Brian Robert Thompson, born on July 10, 1974, in the small town of Jewell, Iowa, was a man destined for greatness. From his humble Midwestern roots to his rise as the Chief Executive Officer of UnitedHealthcare, one of America’s largest health insurance providers, Thompson’s life was a testament to hard work, resilience, and an unwavering commitment to improving healthcare for millions. Tragically, his journey was cut short on December 4, 2024, when he was fatally shot in a targeted attack outside the New York Hilton Midtown. At just 50 years old, Thompson left behind a legacy that continues to ripple through the healthcare industry and the lives he touched. This biography dives deep into his remarkable story—his early years, career milestones, personal life, and the indelible mark he left on the world.
Early Life: A Small-Town Star with Big Dreams
Growing up in Jewell, a tight-knit community in rural Iowa, Brian Thompson was the quintessential all-American kid. The son of hardworking parents, he learned the value of perseverance early on. At South Hamilton High School, he excelled both academically and athletically, earning the title of valedictorian in 1993. Friends and classmates recall him as the “smartest kid” they’d ever met—a natural leader with a quiet confidence and a knack for problem-solving. Whether he was acing exams or shining on the sports field, Thompson’s drive was unmistakable.
His small-town upbringing instilled in him a grounded perspective that would later define his leadership style. After high school, he headed to the University of Iowa, where he pursued a Bachelor’s degree in Business Administration and Accounting, graduating in 1997. It was here that he met Paulette, his future wife, forging a partnership that would anchor him through decades of ambition and achievement. With a sharp mind and a degree in hand, Thompson was ready to take on the world.
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The Early Career: From Numbers to Healthcare
Fresh out of college, Thompson kicked off his professional journey as a certified public accountant (CPA) at PricewaterhouseCoopers (PwC), one of the “Big Four” accounting firms. For nearly seven years, from 1997 to 2004, he honed his financial acumen, working as a manager and tackling complex corporate challenges. His time at PwC wasn’t just about crunching numbers—it was where he developed the analytical skills and strategic thinking that would propel him into the healthcare industry.
In 2004, Thompson made a pivotal move, joining UnitedHealth Group, a Minnesota-based healthcare giant. Starting as Director of Corporate Development, he quickly proved his worth, navigating the company’s growth strategies with precision. His ability to blend financial expertise with a vision for healthcare innovation caught the attention of leadership, setting the stage for a meteoric rise through the ranks.
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Climbing the Ladder at UnitedHealthcare
UnitedHealthcare, the insurance arm of UnitedHealth Group, became Thompson’s proving ground. Over the next 17 years, he took on a series of high-stakes roles, each one building on the last. He served as financial controller for the Employer and Individual business, sharpening the division’s fiscal operations. Later, as CEO of UnitedHealthcare’s Medicare & Retirement and Community & State programs, he oversaw health plans that served millions, including seniors and underserved populations. His leadership in these government programs showcased his ability to balance profitability with a mission-driven focus on accessibility.
In April 2021, Thompson reached the pinnacle of his career when he was named CEO of UnitedHealthcare. At the helm of a company insuring over 49 million Americans and generating $281 billion in revenue in 2023, he was tasked with steering one of the nation’s most influential healthcare entities. Under his watch, profits soared from $12 billion in 2021 to $16 billion in 2023, driven in part by the explosive growth of Medicare Advantage plans. Thompson’s compensation reflected his success—$10.2 million in 2023, a mix of salary, bonuses, and stock awards. Colleagues nicknamed him “BT,” a nod to his approachable yet commanding presence.
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A Vision for Healthcare: Value-Based Care
Thompson wasn’t just a numbers guy; he was a visionary. He championed “value-based care,” a model that incentivized doctors to keep patients healthy rather than simply treating illness after the fact. At a 2023 investor meeting, he passionately outlined this shift, saying, “Health care should be easier for people. We’re navigating a future where families don’t have to make decisions alone.” His approach aimed to simplify a notoriously complex system, earning him respect among peers and frustration from critics who saw UnitedHealthcare’s claim denials as a barrier to care.
His tenure wasn’t without controversy. Investigations by ProPublica and the U.S. Senate highlighted rising prior authorization denials under Medicare Advantage, sparking debates about the company’s practices. A 2024 insider trading lawsuit also named Thompson, alleging executives hid a Justice Department antitrust probe to inflate stock prices. Yet, those who knew him—like former colleague Matt Burns—praised his dedication. “He had a huge role in Medicare Advantage’s growth,” Burns said. “BT was all in.”
Personal Life: A Family Man at Heart
Beyond the boardroom, Thompson was a devoted husband and father. He and Paulette raised two sons, Bryce and Dane, in Maple Grove, Minnesota, a Minneapolis suburb. The couple, though separated at the time of his death, remained amicable, living near each other to co-parent their boys—one a college freshman, the other a high schooler. Friends described them as the “Leave It to Beaver” family—always polished, always present at lacrosse games and school events. Thompson’s sister-in-law, Elena Reveiz, called him “a good person,” while his wife’s heartfelt tribute after his death echoed the sentiment: “Brian lived life to the fullest and touched so many lives.”
In his downtime, he cheered for the Minnesota Twins, supported the Special Olympics, and advocated for better healthcare access, including American Sign Language services. His enthusiasm was infectious, whether he was boating with family or leading with “unwavering dedication,” as one co-worker put it.
The Tragic End: A Targeted Attack
On December 4, 2024, Thompson’s life was abruptly ended in a chilling, premeditated shooting outside the New York Hilton Midtown. He was in Manhattan for UnitedHealth Group’s annual investor conference when a masked gunman—later identified as Luigi Mangione—shot him in the back and leg. Shell casings inscribed with “delay,” “deny,” and “depose” hinted at a motive tied to frustration with insurance practices. Paulette revealed he’d received threats over coverage issues, though details remained murky. Mangione, arrested days later in Pennsylvania, faced murder and terrorism charges, igniting a firestorm of public reaction—some condemning the act, others celebrating it amid widespread anger at the healthcare system.
The news sent shockwaves through Minnesota and beyond. Governor Tim Walz called it “horrifying,” while UnitedHealth Group CEO Andrew Witty mourned him as “one of the good guys.” Flags flew at half-mast at the company’s Minnetonka headquarters, and the healthcare industry reeled from the loss of a titan.
Legacy: A Complicated Giant
Brian Thompson’s death thrust UnitedHealthcare—and the broader U.S. healthcare system—into the spotlight. His 20-year career transformed how millions accessed care, for better or worse. To some, he was a brilliant leader who made health insurance more efficient; to others, a symbol of a profit-driven industry that left patients behind. His legacy is a paradox: a man who climbed from a small Iowa town to the top of Corporate America, only to become a lightning rod in a national debate.
As UnitedHealthcare named Tim Noel his successor in January 2025, Thompson’s influence lingered. He was laid to rest in Minnesota, remembered by colleagues as a “servant-leader” and by family as a “wonderful person with a big heart.” His story—equal parts triumph and tragedy—remains a powerful chapter in the ongoing saga of American healthcare.