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Segment Reporting (Tables)
 9 Months Ended
Sep. 30, 2024
Segment Reporting [Abstract]  
Summarized Financial Information Of Segments
The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millionsHealth Care
Benefits
Health 
Services (1)
Pharmacy &
Consumer
Wellness		Corporate/
Other
Intersegment
Eliminations (2)
Consolidated
Totals
Three Months Ended
September 30, 2024
Revenues from external customers$32,555 $40,794 $21,515 $14 $— $94,878 
Intersegment revenues 18 3,336 10,908 — (14,262)— 
Net investment income (loss)423 (1)— 128 — 550 
Total revenues32,996 44,129 32,423 142 (14,262)95,428 
Adjusted operating income (loss)(924)2,204 1,596 (329)— 2,547 
September 30, 2023
Revenues from external customers$26,089 $44,064 $19,321 $13 $— $89,487 
Intersegment revenues 20 2,827 9,553 — (12,400)— 
Net investment income (loss)
187 — (2)92 — 277 
Total revenues26,296 46,891 28,872 105 (12,400)89,764 
Adjusted operating income (loss)1,536 1,878 1,389 (347)— 4,456 
Nine Months Ended
September 30, 2024
Revenues from external customers$96,577 $115,954 $61,127 $43 $— $273,701 
Intersegment revenues54 10,634 29,859 — (40,547)— 
Net investment income (loss)1,076 (3)— 325 — 1,398 
Total revenues97,707 126,585 90,986 368 (40,547)275,099 
Adjusted operating income (loss)746 5,482 4,016 (996)— 9,248 
September 30, 2023
Revenues from external customers$78,302 $127,907 $56,826 $43 $— $263,078 
Intersegment revenues62 9,790 28,756 — (38,608)— 
Net investment income (loss)556 — (4)333 — 885 
Total revenues78,920 137,697 85,578 376 (38,608)263,963 
Adjusted operating income (loss)4,901 5,452 3,936 (982)— 13,307 
_____________________________________________
(1)Total revenues of the Health Services segment include approximately $2.7 billion and $3.2 billion of retail co-payments for the three months ended September 30, 2024 and 2023, respectively. Total revenues of the Health Services segment include approximately $8.9 billion and $10.7 billion of retail co-payments for the nine months ended September 30, 2024 and 2023, respectively.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment.
Reconciliation of Consolidated Operating Income to Adjusted Operating Income
The following are reconciliations of consolidated operating income to adjusted operating income for the three and nine months ended September 30, 2024 and 2023:
Three Months Ended
September 30,		Nine Months Ended
September 30,
In millions2024202320242023
Operating income (GAAP measure)$832 $3,690 $6,148 $10,370 
Amortization of intangible assets (1)
507 509 1,522 1,396 
Net realized capital (gains) losses (2)
(19)142 89 345 
Acquisition-related transaction and integration costs (3)
41 94 203 294 
Restructuring charges (4)
1,169 11 1,169 507 
Office real estate optimization charges (5)
17 10 17 46 
Opioid litigation charge (6)
— — 100 — 
Loss on assets held for sale (7)
— — — 349 
Adjusted operating income$2,547 $4,456 $9,248 $13,307 
_____________________________________________
(1)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the unaudited condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(2)The Company’s net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in the unaudited condensed consolidated statements of operations in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company’s business, and the amount and timing of these capital gains and losses do not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Accordingly, the Company believes excluding net realized capital gains and losses enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends.
(3)During the three and nine months ended September 30, 2024, the acquisition-related integration costs relate to the acquisitions of Signify Health and Oak Street Health. During the three and nine months ended September 30, 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in the Company’s unaudited condensed consolidated statements of operations in operating expenses within the Corporate/Other segment.
(4)During the three and nine months ended September 30, 2024, the restructuring charges are primarily comprised of a store impairment charge, corporate workforce optimization costs, including severance and employee-related costs, and other asset impairment and related charges associated with the discontinuation of certain non-core assets. During the third quarter of 2024, the Company finalized an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with this restructuring plan, the Company completed a strategic review of its retail business and determined that it plans to close 271 retail stores in 2025, and, accordingly, it recorded a store impairment charge to write down the associated operating lease right-of-use assets and property and equipment. In addition, during the third quarter of 2024, the Company also conducted a review of its various strategic assets and determined that it would discontinue the use of certain non-core assets, at which time impairment losses were recorded to write down the carrying value of these assets to the Company’s best estimate of their fair value. During the three months ended September 30, 2023, the restructuring charges are primarily comprised of a stock-based compensation charge. During the nine months ended September 30, 2023, the restructuring charges also include severance and employee-related costs and asset impairment charges. The restructuring charges associated with the store impairments are reflected within the Pharmacy & Consumer Wellness segment, other asset impairments and related charges are reflected within the Corporate/Other and Pharmacy & Consumer Wellness segments and corporate workforce optimization costs, including severance and employee-related costs, are reflected within the Corporate/Other segment.
(5)During the three and nine months ended September 30, 2024 and 2023, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the Company’s continuous evaluation of corporate office real estate space in response to its ongoing flexible work arrangement. The office real estate optimization charges are reflected in the Company’s unaudited condensed consolidated statements of operations in operating expenses within each segment.
(6)During the nine months ended September 30, 2024, the opioid litigation charge relates to a change in the Company’s accrual related to ongoing opioid litigation matters.
(7)During the nine months ended September 30, 2023, the loss on assets held for sale relates to the LTC reporting unit within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. During the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflected its estimated fair value less costs to sell. As of the third quarter of 2023, the Company determined the LTC business no
longer met the criteria for held-for-sale accounting and accordingly the net assets associated with the LTC business were reclassified to held and used at their respective fair values.