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Supplemental Condensed Consolidating Financial Information - Condensed Consolidating Statements of Operations (Details) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue | $ 4,664 | $ 4,697 | $ 4,883 | $ 4,646 | $ 4,949 | $ 5,031 | $ 4,999 | $ 4,904 | $ 18,890 | $ 19,883 | $ 17,782
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | 1,333 | 1,594 | 1,393
Premium tax expenses |  |  |  |  |  |  |  |  | 417 | 438 | 468
Health insurer fees |  |  |  |  |  |  |  |  | 348 | 0 | 217
Depreciation and amortization |  |  |  |  |  |  |  |  | 99 | 137 | 139
Restructuring and separation costs | 8 | 5 | 8 | 25 | 73 | 118 | 43 | 0 | 46 | 234 | 0
Impairment losses |  |  |  |  | 269 | 129 | 72 | 0 | 0 | 470 | 0
Total operating expenses |  |  |  |  |  |  |  |  | 17,744 | 20,438 | 17,476
Gain (loss) on sales of subsidiaries | (52) | 37 | 0 | 0 |  |  |  |  | (15) | 0 | 0
Operating income (loss) |  |  |  |  |  |  |  |  | 1,131 | (555) | 306
Interest expense |  |  |  |  |  |  |  |  | 115 | 118 | 101
Other expense |  |  |  |  |  |  |  |  | (17) | 61 | 0
Total other expenses, net |  |  |  |  |  |  |  |  | (132) | (57) | (101)
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | 999 | (612) | 205
Income tax (benefit) expense |  |  |  |  |  |  |  |  | 292 | (100) | 153
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 707 | (512) | 52
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 0 | 0 | 0
Net income (loss) | $ 201 | $ 197 | $ 202 | $ 107 | $ (262) | $ (97) | $ (230) | $ 77 | 707 | (512) | 52
Parent Issuer |  |  |  |  |  |  |  |  |  |  |
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue |  |  |  |  |  |  |  |  | 1,155 | 1,333 | 1,078
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | 1,007 | 1,082 | 899
Depreciation and amortization |  |  |  |  |  |  |  |  | 69 | 93 | 95
Restructuring and separation costs |  |  |  |  |  |  |  |  | 35 | 153 | 0
Impairment losses |  |  |  |  |  |  |  |  | 0 | 39 | 0
Total operating expenses |  |  |  |  |  |  |  |  | 1,119 | 1,383 | 1,067
Gain (loss) on sales of subsidiaries |  |  |  |  |  |  |  |  | 37 | 0 | 0
Operating income (loss) |  |  |  |  |  |  |  |  | 73 | (50) | 11
Interest expense |  |  |  |  |  |  |  |  | 114 | 117 | 101
Other expense |  |  |  |  |  |  |  |  | (17) | 61 | 0
Income tax (benefit) expense |  |  |  |  |  |  |  |  | (14) | 8 | (24)
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | (44) | (114) | (66)
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 751 | (398) | 118
Net income (loss) |  |  |  |  |  |  |  |  | 707 | (512) | 52
Reportable Legal Entities | Parent Issuer |  |  |  |  |  |  |  |  |  |  |
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue |  |  |  |  |  |  |  |  | 1,155 | 1,333 | 1,078
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | 1,007 | 1,082 | 899
Premium tax expenses |  |  |  |  |  |  |  |  | 0 | 0 | 0
Health insurer fees |  |  |  |  |  |  |  |  | 0 |  | 0
Depreciation and amortization |  |  |  |  |  |  |  |  | 69 | 93 | 95
Restructuring and separation costs |  |  |  |  |  |  |  |  | 35 | 153 |
Impairment losses |  |  |  |  |  |  |  |  |  | 39 |
Total operating expenses |  |  |  |  |  |  |  |  | 1,119 | 1,383 | 1,067
Gain (loss) on sales of subsidiaries |  |  |  |  |  |  |  |  | 37 |  |
Operating income (loss) |  |  |  |  |  |  |  |  | 73 | (50) | 11
Interest expense |  |  |  |  |  |  |  |  | 114 |  |
Other expense |  |  |  |  |  |  |  |  | (17) |  |
Total other expenses, net |  |  |  |  |  |  |  |  |  | (56) | (101)
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | (58) | (106) | (90)
Income tax (benefit) expense |  |  |  |  |  |  |  |  | (14) | 8 | (24)
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | (44) | (114) | (66)
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 751 | (398) | 118
Net income (loss) |  |  |  |  |  |  |  |  | 707 | (512) | 52
Reportable Legal Entities | Other Guarantor |  |  |  |  |  |  |  |  |  |  |
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue |  |  |  |  |  |  |  |  | 3 | 2 | 0
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | 4 | 2 | 2
Premium tax expenses |  |  |  |  |  |  |  |  | 0 | 0 | 0
Health insurer fees |  |  |  |  |  |  |  |  | 0 |  | 0
Depreciation and amortization |  |  |  |  |  |  |  |  | 0 | 0 | 0
Restructuring and separation costs |  |  |  |  |  |  |  |  | 0 | 0 |
Impairment losses |  |  |  |  |  |  |  |  |  | 0 |
Total operating expenses |  |  |  |  |  |  |  |  | 4 | 2 | 2
Gain (loss) on sales of subsidiaries |  |  |  |  |  |  |  |  | (52) |  |
Operating income (loss) |  |  |  |  |  |  |  |  | (53) | 0 | (2)
Interest expense |  |  |  |  |  |  |  |  | 0 |  |
Other expense |  |  |  |  |  |  |  |  | 0 |  |
Total other expenses, net |  |  |  |  |  |  |  |  |  | 0 | 0
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | (53) | 0 | (2)
Income tax (benefit) expense |  |  |  |  |  |  |  |  | (11) | 0 | (1)
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | (42) | 0 | (1)
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | (5) | (164) | 2
Net income (loss) |  |  |  |  |  |  |  |  | (47) | (164) | 1
Reportable Legal Entities | Non-Guarantors |  |  |  |  |  |  |  |  |  |  |
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue |  |  |  |  |  |  |  |  | 18,884 | 19,904 | 17,786
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | 1,474 | 1,865 | 1,573
Premium tax expenses |  |  |  |  |  |  |  |  | 417 | 438 | 468
Health insurer fees |  |  |  |  |  |  |  |  | 348 |  | 217
Depreciation and amortization |  |  |  |  |  |  |  |  | 30 | 44 | 44
Restructuring and separation costs |  |  |  |  |  |  |  |  | 11 | 81 |
Impairment losses |  |  |  |  |  |  |  |  |  | 431 |
Total operating expenses |  |  |  |  |  |  |  |  | 17,773 | 20,409 | 17,489
Gain (loss) on sales of subsidiaries |  |  |  |  |  |  |  |  | 0 |  |
Operating income (loss) |  |  |  |  |  |  |  |  | 1,111 | (505) | 297
Interest expense |  |  |  |  |  |  |  |  | 1 |  |
Other expense |  |  |  |  |  |  |  |  | 0 |  |
Total other expenses, net |  |  |  |  |  |  |  |  |  | (1) | 0
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | 1,110 | (506) | 297
Income tax (benefit) expense |  |  |  |  |  |  |  |  | 317 | (108) | 178
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 793 | (398) | 119
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 0 | 8 | 0
Net income (loss) |  |  |  |  |  |  |  |  | 793 | (390) | 119
Eliminations |  |  |  |  |  |  |  |  |  |  |
Revenue: |  |  |  |  |  |  |  |  |  |  |
Total revenue |  |  |  |  |  |  |  |  | (1,152) | (1,356) | (1,082)
Expenses: |  |  |  |  |  |  |  |  |  |  |
General and administrative expenses |  |  |  |  |  |  |  |  | (1,152) | (1,355) | (1,081)
Premium tax expenses |  |  |  |  |  |  |  |  | 0 | 0 | 0
Health insurer fees |  |  |  |  |  |  |  |  | 0 |  | 0
Depreciation and amortization |  |  |  |  |  |  |  |  | 0 | 0 | 0
Restructuring and separation costs |  |  |  |  |  |  |  |  | 0 | 0 |
Impairment losses |  |  |  |  |  |  |  |  |  | 0 |
Total operating expenses |  |  |  |  |  |  |  |  | (1,152) | (1,356) | (1,082)
Gain (loss) on sales of subsidiaries |  |  |  |  |  |  |  |  | 0 |  |
Operating income (loss) |  |  |  |  |  |  |  |  | 0 | 0 | 0
Interest expense |  |  |  |  |  |  |  |  | 0 |  |
Other expense |  |  |  |  |  |  |  |  | 0 |  |
Total other expenses, net |  |  |  |  |  |  |  |  |  | 0 | 0
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | 0 | 0 | 0
Income tax (benefit) expense |  |  |  |  |  |  |  |  | 0 | 0 | 0
Net loss before equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | 0 | 0 | 0
Equity in net earnings (losses) of subsidiaries |  |  |  |  |  |  |  |  | (746) | 554 | (120)
Net income (loss) |  |  |  |  |  |  |  |  | (746) | 554 | (120)
Medical care costs |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 15,137 | 17,073 | 14,774
Medical care costs | Reportable Legal Entities | Parent Issuer |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 8 | 16 | 73
Medical care costs | Reportable Legal Entities | Other Guarantor |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 0 | 0 | 0
Medical care costs | Reportable Legal Entities | Non-Guarantors |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 15,129 | 17,058 | 14,702
Medical care costs | Eliminations |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 0 | (1) | (1)
Cost of service revenue |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 364 | 492 | 485
Cost of service revenue | Reportable Legal Entities | Parent Issuer |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 0 | 0 | 0
Cost of service revenue | Reportable Legal Entities | Other Guarantor |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 0 | 0 | 0
Cost of service revenue | Reportable Legal Entities | Non-Guarantors |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | 364 | 492 | 485
Cost of service revenue | Eliminations |  |  |  |  |  |  |  |  |  |  |
Expenses: |  |  |  |  |  |  |  |  |  |  |
Cost of revenue |  |  |  |  |  |  |  |  | $ 0 | $ 0 | $ 0

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