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Consolidated Statements of Operations - USD ($)
shares in Millions, $ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Revenue:      
Premium revenue $ 17,612 $ 18,854 $ 16,445
Service revenue 407 521 539
Premium tax revenue 417 438 468
Health insurer fees reimbursed 329 0 292
Investment income and other revenue 125 70 38
Total revenue 18,890 19,883 17,782
Operating 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 46 234 0
Impairment losses 0 470 0
Total operating expenses 17,744 20,438 17,476
Loss on sales of subsidiaries, net of gain (15) 0 0
Operating income (loss) 1,131 (555) 306
Interest expense 115 118 101
Other expenses (income), net 17 (61) 0
Total other expenses, net 132 57 101
Income (loss) before income tax expense (benefit) 999 (612) 205
Income tax expense (benefit) 292 (100) 153
Net income (loss) $ 707 $ (512) $ 52
Net income (loss) per share:      
Basic (in dollars per share) $ 11.57 $ (9.07) $ 0.93
Diluted (in dollars per share) $ 10.61 $ (9.07) $ 0.92
Weighted average shares outstanding:      
Basic (in shares) 61.1 56.4 55.4
Diluted (in shares) 66.6 56.4 56.2
Medical care costs      
Operating expenses:      
Cost of revenue $ 15,137 $ 17,073 $ 14,774
Cost of service revenue      
Operating expenses:      
Cost of revenue $ 364 $ 492 $ 485