to a broad variety of customers across the U.S. health system, as well as in international markets. Through these offerings, these businesses seek to improve health system performance for customers and their constituents.

Full year 2009 Health Services combined revenues increased $2.5 billion or 13 percent to $21.8 billion. The revenue advance was driven by strong growth in consumers served, particularly through pharmaceutical benefit management programs, as well as increasing revenues from public sector specialty benefit offerings and health care technology software and services. Health Services earnings from operations for the full year increased $261 million or 20 percent year-over-year to $1.6 billion; fourth quarter earnings from operations were $425 million. Earnings growth for the full year and the quarter were driven by strong sales and margin performance in pharmacy benefit management. The operating margin for this group of businesses improved 40 basis points year-over-year to 7.2 percent on a full year basis and 50 basis points year-over-year in the fourth quarter of 2009.

OptumHealth is a national leader in health and wellness services. Employers, payers and public sector organizations use OptumHealth behavioral benefit solutions, clinical care management, financial services and specialty benefits such as dental and vision. OptumHealth helps consumers navigate the health care system, finance their health care needs and achieve their health and well-being goals.

Full year OptumHealth revenues increased $303 million or 6 percent year-over-year to $5.5 billion, including an increase of $119 million or 9 percent in the fourth quarter. During 2009, growth from large scale public sector care and behavioral health programs mitigated revenue losses associated with the UnitedHealthcare commercial membership decrease. Full year 2009 earnings from operations of $636 million decreased by $82 million or 11 percent year-over-year, including a decrease of $13 million or 7 percent in the fourth quarter, and the full year operating margin declined by 220 basis points to 11.5 percent. These decreases reflect the impact of the economic downturn, including loss of higher margin UnitedHealthcare risk-based business, as well as start-up costs for new large contracts and lower investment income, partially offset by earnings growth from expanding services in the public sector and operating cost management. OptumHealth ™s public sector business continued to grow strongly in 2009, with significant new sales for services commencing in 2009 or 2010 to five state programs serving a total of nearly 1 million people. OptumHealth Financial Services, the Company ™s dedicated health banking organization, ended the fourth quarter serving 1.9 million consumer accounts, up 10 percent year-over-year. Assets under management grew 31 percent to $860 million in 2009. OptumHealth Financial Services grew its connectivity network to more than 500,000 physicians and care providers in 2009 and electronically transmitted $36 billion in medical payments to them, up 36 percent year-over-year. This health care modernization program simplifies the payment process, accelerates cash receipts for physicians and reduces costs.

Ingenix is a leader in the field of health care information, services and consulting, serving physicians, hospitals and other health care providers, large employers and governments, health insurers and other benefits payers and pharmaceutical companies.

On a full year basis, Ingenix revenues increased $271 million or 17 percent to $1.8 billion, including an increase of $110 million or 26 percent in the fourth quarter. The Ingenix contract revenue backlog grew $380 million or 21 percent year-over-year to $2.2 billion at year end, led by growth in the government and payer sectors. Ingenix full year earnings from operations of $246 million increased $17 million or 7 percent year-over-year. Fourth quarter earnings from operations of $74 million were stable year-over-year, decreasing by $2 million, despite significant up-front investments in areas targeted for growth in 2010. These included international markets and offerings and hospital revenue cycle management, as well as investment in data privacy and security capabilities in light of advancing legal requirements. The Ingenix operating margin decreased year-over-year by 130 basis points for the full year and 400 basis points in the fourth quarter, primarily due to growth in services offerings, including outsourcing services for pharmaceutical customers, and start-up investments, particularly in the fourth quarter, for international expansion, hospital revenue cycle management, and data privacy and security.

Prescription Solutions offers a comprehensive array of pharmacy benefit management and specialty pharmacy management services to employer groups, union trusts, seniors and commercial health plans.

Prescription Solutions full year revenues of $14.5 billion grew $1.9 billion or 15 percent year-over-year, driven by strong growth in consumers served. Fourth quarter 2009 revenues grew $659 million or 21 percent year-over-year. Full year 2009 earnings from operations of $689 million increased by $326 million or 90 percent year-over-year; fourth quarter earnings from operations grew $107 million to $187 million. The 2009 results were driven by script volume growth, improved drug purchasing, steady gains in mail service drug fulfillment, and a continuing favorable mix shift to generic pharmaceuticals, which reached nearly 70 percent of total volume in the quarter. These factors lifted Prescription Solutions full year and fourth quarter operating margins to 4.8 percent and 4.9 percent, respectively. During 2009 Prescription Solutions was recognized for service and value. Prescription Solutions received the highest rankings for customer service and cost competitiveness among mail order pharmacies in the J.D. Power and Associates 2009 National Pharmacy StudySM and, for the third consecutive year, Prescription Solutions was rated as the No. 1 national mail order pharmacy in customer satisfaction by WilsonRx?®. Source: UnitedHealth Group