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Commitments and Contingencies (Details) - USD ($)
$ / shares in Units, $ in Millions
1 Months Ended 3 Months Ended 12 Months Ended 42 Months Ended
May 24, 2018
Apr. 26, 2019
Mar. 31, 2019
Dec. 31, 2015
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Mar. 31, 2019
Oct. 26, 2015
Commitments and Contingencies                  
Percentage of total net revenues generated by AFSC     2.00%   2.00%        
Maximum | Pharmacy Management segment network provider pricing dispute                  
Commitments and Contingencies                  
Estimate of possible loss     $ 20.0         $ 20.0  
Minimum | Pharmacy Management segment network provider pricing dispute                  
Commitments and Contingencies                  
Estimate of possible loss     $ 0.0         $ 0.0  
October 2015 Share Repurchase Program                  
Commitments and Contingencies                  
Amount authorized under stock repurchase plan $ 400.0               $ 200.0
Increase in amount authorized under stock repurchase plan $ 200.0                
Share repurchases made in open market (in shares)   0 60,901 345,044 844,872 280,140 1,828,183 3,359,140  
Average Price Paid per Share (in dollars per share)     $ 61.15 $ 53.46 $ 74.59 $ 77.67 $ 58.40    
Aggregate Cost     $ 3.7 $ 18.4 $ 63.0 $ 21.8 $ 106.8 $ 213.7  
Remaining authorized repurchase amount     $ 186.3         $ 186.3