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Insurance and Contractholder Liabilities (Tables)
 9 Months Ended
Sep. 30, 2021
Insurance Loss Reserves [Abstract]  
Summary of Insurance and Contractholder Liabilities, Activity in the Unpaid Claims Liability and Liability Details for Unpaid Claims and Claim Expenses
The Company’s insurance and contractholder liabilities were comprised of the following:
September 30, 2021December 31, 2020September 30, 2020
(In millions)CurrentNon-currentTotalCurrentNon-currentTotalTotal
Contractholder deposit funds$362 $6,717 $7,079 $350 $6,823 $7,173 $7,662 
Future policy benefits307 9,183 9,490 327 9,317 9,644 10,102 
Unearned premiums494 408 902 485 394 879 828 
Unpaid claims and claim expenses
U.S. Medical
3,825 21 3,846 3,166 18 3,184 3,200 
Other segments929 247 1,176 980 292 1,272 6,235 
Total28,027 
Insurance and contractholder liabilities classified as Liabilities of business held for sale (1)
(6,591)
Total insurance and contractholder liabilities$5,917 $16,576 $22,493 $5,308 $16,844 $22,152 $21,436 
(1)Amounts classified as Liabilities of business held for sale primarily include $5.2 billion of unpaid claims, $759 million of contractholder deposit funds and $646 million of future policy benefits as of September 30, 2020.
Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the nine months ended September 30 was as follows:
 Nine Months Ended
(In millions)September 30, 2021September 30, 2020
Beginning balance$3,184 $2,892 
Less: Reinsurance and other amounts recoverable224 303 
Beginning balance, net2,960 2,589 
Incurred costs related to:
Current year22,167 18,935 
Prior years(180)(126)
Total incurred21,987 18,809 
Paid costs related to:
Current year18,701 16,061 
Prior years2,665 2,363 
Total paid21,366 18,424 
Ending balance, net3,581 2,974 
Add: Reinsurance and other amounts recoverable265 226 
Ending balance$3,846 $3,200 
Liability balance details. The liability details for unpaid claims and claim expenses are as follows:
(In millions)September 30, 2021September 30, 2020
Other Operations
Group Disability and Life$— $5,206 
Other Operations267 162 
Total Other Operations
267 5,368 
International Markets
909 867 
Unpaid claims and claim expenses Other Operations and International Markets
$1,176 $6,235 
Activity, net of intercompany transactions, in the unpaid claims and claim expenses for International Markets and, prior to the sale, Group Disability and Life (see Note 4 for further information) is presented in the following table. Prior to the sale, the majority of the liability related to disability claims with long tailed payouts. See Note 9C to the Consolidated Financial Statements included in our 2020 Form 10-K for additional discussion of these disability reserves that are now sold. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been fully reinsured.
Nine Months Ended
(In millions)
September 30, 2021
September 30, 2020 (1)
Beginning balance$963 $5,816 
Less: Reinsurance59 184 
Beginning balance, net904 5,632 
Incurred claims related to:
Current year2,110 4,277 
Prior years:
Interest accretion— 118 
All other incurred(38)(12)
Total incurred2,072 4,383 
Paid claims related to:
Current year1,549 2,435 
Prior years532 1,702 
Total paid2,081 4,137 
Foreign currency(43)5 
Ending balance, net852 5,883 
Add: Reinsurance57 190 
Ending balance$909 $6,073 
(1)Includes unpaid claims amounts classified as Liabilities of business held for sale.
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses
Variances in incurred costs related to prior years’ unpaid claims and claim expenses that resulted from the differences between actual experience and the Company’s key assumptions for the nine months ended September 30 were as follows:
Nine Months Ended
(Dollars in millions)September 30, 2021September 30, 2020
$
%(1)
$
%(2)
Actual completion factors$56 0.2 %$47 0.2 %
Medical cost trend124 0.5 79 0.3 
Total favorable variance$180 0.7 %$126 0.5 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2020.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2019.