Segment Information (Tables)

12 Months Ended

Dec. 31, 2019

Segment Information [Abstract]

Special item charges

(In millions)
Description of Special Item Charges (Benefits) and Financial Statement Line Item(s)			After-tax		Before-tax
Year ended December 31, 2019
	Total integration and transaction-related costs (Selling, general and administrative expenses)	$	427	$	552
	Charge for organizational efficiency plan (Selling, general and administrative expenses)	$	162	$	207
	Charges associated with litigation matters (Selling, general and administrative expenses)	$	41	$	51
Year ended December 31, 2018
	Integration and transaction-related costs
	- Selling, general and administrative expenses	$	587	$	748
	- Interest expense and other		179		227
	- Net investment income		(97)		(123)
	Total integration and transaction-related costs	$	669	$	852
	Charges associated with litigation matters (Selling, general and administrative expenses)	$	19	$	25
	Charges associated with U.S. tax reform
	- Selling, general and administrative expenses	$	1	$	2
	- Tax (benefit)		(3)
	Total (benefits) charges associated with U.S. tax reform	$	(2)	$	2
Year ended December 31, 2017
	Integration and transaction-related costs
	- Selling, general and administrative expenses	$	92	$	126
	- Tax (benefit)		(59)
	Total integration and transaction-related costs	$	33	$	126
	Charges associated with U.S. tax reform
	- Selling, general and administrative expenses	$	(36)	$	(56)
	- Tax expense		232
	Total charges (benefits) associated with U.S. tax reform	$	196	$	(56)
	Debt extinguishment costs	$	209	$	321
	Long-term care guaranty fund assessment (Selling, general and administrative expenses)	$	83	$	129

Summarized segment financial information

(In millions)	Health Services		Integrated Medical		International Markets		Group Disability and Other		Corporate and Eliminations		Total
2019
Revenues from external customers (1)	$	107,354	$	34,861	$	5,500	$	4,461	$	-	$	152,176
Inter-segment revenues		2,380		1,180		-		26		(3,586)
Net investment income		60		478		159		695		(2)		1,390
Total revenues		109,794		36,519		5,659		5,182		(3,588)		153,566
Revenue contributions from transitioning clients		(13,347)		-		-		-		-		(13,347)
Net realized investment results from equity method subsidiaries (2)		-		-		(44)		-		-		(44)
Adjusted revenues	$	96,447	$	36,519	$	5,615	$	5,182	$	(3,588)	$	140,175
Depreciation and amortization	$	3,071	$	449	$	87	$	41	$	3	$	3,651
Income (loss) before taxes	$	3,983	$	3,904	$	785	$	562	$	(2,664)	$	6,570
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients		(1,726)		-		-		-		-		(1,726)
(Income) attributable to noncontrolling interests		(4)		-		(16)		-		-		(20)
Net realized investment (gains) (2)		-		(112)		(43)		(66)		-		(221)
Amortization of acquired intangible assets		2,839		69		36		5		-		2,949
Special items
Integration and transaction-related costs		-		-		-		-		552		552
Charge for organizational efficiency plan		-		-		-		-		207		207
Charges associated with litigation matters		-		(30)		-		-		81		51
Pre-tax adjusted income (loss) from operations	$	5,092	$	3,831	$	762	$	501	$	(1,824)	$	8,362
(In millions)	Health Services		Integrated Medical		International Markets		Group Disability and Other		Corporate and Eliminations		Total
2018
Revenues from external customers (1)	$	5,902	$	31,759	$	5,174	$	4,335	$	-	$	47,170
Inter-segment revenues		1,154		573		-		14		(1,741)
Net investment income		9		459		149		712		151		1,480
Total revenues	$	7,065	$	32,791	$	5,323	$	5,061	$	(1,590)	$	48,650
Revenue contributions from transitioning clients		(459)		-		-		-		-		(459)
Net realized investment results from equity method subsidiaries (2)		-		-		43		-		-		43
Special items reported in integration and transaction-related costs		-		-		-		-		(123)		(123)
Adjusted revenues	$	6,606	$	32,791	$	5,366	$	5,061	$	(1,713)	$	48,111
Depreciation and amortization	$	120	$	466	$	55	$	53	$	1	$	695
Income (loss) before taxes	$	329	$	3,342	$	670	$	497	$	(1,257)	$	3,581
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients		(62)		-		-		-		-		(62)
(Income) attributable to noncontrolling interests		-		-		(14)		-		-		(14)
Net realized investment losses(2)		-		36		61		25		2		124
Amortization of acquired intangible assets		113		99		18		5		-		235
Special items
Integration and transaction-related costs		-		-		-		-		852		852
Charges associated with litigation matters		-		25		-		-		-		25
U.S. tax reform		-		-		-		2		-		2
Pre-tax adjusted income (loss) from operations	$	380	$	3,502	$	735	$	529	$	(403)	$	4,743
(1) Includes the Company’s share of the earnings of its joint ventures reported in the International Markets segment using the equity method of accounting.
(2) Beginning in 2018, includes the Company's share of certain realized investment gains (losses) of its joint ventures reported using the equity method of accounting.

(In millions)	Health Services		Integrated Medical		International Markets		Group Disability and Other		Corporate and Eliminations		Total
2017
Revenues from external customers (1)	$	3,250	$	28,193	$	4,774	$	4,363	$	-	$	40,580
Inter-segment revenues		988		476		-		12		(1,476)
Net investment income		3		366		127		700		30		1,226
Total revenues	$	4,241	$	29,035	$	4,901	$	5,075	$	(1,446)	$	41,806
Adjusted revenues	$	4,241	$	29,035	$	4,901	$	5,075	$	(1,446)	$	41,806
Depreciation and amortization	$	-	$	470	$	61	$	31	$	4	$	566
Income (loss) before taxes	$	288	$	2,859	$	667	$	614	$	(822)	$	3,606
Pre-tax adjustments to reconcile to adjusted income from operations
Loss attributable to noncontrolling interests		-		1		1		-		-		2
Net realized investment (gains)		-		(137)		(31)		(69)		-		(237)
Amortization of acquired intangible assets		-		93		17		5		-		115
Special items
Debt extinguishment costs		-		-		-		-		321		321
Long-term care guaranty fund assessment		-		106		-		23		-		129
Integration and transaction-related costs		-		-		-		-		126		126
U.S. tax reform		-		-		-		(56)		-		(56)
Pre-tax adjusted income (loss) from operations	$	288	$	2,922	$	654	$	517	$	(375)	$	4,006
(1) Includes the Company’s share of the earnings of its joint ventures reported in the International Markets segment using the equity method of accounting.

(In millions)	2019		2018		2017
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	50,431	$	1,415	$	-
Home delivery and specialty revenues		47,768		3,997		2,979
Other		4,900		67		-
Total pharmacy revenues		103,099		5,479		2,979
Integrated Medical premiums (ASC 944)
Commercial
Health Insurance		12,523		10,710		9,439
Stop loss		4,328		4,008		3,483
Other		1,040		1,038		917
Government
Medicare Advantage		6,314		5,832		5,534
Medicare Part D		1,699		764		764
Other		4,185		4,496		3,494
Total Integrated Medical premiums		30,089		26,848		23,631
International Markets premiums		5,266		5,043		4,619
Domestic disability, life and accident premiums		4,225		4,000		3,973
Other premiums		134		222		268
Total premiums		39,714		36,113		32,491
Services (ASC 606)
Fees		9,229		5,558		5,053
Other external revenues		134		20		57
Total services		9,363		5,578		5,110
Total revenues from external customers	$	152,176	$	47,170	$	40,580

Revenue from external customers

(In millions)	2019		2018		2017
Products (Pharmacy revenues) (ASC 606)
Network revenues	$	50,431	$	1,415	$	-
Home delivery and specialty revenues		47,768		3,997		2,979
Other		4,900		67		-
Total pharmacy revenues		103,099		5,479		2,979
Integrated Medical premiums (ASC 944)
Commercial
Health Insurance		12,523		10,710		9,439
Stop loss		4,328		4,008		3,483
Other		1,040		1,038		917
Government
Medicare Advantage		6,314		5,832		5,534
Medicare Part D		1,699		764		764
Other		4,185		4,496		3,494
Total Integrated Medical premiums		30,089		26,848		23,631
International Markets premiums		5,266		5,043		4,619
Domestic disability, life and accident premiums		4,225		4,000		3,973
Other premiums		134		222		268
Total premiums		39,714		36,113		32,491
Services (ASC 606)
Fees		9,229		5,558		5,053
Other external revenues		134		20		57
Total services		9,363		5,578		5,110
Total revenues from external customers	$	152,176	$	47,170	$	40,580

Foreign and U.S. revenues from external customers

(In millions)	2019		2018		2017
United States	$	147,332	$	42,773	$	36,555
South Korea		2,022		2,093		1,892
All other foreign countries		2,822		2,304		2,133
Total	$	152,176	$	47,170	$	40,580