v3.25.0.1
Segment Reporting
 12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company has four reportable segments: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other. The Company’s segments maintain separate financial information, and the CODM, the Company’s Chief Executive Officer, evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income. Total assets by segment are not used by the CODM to assess the performance of, or allocate resources to, the Company’s segments, therefore total assets by segment are not disclosed.

Adjusted operating income (loss) is defined as operating income (loss) (GAAP measure) excluding the impact of amortization of intangible assets, net realized capital gains or losses, and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. The CODM uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

In 2024, 2023 and 2022, revenues from the federal government accounted for 24%, 19% and 18%, respectively, of the Company’s consolidated total revenues, primarily related to contracts with CMS for coverage of Medicare-eligible individuals within the Health Care Benefits segment.

The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
Year Ended December 31, 2024
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$129,120 $158,016 $83,464 $56 $370,656 
Intersegment revenues72 15,304 41,036 — 56,412 
Net investment income
1,473 285 — 395 2,153 
Total revenues130,665 173,605 124,500 451 429,221 
Intersegment eliminations (2)
(56,412)
Total consolidated revenues$372,809 
Less: Net realized capital gains (losses)
(97)289 — (75)
Cost of products sold— 160,036 99,337 — 
Health care costs113,659 3,407 — 187 
Other segment items (3)
16,796 2,630 19,389 1,687 
Adjusted operating income (loss)$307 $7,243 $5,774 $(1,348)$11,976 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
2,025 
Net realized capital gains (5)
(117)
Acquisition-related integration costs (6)
243 
Restructuring charges (7)
1,179 
Office real estate optimization charges (8)
30 
Opioid litigation charge (9)
100 
Operating income (GAAP measure)8,516 
Interest expense2,958 
Gain on early extinguishment of debt (12)
(491)
Other income(99)
Income before income tax provision$6,148 
Depreciation and amortization$1,599 $1,059 $1,543 $396 $4,597 
Year Ended December 31, 2023
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$104,800 $174,018 $77,748 $57 $356,623 
Intersegment revenues81 12,826 39,020 — 51,927 
Net investment income (loss)765 (1)(5)394 1,153 
Total revenues105,646 186,843 116,763 451 409,703 
Intersegment eliminations (2)
(51,927)
Total consolidated revenues$357,776 
Less: Net realized capital losses(402)— (5)(90)
Cost of products sold— 175,424 91,447 1 
Health care costs85,504 1,607 — 210 
Other segment items (3)
14,967 2,500 19,358 1,648 
Adjusted operating income (loss)$5,577 $7,312 $5,963 $(1,318)$17,534 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,905 
Net realized capital losses (5)
497 
Acquisition-related transaction and integration costs (6)
487 
Restructuring charges (7)
507 
Office real estate optimization charges (8)
46 
Loss on assets held for sale (10)
349 
Operating income (GAAP measure)13,743 
Interest expense2,658 
Other income(88)
Income before income tax provision$11,173 
Depreciation and amortization$1,572 $880 $1,549 $365 $4,366 
Year Ended December 31, 2022
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$90,798 $157,968 $72,739 $124 $321,629 
Intersegment revenues76 11,608 35,901 — 47,585 
Net investment income (loss)476 — (44)406 838 
Total revenues91,350 169,576 108,596 530 370,052 
Intersegment eliminations (2)
(47,585)
Total consolidated revenues$322,467 
Less: Net realized capital losses(225)— (44)(51)
Cost of products sold— 160,738 82,063 42 
Health care costs71,473 — — 249 
Other segment items (3)
13,764 2,057 20,046 1,903 
Adjusted operating income (loss)$6,338 $6,781 $6,531 $(1,613)$18,037 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,785 
Net realized capital losses (5)
320 
Office real estate optimization charges (8)
117 
Opioid litigation charge (9)
5,803 
Loss on assets held for sale (10)
2,533 
Gain on divestiture of subsidiaries (11)
(475)
Operating income (GAAP measure)7,954 
Interest expense2,287 
Other income(169)
Income before income tax provision$5,836 
Depreciation and amortization$1,579 $519 $1,889 $237 $4,224 
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(1)Total revenues of the Health Services segment include approximately $11.4 billion, $13.7 billion and $12.6 billion of retail co-payments for 2024, 2023 and 2022, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information about retail co-payments.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment.
(3)Other segment items for each reportable segment includes operating expenses, which primarily consists of selling, general and administrative expenses. Other segment items excludes the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance.
(4)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(5)The Company’s net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company’s business, and the amount and timing of these capital gains and losses do not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Accordingly, the Company believes excluding net realized capital gains and losses enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends.
(6)In 2024, the acquisition-related integration costs relate to the acquisitions of Signify Health and Oak Street Health. In 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in operating expenses within the Corporate/Other segment.
(7)In 2024, the restructuring charges are primarily comprised of a store impairment charge, corporate workforce optimization costs, including severance and employee-related costs, other asset impairment and related charges associated with the discontinuation of certain non-core assets and a stock-based compensation charge. During the third quarter of 2024, the Company finalized an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with this restructuring plan, the Company completed a strategic review of its retail business and determined that it plans to close 271 retail stores in 2025, and, accordingly, it recorded a store impairment charge to write down the associated operating or financing lease right-of-use assets and property and equipment. In addition, during the third quarter of 2024, the Company also conducted a review of its various strategic assets and determined that it would discontinue the use of certain non-core assets, at which time impairment losses were recorded to write down the carrying value of these assets to the Company’s best estimate of their fair value. In 2023, the restructuring charges are primarily comprised of severance and employee-related costs, asset impairment charges and a stock-based compensation charge. The restructuring charges associated with the store impairments are reflected within the Pharmacy & Consumer Wellness segment, other asset impairments and related charges are reflected within the Corporate/Other and Pharmacy & Consumer Wellness segments and corporate workforce optimization costs, including severance and employee-related costs, as well as stock-based compensation charges, are reflected within the Corporate/Other segment.
(8)In 2024, 2023 and 2022, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the Company’s evaluation of corporate office real estate space in response to its ongoing flexible work arrangement. The office real estate optimization charges are reflected in operating expenses within each segment.
(9)In 2024, the opioid litigation charge relates to a change in the Company’s accrual related to ongoing opioid litigation matters. In 2022, the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate/Other segment.
(10)In 2023 and 2022, the loss on assets held for sale relates to the LTC business within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and, accordingly, the Company recorded a loss on assets held for sale during 2022. During the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflected its estimated fair value less costs to sell. As of the third quarter of 2023, the Company determined the LTC business no longer met the criteria for held-for-sale accounting and, accordingly, the net assets associated with the LTC business were reclassified to held and used at their respective fair values. During 2022, the loss on assets held for sale also relates to the Company’s Thailand business, which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(11)In 2022, the gain on divestiture of subsidiaries represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022, and the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. The gains on divestitures are reflected as a reduction of operating expenses within the Health Care Benefits segment.
(12)In 2024, the gain on early extinguishment of debt relates to the Company’s repayment of approximately $2.6 billion of its outstanding senior notes in December 2024, pursuant to its tender offer for such senior notes.