XML 25 R8.htm IDEA: XBRL DOCUMENT v3.10.0.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Cash flows from operating activities:      
Net earnings $ 894 $ 808 $ 561
Adjustments to reconcile net earnings to net cash provided by operating activities      
Depreciation and amortization 495 361 278
Stock compensation expense 145 135 148
Debt extinguishment costs 0 0 (7)
Deferred income taxes (129) (108) 92
Changes in assets and liabilities      
Premium and trade receivables (1,173) (50) 74
Other assets (38) (146) 167
Medical claims liabilities 1,325 359 145
Unearned revenue (52) 19 43
Accounts payable and accrued expenses (533) 53 402
Other long-term liabilities 258 68 (61)
Other operating activities, net 42 (10) 9
Net cash provided by operating activities 1,234 1,489 1,851
Cash flows from investing activities:      
Capital expenditures (675) (422) (306)
Purchases of investments (3,846) (2,656) (2,432)
Sales and maturities of investments 1,991 1,862 1,566
Investments in acquisitions, net of cash acquired (2,055) (50) (1,297)
Other investing activities, net 0 12 0
Net cash used in investing activities (4,585) (1,254) (2,469)
Cash flows from financing activities:      
Proceeds from the issuance of common stock 2,779 0 0
Proceeds from borrowings 6,077 1,400 8,946
Payment of long-term debt (4,083) (1,353) (6,076)
Common stock repurchases (71) (65) (63)
Purchase of noncontrolling interest (74) (66) (14)
Debt issue costs (25) (3) (76)
Other financing activities, net 9 5 0
Net cash provided by (used in) financing activities 4,612 (82) 2,717
Effect of exchange rate changes on cash, cash equivalents and restricted cash 0 0 (1)
Net increase in cash, cash equivalents and restricted cash 1,261 153 2,098
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 4,089 3,936 1,838
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 5,350 4,089 3,936
Supplemental disclosures of cash flow information:      
Interest paid 323 237 165
Income taxes paid 448 496 556
Equity issued in connection with acquisitions $ 507 $ 0 $ 3,105