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Goodwill and Other Intangibles
 12 Months Ended
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangibles Goodwill and Other Intangibles
Goodwill

Below is a summary of the changes in the carrying amount of goodwill by segment for the years ended December 31, 2023 and 2022:
In millionsHealth Care
Benefits		Health
Services		Pharmacy &
Consumer
Wellness		Total
Balance at December 31, 2021$45,130 $23,615 $10,376 $79,121 
Divestitures
(971)— — (971)
Balance at December 31, 202244,159 23,615 10,376 78,150 
Segment realignment(109)109 — — 
Acquisitions2,594 10,342 186 13,122 
Balance at December 31, 2023$46,644 $34,066 $10,562 $91,272 

During the year ended December 31, 2023, the increase in the carrying amount of goodwill was primarily driven by the acquisitions of Oak Street Health and Signify Health. See Note 2 ‘‘Acquisitions, Divestitures and Asset Sales’’ for additional information. During 2023, the Company also realigned the composition of its segments to correspond with changes to its operating model and reflect how the CODM reviews information and manages the business as discussed in Note 1 “Significant Accounting Policies.” As a result of this realignment, the Company reallocated a portion of the goodwill balance associated with these movements from the Health Care Benefits segment to the Health Services segment based on a relative fair value approach.

During the year ended December 31, 2022, the decrease in the carrying amount of goodwill was primarily driven by the divestitures of bswift, PayFlex and the Thailand business. See Note 2 ‘‘Acquisitions, Divestitures and Asset Sales’’ for additional information.

During the fourth quarter of 2023 and the third quarter of 2022, the Company performed its required annual impairment tests of goodwill. The results of these impairment tests indicated that there was no impairment of goodwill.

During the third quarter of 2021, the Company performed its required annual impairment tests of goodwill. The results of the impairment tests indicated an impairment of the goodwill associated with the LTC reporting unit, as the reporting unit’s carrying value exceeded its fair value as of the testing date. The results of the impairment tests of the remaining reporting units indicated that there was no impairment of goodwill as of the testing date.

During 2021, the LTC reporting unit within the Pharmacy & Consumer Wellness segment continued to face challenges that impacted the Company’s ability to grow the LTC reporting unit’s business at the rate estimated when its 2020 goodwill impairment test was performed. These challenges included lower net facility admissions, net long-term care facility customer losses and the prolonged adverse impact of the COVID-19 pandemic and the emerging new variants, which resulted in more significant declines in occupancy rates experienced by the Company’s long-term care facility customers than previously
anticipated. During the third quarter of 2021, LTC management updated their 2021 annual forecast and submitted their long-term plan which showed deterioration in the financial results for the remainder of 2021 and beyond. The Company utilized these updated projections in performing its annual impairment test, which indicated that the fair value of the LTC reporting unit was lower than its carrying value, resulting in a $431 million goodwill impairment charge in the third quarter of 2021. The fair value of the LTC reporting unit was determined using a combination of a discounted cash flow method and a market multiple method. As of December 31, 2021, there was no remaining goodwill balance in the LTC reporting unit.

At December 31, 2023 and 2022, cumulative goodwill impairments were $6.6 billion.

Intangible Assets

The following table is a summary of the Company’s intangible assets as of December 31, 2023 and 2022:
In millions, except weighted average lifeGross
Carrying
Amount		Accumulated
Amortization		Net
Carrying
Amount		Weighted
Average
Life (years)
2023
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete26,784 (12,241)14,543 14.2
Technology1,253 (1,104)149 3.0
Provider networks4,203 (1,072)3,131 20.0
Value of Business Acquired 590 (201)389 20.0
Other838 (314)524 9.3
Total$44,166 $(14,932)$29,234 14.5
2022
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete21,206 (10,668)10,538 13.3
Technology1,060 (1,060)— — 
Provider networks4,203 (862)3,341 20.0
Value of Business Acquired 590 (174)416 20.0
Other302 (264)38 12.4
Total (1)
$37,859 $(13,028)$24,831 13.9
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(1)Includes intangible assets of $28 million which were accounted for as assets held for sale and were included in assets held for sale on the consolidated balance sheet at December 31, 2022. See Note 2 ‘‘Acquisitions, Divestitures and Asset Sales’’ for additional information.

During the year ended December 31, 2023, the increase in the customer contracts/relationships intangible assets was primarily related to relationships with health plan payors acquired in the Oak Street Health Acquisition and the Signify Health Acquisition. See Note 2 ‘‘Acquisitions, Divestitures and Asset Sales’’ for additional information.

Amortization expense for intangible assets totaled $1.9 billion, $1.8 billion and $2.2 billion for the years ended December 31, 2023, 2022 and 2021, respectively. The projected annual amortization expense for the Company’s intangible assets for the next five years is as follows:
In millions
2024$2,011 
20251,964 
20261,687 
20271,580 
20281,306