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Segment Information | 3 Months Ended
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Mar. 31, 2026
Segment Reporting [Abstract] |
Segment Information | Segment Information The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Medicaid, Medicare and Commercial segments primarily represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, and corporate management company, among others. Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams and the type of information presented to the Company's chief operating decision-maker (CODM) to evaluate all results of operations. The Company's CODM is its Chief Executive Officer. The Company's CODM focuses primarily on each segment's ability to generate sufficient revenues and manage expenses associated with health benefits and cost of services (including estimated costs incurred). As such, the CODM measures operating performance at the segment level based on gross margin, including evaluation of budget to actual variances, to determine the allocation of financial and capital resources for each segment. The Company does not report total assets by segment since this is not a metric used by the Company's CODM to allocate resources or evaluate segment performance. Segment information for the three months ended March 31, 2026, is as follows ($ in millions):
|  | Medicaid |  | Medicare |  | Commercial |  | Other/Eliminations |  |  |  | Consolidated Total
Premium | $ | 23,573 |  |  | $ | 10,326 |  |  | $ | 9,555 |  |  | $ | 433 |  |  |  |  | $ | 43,887 |
Service | 23 |  |  | — |  |  | 1 |  |  | 744 |  |  |  |  | 768 |
Premium and service revenues | 23,596 |  |  | 10,326 |  |  | 9,556 |  |  | 1,177 |  |  |  |  | 44,655 |
Premium tax | 5,289 |  |  | — |  |  | — |  |  | — |  |  |  |  | 5,289 |
Total external revenues | 28,885 |  |  | 10,326 |  |  | 9,556 |  |  | 1,177 |  |  |  |  | 49,944 |
Internal revenues | — |  |  | — |  |  | — |  |  | 4,146 |  |  |  |  | 4,146 |
Eliminations | — |  |  | — |  |  | — |  |  | (4,146) |  |  |  |  | (4,146) |
Total revenues | $ | 28,885 |  |  | $ | 10,326 |  |  | $ | 9,556 |  |  | $ | 1,177 |  |  |  |  | $ | 49,944 |
Medical costs | $ | 21,955 |  |  | $ | 8,772 |  |  | $ | 7,198 |  |  | $ | 378 |  |  |  |  | $ | 38,303 |
Cost of services | 23 |  |  | — |  |  | — |  |  | 679 |  |  |  |  | 702 |
Other operating expenses (1) |  |  |  |  |  |  |  |  |  |  | 9,078 |
Other income (expense) (2) |  |  |  |  |  |  |  |  |  |  | 238 |
Earnings before income tax |  |  |  |  |  |  |  |  |  |  | $ | 2,099 |
Segment gross margin (3) | $ | 1,618 |  |  | $ | 1,554 |  |  | $ | 2,358 |  |  | $ | 120 |  |  |  |  | $ | 5,650 |
(1) | Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2) | Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3) | Segment gross margin represents premium and service revenues less medical costs and cost of services.
Segment information for the three months ended March 31, 2025, is as follows ($ in millions):
|  | Medicaid |  | Medicare |  | Commercial |  | Other/Eliminations |  |  |  | Consolidated Total
Premium | $ | 22,275 |  |  | $ | 8,759 |  |  | $ | 10,148 |  |  | $ | 530 |  |  |  |  | $ | 41,712 |
Service | 24 |  |  | — |  |  | 1 |  |  | 752 |  |  |  |  | 777 |
Premium and service revenues | 22,299 |  |  | 8,759 |  |  | 10,149 |  |  | 1,282 |  |  |  |  | 42,489 |
Premium tax | 4,131 |  |  | — |  |  | — |  |  | — |  |  |  |  | 4,131 |
Total external revenues | 26,430 |  |  | 8,759 |  |  | 10,149 |  |  | 1,282 |  |  |  |  | 46,620 |
Internal revenues | — |  |  | — |  |  | — |  |  | 4,164 |  |  |  |  | 4,164 |
Eliminations | — |  |  | — |  |  | — |  |  | (4,164) |  |  |  |  | (4,164) |
Total revenues | $ | 26,430 |  |  | $ | 8,759 |  |  | $ | 10,149 |  |  | $ | 1,282 |  |  |  |  | $ | 46,620 |
Medical costs | $ | 20,843 |  |  | $ | 7,555 |  |  | $ | 7,607 |  |  | $ | 498 |  |  |  |  | $ | 36,503 |
Cost of services | 24 |  |  | — |  |  | — |  |  | 674 |  |  |  |  | 698 |
Other operating expenses (1) |  |  |  |  |  |  |  |  |  |  | 7,885 |
Other income (expense) (2) |  |  |  |  |  |  |  |  |  |  | 212 |
Earnings before income tax |  |  |  |  |  |  |  |  |  |  | $ | 1,746 |
Segment gross margin (3) | $ | 1,432 |  |  | $ | 1,204 |  |  | $ | 2,542 |  |  | $ | 110 |  |  |  |  | $ | 5,288 |
(1) | Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2) | Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3) | Segment gross margin represents premium and service revenues less medical costs and cost of services.

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- Definition The entire disclosure for reporting segments including data and tables. 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