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Segment Information - Additional Information (Detail) (USD $)
3 Months Ended 6 Months Ended
Jun. 30, 2014
Jun. 30, 2013
Jun. 30, 2014
Segment
Jun. 30, 2013
Segment Reporting Information [Line Items]        
Number of reportable segments     3  
Member co-share amounts and government subsidies $ 2,300,000,000 $ 1,700,000,000 $ 4,100,000,000 $ 3,200,000,000
Depreciation and amortization classified as benefit expense $ 27,000,000 $ 24,000,000 $ 52,000,000 $ 46,000,000