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FAIR VALUE
 9 Months Ended
Sep. 30, 2025
Fair Value Disclosures [Abstract]  
FAIR VALUE FAIR VALUE
Financial Assets
The following table summarizes our fair value measurements at September 30, 2025 and December 31, 2024, respectively, for financial assets measured at fair value on a recurring basis:
 Fair Value Measurements Using
 Fair
Value		Quoted Prices
in Active
Markets
(Level 1)		Other
Observable
Inputs
(Level 2)		Unobservable
Inputs
(Level 3)
 (in millions)
September 30, 2025
Cash equivalents$5,264 $5,264 $— $— 
Debt securities:
U.S. Treasury and other U.S. government
    corporations and agencies:
U.S. Treasury and agency obligations2,675 — 2,675 — 
Mortgage-backed securities3,524 — 3,524 — 
Tax-exempt municipal securities439 — 439 — 
Mortgage-backed securities:
Residential570 — 570 — 
Commercial1,149 — 1,133 16 
Asset-backed securities1,022 — 933 89 
Corporate debt securities7,797 — 7,492 305 
Total debt securities17,176 — 16,766 410 
Securities lending invested collateral560 560 — — 
Total invested assets$23,000 $5,824 $16,766 $410 
December 31, 2024
Cash equivalents$2,048 $2,048 $— $— 
Debt securities:
U.S. Treasury and other U.S. government
    corporations and agencies:
U.S. Treasury and agency obligations3,227 — 3,227 — 
Mortgage-backed securities3,995 — 3,995 — 
Tax-exempt municipal securities526 — 526 — 
Mortgage-backed securities:
Residential522 — 522 — 
Commercial1,206 — 1,199 7 
Asset-backed securities1,403 — 1,330 73 
Corporate debt securities7,756 — 7,514 242 
Total debt securities18,635 — 18,313 322 
Securities lending invested collateral418 418 — — 
Total invested assets$21,101 $2,466 $18,313 $322 
Our Level 3 assets had a fair value of $410 million, or 1.8% of total invested assets, and $322 million, or 1.5% or total invested assets, at September 30, 2025 and December 31, 2024, respectively. During the nine months ended
September 30, 2025 and 2024, the changes in the fair value of the assets measured using significant unobservable inputs (Level 3) were comprised of the following:    
Private Placements
For the nine months ended September 30, 2025For the nine months ended September 30, 2024
(in millions)
Beginning balance at January 1$322 $218 
Total gains or losses:
Realized in earnings— — 
Unrealized in other comprehensive income10 6 
Purchases81 72 
Maturities(2)— 
Sales— — 
Settlements(1)(5)
Balance at September 30$410 $291 
During the nine months ended September 30, 2025 and 2024, there were no transfers into or out of Level 3.
Interest Rate Swaps

We have entered into interest-rate swap agreements with major financial institutions to convert our interest-rate exposure on some of our senior notes payable from fixed rates to variable rates, based on the Secured Overnight Financing Rate (SOFR), to align interest costs more closely with floating interest rates received on our cash equivalents and investment securities. These swap agreements were qualified and designated as a fair value hedge. Our interest rate swaps are recognized in other assets or other liabilities, as appropriate, in our condensed consolidated balance sheets at fair value as of the reporting date. Our interest rate swaps are highly effective at reflecting the fair value of our hedged fixed rate senior notes payable. We utilize market-based financing rates, forward yield curves and discount rates in determining fair value of these swaps at each reporting date, a Level 2 measure within the fair value hierarchy. The cumulative, aggregate adjustment to the carrying value of the senior notes was an increase of approximately $48 million at September 30, 2025. Our swap positions at September 30, 2025 included swap assets of $82 million, included within other long-term assets on our condensed consolidated balance sheet, and swap liabilities of $34 million, included within other long-term liabilities on our condensed consolidated balance sheet. Our swap positions at December 31, 2024 included swap liabilities of $129 million, included within other long-term liabilities on our condensed consolidated balance sheet. We include the gain or loss on the swap agreements in interest expense on our condensed consolidated income statement, the same line item as the offsetting loss or gain on the related senior notes. The gain or loss due to hedge ineffectiveness was not material for the three and nine months ended September 30, 2025 and 2024.
The following table summarizes the notional amounts at September 30, 2025 and December 31, 2024, respectively, for our senior notes under the swap agreements:
Notional amount at
Senior Notes Under Swap AgreementsSeptember 30, 2025December 31, 2024
(in millions)
$1,500 million, 5.375% due April 15, 2031
$700 $700 
$750 million, 5.875% due March 1, 2033
650 650 
$850 million, 5.950% due March 15, 2034
800 800 
$750 million, 5.550% due May 1, 2035
600 — 
$400 million, 4.625% due December 1, 2042
400 400 
$750 million, 4.950% due October 1, 2044
400 400 
$400 million, 4.800% due March 15, 2047
350 200 
$500 million, 3.950% due August 15, 2049
450 450 
$750 million, 5.500% due March 15, 2053
700 700 
$1,000 million, 5.750% due April 15, 2054
800 700 
$500 million, 6.000% due May 1, 2055
300 — 
Total Senior Notes Under Swap Agreements $6,150 $5,000 

Financial Liabilities
Our debt is recorded at carrying value in our condensed consolidated balance sheets. The carrying value of our senior notes debt outstanding, net of unamortized debt issuance costs, was $12.6 billion at September 30, 2025 and $11.7 billion at December 31, 2024. The fair value of our senior notes debt was $12.3 billion at September 30, 2025 and $11.2 billion at December 31, 2024. The fair value of our senior notes debt is determined based on Level 2 inputs, including quoted market prices for the same or similar debt, or if no quoted market prices are available, on the current prices estimated to be available to us for debt with similar terms and remaining maturities. Carrying value approximates fair value for our commercial paper borrowings. We had no outstanding commercial paper borrowings at September 30, 2025 and December 31, 2024.
Put and Call Options Measured at Fair Value
The put and call options fair values associated with our primary care strategic partnership with Welsh, Carson, Anderson & Stowe, or WCAS, which are exercisable at a fixed revenue exit multiple and provide a minimum return on WCAS' investment if exercised, are measured at fair value each reporting period using a Monte Carlo simulation. The put and call options fair values, derived from the Monte Carlo simulation, were $1.35 billion and $13 million, respectively, at September 30, 2025. The put and call options fair values, derived from the Monte Carlo simulation, were $883 million and $10 million, respectively, at December 31, 2024. The put liability and call asset are included within other long-term liabilities and other long-term assets, respectively, within our condensed consolidated balance sheets. Fair value changes to the put and call options are included within Other expense, net within our condensed consolidated income statement.
With the continued expansion of primary care clinics under the partnership with WCAS and updated revenue growth assumptions in our most recent projections available at September 30, 2025, all existing cohorts can be called by us from 2026 to 2033 and could require $3.0 billion to $5.0 billion to purchase.
The significant unobservable inputs utilized in these Level 3 fair value measurements (and selected values) include the enterprise value, annualized volatility and credit spread. Enterprise value was derived from a discounted cash flow model, which utilized significant unobservable inputs for long-term revenue, to measure underlying cash flows, weighted average cost of capital and long term growth rate. The table below presents the assumptions used for each reporting period.
September 30, 2025December 31, 2024
Annualized volatility
17.4% - 18.5%
17.5% - 18.9%
Credit spread
1.1% - 1.8%
0.9% - 1.5%
Revenue exit multiple
1.5x - 2.5x
1.5x - 2.5x
Weighted average cost of capital
10.5% - 14.5%
11.0% - 14.5%
Long term growth rate3.0 %3.0 %
The assumptions used for annualized volatility, credit spread and weighted average cost of capital reflect the lowest and highest values where they differ significantly across the series of put and call options due to their expected exercise dates.
Assets and Liabilities Measured at Fair Value on a Nonrecurring Basis
Certain assets and liabilities are measured at fair value on a non-recurring basis subject to fair value adjustment only in certain circumstances. As disclosed in Note 3, we acquired various health and wellness related businesses during 2025 and 2024. The values of net tangible assets acquired and resulting goodwill and other intangible assets were recorded at fair value primarily using Level 3 inputs. The majority of the related tangible assets acquired and liabilities assumed were recorded at their carrying value as of the respective dates of acquisition, as their carrying values approximated their fair values due to their short-term nature. The fair values of goodwill and other intangible assets acquired in these acquisitions were internally estimated primarily based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets are expected to generate in the future. We developed internal estimates for expected cash flows and discount rates in the present value calculations. There were no material asset or liabilities measured at fair value on a nonrecurring basis during 2025 and 2024 other than the assets and liabilities assumed in these acquisitions and any subsequent impairments. We recorded a $32 million and $200 million charge relating to our indefinite-lived intangible assets during the second quarter of 2025 and fourth quarter of 2024, respectively.
For additional information regarding our fair value measurements, refer to Note 2 to the audited Consolidated Financial Statements included in Part II, Item 8, "Financial Statements and Supplementary Data" in our 2024 Form 10-K.