NEW YORK (AP) — Despite leading one of the largest health insurers in the U.S., Brian Thompson was largely unknown to the millions of people affected by his decision-making.

The fatal shooting of United Healthcare’s CEO on a midtown Manhattan sidewalk on Wednesday – police say it was a targeted killing – put the manager and his company in the spotlight.

Thompson, 50, has led health care giant UnitedHealth Group Inc.’s insurance division since 2021 and worked for the company for 20 years.

As CEO, Thompson led a company that provides health insurance to more than 49 million Americans. United is the largest provider of Medicare Advantage plans, the privately run versions of the U.S. government’s Medicare program for people age 65 and older. The company also sells individual insurance and manages health insurance coverage for thousands of employers and state and federally funded Medicaid programs.

The portfolio managed by Thompson had sales of $74 billion last quarter, making it the largest subsidiary of Minnetonka, Minnesota-based UnitedHealth Group. His $10.2 million annual compensation package, including salary, bonus and stock options, made him one of the company’s highest-paid executives.

The University of Iowa graduate, who began his career as an accountant, enjoyed little recognition outside the industry. Even for investors who own shares, the public face of the parent company belonged to CEO Andrew Witty, a knighted British triathlete who has testified before Congress.