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Goodwill and Intangible Assets (Tables)
 12 Months Ended
Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of changes In goodwill by operating segment
The following table summarizes the changes in goodwill by operating segment ($ in millions):  
 
 Managed Care 
 
Specialty Services
 
Total 
Balance as of December 31, 2016
$
4,015

 
$
697

 
$
4,712

Acquisitions and purchase accounting adjustments
—

 
37

 
37

Balance as of December 31, 2017
4,015

 
734

 
4,749

Acquisitions and purchase accounting adjustments
1,671

 
595

 
2,266

Balance as of December 31, 2018
$
5,686

 
$
1,329

 
$
7,015
Schedule of intangible assets
Intangible assets at December 31, consist of the following ($ in millions):  
 
 
 
 
 
Weighted Average Life in Years
 
2018
 
2017
 
2018
 
2017
Purchased contract rights
$
1,173

 
$
1,173

 
12.6
 
12.6
Provider contracts
311

 
274

 
12.3
 
11.9
Customer relationships
769

 
22

 
10.9
 
8.2
Trade names
361

 
162

 
15.2
 
9.6
Developed technologies
180

 
109

 
5.2
 
5.0
Other Intangibles
5

 
7

 
2.7
 
2.8
Intangible assets
2,799

 
1,747

 
11.9
 
11.6
Less accumulated amortization:
 
 
 
 
 
 
 
Purchased contract rights
(283
)
 
(188
)
 
 
 
 
Provider contracts
(90
)
 
(66
)
 
 
 
 
Customer relationships
(57
)
 
(21
)
 
 
 
 
Trade names
(55
)
 
(34
)
 
 
 
 
Developed technologies
(72
)
 
(40
)
 
 
 
 
Other Intangibles
(3
)
 
—

 
 
 
 
Total accumulated amortization
(560
)
 
(349
)
 
 
 
 
Intangible assets, net
$
2,239

 
$
1,398

 
 
 
 
Schedule of future amortization expenses
Estimated total amortization expense related to intangible assets for each of the five succeeding fiscal years is as follows ($ in millions):
Year
 
Expense
2019
 
$
252

2020
 
244

2021
 
223

2022
 
217

2023
 
214