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Segment Reporting
 9 Months Ended
Sep. 30, 2022
Segment Reporting [Abstract]  
Segment Reporting Segment ReportingThe Company has three operating segments, Health Care Benefits, Pharmacy Services and Retail/LTC, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the Company’s chief operating decision maker (the “CODM”) evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income, which is defined as operating income (loss) (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. See the reconciliations of consolidated operating income (loss) (GAAP measure) to consolidated adjusted operating income below for further context regarding the items excluded from operating income (loss) in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.
The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millionsHealth Care
Benefits
Pharmacy 
Services (1)
Retail/
LTC		Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months Ended
September 30, 2022
Revenues from external customers$22,387 $40,545 $17,994 $32 $— $80,958 
Intersegment revenues 23 2,671 8,722 — (11,416)— 
Net investment income (loss)101 — (10)110 — 201 
Total revenues22,511 43,216 26,706 142 (11,416)81,159 
Adjusted operating income (loss)1,544 1,877 1,398 (417)(169)4,233 
September 30, 2021
Revenues from external customers$20,311 $36,851 $16,347 $39 $— $73,548 
Intersegment revenues 21 2,195 8,678 — (10,894)— 
Net investment income (loss)147 — (33)132 — 246 
Total revenues20,479 39,046 24,992 171 (10,894)73,794 
Adjusted operating income (loss)1,106 1,773 1,723 (343)(186)4,073 
Nine Months Ended
September 30, 2022
Revenues from external customers$68,029 $116,600 $53,380 $97 $— $238,106 
Intersegment revenues69 8,889 25,074 — (34,032)— 
Net investment income (loss)278 — (44)281 — 515 
Total revenues68,376 125,489 78,410 378 (34,032)238,621 
Adjusted operating income (loss)5,126 5,368 4,865 (1,277)(556)13,526 
September 30, 2021
Revenues from external customers$60,993 $105,909 $47,672 $101 $— $214,675 
Intersegment revenues62 7,772 25,309 — (33,143)— 
Net investment income432 — 13 387 — 832 
Total revenues61,487 113,681 72,994 488 (33,143)215,507 
Adjusted operating income (loss)4,502 5,035 5,166 (1,015)(523)13,165 
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(1)Total revenues of the Pharmacy Services segment include approximately $2.9 billion and $2.8 billion of retail co-payments for the three months ended September 30, 2022 and 2021, respectively, and $9.8 billion and $9.0 billion of retail co-payments for the nine months ended September 30, 2022 and 2021, respectively.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Pharmacy Services segment, and/or the Retail/LTC segment. Intersegment adjusted operating income eliminations occur when members of Pharmacy Services Segment clients (“PSS members”) enrolled in Maintenance Choice® elect to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail. When this occurs, both the Pharmacy Services and Retail/LTC segments record the adjusted operating income on a stand-alone basis.
The following are reconciliations of consolidated operating income (loss) to adjusted operating income for the three and nine months ended September 30, 2022 and 2021:
Three Months Ended
September 30,		Nine Months Ended
September 30,
In millions2022202120222021
Operating income (loss) (GAAP measure)$(3,931)$3,061 $4,128 $10,964 
Amortization of intangible assets (1)
464 561 1,398 1,730 
Opioid litigation charges (2)
5,220 — 5,704 — 
Loss on assets held for sale (3)
2,480 — 2,521 — 
Gain on divestiture of subsidiary (4)
— — (225)— 
Acquisition-related integration costs (5)
— 20 — 101 
Goodwill impairment (6)
— 431 — 431 
Acquisition purchase price adjustment outside of measurement period (7)
— — — (61)
Adjusted operating income$4,233 $4,073 $13,526 $13,165 
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(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the unaudited condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(2)During the three and nine months ended September 30, 2022 the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate/Other segment.
(3)During the three and nine months ended September 30, 2022, the loss on assets held for sale relates to the LTC reporting unit within the Retail/LTC segment. The Company continually evaluates its portfolio for nonstrategic assets. The Company determined that its LTC business was no longer a strategic asset and during the third quarter of 2022 committed to a plan to sell the LTC business. As of September 30, 2022, the LTC business met the criteria for held-for-sale accounting and the net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its fair value and a loss on assets held for sale was recorded during the third quarter of 2022. During the nine months ended September 30, 2022, the loss on assets held for sale also relates to the Commercial Business reporting unit within the Health Care Benefits segment. In March 2022, the Company reached an agreement to sell its Thailand business, which was included in the Commercial Business reporting unit. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its fair value and a loss on assets held for sale was recorded during the first quarter of 2022. The sale closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(4)During the nine months ended September 30, 2022, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022, for approximately $775 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statement of operations within the Health Care Benefits segment.
(5)During the three and nine months ended September 30, 2021, acquisition-related integration costs relate to the acquisition of Aetna. The acquisition-related integration costs are reflected in the unaudited condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(6)During the three and nine months ended September 30, 2021, the goodwill impairment charge relates to an impairment of the remaining goodwill of the LTC reporting unit within the Retail/LTC segment.
(7)In June 2021, the Company received $61 million related to a purchase price working capital adjustment for an acquisition completed during the first quarter of 2020. The resolution of this matter occurred subsequent to the acquisition accounting measurement period and is reflected in the Company’s unaudited condensed consolidated statement of operations for the nine months ended September 30, 2021 as a reduction of operating expenses within the Health Care Benefits segment.