Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Cash and cash equivalents	$	2,826	$	3,186	$	2,819
Restricted cash and cash equivalents, non-current	100		95		93
Restricted cash and cash equivalents, current	—		9		—
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,926	$	3,290	$	2,912

Summarized premium revenue

The following table summarizes premium revenue by geography for the periods indicated:



	Year Ended December 31,
	2018				2017				2016
	Amount		% of Total		Amount		% of Total		Amount		% of Total
	(Dollars in millions)
California	$	2,150	12.2	%	$	2,701	14.3	%	$	2,378	14.4	%
Florida	1,790		10.2		2,568		13.6		1,938		11.8
Illinois	793		4.5		593		3.1		603		3.7
Michigan	1,601		9.1		1,596		8.5		1,527		9.3
New Mexico	1,356		7.7		1,368		7.3		1,305		7.9
Ohio	2,388		13.6		2,216		11.8		1,967		12.0
Puerto Rico	696		3.9		732		3.9		726		4.4
South Carolina	495		2.8		445		2.4		378		2.3
Texas	3,244		18.4		2,813		14.9		2,461		15.0
Washington	2,361		13.4		2,608		13.8		2,222		13.5
Other ⁽¹⁾	738		4.2		1,214		6.4		940		5.7
	$	17,612	100.0	%	$	18,854	100.0	%	$	16,445	100.0	%

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(1)	“Other” includes the Idaho, Mississippi, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

Quality incentive premium revenue recognized

The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the periods presented and prior periods. Although the reasonably possible effects of a change in estimate related to quality incentive premium revenue as of December 31, 2018 are not known, we have no reason to believe that the adjustments to prior periods noted below are not indicative of the potential future changes in our estimates as of December 31, 2018.



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Maximum available quality incentive premium - current period	$	182		$	150		$	147

Amount of quality incentive premium revenue recognized in current period:
Earned current period	$	133		$	97		$	104
Earned prior periods	31			10			47
Total	$	164		$	107		$	151

Quality incentive premium revenue recognized as a percentage of total premium revenue	0.9		%	0.6		%	0.9		%

Amounts due to government agencies

A summary of the categories of amounts due government agencies is as follows:



	December 31,
	2018		2017
	(In millions)
Medicaid program:
Medical cost floors and corridors	$	103	$	135
Other amounts due to states	81		71
Marketplace program:
Risk adjustment	466		917
Cost sharing reduction	183		275
Other	134		144
	$	967	$	1,542

Consolidated medical care costs

The following table provides the details of our consolidated medical care costs for the periods indicated:



	Year Ended December 31,
	2018						2017						2016
	Amount		PMPM		% of Total		Amount		PMPM		% of Total		Amount		PMPM		% of Total
	(In millions, except PMPM amounts)
Fee-for-service	$	11,278	$	232.15	74.5	%	$	12,682	$	229.63	74.3	%	$	10,993	$	217.84	74.4	%
Pharmacy	2,138		44.01		14.1		2,563		46.40		15.0		2,213		43.84		15.0
Capitation	1,184		24.38		7.8		1,360		24.63		8.0		1,218		24.13		8.2
Other	537		11.05		3.6		468		8.48		2.7		350		6.94		2.4
Total	$	15,137	$	311.59	100.0	%	$	17,073	$	309.14	100.0	%	$	14,774	$	292.75	100.0	%