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Segment Information - Additional Information (Detail)
$ in Millions
3 Months Ended 9 Months Ended
Sep. 30, 2015
USD ($)
Sep. 30, 2014
USD ($)
Sep. 30, 2015
USD ($)
Segment
Sep. 30, 2014
USD ($)
Segment Reporting [Abstract]        
Number of reportable segments | Segment     3  
Member co-share amounts and government subsidies $ 3,300 $ 2,600 $ 8,800 $ 6,800
Depreciation and amortization classified as benefit expense $ 23 $ 27 $ 68 $ 79