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Segment Reporting
 6 Months Ended
Jun. 30, 2023
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company has three operating segments, Health Care Benefits, Health Services and Pharmacy & Consumer Wellness, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and 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. Adjusted operating income is defined as operating income (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. Effective for the first quarter of 2023, adjusted operating income also excludes the impact of net realized capital gains or losses. See the reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income below for further context regarding the items excluded from operating income 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.

Segment financial information for the three and six months ended June 30, 2022 has been revised to conform with current period presentation for the following items:
•The realignment of the Company’s segments to correspond with changes made to its operating model as described in Note 1 “Significant Accounting Policies,” including the discontinuance of the former Maintenance Choice segment reporting practice as described in Note (1) of the table included on the next page.
•The impact of the adoption of the long-duration insurance accounting standard, which the Company adopted on January 1, 2023 using a modified retrospective transition method, as described in Note 1 “Significant Accounting Policies.”
•The exclusion of the impact of net realized capital gains or losses from adjusted operating income, as described above.

The impact of these items on segment financial information for the three and six months ended June 30, 2022 is reflected in the “Adjustments” lines of the table included on the next page.
Three Months Ended June 30, 2022
In millionsHealth Care
Benefits		Health
Services		Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (1)
Consolidated
Totals
Total revenues, as previously reported$22,756 $42,812 $26,286 $110 $(11,328)$80,636 
Adjustments(15)126 460 — (571)— 
Total revenues, as adjusted$22,741 $42,938 $26,746 $110 $(11,899)$80,636 
Adjusted operating income (loss), as previously reported$1,831 $1,855 $1,862 $(555)$(183)$4,810 
Adjustments92 (25)(152)94 183 192 
Adjusted operating income (loss), as adjusted$1,923 $1,830 $1,710 $(461)$— $5,002 
Six Months Ended June 30, 2022
In millionsHealth Care
Benefits		Health
Services		Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (1)
Consolidated
Totals
Total revenues, as previously reported$45,865 $82,273 $51,704 $236 $(22,616)$157,462 
Adjustments(30)280 940 — (1,190)— 
Total revenues, as adjusted$45,835 $82,553 $52,644 $236 $(23,806)$157,462 
Adjusted operating income (loss), as previously reported$3,582 $3,491 $3,467 $(860)$(387)$9,293 
Adjustments202 (190)(184)101 387 316 
Adjusted operating income (loss), as adjusted$3,784 $3,301 $3,283 $(759)$— $9,609 
_____________________________________________
(1)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment. Prior to January 1, 2023, intersegment adjusted operating income eliminations occurred when members of the Health Services segment’s clients enrolled in Maintenance Choice elected to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail. When this occurred, both the Health Services and Pharmacy & Consumer Wellness segments recorded the adjusted operating income on a stand-alone basis. Effective January 1, 2023, the adjusted operating income associated with such transactions is reported only in the Pharmacy & Consumer Wellness segment, therefore no adjusted operating income elimination is required. Prior period financial information has been recast to conform with current period presentation.
The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millionsHealth Care
Benefits
Health 
Services (1)
Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months Ended
June 30, 2023
Revenues from external customers$26,521 $43,032 $19,079 $15 $— $88,647 
Intersegment revenues 21 3,183 9,704 — (12,908)— 
Net investment income205 — 1 68 — 274 
Total revenues26,747 46,215 28,784 83 (12,908)88,921 
Adjusted operating income (loss)1,541 1,894 1,413 (367)— 4,481 
June 30, 2022
Revenues from external customers$22,633 $39,946 $17,877 $34 $— $80,490 
Intersegment revenues 20 2,992 8,887 — (11,899)— 
Net investment income (loss)88 — (18)76 — 146 
Total revenues22,741 42,938 26,746 110 (11,899)80,636 
Adjusted operating income (loss)1,923 1,830 1,710 (461)— 5,002 
Six Months Ended
June 30, 2023
Revenues from external customers$52,213 $83,843 $37,505 $30 $— $173,591 
Intersegment revenues42 6,963 19,203 — (26,208)— 
Net investment income (loss)369 — (2)241 — 608 
Total revenues52,624 90,806 56,706 271 (26,208)174,199 
Adjusted operating income (loss)3,365 3,574 2,547 (635)— 8,851 
June 30, 2022
Revenues from external customers$45,618 $76,257 $35,208 $65 $— $157,148 
Intersegment revenues40 6,296 17,470 — (23,806)— 
Net investment income (loss)177 — (34)171 — 314 
Total revenues45,835 82,553 52,644 236 (23,806)157,462 
Adjusted operating income (loss)3,784 3,301 3,283 (759)— 9,609 
_____________________________________________
(1)Total revenues of the Health Services segment include approximately $3.4 billion and $3.1 billion of retail co-payments for the three months ended June 30, 2023 and 2022, respectively. Total revenues of the Health Services segment include approximately $7.5 billion and $6.9 billion of retail co-payments for the six months ended June 30, 2023 and 2022, respectively.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment.
The following are reconciliations of consolidated operating income to adjusted operating income for the three and six months ended June 30, 2023 and 2022:
Three Months Ended
June 30,		Six Months Ended
June 30,
In millions2023202220232022
Operating income (GAAP measure)$3,234 $4,669 $6,680 $8,214 
Amortization of intangible assets (1)
485 460 887 922 
Net realized capital losses (2)
98 98 203 173 
Acquisition-related transaction and integration costs (3)
157 — 200 — 
Restructuring charge (4)
496 — 496 — 
Office real estate optimization charges (5)
11 — 36 — 
Loss on assets held for sale (6)
— — 349 41 
Gain on divestiture of subsidiary (7)
— (225)— (225)
Opioid litigation charge (8)
— — — 484 
Adjusted operating income$4,481 $5,002 $8,851 $9,609 
_____________________________________________
(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)The Company’s net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in the unaudited condensed consolidated statements of operations in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company’s business, and the amount and timing of these capital gains and losses do 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. Accordingly, the Company believes excluding net realized capital gains and losses 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.
(3)During the three and six months ended June 30, 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in the Company’s unaudited condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(4)During the three and six months ended June 30, 2023, the restructuring charge is primarily comprised of severance and employee-related costs and asset impairment charges. During the second quarter of 2023, the Company developed an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with the development of this plan and the recently completed acquisitions of Signify Health and Oak Street Health, the Company also conducted a strategic review of its various transformation initiatives and determined that it would terminate certain initiatives. The restructuring charge is reflected within the Corporate/Other segment.
(5)During the three and six months ended June 30, 2023, 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 unaudited condensed consolidated statements of operations in operating expenses within the Health Care Benefits, Health Services and Corporate/Other segments.
(6)During the six months ended June 30, 2023, the loss on assets held for sale relates to the Company’s LTC reporting unit within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. As of June 30, 2023, the net assets of the LTC business continued to meet the criteria for held-for-sale accounting and the carrying value of the LTC business reflected its estimated fair value less costs to sell. During the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflects its estimated fair value less costs to sell. During the six months ended June 30, 2022, the loss on assets held for sale relates to the Company’s international health care business domiciled in Thailand (“Thailand business”), which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(7)During the three and six months ended June 30, 2022, the gain on divestiture of subsidiary represents the pre-tax gain on the sale of PayFlex Holdings, Inc., which the Company sold on June 1, 2022, for approximately $775 million. The gain on divestiture is reflected as a reduction in operating expenses in the Company’s unaudited condensed consolidated statements of operations within the Health Care Benefits segment.
(8)During the six months ended June 30, 2022, the opioid litigation charge relates to an agreement to resolve substantially all opioid claims against the Company by the State of Florida. The opioid litigation charge is reflected within the Corporate/Other segment.