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Segment Reporting (Tables)
12 Months Ended
Dec. 31, 2022
Segment Reporting [Abstract]  
Summarized Financial Information Of Segments
In millionsHealth Care
Benefits
Pharmacy 
Services
(1)
Retail/
LTC
Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
2022:
Revenues from external customers$90,844 $157,787 $72,874 $124 $— $321,629 
Intersegment revenues89 11,449 33,764 — (45,302)— 
Net investment income (loss)476 — (44)406 — 838 
Total revenues91,409 169,236 106,594 530 (45,302)322,467 
  Adjusted operating income (loss) 5,984 7,356 6,705 (1,785)(728)17,532 
Depreciation and amortization1,629 567 1,813 238 — 4,247 
2021:
Revenues from external customers81,515 143,194 66,078 125 — 290,912 
Intersegment revenues85 9,828 34,010 — (43,923)— 
Net investment income586 — 17 596 — 1,199 
Total revenues 82,186 153,022 100,105 721 (43,923)292,111 
  Adjusted operating income (loss) 5,012 6,859 7,623 (1,471)(711)17,312 
Depreciation and amortization1,837 576 1,884 215 — 4,512 
2020:
Revenues from external customers74,926 132,663 60,208 111 — 267,908 
Intersegment revenues58 9,275 30,990 — (40,323)— 
Net investment income483 — — 315 — 798 
Total revenues75,467 141,938 91,198 426 (40,323)268,706 
  Adjusted operating income (loss) 6,188 5,688 6,146 (1,306)(708)16,008 
Depreciation and amortization1,832 612 1,801 196 — 4,441 
_____________________________________________
(1)Total revenues of the Pharmacy Services segment include approximately $12.6 billion, $11.6 billion and $10.9 billion of retail co-payments for 2022, 2021 and 2020, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information about retail co-payments.
(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 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.
Reconciliation Of Consolidated Operating Income to Adjusted Operating Income
The following is a reconciliation of consolidated operating income to adjusted operating income for the years ended December 31, 2022, 2021 and 2020:
In millions202220212020
Operating income (GAAP measure)$7,746 $13,193 $13,911 
Amortization of intangible assets (1)
1,808 2,259 2,341 
Office real estate optimization charges (2)
117 — — 
Gain on divestiture of subsidiaries (3)
(475)— (269)
Opioid litigation charges (4)
5,803 — — 
Loss on assets held for sale (5)
2,533 — — 
Acquisition-related integration costs (6)
— 132 332 
Store impairments (7)
— 1,358 — 
Goodwill impairment (8)
— 431 — 
Acquisition purchase price adjustment outside of measurement period (9)
— (61)— 
Receipt of fully reserved ACA risk corridor receivable (10)
— — (307)
Adjusted operating income$17,532 $17,312 $16,008 
_____________________________________________
(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 Company’s GAAP 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)In 2022, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the planned reduction of corporate office real estate space in response to the Company’s new flexible work arrangement. The office real estate optimization charges are reflected in the Company’s GAAP consolidated statement of operations in operating expenses within the Health Care Benefits, Corporate/Other and Pharmacy Services segments.
(3)In 2022, the gain on divestiture of subsidiaries represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022, and the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. In 2020, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of the Workers’ Compensation business, which the Company sold in July 2020. The gains on divestitures are reflected as a reduction of operating expenses in the Company’s GAAP consolidated statements of operations within the Health Care Benefits segment.
(4)In 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.
(5)In 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 non-strategic 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 its net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and a loss on assets held for sale was recorded during the third quarter of 2022. As of December 31, 2022, the net assets of the LTC business continued to meet the criteria for held-for-sale accounting and during the fourth quarter of 2022, an incremental loss on assets held for sale was recorded to write down the carrying value of the LTC business to its estimated fair value less costs to sell. During 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 estimated fair value less costs to sell and a loss on assets held for sale was recorded during the first quarter of 2022. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(6)In 2021 and 2020, acquisition-related integration costs relate to the acquisition of Aetna. The acquisition-related integration costs are reflected in the Company’s GAAP consolidated statements of operations in operating expenses within the Corporate/Other segment.
(7)In 2021, the store impairment charge relates to the write down of operating lease right-of-use assets and property and equipment in connection with the planned closure of approximately 900 retail stores between 2022 and 2024. The store impairment charge is reflected within the Retail/LTC segment.
(8)In 2021, the goodwill impairment charge relates to an impairment of the remaining goodwill of the LTC reporting unit within the Retail/LTC segment.
(9)In 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 GAAP consolidated statement of operations as a reduction of operating expenses within the Health Care Benefits segment.
(10)In 2020, the Company received $313 million owed to it under the ACA’s risk corridor program that was previously fully reserved for as payment was uncertain. After considering offsetting items such as the ACA’s minimum MLR rebate requirements and premium taxes, the Company recognized pre-tax income of $307 million in the Company’s GAAP consolidated statement of operations within the Health Care Benefits segment.