UnitedHealth Group's new CEO Steve Hemsley on Monday told shareholders he was determined to earn back their trust after its surprising earnings shortfall earlier this year, saying the company was evaluating trends in medical costs and how that will affect its future performance.

It has been quite a year for UnitedHealth Group (UHG)—and now in addition to myriad other troubles, UHG is adding a controversial CEO pay package to its plate. The giant healthcare concern has seen an unprecedented loss of value recently.

The advisory vote is a sign of shareholders’ confidence in Stephen Hemsley, the chairman and returning CEO, who helped shape UnitedHealth for decades.