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Investments (Notes) | 12 Months Ended
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Dec. 31, 2022
Investments [Abstract] |
Investments [Text Block] | Investments A summary of debt securities by major security type is as follows:
(in millions) |  | Amortized Cost |  | Gross Unrealized Gains |  | Gross Unrealized Losses |  | Fair Value
December 31, 2022 |  |  |  |  |  |  |  |
Debt securities - available-for-sale: |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | $ | 4,093 |  |  | $ | 1 |  |  | $ | (285) |  |  | $ | 3,809 |
State and municipal obligations |  | 7,702 |  |  | 25 |  |  | (479) |  |  | 7,248 |
Corporate obligations |  | 23,675 |  |  | 17 |  |  | (1,798) |  |  | 21,894 |
U.S. agency mortgage-backed securities |  | 7,379 |  |  | 15 |  |  | (808) |  |  | 6,586 |
Non-U.S. agency mortgage-backed securities |  | 3,077 |  |  | 1 |  |  | (294) |  |  | 2,784 |
Total debt securities - available-for-sale |  | 45,926 |  |  | 59 |  |  | (3,664) |  |  | 42,321 |
Debt securities - held-to-maturity: |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | 578 |  |  | — |  |  | (14) |  |  | 564 |
State and municipal obligations |  | 29 |  |  | — |  |  | (3) |  |  | 26 |
Corporate obligations |  | 89 |  |  | — |  |  | — |  |  | 89 |
Total debt securities - held-to-maturity |  | 696 |  |  | — |  |  | (17) |  |  | 679 |
Total debt securities |  | $ | 46,622 |  |  | $ | 59 |  |  | $ | (3,681) |  |  | $ | 43,000 |
December 31, 2021 |  |  |  |  |  |  |  |
Debt securities - available-for-sale: |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | $ | 3,206 |  |  | $ | 23 |  |  | $ | (31) |  |  | $ | 3,198 |
State and municipal obligations |  | 6,829 |  |  | 297 |  |  | (20) |  |  | 7,106 |
Corporate obligations |  | 20,947 |  |  | 372 |  |  | (145) |  |  | 21,174 |
U.S. agency mortgage-backed securities |  | 5,868 |  |  | 88 |  |  | (55) |  |  | 5,901 |
Non-U.S. agency mortgage-backed securities |  | 2,819 |  |  | 42 |  |  | (23) |  |  | 2,838 |
Total debt securities - available-for-sale |  | 39,669 |  |  | 822 |  |  | (274) |  |  | 40,217 |
Debt securities - held-to-maturity: |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | 511 |  |  | 2 |  |  | (2) |  |  | 511 |
State and municipal obligations |  | 30 |  |  | 2 |  |  | — |  |  | 32 |
Corporate obligations |  | 100 |  |  | — |  |  | — |  |  | 100 |
Total debt securities - held-to-maturity |  | 641 |  |  | 4 |  |  | (2) |  |  | 643 |
Total debt securities |  | $ | 40,310 |  |  | $ | 826 |  |  | $ | (276) |  |  | $ | 40,860 |
Nearly all of the Company’s investments in mortgage-backed securities were rated “Triple A” as of December 31, 2022. The Company held $3.7 billion and $3.5 billion of equity securities as of December 31, 2022 and 2021, respectively. The Company’s investments in equity securities primarily consist of employee savings plan related investments, venture investments and shares of Brazilian real denominated fixed-income funds with readily determinable fair values. Additionally, the Company’s investments included $1.5 billion and $1.3 billion of equity method investments in operating businesses in the health care sector, as of December 31, 2022 and 2021, respectively. The allowance for credit losses on held-to-maturity securities as of December 31, 2022 and 2021 was not material. The amortized cost and fair value of debt securities as of December 31, 2022, by contractual maturity, were as follows:
|  | Available-for-Sale |  | Held-to-Maturity
(in millions) |  | Amortized Cost |  | Fair Value |  | Amortized Cost |  | Fair Value
Due in one year or less |  | $ | 4,713 |  |  | $ | 4,682 |  |  | $ | 374 |  |  | $ | 369 |
Due after one year through five years |  | 13,135 |  |  | 12,404 |  |  | 265 |  |  | 256 |
Due after five years through ten years |  | 12,210 |  |  | 10,897 |  |  | 37 |  |  | 36 |
Due after ten years |  | 5,412 |  |  | 4,968 |  |  | 20 |  |  | 18 |
U.S. agency mortgage-backed securities |  | 7,379 |  |  | 6,586 |  |  | — |  |  | — |
Non-U.S. agency mortgage-backed securities |  | 3,077 |  |  | 2,784 |  |  | — |  |  | — |
Total debt securities |  | $ | 45,926 |  |  | $ | 42,321 |  |  | $ | 696 |  |  | $ | 679 |
The fair value of available-for-sale debt securities with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
|  | Less Than 12 Months |  | 12 Months or Greater |  | Total
(in millions) |  | Fair Value |  | Gross Unrealized Losses |  | Fair Value |  | Gross Unrealized Losses |  | Fair Value |  | Gross Unrealized Losses
December 31, 2022 |  |  |  |  |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | $ | 2,007 |  |  | $ | (96) |  |  | $ | 1,290 |  |  | $ | (189) |  |  | $ | 3,297 |  |  | $ | (285) |
State and municipal obligations |  | 4,630 |  |  | (288) |  |  | 1,178 |  |  | (191) |  |  | 5,808 |  |  | (479) |
Corporate obligations |  | 13,003 |  |  | (893) |  |  | 6,637 |  |  | (905) |  |  | 19,640 |  |  | (1,798) |
U.S. agency mortgage-backed securities |  | 3,561 |  |  | (345) |  |  | 2,239 |  |  | (463) |  |  | 5,800 |  |  | (808) |
Non-U.S. agency mortgage-backed securities |  | 1,698 |  |  | (128) |  |  | 976 |  |  | (166) |  |  | 2,674 |  |  | (294) |
Total debt securities - available-for-sale |  | $ | 24,899 |  |  | $ | (1,750) |  |  | $ | 12,320 |  |  | $ | (1,914) |  |  | $ | 37,219 |  |  | $ | (3,664) |
December 31, 2021 |  |  |  |  |  |  |  |  |  |  |  |
U.S. government and agency obligations |  | $ | 1,976 |  |  | $ | (18) |  |  | $ | 249 |  |  | $ | (13) |  |  | $ | 2,225 |  |  | $ | (31) |
State and municipal obligations |  | 1,386 |  |  | (19) |  |  | 31 |  |  | (1) |  |  | 1,417 |  |  | (20) |
Corporate obligations |  | 9,357 |  |  | (130) |  |  | 376 |  |  | (15) |  |  | 9,733 |  |  | (145) |
U.S. agency mortgage-backed securities |  | 3,078 |  |  | (52) |  |  | 116 |  |  | (3) |  |  | 3,194 |  |  | (55) |
Non-U.S. agency mortgage-backed securities |  | 1,321 |  |  | (18) |  |  | 114 |  |  | (5) |  |  | 1,435 |  |  | (23) |
Total debt securities - available-for-sale |  | $ | 17,118 |  |  | $ | (237) |  |  | $ | 886 |  |  | $ | (37) |  |  | $ | 18,004 |  |  | $ | (274) |
The Company’s unrealized losses from all securities as of December 31, 2022 were generated from approximately 35,000 positions out of a total of 41,000 positions. The Company believes it will collect the timely principal and interest due on its debt securities having an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities which impacted the Company’s assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers noting no significant credit deterioration since purchase. As of December 31, 2022, the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities as of December 31, 2022 and 2021 was not material.

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- Definition The entire disclosure for investments in certain debt and equity securities. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 942 -SubTopic 320 -URI https://asc.fasb.org/subtopic&trid=2209399 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 946 -SubTopic 320 -URI https://asc.fasb.org/subtopic&trid=2324412 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 320 -URI https://asc.fasb.org/topic&trid=2196928 Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 940 -SubTopic 320 -URI https://asc.fasb.org/subtopic&trid=2176304 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher SEC -Name Regulation S-K (SK) -Number 229 -Section 1403 -Paragraph (b) + Details
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