Investors are reaping major rewards as well. In the first nine months of the year, UnitedHealth spent $1.1 billion in share repurchases and $1.7 billion in direct dividend cash payments to shareholders, according to its quarterly filing. From 2012 to 2015, UnitedHealth spent $12.6 billion in buybacks and dividends. Because most revenue for health insurers comes from insurance premiums, any cash doled out to shareholders essentially behaves as a transfer of wealth from a consumer's health care budget to an investor's annual capital gains income.