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Segment Information (Tables)
 9 Months Ended
Sep. 30, 2021
Segment Reporting [Abstract]  
Summary of Special Items
The following tables present the special items recorded by the Company for the three and nine months ended September 30, 2021 and 2020:
Three Months EndedNine Months Ended
(In millions)September 30, 2021September 30, 2020September 30, 2021September 30, 2020
Description of Special Item Charges (Benefits) and Financial Statement Line Item(s)After-taxBefore-taxAfter-taxBefore-taxAfter-taxBefore-taxAfter-taxBefore-tax
Debt extinguishment costs$— $— $— $— $110 $141 $151 $199 
Integration and transaction-related (benefits) costs
 (Selling, general and administrative expenses)		(35)13 83 112 1 58 256 339 
(Benefits) charges associated with litigation matters
 (Selling, general and administrative expenses)		— — — — (21)(27)19 25 
Charge for organizational efficiency plan
 (Selling, general and administrative expenses)		— — — — — — 24 31 
Risk corridors recovery
 (Selling, general and administrative expenses)		— — (76)(101)— — (76)(101)
Contractual adjustment for a former client
 (Pharmacy revenues)		— — (89)(117)— — (155)(204)
Total impact from special items$(35)$13 $(82)$(106)$90 $172 $219 $289 
Summarized Segment Financial Information Summarized segment financial information was as follows:
(In millions)
Evernorth
U.S. Medical
International Markets
Other Operations
Corporate and Eliminations
Total
Three months ended September 30, 2021
Revenues from external customers $32,668 $9,588 $1,500 $63 $1 $43,820 
Inter-segment revenues942 587 — — (1,529)
Net investment income4 322 66 77 (1)468 
Total revenues33,614 10,497 1,566 140 (1,529)44,288 
Net realized investment results from certain equity method investments — — 22 — — 22 
Adjusted revenues$33,614 $10,497 $1,588 $140 $(1,529)$44,310 
Income (loss) before taxes$1,074 $1,075 $199 $32 $(321)$2,059 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests(10)— (6)— — (16)
Net realized investment (gains) losses — (93)46 1 — (46)
Amortization of acquired intangible assets484 6 11 — — 501 
Special items
Integration and transaction-related (benefits) costs— — — — 13 13 
Pre-tax adjusted income (loss) from operations$1,548 $988 $250 $33 $(308)$2,511 
(In millions)
Evernorth
U.S. Medical
International Markets
Other Operations
Corporate and Eliminations
Total
Three months ended September 30, 2020
Revenues from external customers $29,016 $9,047 $1,439 $1,156 $— $40,658 
Inter-segment revenues926 478 — 6 (1,410)
Net investment income2 104 38 152 1 297 
Total revenues29,944 9,629 1,477 1,314 (1,409)40,955 
Net realized investment results from certain equity method investments— — (37)— — (37)
Special item related to contractual adjustment for a former client(117)— — — — (117)
Adjusted revenues$29,827 $9,629 $1,440 $1,314 $(1,409)$40,801 
Income (loss) before taxes$1,086 $846 $253 $97 $(478)$1,804 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests(5)— (5)— — (10)
Net realized investment (gains) losses— 6 (48)(27)— (69)
Amortization of acquired intangible assets479 6 8 — — 493 
Special items
Integration and transaction-related (benefits) costs— — — — 112 112 
Risk corridors recovery— (101)— — — (101)
Contractual adjustment for a former client(117)— — — — (117)
Pre-tax adjusted income (loss) from operations$1,443 $757 $208 $70 $(366)$2,112 
(In millions)
Evernorth
U.S. Medical
International Markets
Other Operations
Corporate and Eliminations
Total
Nine months ended September 30, 2021
Revenues from external customers$93,640 $28,879 $4,526 $175 $1 $127,221 
Inter-segment revenues3,174 1,692 — — (4,866)
Net investment income12 744 180 233 — 1,169 
Total revenues96,826 31,315 4,706 408 (4,865)128,390 
Net realized investment results from certain equity method investments
— — 12 — — 12 
Adjusted revenues$96,826 $31,315 $4,718 $408 $(4,865)$128,402 
Income (loss) before taxes$2,752 $3,144 $685 $67 $(1,178)$5,470 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests(21)— (18)— — (39)
Net realized investment (gains) losses (1)
4 (172)49 3 — (116)
Amortization of acquired intangible assets1,449 20 30 — — 1,499 
Special items
Debt extinguishment costs— — — — 141 141 
Integration and transaction-related (benefits) costs— — — — 58 58 
(Benefits) charges associated with litigation matters— — — — (27)(27)
Pre-tax adjusted income (loss) from operations$4,184 $2,992 $746 $70 $(1,006)$6,986 
(In millions)
Evernorth
U.S. Medical
International Markets
Other Operations
Corporate and Eliminations
Total
Nine months ended September 30, 2020
Revenues from external customers
$82,986 $26,999 $4,325 $3,506 $— $117,816 
Inter-segment revenues2,785 1,448 — 17 (4,250)
Net investment income30 279 104 458 2 873 
Total revenues85,801 28,726 4,429 3,981 (4,248)118,689 
Net realized investment results from certain equity method investments— — (87)— — (87)
Special item related to contractual adjustment for a former client(204)— — — — (204)
Adjusted revenues$85,597 $28,726 $4,342 $3,981 $(4,248)$118,398 
Income (loss) before taxes$2,551 $3,529 $877 $298 $(1,765)$5,490 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests(12)— (15)— — (27)
Net realized investment (gains) losses (1)
— 28 (75)(22)— (69)
Amortization of acquired intangible assets1,439 23 22 3 — 1,487 
Special items
Debt extinguishment costs— — — — 199 199 
Integration and transaction-related (benefits) costs— — — — 339 339 
(Benefits) charges associated with litigation matters— — — — 25 25 
Charge for organizational efficiency plan— — — — 31 31 
Risk corridors recovery— (101)— — — (101)
Contractual adjustment for a former client(204)— — — — (204)
Pre-tax adjusted income (loss) from operations$3,774 $3,479 $809 $279 $(1,171)$7,170 
(1)Includes the Company's share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting.
Revenue from External Customers
Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type for the three and nine months ended September 30:
Three Months Ended September 30,Nine Months Ended September 30,
(In millions)2021202020212020
Products (Pharmacy revenues) (ASC 606)
Network revenues$15,797 $13,968 $45,390 $39,200 
Home delivery and specialty revenues13,515 12,422 38,987 36,319 
Other1,701 1,412 4,708 3,945 
Total pharmacy revenues31,013 27,802 89,085 79,464 
Insurance premiums (ASC 944)
U.S. Medical premiums
U.S. Commercial
Health Insurance3,591 3,397 10,692 9,948 
Stop loss1,225 1,146 3,613 3,459 
Other320 281 938 853 
U.S. Government
Medicare Advantage2,079 1,895 6,287 5,680 
Medicare Part D315 360 1,175 1,242 
Other1,241 1,117 3,606 3,246 
Total U.S. Medical premiums
8,771 8,196 26,311 24,428 
International Markets premiums
1,446 1,360 4,338 4,079 
Domestic disability, life and accident premiums— 1,106 — 3,346 
Other premiums58 20 163 75 
Total premiums10,275 10,682 30,812 31,928 
Services (ASC 606)
Fees2,513 2,120 7,185 6,253 
Other external revenues19 54 139 171 
Total services2,532 2,174 7,324 6,424 
Total revenues from external customers$43,820 $40,658 $127,221 $117,816