UnitedHealth Group Inc. shareholders approved a pay package for Chief Executive Officer Stephen Hemsley that includes a $60 million stock option award.

The advisory vote is a sign of shareholders’ confidence in Hemsley, the chairman and returning CEO who helped shape UnitedHealth for decades. He reclaimed the top job last month as the health giant faces multiple crises that cut its market value by more than half since its November peak. In addition to the $60 million award that vests in three years, Hemsley will get a $1 million annual salary.

The company’s shares were little changed at 11:49 a.m. on Monday in New York. They had fallen 40% this year through Friday’s close.

In his first public address since taking the job, Hemsley said at the annual shareholder meeting that management is determined to “earn back your trust and your confidence.”

The company will conduct a comprehensive review of all its policies and practices related to risk assessment coding, managed care and pharmacy services, according to Hemsley. Independent experts will assess the review.

Hemsley said that UnitedHealth underestimated the amount of medical care patients would receive, as well as costs. The company is updating its estimates and recently submitted bids for Medicare Advantage plans, a private version of Medicare, that take this into account, he said. It plans to announce financial guidance at the end of July.

The investor advisory group Institutional Shareholder Services had warned in May that Hemsley’s compensation “raises significant concern” and urged a vote against it.

The bonus “lacks any performance-vesting criteria,” the group wrote, meaning Hemsley’s pay won’t be conditioned on the company meeting specific goals.

Since 2011, companies have been required to hold a nonbinding vote at least once every three years, usually described as the “say on pay” review, where investors can demonstrate their support, or lack thereof, for the organization’s compensation practices. Last year votes failed at companies such as Salesforce Inc., AMC Entertainment Holdings Inc., Harley-Davidson Inc., JetBlue Airways Corp. and 3M Co.

UnitedHealth operates the largest US health insurer and has a health services operation under its Optum division. Long seen as a company that could reliably grow profits at unrivaled scale in the industry, recent stumbles rocked investors’ confidence.

CEO Exit

The company missed Wall Street earnings targets and cut its forecast in April, citing medical expenses rising faster than management anticipated. The shock report sent the shares plunging, but there was more bad news ahead. In May the company withdrew its annual forecast and former CEO Andrew Witty stepped down, replaced by Hemsley.

It’s also facing multiple investigations from the Department of Justice over billing and antitrust issues in the Medicare program for the elderly and disabled. UnitedHealth has defended its practices.

Hemsley owns more than 1.1 million shares of UnitedHealth, worth about $330 million when markets opened Monday, making him the largest individual shareholder, according to data compiled by Bloomberg. He recently increased his stake.

--With assistance from Jeff Green.

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