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FAIR VALUE
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
FAIR VALUE FAIR VALUE
Financial Assets
The following table summarizes our fair value measurements at December 31, 2025 and 2024, respectively, for financial assets measured at fair value on a recurring basis:
  Fair Value Measurements Using
 Fair ValueQuoted Prices
in Active
Markets
(Level 1)		Other
Observable
Inputs
(Level 2)		Unobservable
Inputs
(Level 3)
 (in millions)
December 31, 2025
Cash equivalents$3,945 $3,945 $— $— 
Debt securities:
U.S. Treasury and other U.S. government corporations and agencies:
U.S. Treasury and agency obligations2,278 — 2,278 — 
Mortgage-backed securities3,651 — 3,651 — 
Tax-exempt municipal securities428 — 428 — 
Mortgage-backed securities:
Residential388 — 388 — 
Commercial1,012 — 996 16 
Asset-backed securities783 — 656 127 
Corporate debt securities7,656 — 7,359 297 
Total debt securities16,196 — 15,756 440 
Securities lending invested collateral 638 638 — — 
Total invested assets$20,779 $4,583 $15,756 $440 
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 $440 million, or 2.1% of total invested assets, and $322 million, or 1.5% of total invested assets, at December 31, 2025 and 2024, respectively. During the years ended December 31, 2025 and 2024, the changes in the fair value of the assets measured using significant unobservable inputs (Level 3) were comprised of the following:
20252024
Mortgage-backed securities: Commercial Asset-backed securitiesCorporate debt securitiesTotalMortgage-backed securities: CommercialAsset-backed securitiesCorporate debt securitiesTotal
(in millions)(in millions)
Beginning balance at January 1$7 $73 $242 $322 $4 $38 $176 $218 
Total gains or losses:
Realized in earnings— — — — (1)— — (1)
Unrealized in other comprehensive income— 18 9 — — (1)(1)
Purchases9 5564 128 6 3672 114 
Sales— — — — (2)— (1)(3)
Settlements— (2)(17)(19)— (1)(4)(5)
Transfers Out— — — — — — — — 
Transfers In— — — — — — — — 
Balance at December 31$16 $127 $297 $440 $7 $73 $242 $322 
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 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 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 increase to the carrying value of the senior notes was approximately $6 million at December 31, 2025. Our swap positions at December 31, 2025 included swap assets of $57 million included within other long-term assets on our consolidated balance sheet, and swap liabilities of $51 million included within other long-term liabilities on our consolidated balance sheet. The cumulative, aggregate adjustment to the carrying value of the senior notes was a decrease of approximately $129 million at December 31, 2024. Our swap positions at December 31, 2024 included swap liabilities of $129 million, included within other long-term liabilities on our consolidated balance sheet. We include the gain or loss on the swap agreements in interest expense on our 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 years ended December 31, 2025 and December 31, 2024.
The following table summarizes the notional amounts at December 31, 2025 and December 31, 2024, respectively, for our senior notes under the swap agreements:

Notional amount at
Senior Notes Under Swap Agreements December 31, 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
600 400 
$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
450 — 
    Total Senior Notes Under Swap Agreements$6,500 $5,000 

Financial Liabilities
Our debt is recorded at carrying value in our consolidated balance sheets. The carrying value of our senior notes debt outstanding, net of unamortized debt issuance costs, was $12.4 billion at December 31, 2025 and $11.7 billion at December 31, 2024. The fair value of our senior note debt was $12.2 billion at December 31, 2025 and $11.2 billion at December 31, 2024. The fair value of our senior note 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 term loans and commercial paper borrowings. We had no  outstanding commercial paper borrowings at December 31, 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 $1,400 million and $13 million, respectively, at December 31, 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 consolidated balance sheets. Fair value changes to the put and call options are included within Other expense, net within our consolidated income statement.
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 December 31, 2025 and 2024, respectively:
December 31, 2025December 31, 2024
Annualized volatility
18.8% - 19.9%
17.5% to 18.9%
Credit spread
1.1% - 1.6%
0.9% to 1.5%
Revenue exit multiple
1.5x - 2.5x
1.5x - 2.5x
Weighted average cost of capital
10.5% - 14.5%
11.0% to 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, 2024, and 2023. The values of net tangible assets acquired and the 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, 2024, or 2023 other than the assets and liabilities assumed in these acquisitions and any subsequent impairments. We recorded impairment charges of $128 million and $200 million relating to indefinite-lived intangible assets in 2025 and 2024, respectively.