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Investments | 12 Months Ended
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Dec. 31, 2023
Investments, Debt and Equity Securities [Abstract] |
Investments | Investments Available-for-Sale We consider all of our investments classified as current assets to be available-for-sale. The following tables summarize our current investments as of the dates indicated:
| December 31, 2023
| Amortized Cost |  | Gross Unrealized |  | Estimated Fair Value
|  | Gains |  | Losses |
| (In millions)
Corporate debt securities | $ | 2,781 |  |  | $ | 16 |  |  | $ | 65 |  |  | $ | 2,732 |
Mortgage-backed securities | 951 |  |  | 4 |  |  | 44 |  |  | 911 |
Asset-backed securities | 376 |  |  | 1 |  |  | 12 |  |  | 365 |
Municipal securities | 172 |  |  | — |  |  | 6 |  |  | 166 |
U.S. Treasury notes | 40 |  |  | — |  |  | — |  |  | 40 |
Other | 47 |  |  | — |  |  | 2 |  |  | 45 |
Total | $ | 4,367 |  |  | $ | 21 |  |  | $ | 129 |  |  | $ | 4,259 |
| December 31, 2022
| Amortized Cost |  | Gross Unrealized |  | Estimated Fair Value
|  | Gains |  | Losses |
| (In millions)
Corporate debt securities | $ | 2,303 |  |  | $ | 2 |  |  | $ | 121 |  |  | $ | 2,184 |
Mortgage-backed securities | 787 |  |  | — |  |  | 56 |  |  | 731 |
Asset-backed securities | 308 |  |  | — |  |  | 20 |  |  | 288 |
Municipal securities | 160 |  |  | — |  |  | 11 |  |  | 149 |
U.S. Treasury notes | 106 |  |  | — |  |  | 1 |  |  | 105 |
Other | 45 |  |  | — |  |  | 3 |  |  | 42 |
Total | $ | 3,709 |  |  | $ | 2 |  |  | $ | 212 |  |  | $ | 3,499 |
Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties. The contractual maturities of our current investments as of December 31, 2023 are summarized below:
| Amortized Cost |  | Estimated Fair Value
| (In millions)
Due in one year or less | $ | 538 |  |  | $ | 530 |
Due after one year through five years | 2,437 |  |  | 2,384 |
Due after five years through ten years | 406 |  |  | 405 |
Due after ten years | 986 |  |  | 940 |
Total | $ | 4,367 |  |  | $ | 4,259 |
In the years ended December 31, 2023, 2022, and 2021, maturities and redemptions of available-for-sale securities amounted to $513 million, $1,069 million, and $948 million, respectively, and sales amounted to $259 million, $329 million, and $381 million, respectively. Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains amounted to $1 million, $1 million and $10 million in the years ended December 31, 2023, 2022 and 2021, respectively, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses amounted to $11 million and $7 million in the years ended December 31, 2023 and 2022, respectively, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses were insignificant in the year ended December 31, 2021. We have determined that unrealized losses at December 31, 2023 and 2022 primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience realized losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant. The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2023:
| In a Continuous Loss Position for Less than 12 Months |  | In a Continuous Loss Position for 12 Months or More
| Estimated Fair Value |  | Unrealized Losses |  | Total Number of Positions |  | Estimated Fair Value |  | Unrealized Losses |  | Total Number of Positions
| (Dollars in millions)
Corporate debt securities | $ | 263 |  |  | $ | 1 |  |  | 160 |  |  | $ | 1,553 |  |  | $ | 64 |  |  | 754 |
Mortgage-backed securities | 123 |  |  | 2 |  |  | 98 |  |  | 549 |  |  | 42 |  |  | 283 |
Asset-backed securities | — |  |  | — |  |  | — |  |  | 195 |  |  | 12 |  |  | 91 |
Municipal securities | — |  |  | — |  |  | — |  |  | 117 |  |  | 6 |  |  | 116 |
Other | — |  |  | — |  |  | — |  |  | 17 |  |  | 2 |  |  | 17 |
Total | $ | 386 |  |  | $ | 3 |  |  | 258 |  |  | $ | 2,431 |  |  | $ | 126 |  |  | 1,261 |
The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2022:
| In a Continuous Loss Position for Less than 12 Months |  | In a Continuous Loss Position for 12 Months or More
| Estimated Fair Value |  | Unrealized Losses |  | Total Number of Positions |  | Estimated Fair Value |  | Unrealized Losses |  | Total Number of Positions
| (Dollars in millions)
Corporate debt securities | $ | 1,124 |  |  | $ | 45 |  |  | 683 |  |  | $ | 887 |  |  | $ | 76 |  |  | 371 |
Mortgage-backed securities | 395 |  |  | 20 |  |  | 220 |  |  | 319 |  |  | 36 |  |  | 131 |
Asset-backed securities | 161 |  |  | 6 |  |  | 108 |  |  | 118 |  |  | 14 |  |  | 59 |
Municipal securities | 75 |  |  | 4 |  |  | 83 |  |  | 57 |  |  | 7 |  |  | 57 |
U.S. Treasury notes | 88 |  |  | 1 |  |  | 6 |  |  | — |  |  | — |  |  | — |
Other | 15 |  |  | 1 |  |  | 16 |  |  | 17 |  |  | 2 |  |  | 6 |
Total | $ | 1,858 |  |  | $ | 77 |  |  | 1,116 |  |  | $ | 1,398 |  |  | $ | 135 |  |  | 624 |
Restricted Investments Held-to-Maturity Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, U.S. Treasury securities, and corporate debt securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets. We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value, of which $190 million will mature in one year or less, $65 million will mature in one through five years, and $6 million will mature after five years. The following table presents the balances of restricted investments:
| December 31,
| 2023 |  | 2022
| (In millions)
Cash and cash equivalents | $ | 60 |  |  | $ | 42 |
U.S. Treasury notes | 167 |  |  | 159 |
Corporate debt securities | 34 |  |  | 37 |
Total restricted investments | $ | 261 |  |  | $ | 238 |

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