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Segment Reporting | 12 Months Ended
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Dec. 31, 2023
Segment Reporting [Abstract] |
Segment Reporting | Segment Reporting The Company has three operating segments, Health Care Benefits, Health Services and Pharmacy & Consumer Wellness, as well as a Corporate/Other segment. The Company’s segments maintain separate financial information, and the CODM evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income. Total assets by segment are not used by the CODM to assess the performance of, or allocate resources to, the Company’s segments, therefore total assets by segment are not disclosed. Adjusted operating income is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. Effective for the first quarter of 2023, adjusted operating income also excludes the impact of net realized capital gains or losses. See the reconciliation of consolidated operating income (GAAP measure) to consolidated adjusted operating income below for further context regarding the items excluded from operating income in determining adjusted operating income. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP. Segment financial information for the years ended December 31, 2022 and 2021 has been revised to conform with the current period presentation for the following items: •The realignment of the Company’s segments to correspond with changes made to its operating model as described in Note 1 “Significant Accounting Policies,” including the discontinuance of the former Maintenance Choice segment reporting practice as described in Note (1) of the table included on the next page. •The impact of the adoption of the long-duration insurance accounting standard, which the Company adopted on January 1, 2023 using a modified retrospective transition method as of January 1, 2021, as described in Note 1 “Significant Accounting Policies.” •The exclusion of the impact of net realized capital gains or losses from adjusted operating income, as described above. The impact of these items on segment financial information for the years ended December 31, 2022 and 2021 is reflected in the “Adjustments” lines of the table included on the next page.
| Year Ended December 31, 2022
In millions | Health Care Benefits |  | Health Services |  | Pharmacy & Consumer Wellness |  | Corporate/ Other |  | Intersegment Eliminations (1) |  | Consolidated Totals
Total revenues, as previously reported | $ | 91,409 |  |  | $ | 169,236 |  |  | $ | 106,594 |  |  | $ | 530 |  |  | $ | (45,302) |  |  | $ | 322,467 |
Adjustments | (59) |  |  | 340 |  |  | 2,002 |  |  | — |  |  | (2,283) |  |  | — |
Total revenues, as adjusted | $ | 91,350 |  |  | $ | 169,576 |  |  | $ | 108,596 |  |  | $ | 530 |  |  | $ | (47,585) |  |  | $ | 322,467 |
Adjusted operating income (loss), as previously reported | $ | 5,984 |  |  | $ | 7,356 |  |  | $ | 6,705 |  |  | $ | (1,785) |  |  | $ | (728) |  |  | $ | 17,532 |
Adjustments | 354 |  |  | (575) |  |  | (174) |  |  | 172 |  |  | 728 |  |  | 505 |
Adjusted operating income (loss), as adjusted | $ | 6,338 |  |  | $ | 6,781 |  |  | $ | 6,531 |  |  | $ | (1,613) |  |  | $ | — |  |  | $ | 18,037 |
| Year Ended December 31, 2021
In millions | Health Care Benefits |  | Health Services |  | Pharmacy & Consumer Wellness |  | Corporate/ Other |  | Intersegment Eliminations (1) |  | Consolidated Totals
Total revenues, as previously reported | $ | 82,186 |  |  | $ | 153,022 |  |  | $ | 100,105 |  |  | $ | 721 |  |  | $ | (43,923) |  |  | $ | 292,111 |
Adjustments | (67) |  |  | 870 |  |  | 1,515 |  |  | — |  |  | (2,318) |  |  | — |
Total revenues, as adjusted | $ | 82,119 |  |  | $ | 153,892 |  |  | $ | 101,620 |  |  | $ | 721 |  |  | $ | (46,241) |  |  | $ | 292,111 |
Adjusted operating income (loss), as previously reported | $ | 5,012 |  |  | $ | 6,859 |  |  | $ | 7,623 |  |  | $ | (1,471) |  |  | $ | (711) |  |  | $ | 17,312 |
Adjustments | 98 |  |  | (367) |  |  | (363) |  |  | (164) |  |  | 711 |  |  | (85) |
Adjusted operating income (loss), as adjusted | $ | 5,110 |  |  | $ | 6,492 |  |  | $ | 7,260 |  |  | $ | (1,635) |  |  | $ | — |  |  | $ | 17,227 |
_____________________________________________ (1)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. Prior to January 1, 2023, intersegment adjusted operating income eliminations occurred when members of the Health Services segment's clients enrolled in Maintenance Choice elected to pick up maintenance prescriptions at one of the Company’s retail pharmacies instead of receiving them through the mail. When this occurred, both the Health Services and Pharmacy & Consumer Wellness segments recorded the adjusted operating income on a stand-alone basis. Effective January 1, 2023, the adjusted operating income associated with such transactions is reported only in the Pharmacy & Consumer Wellness segment, therefore no adjusted operating income elimination is required. Segment financial information has been recast to reflect this change. In 2023, 2022 and 2021, revenues from the federal government accounted for 19%, 18% and 17%, respectively, of the Company’s consolidated total revenues, primarily related to contracts with CMS for coverage of Medicare-eligible individuals within the Health Care Benefits segment. The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
In millions | Health Care Benefits |  | Health Services (1) |  | Pharmacy & Consumer Wellness |  | Corporate/ Other |  | Intersegment Eliminations (2) |  | Consolidated Totals
2023: |  |  |  |  |  |  |  |  |  |  |
Revenues from external customers | $ | 104,800 |  |  | $ | 174,018 |  |  | $ | 77,748 |  |  | $ | 57 |  |  | $ | — |  |  | $ | 356,623 |
Intersegment revenues | 81 |  |  | 12,826 |  |  | 39,020 |  |  | — |  |  | (51,927) |  |  | — |
Net investment income (loss) | 765 |  |  | (1) |  |  | (5) |  |  | 394 |  |  | — |  |  | 1,153 |
Total revenues | 105,646 |  |  | 186,843 |  |  | 116,763 |  |  | 451 |  |  | (51,927) |  |  | 357,776 |
Adjusted operating income (loss) | 5,577 |  |  | 7,312 |  |  | 5,963 |  |  | (1,318) |  |  | — |  |  | 17,534 |
Depreciation and amortization | 1,572 |  |  | 880 |  |  | 1,549 |  |  | 365 |  |  | — |  |  | 4,366 |
2022: |  |  |  |  |  |  |  |  |  |  |
Revenues from external customers | 90,798 |  |  | 157,968 |  |  | 72,739 |  |  | 124 |  |  | — |  |  | 321,629 |
Intersegment revenues | 76 |  |  | 11,608 |  |  | 35,901 |  |  | — |  |  | (47,585) |  |  | — |
Net investment income (loss) | 476 |  |  | — |  |  | (44) |  |  | 406 |  |  | — |  |  | 838 |
Total revenues | 91,350 |  |  | 169,576 |  |  | 108,596 |  |  | 530 |  |  | (47,585) |  |  | 322,467 |
Adjusted operating income (loss) | 6,338 |  |  | 6,781 |  |  | 6,531 |  |  | (1,613) |  |  | — |  |  | 18,037 |
Depreciation and amortization | 1,579 |  |  | 519 |  |  | 1,889 |  |  | 237 |  |  | — |  |  | 4,224 |
2021: |  |  |  |  |  |  |  |  |  |  |
Revenues from external customers | 81,457 |  |  | 143,912 |  |  | 65,418 |  |  | 125 |  |  | — |  |  | 290,912 |
Intersegment revenues | 76 |  |  | 9,980 |  |  | 36,185 |  |  | — |  |  | (46,241) |  |  | — |
Net investment income | 586 |  |  | — |  |  | 17 |  |  | 596 |  |  | — |  |  | 1,199 |
Total revenues | 82,119 |  |  | 153,892 |  |  | 101,620 |  |  | 721 |  |  | (46,241) |  |  | 292,111 |
Adjusted operating income (loss) | 5,110 |  |  | 6,492 |  |  | 7,260 |  |  | (1,635) |  |  | — |  |  | 17,227 |
Depreciation and amortization | 1,811 |  |  | 505 |  |  | 1,955 |  |  | 215 |  |  | — |  |  | 4,486 |
_____________________________________________ (1)Total revenues of the Health Services segment include approximately $13.7 billion, $12.6 billion and $11.6 billion of retail co-payments for 2023, 2022 and 2021, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information about retail co-payments. (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. The following is a reconciliation of consolidated operating income to adjusted operating income for the years ended December 31, 2023, 2022 and 2021:
In millions | 2023 |  | 2022 |  | 2021
Operating income (GAAP measure) | $ | 13,743 |  |  | $ | 7,954 |  |  | $ | 13,310 |
Amortization of intangible assets (1) | 1,905 |  |  | 1,785 |  |  | 2,233 |
Net realized capital (gains) losses (2) | 497 |  |  | 320 |  |  | (176) |
Acquisition-related transaction and integration costs (3) | 487 |  |  | — |  |  | 132 |
Restructuring charges (4) | 507 |  |  | — |  |  | — |
Office real estate optimization charges (5) | 46 |  |  | 117 |  |  | — |
Loss on assets held for sale (6) | 349 |  |  | 2,533 |  |  | — |
Opioid litigation charges (7) | — |  |  | 5,803 |  |  | — |
Gain on divestiture of subsidiaries (8) | — |  |  | (475) |  |  | — |
Store impairments (9) | — |  |  | — |  |  | 1,358 |
Goodwill impairment (10) | — |  |  | — |  |  | 431 |
Acquisition purchase price adjustment outside of measurement period (11) | — |  |  | — |  |  | (61) |
Adjusted operating income | $ | 17,534 |  |  | $ | 18,037 |  |  | $ | 17,227 |
_____________________________________________ (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 Company’s GAAP 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 consolidated statements of operations in net investment income 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)In 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. In 2021, the acquisition-related integration costs relate to the acquisition of Aetna. The acquisition-related transaction and integration costs are reflected in the Company’s GAAP consolidated statements of operations in operating expenses within the Corporate/Other segment. (4)In 2023, the restructuring charges are primarily comprised of severance and employee-related costs, asset impairment charges and a stock-based compensation charge. During the second quarter of 2023, the Company developed an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with the development of this plan and the recently completed acquisitions of Signify Health and Oak Street Health, the Company also conducted a strategic review of its various transformation initiatives and determined that it would terminate certain initiatives. The restructuring charges are reflected within the Corporate/Other segment. (5)In 2023 and 2022, 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 planned reduction of corporate office real estate space in response to the Company’s new flexible work arrangement. The office real estate optimization charges are reflected in the Company’s GAAP consolidated statements of operations in operating expenses within the Health Care Benefits, Corporate/Other and Health Services segments. (6)In 2023 and 2022, 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. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and, accordingly, the Company recorded a loss on assets held for sale during 2022. 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 September 30, 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. During 2022, the loss on assets held for sale also relates to the Company’s Thailand business, which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material. (7)In 2022, the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate/Other segment. (8)In 2022, the gain on divestiture of subsidiaries represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022, and the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. The gains on divestitures are reflected as a reduction of operating expenses in the Company’s GAAP consolidated statement of operations within the Health Care Benefits segment. (9)In 2021, the store impairment charge relates to the write down of operating lease right-of-use assets and property and equipment in connection with the planned closure of approximately 900 retail stores between 2022 and 2024. The store impairment charge is reflected within the Pharmacy & Consumer Wellness segment. (10)In 2021, the goodwill impairment charge relates to an impairment of the remaining goodwill of the LTC reporting unit within the Pharmacy & Consumer Wellness segment. (11)In 2021, the Company received $61 million related to a purchase price working capital adjustment for an acquisition completed during the first quarter of 2020. The resolution of this matter occurred subsequent to the acquisition accounting measurement period and is reflected in the Company’s GAAP consolidated statement of operations as a reduction of operating expenses within the Health Care Benefits segment.

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