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Condensed Financial Information of Registrant - Condensed Statements of 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
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
Depreciation and amortization                 99 137 139
Impairment losses         269 129 72 0 0 470 0
Restructuring and separation costs 8 5 8 25 73 118 43 0 46 234 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 (income)                 17 (61) 0
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 Company                      
Revenue:                      
Investment income and other revenue                 17 16 16
Total revenue                 1,155 1,333 1,078
Expenses:                      
Medical care costs                 8 16 73
General and administrative expenses                 1,007 1,082 899
Depreciation and amortization                 69 93 95
Impairment losses                 0 39 0
Restructuring and separation costs                 35 153 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 (income)                 17 (61) 0
Loss before income tax (benefit) expense and equity in net earnings (losses) of subsidiaries                 (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
Management Fees | Parent Company                      
Revenue:                      
Management fees                 $ 1,138 $ 1,317 $ 1,062