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v3.20.4

Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
Operating activities: |  |  |
Net income | $ 673 | $ 737 | $ 707
Adjustments to reconcile net income to net cash provided by (used in) operating activities: |  |  |
Depreciation and amortization | 88 | 89 | 127
Deferred income taxes | (19) | 10 | (6)
Share-based compensation | 57 | 39 | 27
Loss (gain) on debt repayment | 15 | (15) | 22
Loss on sales of subsidiaries, net of gain | 0 | 0 | 15
Non-cash restructuring charges | 0 | 0 | 17
Other, net | 12 | 0 | 26
Changes in operating assets and liabilities, net of the effect of acquisitions: |  |  |
Receivables | (100) | (76) | (530)
Prepaid expenses and other current assets | (16) | 28 | 6
Medical claims and benefits payable | 544 | (107) | (226)
Amounts due government agencies | 446 | (303) | (574)
Accounts payable, accrued liabilities and other | 78 | 2 | 45
Deferred revenue | 126 | 38 | (21)
Income taxes | (14) | (15) | 51
Net cash provided by operating activities | 1,890 | 427 | (314)
Investing activities: |  |  |
Purchases of investments | (670) | (2,536) | (1,444)
Proceeds from sales and maturities of investments | 1,097 | 2,302 | 2,445
Purchases of property, equipment and capitalized software | (74) | (57) | (30)
Net cash paid in business combinations | (755) | 0 | 0
Net cash received from sale of subsidiaries | 0 | 0 | 190
Other, net | 2 | (2) | (18)
Net cash (used in) provided by investing activities | (400) | (293) | 1,143
Financing activities: |  |  |
Proceeds from senior notes offerings, net of issuance costs | 1,429 | 0 | 0
Common stock purchases | (606) | (47) | 0
Repayment of term loan facility | (600) | 0 | 0
Proceeds from borrowings under term loan facility | 380 | 220 | 0
Repayment of senior notes | (338) | 0 | 0
Cash paid for partial termination of warrants | (30) | (514) | (549)
Cash paid for partial settlement of conversion option | (27) | (578) | (623)
Cash received for partial settlement of call option | 27 | 578 | 623
Repayment of principal amount of convertible senior notes | (12) | (240) | (362)
Repayment of credit facility | 0 | 0 | (300)
Other, net | 2 | 29 | 18
Net cash provided by (used in) financing activities | 225 | (552) | (1,193)
Net increase (decrease) in cash and cash equivalents, and restricted cash and cash equivalents | 1,715 | (418) | (364)
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period | 2,508 | 2,926 | 3,290
Cash and cash equivalents, and restricted cash and cash equivalents at end of period | 4,223 | 2,508 | 2,926
Cash paid during the period for: |  |  |
Income taxes | 321 | 239 | 240
Interest | 112 | 78 | 93
Schedule of non-cash investing and financing activities: |  |  |
Fair value of assets acquired | (1,340) | 0 | 0
Fair value of contingent consideration liabilities | 40 | 0 | 0
Fair value of liabilities assumed | 545 | 0 | 0
Net cash paid in business combinations | (755) | 0 | 0
Convertible senior notes exchange transaction: |  |  |
Common stock issued in exchange for convertible senior notes | 0 | 0 | 131
Component of convertible senior notes allocated to additional paid-in capital, net of income taxes | 0 | 0 | (23)
Net increase to additional paid-in capital | 0 | 0 | 108
Common stock used for stock-based compensation | (8) | (7) | (6)
Common stock purchases not settled at end of period | 6 | 7 | 0
Details of change in fair value of derivatives, net: |  |  |
Change in fair value of derivatives, net | 0 | 0 | 0
Details of sales of subsidiaries: |  |  |
Decrease in carrying amount of assets | 0 | 0 | (327)
Decrease in carrying amount of liabilities | 0 | 0 | 85
Transaction costs | 0 | 0 | (15)
Cash received from buyers | 0 | 0 | 242
Loss on sale of subsidiaries, net of gain | 0 | 0 | (15)
(Loss) gain on call option |  |  |
Details of change in fair value of derivatives, net: |  |  |
Change in fair value of derivatives, net | (2) | 132 | 577
Gain (loss) on conversion option |  |  |
Details of change in fair value of derivatives, net: |  |  |
Change in fair value of derivatives, net | $ 2 | $ (132) | $ (577)

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