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Segment Information - Reconciliation of Gross Margin to Consolidated Income (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
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total margin | $ 664 | $ 566 | $ 673 | $ 615 | $ 446 | $ 564 | $ 254 | $ 546 | $ 2,518 | $ 1,810 | $ 1,725
Add: Other operating revenues | 4,664 | 4,697 | 4,883 | 4,646 | $ 4,949 | $ 5,031 | $ 4,999 | $ 4,904 | 18,890 | 19,883 | 17,782
Less: Other operating expenses |  |  |  |  |  |  |  |  | (17,744) | (20,438) | (17,476)
Less: loss on sales of subsidiaries, net of gain | $ (52) | $ 37 | $ 0 | $ 0 |  |  |  |  | (15) | 0 | 0
Operating income (loss) |  |  |  |  |  |  |  |  | 1,131 | (555) | 306
Less: other expenses, net |  |  |  |  |  |  |  |  | 132 | 57 | 101
Income (loss) before income tax expense (benefit) |  |  |  |  |  |  |  |  | 999 | (612) | 205
Health Plans |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Add: Other operating revenues |  |  |  |  |  |  |  |  | 18,471 | 19,352 | 17,234
Other |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total margin |  |  |  |  |  |  |  |  | 43 | 29 | 54
Add: Other operating revenues |  |  |  |  |  |  |  |  | 419 | 531 | 548
Operating Segments |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total margin |  |  |  |  |  |  |  |  | 2,518 | 1,810 | 1,725
Operating Segments | Health Plans |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total margin |  |  |  |  |  |  |  |  | 2,475 | 1,781 | 1,671
Operating Segments | Other |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Total margin |  |  |  |  |  |  |  |  | 43 | 29 | 54
Other Operating |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Add: Other operating revenues |  |  |  |  |  |  |  |  | 871 | 508 | 798
Less: Other operating expenses |  |  |  |  |  |  |  |  | (2,243) | (2,873) | (2,217)
Less: loss on sales of subsidiaries, net of gain |  |  |  |  |  |  |  |  | $ (15) | $ 0 | $ 0

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