As a parent, you want to do your best. You focus on your child, ensuring they're emotionally safe, properly socialized, and academically challenged — anything to set them up for success.

It's hard to fathom a dark outcome: that your child would grow up to assassinate someone, or be accused of doing so.

That's what Luigi Mangione's parents experienced last week, as the 26-year-old accused killer of UnitedHealthcare CEO Brian Thompson was charged with murder as an act of terrorism. And the parents of 15-year-old Natalie Rupnow, who killed two and injured six others at a Wisconsin school before dying of a self-inflicted gunshot, according to police.

Working with parents who've watched their kids sink into dangerous behavior, family therapist Rachel Goldberg said it's very hard for them to heal. She said parents must strive to find self-compassion and "separate their identity from their child's actions," no matter how challenging.

Parents of shooters experience remorse and confusion

In her 2016 memoir, "A Mother's Reckoning," Sue Klebold, the mother of Columbine shooter Dylan Klebold, wrote about struggling to call her son a "monster" after he killed 13 people in 1999. "When I hear about terrorists in the news, I think, 'That's somebody's kid,'" she wrote in the book.

Peter Rodger, the father of Isla Vista killer Elliot Rodger, wrestled with similar confusion and guilt. He remembers sitting in horror, watching his son's retribution video, which he posted on YouTube before stabbing, shooting, and using a car to hit bystanders in 2014. "Elliot was far from evil," Rodger told ABC that year. "Something happened to him. He was the most beautiful, kind, sweetheart of a boy."

Such an event "forces us as parents to contend with our worst fears," Annie Wright, another family therapist, told Business Insider. "The lack of control, at some level, over who they become."

Mangione's family is wealthy and well-known in their community as the owners of a golf club and philanthropists. He attended the Gilman School, a prestigious private school in Baltimore, where he graduated as valedictorian and was described by his peers as "very social" and "very into sports."

Goldberg said that a parent's imagined worst-case scenario is usually that their child would become a lonely, unemployed adult living in their basement. If a child does the unthinkable, recovering as a parent can feel impossible.

Limits to a parent's control

Kids don't need to be out of the house to be mysteries to their parents. In the wake of the Wisconsin shooting, authorities are combing through Rupnow's online activity in search of a motive, finding a version of her life seemingly concealed from others, like her fascination with the Columbine shooters.

Once a child is over 18 and financially independent, parents' control over their lives becomes even more tenuous. In the Mangiones' case, their son stopped responding to messages for months before he was arrested.

For parents watching their adult kids slip into alarming behavior, their options are legally limited, Goldberg said. Often, their best defense is talking to their kid, but "it really depends how much their adult child is willing to let them in."

Wright said that involving third parties can help. Parents can try family therapy or find licensed professionals who can help manage their child's physical or emotional pain. Parents can also call their local authorities in extreme cases, such as when their child is in immediate danger or endangering someone else.

Goldberg said the best thing parents can do is know their child as well as possible and act when something feels off. "Don't wait until it gets really bad if you can possibly intervene earlier," she said.

Even then, sometimes, intervention falls short.

Rodgers, the Isla Vista shooter, was in therapy from the age of 9. Peter Lanza, the father of Sandy Hook shooter Adam Lanza, said his son had been assessed by mental health professionals multiple times.

Pain a parent can't fix

Loneliness and isolation can often be red flags when analyzing a child's behavior. Still, Mangione, who started a gaming club in college and was part of a fraternity, appeared surrounded by people.

This made it harder for him to disappear fully: In July 2024, when he cut off contact with his family, cousins and friends reached out on social media. In November, his mother filed a missing person's report in San Francisco, where Mangione has some relatives.

Despite his seemingly solid network of friends and family, Mangione had spondylolisthesis, a painful spinal condition. He frequented Reddit communities related to back pain, describing his symptoms as "absolutely brutal" and "life-halting." That can be isolating, Goldberg said.

"It is a very lonely place to be in pain all the time because you can't really be present with people," he added.

In 2022, when Mangione lived in a Hawaiian surf community, he experienced sciatica, debilitating nerve pain, in his leg. R.J. Martin, who owned the co-living space, told The New York Times that Mangione "knew that dating and being physically intimate with his back condition wasn't possible."

While parents can do a lot to relate to a child's pain, such as listening and doing their best to understand the nuances of what their child is going through, "empathy alone can't bridge every gap," Wright said.

Parents can still protect themselves

Goldberg's clients, particularly parents of kids with substance abuse issues, struggle to move past their guilt. Acceptance can take a lifetime.

"They live in fear of getting a phone call from the police or hospital; they question everything they have done," she said. "They often feel incredibly helpless and stuck."

Wright said the resulting grief from something like this can be "extraordinarily complex" and "often includes sorrow, not only for the victims and their families but for the loss of the child they thought they knew."

She suggested therapy and, for those with religious affiliations, seeking spiritual leaders they trust. Parents can feel so many conflicting emotions, and it's important to "allow these emotions to coexist without rushing to tidy them up," she said.

This is especially hard for the parents who felt they tried their best.

Upon learning of Mangione's arrest, his family released a statement contrary to the manifesto found with their son during his arrest. "We offer our prayers to the family of Brian Thompson, and we ask people to pray for all involved," they said. "We are devastated by this news."

Some parents try to find meaning in the tragedy. Klebold wrote her memoir and participated in press interviews. Chin Rodger, mother of Elliot, started speaking at threat assessment trainings. She hopes that people will get better at identifying the red flags of someone going through a mental crisis.

Still, some just wish it never happened. Adam Lanza's father blames himself for overlooking the warning signs. "You can't get any more evil," Lanza told the New Yorker in 2014. "How much do I beat up on myself about the fact that he's my son? A lot."

• UnitedHealth Group's CEO eulogized his slain colleague, Brian Thompson, in a New York Times op-ed.
• Thompson's shooting sparked a nationwide debate about the state of the health insurance industry.
• Witty's op-ed faced fierce online criticism from people who said it didn't offer solutions.

The head of UnitedHealth Group, the parent company of UnitedHealthcare, is responding to the "vitriol" that's been lodged — both on- and offline — against the health insurance industry and its workers.

In an op-ed published in The New York Times on Friday, UnitedHealth Group CEO Andrew Witty expressed his grief over the fatal shooting of UnitedHealthcare CEO Brian Thompson last week, as well as his appreciation for the "outpouring of support" for Thompson. He then condemned the mounting rhetoric that he said has glorified violence against health insurance workers.

"We also are struggling to make sense of this unconscionable act and the vitriol that has been directed at our colleagues who have been barraged by threats," Witty wrote.

"No employees — be they the people who answer customer calls or nurses who visit patients in their homes — should have to fear for their and their loved ones' safety," he wrote.

Witty acknowledged growing criticism that the healthcare industry is flawed and defended his company's place within it.

"We know the health system does not work as well as it should, and we understand people's frustrations with it," Witty wrote, adding that his company's mission is to build a system that works better for everyone.

And Thompson, he added, advocated for ideas "aimed at making health care more affordable, more transparent, more intuitive, more compassionate — and more human."

The fatal shooting of Thompson outside a midtown Manhattan hotel last week sparked a nationwide conversation about the state of the US health insurance industry, with many criticizing the system's ability to provide lifesaving care.

Social media has been inundated with memes mocking Thompson's death, praising the shooting suspect, and calling out other healthcare CEOs. Some executives have sought out greater security over fears for their safety, though the suspect has been arrested and charged in connection with Thompson's murder.

Witty's op-ed in the Times had received more than 2,400 comments as of Friday afternoon, many of which ridiculed his statement and condemned what they said were UnitedHealth Group's practices of denying insurance claims.

A number of commenters called out Witty for saying the system is flawed without providing any tangible solutions to fix it. Others criticized the for-profit health insurance system as a whole, with some acknowledging that businesses are meant to make a profit and others advocating for nonprofit healthcare.

UnitedHealth didn't respond to a request for comment from Business Insider.

• Luigi Mangione, charged with killing the CEO of UnitedHealthcare, had a lower back condition.
• Spondylolisthesis occurs when one vertebra in your spine slips out of alignment.
• Mangione seemingly frequented a subreddit for the condition and wrote about symptoms.

Luigi Mangione, the 26-year-old man charged with killing UnitedHealthcare CEO Brian Thompson, suffered from a spinal condition.

Mangione's social media accounts included several references to back pain. On X, Mangione's banner included an X-ray image of a spine after a spinal fusion.

On his Reddit account, he posted in a subreddit for spondylolisthesis, a lower back condition most often caused by joint deterioration. Mangione also mentioned he had spondylolisthesis in handwritten notes from 2019 reviewed by Business Insider.

Spondylolisthesis can cause pain and stiffness

According to Cleveland Clinic, spondylolisthesis is usually caused by aging (as the discs holding the vertebrae weaken) or injuries.

It is a condition when one of the bones in the spine falls out of alignment and "presses down" on the vertebra below it. That pressure on nearby nerves can cause lower back pain.

Other symptoms include sciatica (nerve pain that runs down from the lower back to the legs), back stiffness, numbness, and difficulty walking.

Not everyone needs spinal fusion surgery to realign their vertebrae; depending on the severity of the symptoms, rest, physical therapy, and wearing a brace can help reduce pain, as can taking over-the-counter medications when symptoms flare up.

Mangione had sciatica, a common symptom

In 2022, Mangione moved to a co-living space in Honolulu called Surfbreak. According to a Reddit post, he experienced sciatica, nerve pain that runs down from the lower back to the legs, for the first time after a surf session. "A few weeks later I slipped on a piece of paper and my right glute locked and right leg shut down for a week," he wrote in 2022. "Couldn't support any weight on it."

Prior to his back surgery in 2023, Mangione also described having "near-constant burning/twitching in both ankles/calves" and "back and genital pain" on Reddit — symptoms of sciatica.

R.J. Martin, who owns Surfbreak, told the New York Times that shortly after moving in, Mangione experienced such debilitating pain from a group surfing lesson that he needed Martin to switch out his mattress.

Mangione also told Martin that his condition prevented him from being in a romantic relationship.

"He knew that dating and being physically intimate with his back condition wasn't possible," Martin said. "I remember him telling me that, and my heart just breaks."

At first, the back surgery seemed to improve Mangione's symptoms — he posted in 2023 that it was a "success." But by June 2024, he started criticizing doctors online and eventually lost touch with friends and family.

According to Mayo Clinic, spinal fusion surgeries for spondylolisthesis "can have very good outcomes when performed well and for the right reasons."

• Some high-profile CEOs like Mark Zuckerberg or Elon Musk have multimillion-dollar security details.
• Health insurance companies, by contrast, don't appear to spend as much on executive protection.
• The amount public companies allocate toward executive security and private travel varies widely.

The death of UnitedHealthcare CEO Brian Thompson last week has brought a new level of attention to the question of executive protection.

Thompson's shooting outside a hotel in New York also highlights that executives who aren't as high-profile as someone like Elon Musk may not always have bodyguards with them.

That level of monitoring can be expensive, and the amount companies pay for executive security varies widely.

On the high end, Musk and other CEOs including Meta's Mark Zuckerberg, Alphabet's Sundar Pichai, and Salesforce's Marc Benioff are known for having multimillion-dollar security packages.

Others, including JPMorgan Chase's Jamie Dimon, Amazon's Andy Jassy, and Apple's Tim Cook, have more modest protection services worth hundreds of thousands of dollars — amounts that can further increase when factoring in costs associated with the use of private planes, a common CEO perk tied to security considerations.

Health insurance companies, including UnitedHealth Group, don't appear to spend as much on executive protection as some of the Big Tech giants.

However, the health insurance industry isn't an outlier. Companies in other fields, like retail, also have relatively modest security-specific compensation.

Walmart CEO Doug McMillon and McDonald's CEO Chris Kempczinski, for example, appear to have individual security expenses of less than $25,000 for 2023, according to company filings. When including the use of private aircraft, Walmart paid $192,848 for McMillon's personal use of the company jet, while McDonald's paid $319,301 for Kempczinski's usage in 2023.

Company-paid security costs are typically disclosed in annual corporate filings known as proxy statements. The documents include a breakdown of the salary, benefits, bonuses, and other perks to provide a dollar value of top executives' total compensation package, which must be approved by the board and shareholders.

Security services paid for by the company for the benefit of an individual executive are typically included in a category called "Other Compensation" along with perks like personal corporate jet usage, 401(k) matching, or tax preparation services. It's possible that some security costs may not be reported in proxy statements, particularly if they were paid for by the executives themselves and not reimbursed.

UnitedHealth Group's filings don't specify any personal security costs for Thompson last year

It's not clear if Thompson had a security detail with him on the day of his death. Video footage obtained by the New York City Police Department appears to show him walking alone on his way into an "investor day" event in Manhattan.

Although he was CEO of UnitedHealthcare, Thompson was also an executive vice president of UnitedHealth Group, for which he received $21,187 in other compensation in 2023. That amount represented $14,850 in 401(k) matching and $6,337 in health insurance premiums, with no amount indicated for personal security.

The company has yet to release its annual proxy statement outlining 2024 expenses.

Looking further up the corporate ladder, Thompson's boss, UHG CEO Andrew Witty, also did not receive payment for personal security as part of his 2023 compensation package. However, the company did make corporate aircraft available for his use.

"Witty is required for personal security reasons to use corporate aircraft for all business travel and is encouraged to use corporate aircraft for all personal travel," the proxy statement says, adding that Witty did not make personal use of the company plane in 2023.

A UHG spokesperson told BI the company is "partnering with local law enforcement to ensure a safe work environment and reinforce security guidelines and building access policies."

CVS, which owns Aetna, does not disclose the compensation of Aetna's president. However, CVS did provide its former CEO Karen Lynch with $44,148 for "personal protection" in 2023, as well as $243,281 for personal use of the company jet and $106,086 for personal use of a company car. A CVS spokesperson declined to comment.

Cigna CEO David Cordani received $310,437 in "other compensation" in 2023, largely constituted of $178,704 in personal travel on the company aircraft. Roughly $95,000 in other costs were provided for residential security system monitoring and maintenance, as well as expanded personal liability coverage.

Proxy statements for Humana and Elevance (owner of Anthem) did not specify personal security costs, while Kaiser Permanente is a nonprofit and not subject to the same reporting requirements.

Musk-level security can cost millions

Former Secret Service agent Joseph LaSorsa, who now runs the private security firm LaSorsa & Associates, previously told BI that an around-the-clock detail can cost $100,000 a month and isn't always enough to stop a motivated attacker.

At those rates, the annual cost of protection could balloon to $1.2 million — comparable to the base salaries of UnitedHealth's executive officers.

In other words, company-provided personal security can be an expensive proposition, and typically reserved only for a small number of top leaders. Different executives may also have their own personal preference for the level of security they travel with.

"Protection is very much driven on what a executive really wants," said John Orloff, a former US Secret Service agent who now leads security risk consulting at Jensen Hughes.

Orloff told Business Insider that his firm typically works with corporate security departments to develop their executive protection strategies in response to relevant threats.

Musk, the world's wealthiest person, has spoken out about personal security concerns in recent years. He told Tesla shareholders at the annual shareholder meeting that "two homicidal maniacs" had threatened to kill him and things were "getting a little crazy these days."

Filings show Tesla paid a Musk-owned personal security company $2.4 million to protect him in 2023. However, the agreement is not structured as compensation for his services as CEO and is unusual among public companies (Tesla is fighting to reinstate Musk's 2018 compensation package after a Delaware judge ruled against it for the second time).

Musk travels with multiple bodyguards — sometimes as many as 20, according to a recent report. Employees at X, formerly Twitter, reported seeing his security follow him into the bathrooms at the company's headquarters.

While executives at health insurance companies may not be as recognizable as someone like Musk or Zuckerberg, Thompson's death could lead board members and CEOs to review executive protection costs in a different light. The matter could feature more prominently as compensation committees draft proposals for their companies' future annual meetings.

• Luigi Mangione, a 26-year-old tech worker, was charged with the killing of UnitedHealthcare CEO Brian Thompson.
• The University of Pennsylvania graduate reportedly stopped speaking with friends and family after back surgery last year.
• Deleted social media posts show skepticism toward doctors, Donald Trump, and Joe Biden, and support for RFK Jr.

Luigi Mangione, the man charged with the murder of UnitedHealthcare CEO Brian Thompson, seemingly supported Robert F. Kennedy Jr., appeared to harbor frustrations with the medical field, and expressed skepticism toward both Donald Trump and Joe Biden, deleted posts on X show.

Mangione, a 26-year-old software developer who reportedly fell out of touch with friends and family after back surgery last year, reposted Edward Snowden's suggestion that Democrats should nominate Robert F. Kennedy Jr. for president following Joe Biden's disastrous debate performance in June.

The deleted posts, which Business Insider viewed on Archive.org, are among the most recent online clues about Mangione found so far.

Mangione has been described as both an "anti-capitalist" and a member of the "online right." His deleted posts support the idea that his worldview was influenced by reactionary right-wing thinkers.

In another deleted post from May, Mangione reposted another user's skepticism of doctors, adding detail to reports about Mangione's dissatisfaction with the US healthcare system. A former roommate from Hawaii told the Honolulu Civil Beat that Mangione had chronic back pain.

"My experience with the medical profession — and yours is probably similar — is that doctors are basically worthless unless you carefully manage them, and 2/3 of them are worthless even in that case," the post said.

The author of the original post, Zero HP Lovecraft, calls himself a "fascist hipster." His Substack shows he submitted a short story for the Passage Prize, an award run by a publisher known for publishing reactionary and fascist authors.

Mangione also castigated "both parties" in a reply to writer Nate Silver.

"Both parties - Trump with his refusal to accept the results of an election, and Biden with his refusal to accept his age and step down - are simultaneously proving how desperately individuals will cling to power," Mangione posted. He also referred to term limits as "critical."

In June, he reposted a suggestion by Richard Hanania, an author critical of "wokeness," that Trump thought Christians were delusional.

In July, Mangione also reposted a description of Project 2025, a roadmap for Trump's second term developed by the right-wing think tank The Heritage Foundation, as "qanon but for redditors."

• Luigi Mangione has been charged with murder in UnitedHealthcare CEO Brian Thompson's killing.
• Mangione, an Ivy League graduate from a wealthy family, left an online trail before his arrest.
• He founded an app, talked about AI on X, and read the Unabomber Manifesto.

Luigi Mangione, the 26-year-old Ivy League graduate charged with murder in the fatal shooting of UnitedHealthcare CEO Brian Thompson, has a vast online trail.

Police arrested Mangione in Pennsylvania on December 9. He initially faced local gun and forgery charges. He's expected to be extradited to New York.

New York court documents show that in addition to one count of murder, he also faces two counts of second-degree criminal possession of a weapon, one count of second-degree possession of a forged document, and one count of third-degree criminal possession of a firearm.

Here's what to know about Mangione.

Mangione attended elite schools

Mangione graduated from the University of Pennsylvania in 2020.

He achieved a Bachelor of Science in engineering with a major in computer science and a minor in mathematics. He also received a Master of Science in engineering the same year with a major in computer and information science, a university spokesperson told Business Insider.

Before that, he attended Gilman School, an elite all-boys preparatory school in Baltimore. His yearbook entry, obtained by BI, says he was involved in robotics and Model United Nations.

In his valedictorian speech, Mangione praised classmates for "challenging the world" and thanked parents for sending their children to the fee-paying school, which he described as "far from a small financial investment."

He favorably reviewed the Unabomber Manifesto

On Goodreads, Mangione reviewed Ted Kaczynski's "Industrial Society and Its Future" book, also known as The Unabomber Manifesto, in early 2024. He gave it four out of five stars.

"He was a violent individual — rightfully imprisoned — who maimed innocent people," Mangione wrote. "While these actions tend to be characterized as those of a crazy luddite, however, they are more accurately seen as those of an extreme political revolutionary."

Mangione's review of the manifesto also quoted another online comment about the book, which appears to have originated on Reddit, praising the use of violence "when all other forms of communication fail."

"'Violence never solved anything' is a statement uttered by cowards and predators,'" Mangione quoted.

He founded an app and worked in tech

In 2015, while in high school, Mangione founded a company called AppRoar Studios. AppRoar released an iPhone game called "Pivot Plane" that's no longer available, but a reviewer in 2015 said it was "a fun little arcade game brought to you by 3 high school juniors."

He lived in a co-living space in Hawaii as recently as 2023.

He posed for photos indicating he participated in Greek life at the University of Pennsylvania.

The fraternity chapter represented in his photos couldn't be reached for comment.

A blog post on the University of Pennsylvania's website that was removed on December 9 said he cofounded a video game design club there.

Stephen Lane, a professor of video game design at the Ivy League university who didn't advise the club, told BI that "the fact he took the initiative and started something from nothing, that means at least in the context of Penn, that's a pretty good thing." He added, however, that Thompson's shooting was "obviously not a good thing."

Mangione's LinkedIn page says he worked as a data engineer at the vehicle shopping company TrueCar starting in 2020.

A TrueCar spokesperson told BI that Mangione hadn't worked for the company since 2023.

Online breadcrumbs and roommate say he dealt with back pain

At the top of Mangione's profile on X — formerly Twitter — is a triptych of three images: a photo of himself, smiling, shirtless on a mountain ridge; a Pokémon; and an X-ray with four pins or screws visible in the lower back.

The Pokémon featured in his cover image is Breloom, which has special healing abilities in the games.

Some of the books reviewed on Mangione's Goodreads account are related to health and healing back pain, including "Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn't Telling You" and "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery."

R.J. Martin, the founder of the co-living space in Hawaii, told the Honolulu Civil Beat that Mangione had suffered back pain from a misaligned vertebra that was pinching his spinal cord.

Martin told CNN that after leaving Hawaii, Mangione texted him to say he'd undergone surgery and sent him X-rays.

"It looked heinous, with just, giant screws going into his spine," Martin told the outlet.

It's not immediately clear whether the surgery was related to UnitedHealthcare.

Josiah Ryan, a spokesperson for the co-living space founder, told The Wall Street Journal that Mangione stopped replying to texts about six months ago and "sort of disappeared."

A YouTube spokesperson said that the platform had terminated Mangione's three accounts, adding that they had not been active for about seven months.

A senior police official told NBC New York on December 12 that Magione was never a UnitedHealthcare client and may have targeted Thompson because of the insurer's large size and outsize power. That same day, The Wall Street Journal reported that a company spokesperson said Magione was not a client.

Mangione was interested in AI

On his X account, Mangione posted and amplified posts about technological advances such as artificial intelligence. He also posted about fitness and healthy living.

He frequently reposted posts by the writer Tim Urban and the commentator Jonathan Haidt about the promise and perils of technology.

He also appeared to be a fan of Michael Pollan, known for his writing about food, ethics, and lab-grown meat.

On Goodreads, he praised Urban's book "What's Our Problem?: A Self-Help Book for Societies," describing it as "one of the most important philosophical texts of the early 21st century."

Urban posted to X on December 9: "Very much not the point of the book."

He was previously accused of trespassing

Before his arrest, Mangione had at least one encounter with the legal system. Hawaiian court records indicate that in 2023, he was accused of entering a forbidden area of a state park.

Mangione appears to have paid a $100 fine to resolve the matter.

Mangione comes from a wealthy and influential Baltimore family

Mangione is one of 37 grandchildren of the late Nick Mangione Sr., a prominent multimillionaire real-estate developer in Baltimore who died in 2008, The Baltimore Banner reported. Nick Mangione Sr. had 10 children, including Louis Mangione, Luigi Mangione's father.

Members of the Mangione family own the Turf Valley Resort in Ellicott City, Maryland, and Hayfields Country Club in Hunt Valley, Maryland.

One of Luigi Mangione's cousins is the Republican Maryland state legislator Nino Mangione, the Associated Press reported.

Representatives for Nino Mangione's office, in a statement to BI, declined to comment on the news of Luigi Mangione's arrest.

"Unfortunately, we cannot comment on news reports regarding Luigi Mangione," the statement read. "We only know what we have read in the media. Our family is shocked and devastated by Luigi's arrest. We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved. We are devastated by this news."

The Mangione family has donated more than $1 million to the Greater Baltimore Medical Center, where all of Nick Mangione Sr.'s grandkids, including Luigi Mangione, were born, the Banner reported.

A public filing from 2022 for the nonprofit Mangione Family Foundation lists Louis Mangione as vice president.

He was arrested while on his laptop at a McDonald's, the police said

When the police in Altoona, Pennsylvania, responded to a McDonald's after a call about a suspicious person, they found Mangione sitting at a table looking at a silver laptop and wearing a blue medical mask, a criminal complaint said.

The complaint said that when asked for identification, Mangione gave police officers a New Jersey driver's license with the name "Mark Rosario."

When an officer asked Mangione whether he'd been to New York recently, he "became quiet and started to shake," the complaint said.

It added that Mangione correctly identified himself after officers told him he could be arrested for lying about his identity.

When asked why he lied, Mangione replied, "I clearly shouldn't have," the complaint said.

His motive is still not known, but police are analyzing his so-called manifesto

An internal NYPD report obtained by The New York Times said Mangione "likely views himself as a hero of sorts who has finally decided to act upon such injustices."

Mangione "appeared to view the targeted killing of the company's highest-ranking representative as a symbolic takedown and a direct challenge to its alleged corruption and 'power games,' asserting in his note he is the 'first to face it with such brutal honesty,'" according to the NYPD report by the department's Intelligence and Counterterrorism Bureau, the Times reported.

Moments before the December 10 extradition hearing began, Mangione, handcuffed and wearing an orange prison jumpsuit, shouted out to the press as Pennsylvania police escorted him into the courthouse.

Mangione yelled out something partially unintelligible, saying something was "completely out of touch" and "an insult to the American people." He also shouted that something was a "lived experience" as a group of officers led him into the courthouse.

NYPD Chief of Detectives Joseph Kenny told NBC New York that Mangione had prior knowledge that UnitedHealthcare would be having its annual conference in New York City.

Mangione has retained a high-profile New York attorney

Thomas Dickey emerged as Mangione's attorney in Pennsylvania after his arrest in Altoona on December 9.

During a December 10 hearing at Pennsylvania's Blair County Courthouse, Dickey told the judge that Mangione was contesting his extradition to New York City.

Dickey later told reporters that Mangione would plead not guilty to all the charges in Pennsylvania. During an interview with CNN, Dickey said he expected Mangione to plead not guilty to the second-degree murder charge in New York and that he hadn't seen evidence that authorities "have the right guy."

Karen Friedman Agnifilo will represent Mangione in New York, a representative for Agnifilo Intrater LLP confirmed to Business Insider on Sunday.

Friedman Agnifilo worked as the chief assistant district attorney at the Manhattan District Attorney's Office from 2014 to 2021. She pivoted to private practice in 2021.

Do you know Luigi Mangione? Have a tip? Reach out to [email protected].

• A gunman fatally shot UnitedHealthcare CEO Brian Thompson on December 4 in New York City.
• The NYPD launched a manhunt but has so far failed to capture the suspect.
• The suspect's evasion has revealed holes in surveillance, but police say it's just a matter of time.

The Manhattan shooting Wednesday of UnitedHealthcare CEO Brian Thompson was captured by a surveillance camera and shared on social media, where the footage racked up hundreds of thousands of views. Authorities later released full-color surveillance images of the gunman, including one that showed him with his mask pulled down and smiling.

Yet, the gunman is still at large after four days despite a citywide manhunt led by the largest metropolitan police force in the country. On Friday, authorities told CNN they believed the gunman had managed to leave the city by bus.

The gunman's ability to evade capture so far has highlighted the limits of surveillance, even in a city like New York, where authorities have access to thousands of cameras that can track millions of people daily.

"You have got to remember, he was running around a city of 9 million people," Joseph Giacolone, a former NYPD Sergeant and professor at the John Jay School of Criminal Justice, told Business Insider. "You know, it's not that easy to pick somebody up the street, especially if they're all buttoned up."

New York City is under constant surveillance by police and residents

After the September 11 terrorist attacks in 2001, George W. Bush's administration expanded surveillance across the country.

Bush signed the Aviation and Transportation Act that November, creating the Transportation Security Administration. That same year, the Bush administration ushered in the USA Patriot Act, which expanded law enforcement's ability to use surveillance.

The US Congress later created the Department of Homeland Security. The department launched a nationwide campaign — "If You See Something, Say Something" — encouraging citizens to report suspicious activity to law enforcement to prevent terrorism and other criminal acts.

Since then, the emphasis on surveillance and security has spread nationwide, including in New York City, where cameras are now everywhere.

Amnesty International, a human rights organization, said there were over 25,500 surveillance cameras in New York City in a 2022 report. The NYPD has used images from the ubiquitous cameras to track crimes and for use in facial recognition software.

The NYPD's "Facial Identification Section" received 9,850 requests for comparison and returned 2,510 possible matches in 2019 — a roughly 25% match rate. The agency said it's unaware of cases in NYC in which a person was falsely arrested due to a facial recognition match.

This May, New York City Mayor Eric Adams launched a pilot program focused on using technology to increase public safety. The "community-based security camera integration platform" will allow businesses to "voluntarily share information in real-time with the NYPD through existing closed-circuit television cameras," according to a press release.

The emergence of Amazon's Ring cameras and smartphones has added another layer of monitoring. In 2022, the NYPD said it would join and monitor the Neighbors app, where residents share information on crime and safety.

"While the NYPD will not monitor the app around the clock, it will have the capacity to view, post and respond to crime- and safety-related information posted publicly by the users of the app," a press release said.

The NYPD is "processing a tremendous amount of evidence"

Commissioner Jessica Tisch told CNN on Friday that the department had already collected "lots of forensic evidence" and was "processing a tremendous amount of evidence in this case."

She said there is also a "massive camera canvass" of the suspect's movements through the city.

Additionally, a law enforcement official told CNN that investigators found a backpack in Central Park they believe belonged to the suspect but had not officially confirmed where it came from. Authorities took the backpack for tests.

Giacolone told BI that while the shooting suspect has evaded capture for now, it will be difficult for him to elude authorities as they collect more evidence. The NYPD will be looking for what he called "the three horsemen of forensics" to solve the case, which are video surveillance, cellphone records, and internet records.

"I've been on these investigations," Giacolone said. "They know what hole he crawled out of, what hole he went back into. As far as I'm concerned, they already know who he is. They just got to find him."

• Executive security is getting a closer look after the fatal shooting of UnitedHealthcare's CEO.
• Private security companies say they've gotten an influx of calls.
• Executive security spending at S&P 500 companies has been on the rise — doubling from 2021 to 2023.

Update: A "person of interest," 26-year-old Luigi Mangione, was arrested in connection with Brian Thompson's death in Altoona, Pennsylvania, on Monday.

Following the fatal shooting of United Healthcare CEO Brian Thompson this week, some high-level executives are ramping up their own security.

The host of a series of national and international executive leadership summits told Business Insider that a surge of corporate leaders has been reaching out to him this week to inquire about security at the events.

Jeffrey Sonnenfeld — a professor and senior associate dean for Leadership Studies at Yale who also heads Yale's Chief Executive Leadership Institute — has been hosting summits for top company executives for decades.

He said that over the last few years the institute has significantly increased the security it provides executives at its events in the US. But things have shifted this week ahead of the institute's coming CEO Summit in Manhattan in December.

"What's really different for us, this coming one, is so many people inquiring to make sure we have it" Sonnenfeld said, in reference to event security. "We never used to get inquiries about it."

Sonnenfeld said the institute had increased security at its events long before Thompson's fatal shooting because company leaders have increasingly faced threats and general hostility from the public.

"Sadly, CEOs have been made into foils or scapegoats for the far-left and the far-right," he said, "so that the political grandstanding has looked to make excuses for whatever unhappiness people have."

This year marks the first time the December CEO Summit will have armed and uniformed NYPD officers all around it, Sonnenfeld said. But, he added, the CEOs are thrilled to get together to compare notes with other CEOs on what they're doing about security.

Meanwhile, the fatal shooting has led to a surge of interest in beefed-up security for company leaders, people at private security firms said.

Michael Kozhar, the vice president of operations at International Security Services, Inc., of Brooklyn told BI that in the past few days, his company has seen a rise in calls from executives and companies looking to upgrade their security.

Still, because the attack on the healthcare executive appears to have been targeted, Kozhar said there hasn't been a lot of action so far in terms of companies actually engaging in more security services beyond inquiries. "If these incidents become more frequent, the atmosphere surrounding the purchase of security services will change drastically," he cautioned.

Matthew Dumpert, managing director at Kroll Enterprise Security Risk Management, told CNBC on Thursday, that he'd also received calls.

"We had CEOs and other executive-level and board members reaching out to us all throughout yesterday and today to increase their own executive protection, their own personal security around the clock, 24/7," he said.

Because executives are the face of an organization, they can receive the brunt of the blame for their customers' frustrations, Dumpert told the outlet. And for organizations that deal in life and death matters — like health insurance companies — that ire can be even more potent.

Allied Universal, which provides a range of security and protection services to Fortune 500 companies, saw a surge of potential clients reaching out on Wednesday following the attack on Thompson, company leaders told The New York Times.

But it's not just the events of this week that are giving executives cause for concern.

Targeted attacks — both online and offline — on executives and their families have risen dramatically in the last five years, Chris Pierson, the CEO of digital executive protection agency BlackCloak, told the Times. The firm's data shows that the most frequently targeted executives work in the health care, biomedical, and pharmaceutical industries, according to the outlet.

In the last few years, companies have been increasing the amount they spend on security for their top executives.

Between 2021 and 2023, the median total value of security benefits provided to named executive officers at S&P 500 companies doubled, according to data shared with Business Insider from executive compensation research firm Equilar.

The prevalence of companies offering security benefits also increased modestly — by around 4% over the same timeframe, according to Equilar.

The shooting of Thompson, who didn't appear to have security protection when he was killed in Midtown Manhattan on Wednesday morning, sparked a dayslong manhunt for the suspect. As of Friday afternoon, the suspect is still at large, though authorities believe he has fled the city.

On Thursday, United Health Group, the parent company of UnitedHealthcare, issued a statement: "Our priorities are, first and foremost, supporting Brian's family; ensuring the safety of our employees; and working with law enforcement to bring the perpetrator to justice."

• Some health insurance companies are removing executive bios from their websites.
• The deletions came after the fatal shooting of UnitedHealthcare CEO Brian Thompson.
• CVS Health and BlueCross Blue Shield are among those who have removed executive bios.

Some health insurance companies have removed executive leadership bios from their websites after the fatal shooting of UnitedHealthcare CEO Brian Thompson.

Thompson died on Wednesday after a gunman shot him outside a Hilton hotel in New York City. Thompson was scheduled to speak at the company's investor conference.

The New York Police Department said the shooting appeared to be "a brazen, targeted attack." Police say the gunman left the scene on foot before using an electric bike. The gunman remains at large.

As of Friday, the "Our leadership" section on UnitedHealthcare's "About Us" page is no longer accessible. Clicking on the link through Google will redirect to the company's homepage. An archive of the page shows that the leadership section was publicly visible as recently as Wednesday.

When asked for comment, a UnitedHealthcare representative pointed Business Insider toward two separate statements published this week regarding Thompson's death. Neither addressed the removal of the leadership page on its website.

UnitedHealthcare's parent company, UnitedHealth Group, appears to have followed suit.

Following links to UnitedHealth Group's "Our Leaders" and "Board of Directors" pages from Google now read "Page Not Found." An archive link shows that the leadership section was visible as recently as Tuesday.

Blue Cross and Blue Shield, another major American health insurance company, also appeared to have removed the executive bio section from its website. An archive link for the company's site shows that its "Our Leadership" section was visible earlier this year. However, it's inaccessible at the time of writing.

Some of Blue Cross and Blue Shield's regional offices, including its Massachusetts branch, have also made their leadership web pages inaccessible to the public.

Clicking on a link to the "Company Leadership" page for the Massachusetts branch through Google will now lead to the message: "You are not authorized to access this page."

Medica, which provides health insurance plans in states like Iowa and Minnesota, confirmed to BI that it had removed its leadership page.

"The safety of Medica employees is our top priority and we have increased security for all of our employees," the statement read. "Although we have received no specific threats related to our campuses, our office buildings will be temporarily closed out of an abundance of caution."

Other companies like CVS Health still have executive leadership bios on their websites but have removed photos. A representative from CVS Health confirmed the decision to BI, but had no additional comment.

Centene also appeared to have removed photos of its top executives. An archive of the "Executive Leadership" page shows that photos were visible in September.

Representatives for UnitedHealth Group, Blue Cross and Blue Shield, and Blue Cross Blue Shield of Massachusetts did not immediately respond to a request for comment from Business Insider.

On Wednesday, moments after the news broke that Brian Thompson, the CEO of UnitedHealthcare, had been fatally shot in Midtown Manhattan, social media unleashed a barrage of caustic commentary about his death. In lieu of condolences, Americans from all walks of life shared barbed jokes, grim memes, and personal anecdotes about their own experiences with giant insurers like UnitedHealthcare.

On Facebook, UnitedHealthcare's statement about the murder of its chief executive elicited 46,000 reactions — 41,000 of which employed the laughing emoji. The company quickly turned off comments on the post, but hundreds of users shared it with arch commentary.

"The amount of laugh reacts on the original post speaks volumes lol," one user wrote.

"My thoughts & prayers were out of network," wrote another.

While the motive behind Thompson's murder remains unknown, the internet treated it as an occasion for ghoulish schadenfreude. America's health insurance system is so broken and cruel, people openly declared, that the death of one of its most powerful executives merited nothing but scorn and derision. "He was CEO when he was shot," read one tweet that received more than 120,000 likes. "Preexisting condition. Claim denied."

"The UnitedHealthcare CEO might be the most celebrated death on this app since Henry Kissinger," wrote another user on X.

Given the nature of social media, where the most provocative and emotion-laden commentary is engineered to rise to the top, it's not surprising that platforms from TikTok to Reddit would be filled with hateful invective. What's striking, however, is how the backlash revealed the depth of the bitterness toward health insurers. In the face of a man being gunned down in the street, people didn't keep their feelings toward insurers in check; rather, they seized on it as a moment to vent their rage. Everyone from right-wing influencers to tenured Ivy League professors responded to Thompson's killing by posting about what they saw as the injustices of America's health insurers. Even on LinkedIn, one of the internet's last bastions of civility and professionalism, hundreds of business executives, HR leaders, and tech managers shared deeply personal stories about how they and their loved ones had suffered at the hands of a healthcare bureaucracy that often delays and denies reasonable claims.

In one exchange, a hospital executive acknowledged that many Americans are fed up with health insurers. "As healthcare security professionals, we know that many see healthcare as a target for their anger," he wrote. "Family members who have lost a loved one may feel as though a physician, healthcare facility, or insurer is responsible for that loss."

Jill Christensen, a former vice president at Western Union, responded to the post by forcefully rejecting its wording. "In many instances, it's not feel, it's ARE responsible for that loss," she wrote. "I was diagnosed with Stage 4 cancer and UHC denied every claim. While today's event is tragic, it does not come as a surprise to the millions of people — like myself — who pay their OOP costs and premiums, only to be turned away at their greatest time of need."

The joking language of the internet has become a standard way for Americans to process tragic events, whether the September 11, 2001, attacks or the July 2024 assassination attempt on Donald Trump. But Thompson's murder sparked something different: an unparalleled public reckoning with one of the country's largest and most profitable industries. "When you shoot one man in the street it's murder," wrote one user on X. "When you kill thousands of people in hospitals by taking away their ability to get treatment you're an entrepreneur."

To some observers, the outpouring of ire also appeared to have an immediate effect on the industry itself. One day after Thompson's murder, Anthem Blue Cross Blue Shield announced that it was rescinding a controversial plan to limit coverage for anesthesia. "When patients become financially responsible because a health plan cuts how much they pay providers, that's what breeds all this anger," Marianne Udow-Phillips, a former Blue Cross executive, told Axios. An Anthem Blue Cross Blue Shield spokesperson told Business Insider, "It never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines."

The storm of invective surrounding Thompson's killing will soon subside, as online malice always does. But it's also possible that the CEO's death will mark an inflection point in the debate over America's privatized system of health insurance. On X, one user drew a direct line between the callousness of the internet's response to Thompon's murder and an industry that makes it hard for many Americans to receive the medical treatment they need.

"All jokes aside," the user tweeted, "it's really fucked up to see so many people on here celebrating murder. No one here is the judge of who deserves to live or die. That's the job of the AI algorithm the insurance company designed to maximise profits on your health."

Scott Nover is a freelance writer based in Washington, DC. He is a contributing writer at Slate and was previously a staff writer at Quartz and Adweek covering media and technology.

• Brian Thompson, the CEO of UnitedHealthcare, was shot and killed in Manhattan Wednesday morning.
• Thirteen hours later, his home and that of his wife were targeted with bomb threats, police said.
• Police determined the threats were a hoax.

The homes of UnitedHealthcare CEO Brian Thompson and his wife in a suburb outside Minneapolis were targeted with fake bomb threats Wednesday evening, more than 13 hours after Thompson was shot and killed in Manhattan, police said.

Around 7 p.m. Wednesday, city employees in the Minneapolis suburb of Maple Grove received emails threatening to bomb Thompson's home and the home of his wife, according to incident reports released by the Maple Grove police department. Thompson and his wife lived in separate houses less than a mile apart.

Police checked both homes and determined the threats were a hoax. In a statement, Maple Grove police called the threats a form of "swatting," a kind of harassment.

The New York Police Department said Thompson was gunned down at about 6:45 a.m. Wednesday outside the Hilton hotel in midtown Manhattan. The shooter fled the scene before police arrived, and a manhunt is ongoing.

UnitedHealthcare is the largest private insurer in the US, and Thompson was in New York for an investor meeting when he was killed.

• UnitedHealthcare's CEO appeared not to have a bodyguard when he was shot Wednesday in Manhattan.
• Two security consultants told Business Insider that was unusual.
• Even if he'd had a bodyguard, it may not have saved his life, one said.

Two executive-protection consultants say they were surprised UnitedHealthcare CEO Brian Thompson didn't appear to have a bodyguard when he was shot and killed walking into a hotel in midtown Manhattan on Wednesday — though one said it likely wouldn't have saved his life.

A "person of interest," 26-year-old Luigi Mangione, was arrested in connection with Thompson's death in Altoona, Pennsylvania, on Monday.

It's not clear whether Thompson had a security detail, but in the video of the shooting shared by the New York City Police Department, he appears to be walking toward the hotel alone. A spokesperson for UnitedHealthcare did not immediately respond to a request for comment.

Brittney Blair, who specializes in consulting executives about their personal security for the risk-management firm K2 Integrity, said she was "floored, honestly," that Thompson did not appear to have a bodyguard.

"I've seen a lot of CEOs and high-profile business leaders who sometimes feel that corporate security is maybe a little bit overboard," she said. "They feel — I don't want to say untouchable, but they maybe underestimate how much of a public figure they are."

Thompson appeared to live somewhat modestly relative to the $10.2 million he received in compensation last year, in a combination of cash and stock grants, Securities and Exchange Commission records show. He resided in a Minneapolis suburb, in a home purchased for just over $1 million in 2018, tax records show.

His wife, Paulette Thompson, told NBC News that her husband had received threats.

"There had been some threats," she said. "Basically, I don't know, a lack of coverage? I don't know details. I just know that he said there were some people that had been threatening him."

Paulette Thompson couldn't be reached for comment by BI.

Joseph LaSorsa, a former Secret Service agent who now runs the private-security firm LaSorsa & Associates, said that an around-the-clock protective detail costs in the neighborhood of $100,000 a month. But, he said, even if Thompson had such a security detail, it might not have stopped a motivated shooter.

"I know it sounds extreme, but you're not going to mitigate a killing if someone's hell-bent on doing it to you. Sooner or later, they're going to succeed," LaSorsa said.

If Thompson had been walking with a bodyguard, LaSorsa added, "and they'd both had their backs turned, they both would have been shot."

• UnitedHealthcare CEO Brian Thompson was fatally shot in New York City on Wednesday, the police said.
• The NYPD said Thompson, 50, appeared to be killed in a targeted attack.
• Police on Monday arrested a "person of interest" identified as 26-year-old Luigi Mangione.

Police in Pennsylvania on Monday arrested a "person of interest" in connection to the fatal Midtown Manhattan shooting of UnitedHealthcare CEO Brian Thompson.

The 26-year-old man, identified as Luigi Mangione, was arrested in Altoona, Pennsylvania, and charged with local gun and forgery charges, New York Police Department officials said during a press conference.

Mangione was arraigned on Monday evening and charged on five counts, including two felonies: forgery, carrying a firearm without a license, tampering with records or identification, possessing instruments of crime, and false identification to law enforcement, according to a criminal complaint viewed by Business Insider. He was ordered held without bail.

Mangione was arrested after an employee at a McDonald's recognized him from the surveillance photos circulated by law enforcement and called the police. The complaint said Mangione was wearing a blue medical mask and looking at a laptop when Altoona police arrived.

Mangione had fake IDs, a US passport, and a gun and silencer "consistent with" the one thought to have been used by the gunman who killed Thompson, police said. The criminal complaint said the gun and silencer had been 3-D-printed.

NYPD officials said Mangione was also found with a three-page handwritten document that suggested "he has some ill will toward corporate America."

Mangione is expected to be extradited to New York to face additional charges, NYPD officials said.

The manhunt for Thompson's killer

The NYPD had released more than a half-dozen surveillance images of the man suspected to be the shooter in the December 4 attack in the hopes that tips from the public could help authorities track him down.

The latest photos of the man suspected of the shooting — which has been described by police as a targeted attack — included one showing him in the back of what appears to be a taxi, wearing a blue medical mask and a dark hood. Another image showed the man standing outside the vehicle's window wearing a mask, hood, and dark puffer jacket.

Moments after shooting Thompson dead in the heart of Manhattan Wednesday, police say the gunman fled the scene, first on foot and then on an electric bike, which he rode into Central Park. Police believe the shooter ultimately escaped New York City by bus.

Investigators believed the gunman caught a cab on Manhattan's Upper West Side and directed the driver to a bus station as he made his getaway following the shooting, Bloomberg reported.

Police officials told CNN they believed the man left New York City via the Port Authority's George Washington Bridge Bus Station in Washington Heights.

"We have video of him entering the Port Authority bus terminal. We don't have any video of him exiting, so we believe he may have gotten on a bus," NYPD Chief of Detectives Joseph Kenny said in a December 6 interview. "Those buses are interstate buses. That's why we believe he may have left New York City," Kenny said.

NYPD divers were seen over the weekend searching the waters in Central Park for any evidence in the shooting.

A law-enforcement source told CNN that investigators had found a backpack in Central Park that they believed belonged to the gunman. The backpack contained a Tommy Hilfiger jacket and Monopoly money, CNN reported, citing law-enforcement officials and sources.

It was not immediately clear if other items were found in the backpack.

Kenny said on December 6 that officials were investigating the possibility that the gunman may have used a veterinary gun, used on farms to euthanize large animals quietly, in the shooting, CNN reported.

A law-enforcement source previously told BI that the gun used by the shooter appeared to be equipped with a silencer, according to surveillance footage of the attack.

Most of the images that police have released of the man wanted in the shooting show him with a mask covering the bottom half of his face, except a set of two, which NYPD Commissioner Jessica Tisch called the "money shot," that showed the clearest images yet of the suspect unmasked.

"He's been traveling and walking around the streets of New York City largely in a mask, with his face covered. We had to go through lots of video evidence to get that one money shot with the mask down," Tisch told CNN in a December 6 interview.

Tisch said that police released the photos of the man not wearing a mask because they wanted a "wider audience to see the picture outside of New York City."

"We are right now processing a tremendous amount of evidence in this case," the NYPD commissioner told the news outlet, adding that authorities already have "lots of forensic evidence," including fingerprints and DNA evidence.

Police have called the killing of Thompson premeditated

Police have described Thompson's killing as "a brazen, targeted attack."

Thompson was set to speak at UnitedHealth Group's 8 a.m. investor conference on December 4 when a hooded gunman opened fire from behind, striking him at least once in the back and at least once in the right calf, the police said.

"Every indication is that this was a premeditated, pre-planned, targeted attack," Tisch told reporters at a press conference hours after the shooting.

"It appears the suspect was lying in wait for several minutes," Tisch added.

The NYPD offered a $10,000 reward for tips leading to the gunman's arrest, and the FBI said it was also offering a reward of up to $50,000 for information leading to the gunman's arrest and conviction.

Multiple reports said that authorities conducted forensic tests on a discarded cellphone, protein bar wrapper, and water bottle.

How the suspect arrived in New York is also becoming clearer.

Authorities believe he may have traveled to the city 10 days before the shooting on November 24 on a bus that originated in Atlanta and dropped him off at Manhattan's main bus depot, the Port Authority Bus Terminal. It was not yet clear where along the route he boarded the bus.

The Atlanta Police Department announced Friday that the NYPD contacted it and will provide assistance in the investigation as needed.

The unmasked images of the wanted man released by police were captured at a hostel on New York City's Upper West Side, a law enforcement official told CNN, when an employee asked the man to lower his face mask.

The Times, citing a senior law enforcement official, previously reported that the suspect in the shooting used a fake New Jersey ID to book a room at the hostel he was staying at in the days before the attack.

Retired NYPD homicide detective Salvatore Tudisco previously told BI that the photos showing the man's face were likely to speed up the manhunt.

Tudisco led the city's last big manhunt for a murdered CEO, Gokada founder Fahim Saleh, whose killer was captured in three days by traces on credit card, cellphone, and surveillance camera evidence.

"That's the best option — to send it across the country, and someone will know him," the ex-detective said of the latest images.

He added that a facial-recognition trace would be less of an option because the hostel surveillance images do not show the man's full face.

Investigators can still try to run the photo through state driver's license and arrest databases, Tudisco said. However, some states require a judge to issue a warrant before state driver's licenses can be used as evidence in an arrest and beyond.

Shooter was 'proficient in the use of firearms,' police said

Kenny said at the NYPD's press conference in the aftermath of the shooting that the gunman arrived on 6th Avenue about five minutes before Thompson. The shooter's weapon appeared to jam during the attack, he added.

"From watching the video, it does seem that he's proficient in the use of firearms, as he was able to clear the malfunctions pretty quickly," Kenny said.

Surveillance footage captured the incident, showing the gunman firing his weapon as Thompson, wearing a blue suit jacket, was walking several feet in front of him.

A law-enforcement source, who is not authorized to talk to the press, told Business Insider that the gun appeared to be equipped with a silencer. The source added that the gunman "definitely knew" where Thompson was going to be.

The police said officers found Thompson unconscious and unresponsive two minutes after the shooting. Emergency responders rushed him to Mount Sinai Hospital, where he was pronounced dead at 7:12 a.m.

Police have not identified a motive

The shooting occurred blocks from Midtown holiday tourism landmarks, including Radio City Music Hall and Rockefeller Center, whose Christmas tree lighting took place on December 4.

In the aftermath of the shooting, six evidence cups were visible on the taped-off section of the sidewalk where the attack occurred.

"That's covering the shell casings," an officer at the scene told BI, declining to give their name because they were not authorized to talk to the media.

UnitedHealth Group canceled its "investor day" conference shortly after reports of the shooting broke.

Investigators have not yet determined a motive for the killing.

Kenny said investigators were combing through Thompson's social media and interviewing employees and family members and would be talking to law enforcement in Minnesota, where Thompson lived and where UnitedHealth Group and UnitedHealthcare are based.

Thompson's wife, Paulette Thompson, previously told NBC News in an interview that her husband had been receiving threats.

"Basically, I don't know, a lack of coverage?" she said. "I don't know details. I just know that he said there were some people that had been threatening him."

The police department in his hometown of Maple Grove, Minnesota, told BI it hadn't been notified of any threats he might have received. Theresa Keehn, the Maple Grove police administrator, initially said Maple Grove had no record of calls for service to his house. Still, the department later said it had responded to a 2018 call from Paulette Thompson. An incident report said she had been walking to bed when she saw the front door deadbolt turn and grew afraid someone was inside the house. The police did not find anyone inside the home.

An unnamed senior law enforcement official told NBC News that shell cases found at the scene were inscribed with the words "deny," "defend," and "depose." BI has not independently confirmed the description of the evidence, and an NYPD spokesperson didn't return a request for comment.

Jay M. Feinman, an author and legal professor specializing in insurance law, torts, and contract law, wrote a similarly titled book "Delay Deny Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It."

The book is dubbed an exposé of insurance injustice and explains how people can be more careful when shopping for insurance policies and what to do when pursuing a disputed claim.

The NYPD said Thompson arrived in New York City on Monday and was staying at a hotel across the street from where he was shot.

Police in Maple Grove, Minnesota, told BI homes of Thompson and his wife in a suburb outside Minneapolis were targeted with fake bomb threats Wednesday evening, more than 13 hours after the shooting.

Thompson was remembered as a 'hardworking Midwest guy.'

Thompson spent 20 years at UnitedHealth Group and was CEO of UnitedHealthcare, the health-benefits unit, since April 2021.

While announcing his promotion, the company said Thompson would "drive continued growth across the global, employer, individual, specialty, and government benefits business while continuing the company's focus on ensuring access to high-quality, affordable healthcare."

Leaders in the healthcare industry shared their condolences in the hours after Thompson's death.

UnitedHealth's shares were broadly unchanged after the shooting. They've gained about 12% in the past 12 months, less than the 32% increase in the S&P 500, but outperforming competitors, including CVS Health, Humana, and Elevance Health. During its third-quarter results in October, it gave what UBS called a "more conservative than usual" outlook for fiscal 2025. Ahead of Wednesday's investor day, it gave more detailed guidance for next year, forecasting revenue of $450 billion to $455 billion and adjusted earnings of $29.50 to $30 a share. The company also suffered a ransomware attack that disrupted pharmacy deliveries earlier this year.

By the afternoon of the shooting, UnitedHealth Group had removed the names of its executives from its website, an archived version of its site shows. Some executives also appeared to have deleted their LinkedIn profiles, though it's unclear when.

Thompson had previously served as CEO of the group's government programs, running its programs for Medicare and Medicaid recipients.

Thompson's former brother-in-law, Bassel El-Kasaby, told Business Insider that Thompson was "a good guy, very successful and very humble — just a decent, hardworking Midwest guy."

"Whoever did this is a coward and a loser," El-Kasaby said.

Correction: December 4, 2024 — An earlier version of this story misstated Thompson's work history at United Health. He worked at the company for 20 years but was not an executive there for 20 years.

Update December 9, 2024: This story was updated with details on the arrest of a "person of interest" in the shooting.