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Segment Reporting (Tables)
 9 Months Ended
Sep. 30, 2023
Segment Reporting [Abstract]  
Summarized Financial Information Of Segments The impact of these items on segment financial information for the three and nine months ended September 30, 2022 is reflected in the “Adjustments” lines of the table included on the next page.
Three Months Ended September 30, 2022
In millionsHealth Care
Benefits		Health
Services		Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (1)
Consolidated
Totals
Total revenues, as previously reported$22,511 $43,216 $26,706 $142 $(11,416)$81,159 
Adjustments(15)38 531 — (554)— 
Total revenues, as adjusted$22,496 $43,254 $27,237 $142 $(11,970)$81,159 
Adjusted operating income (loss), as previously reported$1,544 $1,877 $1,398 $(417)$(169)$4,233 
Adjustments97 (182)3 29 169 116 
Adjusted operating income (loss), as adjusted$1,641 $1,695 $1,401 $(388)$— $4,349 
Nine Months Ended September 30, 2022
In millionsHealth Care
Benefits		Health
Services		Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (1)
Consolidated
Totals
Total revenues, as previously reported$68,376 $125,489 $78,410 $378 $(34,032)$238,621 
Adjustments(45)318 1,471 — (1,744)— 
Total revenues, as adjusted$68,331 $125,807 $79,881 $378 $(35,776)$238,621 
Adjusted operating income (loss), as previously reported$5,126 $5,368 $4,865 $(1,277)$(556)$13,526 
Adjustments299 (372)(181)130 556 432 
Adjusted operating income (loss), as adjusted$5,425 $4,996 $4,684 $(1,147)$— $13,958 
_____________________________________________
(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
September 30, 2023
Revenues from external customers$26,089 $44,064 $19,321 $13 $— $89,487 
Intersegment revenues 20 2,827 9,553 — (12,400)— 
Net investment income (loss)187 — (2)92 — 277 
Total revenues26,296 46,891 28,872 105 (12,400)89,764 
Adjusted operating income (loss)1,536 1,878 1,389 (347)— 4,456 
September 30, 2022
Revenues from external customers$22,375 $40,544 $18,007 $32 $— $80,958 
Intersegment revenues 20 2,710 9,240 — (11,970)— 
Net investment income (loss)101 — (10)110 — 201 
Total revenues22,496 43,254 27,237 142 (11,970)81,159 
Adjusted operating income (loss)1,641 1,695 1,401 (388)— 4,349 
Nine Months Ended
September 30, 2023
Revenues from external customers$78,302 $127,907 $56,826 $43 $— $263,078 
Intersegment revenues62 9,790 28,756 — (38,608)— 
Net investment income (loss)556 — (4)333 — 885 
Total revenues78,920 137,697 85,578 376 (38,608)263,963 
Adjusted operating income (loss)4,901 5,452 3,936 (982)— 13,307 
September 30, 2022
Revenues from external customers$67,993 $116,801 $53,215 $97 $— $238,106 
Intersegment revenues60 9,006 26,710 — (35,776)— 
Net investment income (loss)278 — (44)281 — 515 
Total revenues68,331 125,807 79,881 378 (35,776)238,621 
Adjusted operating income (loss)5,425 4,996 4,684 (1,147)— 13,958 
_____________________________________________
(1)Total revenues of the Health Services segment include approximately $3.2 billion and $2.9 billion of retail co-payments for the three months ended September 30, 2023 and 2022, respectively. Total revenues of the Health Services segment include approximately $10.7 billion and $9.8 billion of retail co-payments for the nine months ended September 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.
Reconciliation of Consolidated Operating Income to Adjusted Operating Income
The following are reconciliations of consolidated operating income (loss) to adjusted operating income for the three and nine months ended September 30, 2023 and 2022:
Three Months Ended
September 30,		Nine Months Ended
September 30,
In millions2023202220232022
Operating income (loss) (GAAP measure)$3,690 $(3,919)$10,370 $4,295 
Amortization of intangible assets (1)
509 458 1,396 1,380 
Net realized capital losses (2)
142 110 345 283 
Acquisition-related transaction and integration costs (3)
94 — 294 — 
Restructuring charges (4)
11 — 507 — 
Office real estate optimization charges (5)
10 — 46 — 
Loss on assets held for sale (6)
— 2,480 349 2,521 
Opioid litigation charges (7)
— 5,220 — 5,704 
Gain on divestiture of subsidiary (8)
— — — (225)
Adjusted operating income$4,456 $4,349 $13,307 $13,958 
_____________________________________________
(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 nine months ended September 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 months ended September 30, 2023, the restructuring charges are comprised of a stock-based compensation charge. During the nine months ended September 30, 2023, the restructuring charges also include 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 charges are reflected within the Corporate/Other segment.
(5)During the three and nine months ended September 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 nine months ended September 30, 2023 and the three and nine months ended September 30, 2022, 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. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell, and, accordingly the Company recorded a loss on assets held for sale during the third quarter of 2022. 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. As of September 30, 2023, the Company determined the LTC business no longer met the criteria for held-for-sale accounting and accordingly the net assets associated with the LTC business were reclassified to held and used at their respective fair values. During the nine months ended September 30, 2022, the loss on assets held for sale also 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 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 government entities. The opioid litigation charges are reflected within the Corporate/Other segment.
(8)During the nine months ended September 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.