v3.24.3
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash Flows from Operating Activities    
Net income $ 2,242 $ 4,265
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 2,129 2,270
Realized investment losses, net 2,805 44
Deferred income tax benefit (351) (303)
Loss on sale of businesses 106 21
Net changes in assets and liabilities, net of non-operating effects:    
Accounts receivable, net (10,600) (1,916)
Inventories 577 360
Reinsurance recoverable and Other assets (358) 281
Insurance liabilities (214) 1,482
Pharmacy and other service costs payable 8,979 2,250
Accounts payable and Accrued expenses and other liabilities (819) 1,337
Other, net 655 255
NET CASH PROVIDED BY OPERATING ACTIVITIES 5,151 10,346
Proceeds from investments sold:    
Debt securities and equity securities 569 757
Investment maturities and repayments:    
Debt securities and equity securities 585 715
Commercial mortgage loans 79 86
Other sales, maturities and repayments (primarily short-term and other long-term investments) 567 453
Investments purchased or originated:    
Debt securities and equity securities (943) (4,005)
Commercial mortgage loans (54) (94)
Other (primarily short-term and other long-term investments) (1,028) (891)
Property and equipment purchases, net (1,069) (1,208)
Acquisitions, net of cash acquired (132) (443)
Divestitures, net of cash sold 0 13
Other, net (485) (117)
NET CASH USED IN INVESTING ACTIVITIES (1,911) (4,734)
Cash Flows from Financing Activities    
Deposits and interest credited to contractholder deposit funds 120 127
Withdrawals and benefit payments from contractholder deposit funds (180) (139)
Net change in short-term debt 366 1,484
Repayment of long-term debt (3,000) (2,967)
Net proceeds on issuance of long-term debt 4,462 1,491
Repurchase of common stock (5,012) (1,740)
Issuance of common stock 283 113
Common stock dividend paid (1,183) (1,092)
Other, net (255) (321)
NET CASH USED IN FINANCING ACTIVITIES (4,399) (3,044)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash 6 2
Net (decrease) increase in cash, cash equivalents and restricted cash (1,153) 2,570
Cash, cash equivalents and restricted cash January 1, including held for sale assets 8,337 [1] 5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets [2] 7,184 8,546
Cash and cash equivalents reclassified to assets of businesses held for sale (1,249) 0
Cash, cash equivalents and restricted cash and cash equivalents December 31, [2] 5,935 8,546
Supplemental Disclosure of Cash Information:    
Income taxes paid, net of refunds 839 1,380
Interest paid $ 1,037 $ 1,019
[1] Includes $467 million reported in Assets of businesses held for sale as of January 1, 2024.
[2] Restricted cash and cash equivalents were reported in other long-term investments.