> If there's a UnitedHealthcare plan for Apple employees (and I don't know which company Apple currently uses) then Apple sets the policy for what is and isn't

> If there's a UnitedHealthcare plan for Apple employees (and I don't know which company Apple currently uses) then Apple sets the policy for what is and isn't covered. UHC simply enforces the policy set by Apple so blaming UHC in that scenario is simply naive and displays a total misunderstanding of how the healthcare financing system actually works. The reality though is that the employer generally doesn't want to pay 100% of all claims, all the time. So they're left with "well, what do we pay, how much, and how can we use the insurer's negotiated pricing, etc., etc." and they ask UHC to provide plans that largely match UHC's plans, rules and the like, potentially with one or two little carve outs or exceptions, because UHC is the one that has done the math to make sure that balances cost/benefit for Apple. So a lot of time, they just "pass through" plans. Which is why most self-funded plans look "suspiciously similar" to what you might find elsewhere in the market. I wrote software for a healthcare claims benefit management company that drove insurance for direct insureres and TPAs for 12 years.