UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
    
FORM 10-Q

(Mark One)

þ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF
1934

For the quarterly period ended March 31, 20162017
or

o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF
1934

For the transition period from _________ to_________

Commission File Number: 1-16095

aetnalogoa_02a06.jpg
Aetna Inc.
(Exact name of registrant as specified in its charter)

Pennsylvania
(State or other jurisdiction of incorporation or organization)
23-2229683
(I.R.S. Employer Identification No.)
151 Farmington Avenue, Hartford, CT
(Address of principal executive offices)
06156
(Zip Code)
Registrant’s telephone number, including area code:(860) 273-0123
  
Former name, former address and former fiscal year, if changed since last report: N/A

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. þ Yes o No

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter)
during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).
þ Yes o No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”filer,” “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer þ
 
Accelerated filer o
Non-accelerated filer o  (Do not check if a smaller reporting company)
Smaller reporting company o
  
Emerging growth company o
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o
 
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). o Yes þ No

There were 350.6331.7 million shares of the registrant’s voting common stock with a par value of $.01 per share outstanding at March 31, 2016.2017.




Aetna Inc.
Form 10-Q
For the Quarterly Period Ended March 31, 20162017

Unless the context otherwise requires, references to the terms “we”, “our” or “us” used throughout this Quarterly Report on Form 10-Q (except the Report of Independent Registered Public Accounting Firm on page 39)Firm), refer to Aetna Inc. (a Pennsylvania corporation) (“Aetna”) and its subsidiaries (collectively, the “Company”).


Table of ContentsPage
   
Part IFinancial Information 
   
Item 1.
Item 2.40
Item 3.53
Item 4.53
   
Part IIOther Information 
   
Item 1.54
Item 1A.54
Item 2.54
Item 3
Item 4.54
Item 5.
Item 6.55
   
56
Index to Exhibits57





Form 10-Q Table of Contents

Part I.Financial Information


Item 1.Financial Statements
Index to Consolidated Financial Statements

Page

Index to Consolidated Financial Statements

Consolidated Balance Sheets
    (Unaudited)
  
(Millions)   At March 31, 2017
 At December 31, 2016
Assets:      
Current assets:      
Cash and cash equivalents   $3,877
 $17,996
Investments   3,079
 3,046
Premiums receivable, net   2,745
 2,356
Other receivables, net   2,367
 2,224
Accrued investment income   230
 232
Income taxes receivable   75
 44
Other current assets   2,645
 2,551
Total current assets   15,018
 28,449
Long-term investments   21,922
 21,833
Reinsurance recoverables   716
 727
Goodwill   10,637
 10,637
Other acquired intangible assets, net   1,382
 1,442
Property and equipment, net   577
 587
Deferred income taxes   93
 
Other long-term assets   1,762
 1,480
Separate Accounts assets   4,244
 3,991
Total assets   $56,351
 $69,146
       
Liabilities and shareholders’ equity:    
  
Current liabilities:    
  
Health care costs payable   $6,432
 $6,558
Future policy benefits   645
 645
Unpaid claims   790
 801
Unearned premiums   2,078
 556
Policyholders’ funds   2,775
 2,772
Current portion of long-term debt   1,249
 1,634
Accrued expenses and other current liabilities   5,579
 5,728
Total current liabilities   19,548
 18,694
Future policy benefits   5,908
 5,929
Unpaid claims   1,705
 1,703
Policyholders’ funds   870
 812
Long-term debt, less current portion   8,174
 19,027
Deferred income taxes   
 4
Other long-term liabilities   1,564
 1,043
Separate Accounts liabilities   4,244
 3,991
Total liabilities   42,013
 51,203
Commitments and contingencies (Note 14)   

 

Shareholders’ equity:      
Common stock ($.01 par value; 2.5 billion shares authorized and 331.7 million shares issued and outstanding in 2017; 2.5 billion shares authorized and 351.7 million shares issued and outstanding in 2016) and additional paid-in capital   4,006
 4,716
Retained earnings   11,531
 14,717
Accumulated other comprehensive loss   (1,276) (1,552)
Total Aetna shareholders’ equity   14,261
 17,881
Non-controlling interests   77
 62
Total equity   14,338
 17,943
Total liabilities and equity   $56,351
 $69,146
       
Refer to accompanying Condensed Notes to Consolidated Financial Statements (Unaudited).
Index to Consolidated Financial Statements

Consolidated Statements of Income
(Unaudited)
 For the Three Months For the Three Months
 Ended March 31, Ended March 31,
(Millions, except per common share data) 2016
 2015
 2017
 2016
Revenue:        
Health care premiums $13,469.0
 $12,940.1
 $13,219
 $13,469
Other premiums 540.1
 538.0
 544
 540
Fees and other revenue (1)
 1,467.0
 1,375.0
 1,475
 1,467
Net investment income 217.7
 232.9
 260
 218
Net realized capital (losses) gains (.4) 8.1
Net realized capital losses (333) (1)
Total revenue 15,693.4
 15,094.1
 15,165
 15,693
Benefits and expenses:        
Health care costs (2)
 10,847.7
 10,240.5
 10,916
 10,848
Current and future benefits 528.9
 528.1
 545
 529
Operating expenses:        
Selling expenses 421.1
 414.9
 421
 421
General and administrative expenses 2,442.5
 2,400.6
 3,432
 2,442
Total operating expenses 2,863.6
 2,815.5
 3,853
 2,863
Interest expense 101.8
 80.2
 173
 102
Amortization of other acquired intangible assets 62.8
 63.2
 60
 62
Loss on early extinguishment of long-term debt 246
 
Total benefits and expenses 14,404.8
 13,727.5
 15,793
 14,404
Income before income taxes 1,288.6
 1,366.6
(Loss) income before income taxes (628) 1,289
Income taxes:        
Current 573.1
 647.0
 (7) 560
Deferred (12.4) (56.7) (242) (9)
Total income taxes 560.7
 590.3
Net income including non-controlling interests 727.9
 776.3
Less: Net income (loss) attributable to non-controlling interests1.3
 (1.2)
Net income attributable to Aetna $726.6
 $777.5
Earnings per common share:    
Total income tax (benefit) expense (249) 551
Net (loss) income including non-controlling interests (379) 738
Less: Net income attributable to non-controlling interestsLess: Net income attributable to non-controlling interests2
 1
Net (loss) income attributable to Aetna $(381) $737
(Loss) earnings per common share:    
Basic $2.07
 $2.22
 $(1.11) $2.10
Diluted $2.06
 $2.20
 $(1.11) $2.08
        
(1) 
Fees and other revenue include administrative services contract member co-payments and plan sponsor reimbursements related to our mail order and specialty pharmacy operations of $24.4$31 million and $24 million and $24.1 million (net(net of pharmaceutical and processing costs of $308.4$340 million and $299.3$308 million) for the three months ended March 31, 20162017 and 2015,2016, respectively.
(2) 
Health care costs have been reduced by Insured member co-payments related to our mail order and specialty pharmacy operations of $34.0 million and $33.4$34 million for each of the three monthsmonth periods ended March 31, 20162017 and 2015, respectively.
2016.

Refer to accompanying Condensed Notes to Consolidated Financial Statements (Unaudited).

Index to Consolidated Financial Statements

Consolidated Statements of Comprehensive Income
(Unaudited)


 For the Three Months
 Ended March 31,
(Millions)2016
 2015
Net income including non-controlling interests$727.9
 $776.3
Other comprehensive (loss) income, net of tax:   
    Previously impaired debt securities: (1)
   
Net unrealized losses   
($(4.2) and $(3.4) pretax)(2.7) (2.2)
Less: reclassification of (losses) gains to earnings   
($(5.3) and $2.4 pretax)(3.4) 1.6
    Total previously impaired debt securities (1)
.7
 (3.8)
    All other securities:   
Net unrealized gains   
($317.4 and $119.9 pretax)206.3
 77.9
Less: reclassification of losses to earnings   
($(23.4) and $(11.0) pretax)

(15.2) (7.2)
    Total all other securities221.5
 85.1
    Foreign currency and derivatives:   
Net unrealized losses   
($(246.3) and $(21.4) pretax)(160.1) (13.9)
Less: reclassification of losses to earnings   
($(5.5) and $(1.5) pretax)
(3.6) (1.0)
    Total foreign currency and derivatives(156.5) (12.9)
    Pension and other postretirement employee benefit (“OPEB”) plans:   
Less: amortization of net actuarial losses   
($(16.0) and $(16.1) pretax)(10.4) (10.5)
Less: amortization of prior service credit   
($1.0 and $1.0 pretax)
.7
 .7
Total pension and OPEB plans9.7
 9.8
Other comprehensive income75.4
 78.2
Comprehensive income including non-controlling interests803.3
 854.5
Less: Comprehensive income (loss) attributable to non-controlling interests1.3
 (1.2)
Comprehensive income attributable to Aetna$802.0
 $855.7
    
 For the Three Months
 Ended March 31,
(Millions)2017
 2016
Net (loss) income including non-controlling interests$(379) $738
Other comprehensive income, net of tax:   
    Previously impaired debt securities
 1
    All other securities44
 221
    Derivatives and foreign currency222
 (157)
Pension and other postretirement employee benefit (“OPEB”) plans10
 10
Other comprehensive income276
 75
Comprehensive (loss) income including non-controlling interests(103) 813
Less: Comprehensive income attributable to non-controlling interests2
 1
Comprehensive (loss) income attributable to Aetna$(105) $812
    
(1)

Represents unrealized (losses) gains on the non-credit related component of impaired debt securities that we do not intend to sell and subsequent changes in the fair value of any previously impaired security.


Refer to accompanying Condensed Notes to Consolidated Financial Statements (Unaudited)., including Note 11 for further information about other comprehensive (loss) income.



Consolidated Balance Sheets
    (Unaudited)
  
(Millions)   At March 31, 2016
 
At December 31,
2015

Assets:      
Current assets:      
Cash and cash equivalents   $3,766.4
 $2,524.3
Investments   3,127.8
 3,014.8
Premiums receivable, net   2,206.7
 1,753.1
Other receivables, net   2,673.7
 2,443.2
Accrued investment income   227.6
 227.7
Income taxes receivable   
 260.4
Other current assets   3,391.4
 2,509.5
Total current assets   15,393.6
 12,733.0
Long-term investments   22,112.2
 21,664.8
Reinsurance recoverables   730.9
 723.9
Goodwill   10,636.8
 10,636.8
Other acquired intangible assets, net   1,626.4
 1,688.3
Property and equipment, net   616.1
 629.7
Other long-term assets   1,289.8
 1,269.9
Separate Accounts assets   4,017.9
 4,035.1
Total assets   $56,423.7
 $53,381.5
       
Liabilities and shareholders’ equity:    
  
Current liabilities:    
  
Health care costs payable   $6,824.8
 $6,305.7
Future policy benefits   666.3
 671.8
Unpaid claims   775.7
 772.3
Unearned premiums   716.3
 549.2
Policyholders’ funds   2,444.7
 2,262.5
Current portion of long-term debt   398.4
 
Income taxes payable   274.9
 
Accrued expenses and other current liabilities   5,814.1
 4,920.0
Total current liabilities   17,915.2
 15,481.5
Future policy benefits   6,209.1
 6,268.2
Unpaid claims   1,670.7
 1,655.6
Policyholders’ funds   921.0
 885.6
Long-term debt, less current portion   7,382.5
 7,785.4
Deferred income taxes   234.0
 177.4
Other long-term liabilities   1,194.6
 914.1
Separate Accounts liabilities   4,017.9
 4,035.1
Total liabilities   39,545.0
 37,202.9
Commitments and contingencies (Note 14)   

 

Shareholders’ equity:      
Common stock ($.01 par value; 2.5 billion shares authorized and 350.6 million shares issued  
and outstanding in 2016; 2.5 billion shares authorized and 349.5 million shares issued and    
outstanding in 2015) and additional paid-in capital   4,632.0
 4,647.2
Retained earnings   13,436.4
 12,797.4
Accumulated other comprehensive loss   (1,254.9) (1,330.3)
Total Aetna shareholders’ equity   16,813.5
 16,114.3
Non-controlling interests   65.2
 64.3
Total equity   16,878.7
 16,178.6
Total liabilities and equity   $56,423.7
 $53,381.5
       
Refer to accompanying Condensed NotesIndex to Consolidated Financial Statements (Unaudited).


Consolidated Statements of Shareholders’ Equity
(Unaudited)

   Attributable to Aetna    
(Millions)
Number of
Common
Shares
Outstanding

 
Common
Stock and
Additional
Paid-in
Capital

 
Retained
Earnings

Accumulated
Other
Comprehensive
Loss
  
Total Aetna
Shareholders’
Equity

 Non-Controlling Interests
Total
Equity
 
Three Months Ended March 31, 2016            
Balance at December 31, 2015349.5
 $4,647.2
 $12,797.4
 $(1,330.3) $16,114.3
 $64.3
 $16,178.6
Net income
 
 726.6
 
 726.6
 1.3
 727.9
Other decreases in non-             
  controlling interest
 
 
 
 
 (.4) (.4)
Other comprehensive income (Note 8)
 
 
 75.4
 75.4
 
 75.4
Common shares issued for benefit             
  plans, including tax benefits, net of             
  employee tax withholdings1.1
 (15.2) 
 
 (15.2) 
 (15.2)
Dividends declared
 
 (87.6) 
 (87.6) 
 (87.6)
Balance at March 31, 2016350.6
 $4,632.0
 $13,436.4
 $(1,254.9) $16,813.5
 $65.2
 $16,878.7
              
Three Months Ended March 31, 2015            
Balance at December 31, 2014349.8
 $4,542.2
 $11,051.7
 $(1,111.3) $14,482.6
 $69.2
 $14,551.8
Net income (loss)
 
 777.5
 
 777.5
 (1.2) 776.3
Other decreases in non-             
  controlling interest
 
 
 
 
 (1.7) (1.7)
Other comprehensive income (Note 8)
 
 
 78.2
 78.2
 
 78.2
Common shares issued for benefit             
  plans, including tax benefits, net of             
  employee tax withholdings1.5
 (2.4) 
 
 (2.4) 
 (2.4)
Repurchases of common shares(2.1) (.1) (196.2) 
 (196.3) 
 (196.3)
Dividends declared
 
 (87.0) 
 (87.0) 
 (87.0)
Balance at March 31, 2015349.2
 $4,539.7
 $11,546.0
 $(1,033.1) $15,052.6
 $66.3
 $15,118.9
   Attributable to Aetna    
(Millions)
Number of
Common
Shares
Outstanding

 
Common
Stock and
Additional
Paid-in
Capital

 
Retained
Earnings

 
Accumulated
Other
Comprehensive
Loss

 
Total Aetna
Shareholders’
Equity

 Non-Controlling Interests
 
Total
Equity

Three Months Ended March 31, 2017            
Balance at December 31, 2016351.7
 $4,716
 $14,717
 $(1,552) $17,881
 $62
 $17,943
Net (loss) income
 
 (381) 
 (381) 2
 (379)
Other increases in non-controlling interest
 
 
 
 
 13
 13
Other comprehensive income (Note 11)
 
 
 276
 276
 
 276
Common shares issued for benefit plans, net of employee tax withholdings0.9
 (49) 
 
 (49) 
 (49)
Repurchases of common shares(20.9) (661) (2,639) 
 (3,300) 
 (3,300)
Dividends declared
 
 (166) 
 (166) 
 (166)
Balance at March 31, 2017$331.7
 $4,006
 $11,531
 $(1,276) $14,261
 $77
 $14,338
              
Three Months Ended March 31, 2016            
Balance at December 31, 2015349.5
 $4,647
 $12,797
 $(1,330) $16,114
 $65
 $16,179
Net income
 
 737
 
 737
 1
 738
Other decreases in non-controlling interest
 
 
 
 
 (1) (1)
Other comprehensive income (Note 11)
 
 
 75
 75
 
 75
Common shares issued for benefit plans, net of employee tax withholdings1.1
 (15) 
 
 (15) 
 (15)
Dividends declared
 
 (88) 
 (88) 
 (88)
Balance at March 31, 2016350.6
 $4,632
 $13,446
 $(1,255) $16,823
 $65
 $16,888


Refer to accompanying Condensed Notes to Consolidated Financial Statements (Unaudited).


Index to Consolidated Financial Statements

Consolidated Statements of Cash Flows
(Unaudited)
 Three Months Ended Three Months Ended
 March 31, March 31,
(Millions) 2016
 2015
 2017
 2016
Cash flows from operating activities:        
Net income including non-controlling interests $727.9
 $776.3
Net (loss) income including non-controlling interests $(379) $738
Adjustments to reconcile net income to net cash provided by operating activities:Adjustments to reconcile net income to net cash provided by operating activities:    Adjustments to reconcile net income to net cash provided by operating activities:    
Net realized capital losses (gains) .4
 (8.1)
Net realized capital losses 333
 1
Depreciation and amortization 169.2
 164.0
 160
 169
Debt fair value amortization (7.4) (7.8) (7) (7)
Equity in losses (earnings) of affiliates, net 14.8
 (9.7)
Equity in (earnings) losses of affiliates, net (38) 15
Stock-based compensation expense 53.6
 49.8
 54
 54
Amortization of net investment premium 20.6
 22.3
 17
 21
Loss on early extinguishment of long-term debt 246
 
Changes in assets and liabilities:        
Accrued investment income .1
 (.5)
Premiums due and other receivables (495.9) (830.4) (477) (182)
Income taxes 519.3
 629.5
 (271) 519
Other assets and other liabilities 64.9
 123.5
 (95) (262)
Health care and insurance liabilities 713.4
 564.5
 1,356
 725
Net cash provided by operating activities 1,780.9
 1,473.4
 899
 1,791
Cash flows from investing activities:  
  
  
  
Proceeds from sales and maturities of investments 2,938.3
 2,608.9
 2,738
 2,938
Cost of investments (3,060.4) (2,493.9) (2,723) (3,060)
Additions to property, equipment and software (54.6) (82.3) (71) (55)
Cash used for acquisitions, net of cash acquired 
 (10.9)
Net cash (used for) provided by investing activities (176.7) 21.8
Net cash used for investing activities (56) (177)
Cash flows from financing activities:  
  
  
  
Repayment of long-term debt 
 (228.8) (11,484) 
Net repayment of short-term debt 
 (203.0)
Deposits net of (withdrawals) and interest credited to investment contracts .1
 (7.6)
Common shares issued under benefit plans, net (79.1) (79.9) (103) (79)
Stock-based compensation tax benefits 10.3
 27.7
Settlements from repurchase agreements 
 (201.7)
Common shares repurchased 
 (196.3) (3,300) 
Dividends paid to shareholders (87.4) (87.1) (88) (87)
Collateral on interest rate hedges (205.6) (21.4)
Distributions, non-controlling interests (.4) (1.7)
Net payment on interest rate derivatives 
 (206)
Contributions, non-controlling interests 13
 
Net cash used for financing activities (362.1) (999.8) (14,962) (372)
Net increase in cash and cash equivalents 1,242.1
 495.4
Net (decrease) increase in cash and cash equivalents (14,119) 1,242
Cash and cash equivalents, beginning of period 2,524.3
 1,420.4
 17,996
 2,524
Cash and cash equivalents, end of period $3,766.4
 $1,915.8
 $3,877
 $3,766
Supplemental cash flow information:  
  
  
  
Interest paid $43.7
 $47.6
 $130
 $44
Income taxes paid (refunded) 31.1
 (66.8)
Income taxes paid 22
 31
        
 
 Refer to accompanying Condensed Notes to Consolidated Financial Statements (Unaudited).

Index to Consolidated Financial Statements

Condensed Notes to Consolidated Financial Statements
(Unaudited)

1.Organization

We conduct our operations in three business segments:

Health Care consists of medical, pharmacy benefit management services, dental, behavioral health and vision plans offered on both an Insured basis (where we assume all or a majority of the risk for medical and dental care costs) and an employer-funded basis (where the plan sponsor under an administrative services contract (“ASC”) assumes all or a majority of this risk) and emerging business products and services such as Accountable Care Solutions, that complement and enhance our medical products. We also offer Medicare and Medicaid products and services and other medical products, such as medical management and data analytics services, medical stop loss insurance, workers’ compensation administrative services and products that provide access to our provider networks in select geographies.

Group Insurance primarily includes group life insurance and group disability products. Group life insurance products are offered on an Insured basis. Group disability products are offered to employers on both an Insured and an ASC basis. Group Insurance also includes long-term care products that were offered primarily on an Insured basis. We no longer solicit or accept new long-term care customers.

Large Case Pensions manages a variety of retirement products (including pension and annuity products) primarily for tax-qualified pension plans. These products provide a variety of funding and benefit payment distribution options and other services. Large Case Pensions also includes certain discontinued products (refer to Note 17 beginning on page 3616 for additional information).

2.Summary of Significant Accounting Policies

Interim Financial StatementsBasis of Presentation
The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial reporting. Accordingly, they do not include all of the information and footnotes required by GAAP for annual financial statements. We have omitted certain footnote disclosures that would substantially duplicate the disclosures in our 2016 Annual Report on Form 10-K (our “2016 Annual Report”), unless the information contained in those disclosures materially changed or is required by GAAP. The accompanying unaudited consolidated financial statements and related condensed notes should be read in conjunction with the consolidated financial statements and related notes presented in our 2016 Annual Report.

These interim financial statements necessarily rely on estimates, including assumptions as to annualized tax rates.  In the opinion of management, all adjustments necessary for a fair statement of results for the interim periods have been made.  All such adjustments are of a normal, recurring nature.  The accompanying unaudited consolidated financial statements and related notes should be read in conjunction with the consolidated financial statements and related notes presented in our 2015 Annual Report on Form 10-K (our “2015 Annual Report”).  Certain financial information that is normally included in annual financial statements prepared in accordance with U.S. generally accepted accounting principles (“GAAP”), but that is not required for interim reporting purposes, has been condensed or omitted.  We have omitted certain footnote disclosures that would substantially duplicate the disclosures in our 2015 Annual Report, unless the information contained in those disclosures materially changed and is required by GAAP.  The Company has evaluated subsequent events that occurred after March 31, 20162017 through the date the financial statements were issued and determined there were no subsequent events to disclose other than as disclosed in Note 11 beginning on page 26.disclose.

Reclassifications
Certain reclassifications were made to 20152016 financial information to conform with the 20162017 presentation.

Principles of Consolidation
The accompanying unaudited consolidated financial statements have been prepared in accordance with GAAP and include the accounts of Aetna and the subsidiaries we control.  All significant intercompany balances have been eliminated in consolidation.



New Accounting Standards
AccountingSimplifying the Test for Share-Based Payments When the Terms of an Award Provide That a Performance Target Could Be Achieved after the Requisite Service PeriodGoodwill Impairment
Effective January 1, 2016,2017, we adopted, on a prospective basis, new accounting guidance related towhich simplifies the accounting for share-based payments when the terms of an award provide that a performance target could be achieved after the requisite service period. This guidance clarifies that awards with these provisions should be treated as performance conditions that affect vesting, and do not impact the award’s estimated grant-date fair value. The adoption of this new guidance did not have an impact on our financial position or operating results.

Determining Whether the Host Contract in a Hybrid Financial Instrument Issued in the Form of a Share Is More Akin to Debt or to Equity
Effective January 1, 2016, we adopted new accounting guidance related to the approach used in determining whether the host contract in a hybrid financial instrument issued in the form of a share is more akin to debt or equity. The adoption of this new guidance did not have a material impact on our financial position or operating results.

Simplifying Income Statement Presentation by Eliminating the Concept of Extraordinary Items
Effective January 1, 2016, we adopted new accounting guidance related to the presentation of extraordinary items. The amendment eliminates the concept of extraordinary items, which are events that are both unusual and infrequent. Presentation and disclosure of items that are unusual or infrequent will be retained, and will be expanded to include items that are both unusual and infrequent. The adoption of this new guidance did not have a material impact on our financial position or operating results.

Amendments to the Consolidation Analysis
Effective January 1, 2016, we adopted new accounting guidance related to the evaluation of consolidation for certain legal entities. The amendment changes how a reporting entity assesses consolidation, including whether an entity is considered a variable interest entity, determination of the primary beneficiary and how related parties are considered in the analysis. The adoption of this new guidance required more of our other investments to be considered variable interest entities; however, it did not require additional investments to be consolidated or de-consolidated or have a material impact on our financial position or operating results. Our variable interest entity disclosures as of December 31, 2015 were retrospectively adjusted to conform with the new accounting guidance. Refer to Note 6 beginning on page 11 for further discussion.

Simplifying the Presentation of Debt Issuance Costs
Effective January 1, 2016, we adopted new accounting guidance related to the financial statement presentation of all debt issuance costs, including those related to line-of-credit arrangements. The amendment requires debt issuance costs to be presented as a direct deduction from the carrying amount of our debt liability, consistent with the approach used for debt premiums or discounts. We also elected to report debt issuance costs associated with any line-of-credit arrangements as a direct deduction from the carrying amount of our debt liability. Amortization of debt issuance costs also will be reported in our statements of income in interest expense, as opposed to general and administrative expenses. We are applying this new guidance on a full retrospective basis, with all prior periods restated for the new presentation. The adoption of this new guidance requires certain reclassifications in our financial statements and did not have a material impact on our financial position or operating results. As a result of adopting this guidance, we reclassified $41 million and $43 million of other current and long-term assets as a reduction of long-term debt on our balance sheets at March 31, 2016 and December 31, 2015, respectively. Additionally, we reclassified an immaterial amount of general and administrative expenses into interest expense for the three months ended March 31, 2016 and 2015.

Customer’s Accounting for Fees Paid in a Cloud Computing Arrangement
Effective January 1, 2016, we adopted new accounting guidance related to the evaluation of fees paid by a customer in a cloud computing arrangement. The amendment provides additional guidance that aids in determining whether a cloud computing arrangement contains a software license. Arrangements that do not contain a software license must be accounted for as a service contract. If a software license is included in the cloud computing arrangement, the


license element must be accounted for consistent with the acquisition of a software license. The adoption of this new guidance did not have a material impact on our financial position or operating results.

Disclosures for Investments in Certain Entities That Calculate Net Asset Value per Share (or Its Equivalent)
Effective January 1, 2016, we adopted new accounting guidance related to the presentation of investments in certain entities that calculate net asset value per share (or its equivalent). The amendment removes the requirement to categorize within the fair value hierarchy all investments for which fair value is measured using the net asset value per share practical expedient. This new guidance is applicable to certain of our investments that reside in our separate accounts and employee benefit plans. The adoption of this new guidance did not have a material impact on our financial position or operating results.

Simplifying the Accounting for Measurement-Period Adjustments
Effective January 1, 2016, we adopted new accounting guidance related to the recognition of adjustments to provisional amounts that are identified during the measurement period in a business combination.goodwill impairment. The new guidance eliminates the requirement to retrospectively account for measurement-period adjustments as partcalculate the implied fair value of goodwill to measure a goodwill impairment charge. A goodwill impairment charge would be recognized if the carrying amount of a business combination and permits such adjustments to be recognized inreporting unit exceeds the period in which the adjustment was determined. The adoption of this new guidance did not have a material impact on our financial position or operating results.

Future Application of Accounting Standards
Disclosure of Uncertainties About an Entity’s Ability to Continue as a Going Concern
Effective December 31, 2016, we will adopt new accounting guidance related to management’s evaluation of whether there is substantial doubt about an entity’s ability to continue as a going concern and the related disclosures. The adoption of this new guidance will not have a material impact on our financial position or operating results.

Disclosures about Short-Duration Insurance Contracts
Effective December 31, 2016, we will adopt new accounting guidance related to the disclosure of short-duration insurance contracts. The amendment requires insurance companies that issue short-duration contracts to include additional disclosures about those insurance liabilities, including disaggregation of certain disclosures, as appropriate. The adoption of this new guidance will not have a material impact on our financial position or operating results, however, the new guidance will require additional disclosure for our short-duration insurance liabilities that reside in our Health Care and Group Insurance segments.

Effect of Derivative Contract Novations on Existing Hedge Accounting Relationships
Effective January 1, 2017, we will adopt new accounting guidance clarifying that the novation of a derivative contract in a hedge accounting relationship does not, in and of itself, require dedesignationestimated fair value of the hedge accounting relationship.reporting unit. The adoption of this new guidance is not expected to have a material impact on our financial position or operating results.

Contingent PutClassification of Certain Cash Receipts and Call OptionsCash Payments in Debt Instrumentsthe Statement of Cash Flows
Effective January 1, 2017, we will adoptadopted, on a retrospective basis, new accounting guidance related towhich clarifies the assessmentclassification of embedded contingent put or call optionscertain cash receipts and cash payments in debt instruments. The new guidance clarifies that assessmentour Consolidated Statements of whether an embedded contingent put or call option is clearlyCash Flows. As a result, certain cash distributions received from our equity method investments will now be classified as cash inflows from operating activities. These cash distributions previously were classified as cash inflows from investing activities. There were no material reclassifications in our Consolidated Statements of Cash Flows for the three months ended March 31, 2017 and closely related to the debt host requires only an analysisMarch 31, 2016 as a result of the four-step decision sequence. The adoption of this new guidance is not expected to have a material impact on our financial position or operating results.

Simplifying the Transition to the Equity Method of Accounting
Effective January 1, 2017, we will adopt new accounting guidance related to the accounting for investments that subsequently qualify for the equity method of accounting. The new accounting guidance eliminates the requirement that an entity retrospectively apply the equity method of accounting to an investment previously accounted for by another method when we subsequently obtain significant influence. The adoption of this new guidance is not expected to have a material impact on our financial position or operating results.guidance.



Improvements to Employee Share-Based PaymentFuture Application of Accounting
We will adopt new accounting guidance related to the accounting for and financial statement presentation of employee share-based payments. Under the new guidance, entities will be required to recognize all excess tax benefits and tax deficiencies as income tax benefit or expense in the income statement instead of in additional paid-in capital. The new guidance also revises the allowable number of shares an employer can withhold to satisfy the employer’s statutory income tax obligation and still qualify for equity classification on its balance sheets, permits an accounting policy election to recognize the forfeiture of share-based payment awards as they occur and provides clarification on certain statement of cash flow presentation requirements. The new guidance is effective January 1, 2017 with early adoption permitted during 2016, with any adjustments reflected as of January 1, 2016. We are currently assessing the impact of this new guidance on our financial position and operating results.

Standards
Revenue from Contracts with Customers
Effective January 1, 2018, we will adopt new accounting guidance related to revenue recognition from contracts with customers. This newWhile industry-specific guidance removesrelated to contracts with customers within the scope of Accounting Standards Codification (“ASC”) 944 Financial Services - Insurance remains unchanged, most other industry-specific revenue recognition requirements (insurance contracts are not covered by this guidance) andhave been removed. The new guidance requires that an entity recognize revenue for the transfer of goods or services to a customer at an amount that reflects the consideration to which an entity expects to be entitled in exchange for those goods or services. The new guidance also requires additional disclosures regarding the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts. TheWe currently anticipate adopting the new guidance allows an entity to adoptusing the standard either through a full retrospective approach or a modified retrospective approach with a cumulative effect adjustment to retained earnings. Early adoption of this new guidance is permitted as of January 1, 2017. WeWhile we are still assessingevaluating the impact of this new guidance on our financial position and operating results in additionstatements, we anticipate that any impact will only relate to evaluatingcontracts with customers outside the transition method we will use when we adoptscope of ASC Topic 944. Adoption of this new guidance.guidance could result in reclassifications within our Consolidated Statements of Income; however, we do not anticipate any material changes in the timing of our recognition of revenue or net income.

Recognition and Measurement of Financial Assets and Financial Liabilities
Effective January 1, 2018, we will adopt new accounting guidance related to the recognition and measurement of financial assets and financial liabilities. Under the new guidance, all equity investments in unconsolidated entities will be measured at fair value with changes in fair value recognized in net income. A reporting entity may elect to report equity investments without a readily determinable fair value at cost. The new guidance also revises certain disclosures regarding financial assets and liabilities. The adoption of this new guidance is not expected to have a material impact on our financial position or operating results.

Leases
Effective January 1, 2019, we will adopt new accounting guidance related to the recognition, measurement and disclosure requirements for leases. Under the new guidance, lessees will be required to recognize a right-of-use asset and corresponding lease liability on their balance sheets for all leases other than those that meet the definition of a short-term lease. The new guidance also revises certain disclosure requirements regarding leases. While we are still evaluating the impact of adoption of this new guidance, we anticipate that we will be required to record an asset and corresponding liability related to our operating leases (as described in Note 17 in our 2016 Annual Report) on our Consolidated Balance Sheets.

Accounting for Interest Associated with the Purchase of Callable Debt Securities
Effective January 1, 2019, we will adopt new accounting guidance related to the amortization of purchased callable debt securities held at a premium. Under the new guidance, premiums on callable debt securities are amortized to the earliest call date rather than to the contractual maturity date.  Callable debt securities held at a discount will continue to be amortized to the contractual maturity date. We are still assessing the impact of this new guidance on our financial position and operating results.

Measurement of Credit Losses on Financial Instruments
Effective January 1, 2020, we will adopt new accounting guidance related to the measurement of credit losses on financial assets and certain other instruments. The new guidance requires the use of a new forward-looking expected loss impairment model for trade and other receivables, held-to-maturity debt securities, loans and other instruments. The new guidance also requires impairments and recoveries for available-for-sale debt securities to be recorded through an allowance account and revises certain disclosure requirements. We are still assessing the impact of this new guidance on our financial position and operating results.

3.ProposedTerminated Acquisition of Humanaand Terminated Divestiture

On July 2, 2015, we entered into a definitive agreement (as it may be amended, the(the "Merger Agreement") to acquire Humana Inc. ("Humana"). On July 21, 2016, the U.S. Department of Justice (the “DOJ”) and certain state attorneys general filed a civil complaint in a transaction valued at approximately $37 billion, based on the closing priceU.S. District Court for the District of Aetna common shares on July 2, 2015, including the assumption of Humana debtColumbia (the “District Court”) against us and Humana cash and cash equivalents. Under the terms of the Merger Agreement, Humana stockholders will receive $125.00 in cash and 0.8375 Aetna common shares for each Humana share.

On October 19, 2015, Aetna and Humana each obtained the approval of their respective shareholders necessary forcharging that our proposed acquisition of Humana (the “Humana Acquisition”Transaction”).

The Humana Acquisition remains subject to customary closing conditions, including the expiration would violate Section 7 of the federal Hart-Scott-RodinoClayton Antitrust Improvements Act, of 1976 waiting period and approvals of state departments of insurance and other regulators, and therefore has not been reflected in these financial statements.seeking a permanent injunction to prevent Aetna from acquiring Humana. On January 23, 2017, the District Court granted the DOJ’s request to enjoin the Humana Transaction.



4.Earnings Per Common Share

Basic earnings per share (“EPS”On February 14, 2017, Aetna and Humana entered into a mutual termination agreement (the “Termination Agreement”) is computedpursuant to which the parties thereto (collectively the “Parties”) agreed to terminate the Merger Agreement, including all schedules and exhibits thereto, and all ancillary agreements contemplated thereby, entered pursuant thereto or entered in connection therewith (other than certain confidentiality agreements) (collectively with the Merger Agreement, the “Transaction Documents”), effective immediately as of February 14, 2017 (the “Termination Date”). Under the Termination Agreement, Aetna agreed to pay Humana the Regulatory Termination Fee (as defined in the Merger Agreement) of $1.0 billion in cash in full satisfaction of any amounts required to be paid by dividing net income attributableAetna under the Merger Agreement. The Parties also agreed to Aetna byrelease each other from any and all liability, claims, rights, actions, causes of action, suits, liens, obligations, accounts, debts, demands, agreements, promises, liabilities, controversies, costs, charges, damages, expenses and fees, however arising, in connection with, arising out of or related to the weighted average numberTransaction Documents, the transactions contemplated therein or thereby or certain related matters. We paid Humana the Regulatory Termination Fee on February 16, 2017 and recorded the expense in general and administrative expenses. We funded that payment with the proceeds of common shares outstanding during the reporting period.  Diluted EPS is computed in a similar manner, except that the weighted average number of common shares outstanding is adjusted for the dilutive effects of our outstanding stock-based compensation awards, but only if the effect is dilutive.2016 senior notes (as defined below).

The computationsIn June 2016, we issued $13.0 billion of basicsenior notes to partially fund the Humana Transaction (collectively, the “2016 senior notes”). In accordance with the terms of the 2016 senior notes, on February 14, 2017, we issued a notice of redemption for $10.2 billion aggregate principal amount of certain of the 2016 senior notes (collectively, the “Special Mandatory Redemption Notes”) at a redemption price equal to 101% of the aggregate principal amount of those notes plus accrued and diluted EPS forunpaid interest. We redeemed the Special Mandatory Redemption Notes on March 16, 2017, and we funded the redemption with the proceeds of the 2016 senior notes. As a result of the redemption of the Special Mandatory Redemption Notes, we recognized certain costs in our net income during the three months ended March 31, 2016 and 2015 are as follows:
 Three Months Ended
 March 31,
(Millions, except per common share data)2016
 2015
Net income attributable to Aetna$726.6
 $777.5
Weighted average shares used to compute basic EPS350.7
 349.5
Dilutive effect of outstanding stock-based compensation awards2.4
 3.2
Weighted average shares used to compute diluted EPS353.1
 352.7
Basic EPS$2.07
 $2.22
Diluted EPS$2.06
 $2.20
    
2017. Refer to Note 8 for additional information.

In order to address the DOJ’s perceived competitive concerns regarding Medicare Advantage relating to the Humana Transaction, on August 2, 2016, we entered into a definitive agreement (the “Aetna APA”) to sell for cash to Molina Healthcare, Inc. (“Molina”) certain of our Medicare Advantage assets. On February 14, 2017, Aetna and Molina entered into a Termination Agreement (the “APA Termination Agreement”) pursuant to which Aetna terminated the Aetna APA, including all schedules and exhibits thereto, and all ancillary agreements contemplated thereby or entered pursuant thereto. Under the APA Termination Agreement, Aetna agreed to pay Molina in cash (a) a termination fee of $53 million and (b) approximately 70% of Molina’s transaction costs. We paid Molina the termination fee on February 16, 2017 and the applicable transaction costs of $7 million on February 27, 2017 and recorded the expense in general and administrative expenses. The stock-based compensation awards excluded frompayments were funded with the calculationproceeds of diluted EPS for the three months ended March 31, 2016 and 2015 are as follows: senior notes.
 Three Months Ended
 March 31,
(Millions)2016
 2015
Stock appreciation rights (“SARs”) (1)
.2
 1.9
Other stock-based compensation awards (2)
.8
 1.1
    
(1)
SARs are excluded from the calculation of diluted EPS if the exercise price is greater than the average market price of Aetna common shares during the period (i.e., the awards are anti-dilutive).
(2)
Performance stock units ("PSUs"), certain market stock units ("MSUs") with performance conditions, and performance stock appreciation rights ("PSARs") are excluded from the calculation of diluted EPS if all necessary performance conditions have not been satisfied at the end of the reporting period.

5.     Operating Expenses4.    Investments

For the three months ended Total investments at March 31, 20162017 and 2015, selling expenses (which include broker commissions, the variable component of our internal sales force compensation and premium taxes) and general and administrative expensesDecember 31, 2016 were as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Selling expenses$421.1
 $414.9
General and administrative expenses:   
Salaries and related benefits1,252.4
 1,206.6
  Other general and administrative expenses  (1)
1,190.1
 1,194.0
Total general and administrative expenses2,442.5
 2,400.6
Total operating expenses$2,863.6
 $2,815.5
    
(1)
The three months ended March 31, 2016 and 2015 include estimated fees mandated by the ACA comprised primarily of the health insurer fee of $213.8 million and $218.7 million, respectively, and our estimated contribution to the funding of the ACA’s reinsurance program of $29.4 million and $53.6 million, respectively.


 March 31, 2017 December 31, 2016
(Millions)Current
 Long-term
 Total
 Current
 Long-term
 Total
Debt and equity securities available for sale$2,928
 $18,925
 $21,853
 $2,876
 $18,866
 $21,742
Mortgage loans151
 1,356
 1,507
 170
 1,341
 1,511
Other investments
 1,641
 1,641
 
 1,626
 1,626
Total investments$3,079
 $21,922
 $25,001
 $3,046
 $21,833
 $24,879

6.     Investments

Total investments at March 31, 2016 and December 31, 2015 were as follows:
 March 31, 2016 December 31, 2015
(Millions)Current
 Long-term
 Total
 Current
 Long-term
 Total
Debt and equity securities available for sale$2,987.0
 $19,120.6
 $22,107.6
 $2,877.1
 $18,445.9
 $21,323.0
Mortgage loans138.5
 1,367.7
 1,506.2
 126.9
 1,426.8
 1,553.7
Other investments2.3
 1,623.9
 1,626.2
 10.8
 1,792.1
 1,802.9
Total investments$3,127.8
 $22,112.2
 $25,240.0
 $3,014.8
 $21,664.8
 $24,679.6



Debt and Equity Securities
Debt and equity securities available for sale at March 31, 20162017 and December 31, 20152016 were as follows:
(Millions)
Amortized
Cost

 
Gross
Unrealized
Gains

 
Gross
Unrealized
Losses

 
Fair
Value

Amortized
Cost

 
Gross
Unrealized
Gains

 
Gross
Unrealized
Losses

 
Fair
Value

March 31, 2016        
March 31, 2017       
Debt securities:               
U.S. government securities$1,769.9
 $105.2
 $(.4)  $1,874.7
$1,595
 $49
 $
 $1,644
States, municipalities and political subdivisions4,960.2
 290.9
 (5.2)  5,245.9
4,886
 170
 (41) 5,015
U.S. corporate securities8,222.4
 501.3
 (50.7)  8,673.0
8,400
 394
 (44) 8,750
Foreign securities2,853.1
 194.4
 (28.3)  3,019.2
3,004
 180
 (17) 3,167
Residential mortgage-backed securities934.2
 23.7
 (1.7) 956.2
760
 9
 (7) 762
Commercial mortgage-backed securities1,275.2
 27.7
 (1.3)
(1) 
 1,301.6
1,331
 3
 (36) 1,298
Other asset-backed securities910.8
 6.3
 (29.0)
(1) 
 888.1
1,108
 9
 (5) 1,112
Redeemable preferred securities32.8
 8.7
 
  41.5
22
 5
 
 27
Total debt securities20,958.6
 1,158.2
 (116.6)  22,000.2
21,106
 819
 (150) 21,775
Equity securities96.4
 14.4
 (3.4)  107.4
69
 11
 (2) 78
Total debt and equity securities (2)
$21,055.0
 $1,172.6
 $(120.0)  $22,107.6
December 31, 2015 
  
  
   
Total debt and equity securities (1)(2)
$21,175
 $830
 $(152) $21,853
December 31, 2016 
  
  
  
Debt securities: 
  
  
   
 
  
  
  
U.S. government securities$1,803.5
 $68.8
 $(.6)  $1,871.7
$1,643
 $51
 $
 $1,694
States, municipalities and political subdivisions4,889.5
 244.3
 (9.3)  5,124.5
5,047
 152
 (61) 5,138
U.S. corporate securities7,981.5
 339.5
 (146.6)  8,174.4
8,145
 385
 (55) 8,475
Foreign securities2,910.2
 148.3
 (61.4)  2,997.1
2,958
 163
 (33) 3,088
Residential mortgage-backed securities914.6
 16.6
 (6.3) 924.9
793
 11
 (9) 795
Commercial mortgage-backed securities1,262.4
 17.2
 (9.0)
(1) 
 1,270.6
1,382
 5
 (39) 1,348
Other asset-backed securities910.4
 3.1
 (19.2)
(1) 
 894.3
1,077
 7
 (9) 1,075
Redeemable preferred securities33.0
 11.5
 
  44.5
22
 5
 
 27
Total debt securities20,705.1
 849.3
 (252.4)  21,302.0
21,067
 779
 (206) 21,640
Equity securities22.8
 4.1
 (5.9)  21.0
84
 20
 (2) 102
Total debt and equity securities (2)
$20,727.9
 $853.4
 $(258.3)  $21,323.0
Total debt and equity securities (1)(2)
$21,151
 $799
 $(208) $21,742
              
(1) 
At both March 31, 20162017 and December 31, 2015,2016, we held securities for which we previously recognized $4.9 million and $5.4 million, respectively,an immaterial amount of non-credit related impairments in accumulated other comprehensive loss. These securities each had aan immaterial amount of net unrealized capital gaingains at both March 31, 20162017 and December 31, 2015 of $1.5 million and $1.9 million, respectively.
2016.
(2) 
Investment risks associated with our experience-rated and discontinued products generally do not impact our operating results (refer to Note 17 beginning on page 3616 for additional information on our accounting for discontinued products).  At March 31, 2016,2017, debt and equity securities with a fair value of approximately $3.1$2.8 billion,, gross unrealized capital gains of $274.6$192 million and gross unrealized capital losses of $27.1$29 million and, at December 31, 2015,2016, debt and equity securities with a fair value of approximately $3.0$2.9 billion,, gross unrealized capital gains of $208.7$195 million and gross unrealized capital losses of $68.0$35 million were included in total debt and equity securities, but support our experience-rated and discontinued products.  Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive income.




The fair value of debt securities at March 31, 20162017 is shown below by contractual maturity.  Actual maturities may differ from contractual maturities because securities may be restructured, called or prepaid.prepaid, or we intend to sell a security prior to maturity.
(Millions)
Fair
Value

Amortized Cost
 
Fair
Value

Due to mature:    
Less than one year$1,277.2
$1,498
 $1,513
One year through five years6,411.3
6,948
 7,121
After five years through ten years5,295.3
4,775
 4,909
Greater than ten years5,870.5
4,686
 5,060
Residential mortgage-backed securities956.2
760
 762
Commercial mortgage-backed securities1,301.6
1,331
 1,298
Other asset-backed securities888.1
1,108
 1,112
Total$22,000.2
$21,106
 $21,775
 
Mortgage-Backed and Other Asset-Backed Securities
All of our residential mortgage-backed securities at March 31, 20162017 were issued by the Government National Mortgage Association, the Federal National Mortgage Association or the Federal Home Loan Mortgage Corporation and carry agency guarantees and explicit or implicit guarantees by the U.S. Government.  At March 31, 2016,2017, our residential mortgage-backed securities had an average credit quality rating of AAA and a weighted average duration of 3.94.7 years.

Our commercial mortgage-backed securities have underlying loans that are dispersed throughout the United States.  Significant market observable inputs used to value these securities include loss severity and probability of default.  At March 31, 2016,2017, these securities had an average credit quality rating of AA+AAA and a weighted average duration of 3.56.9 years.

Our other asset-backed securities have a variety of underlying collateral (e.g., automobile loans, credit card receivables, home equity loans and commercial loans).  Significant market observable inputs used to value these securities include the unemployment rate, loss severity and probability of default.  At March 31, 2016,2017, these securities had an average credit quality rating of AA- and a weighted average duration of 1.21.3 years.

Unrealized Capital Losses and Net Realized Capital Gains (Losses)
When a debt or equity security is in an unrealized capital loss position, we monitor the duration and severity of the loss to determine if sufficient market recovery can occur within a reasonable period of time.  We recognize an other-than-temporary impairment (“OTTI”) when we intend to sell a debt security that is in an unrealized capital loss position or if we determine a credit-related loss on a debt or equity security has occurred.



Summarized below are the debt and equity securities we held at March 31, 20162017 and December 31, 20152016 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 months Greater than 12 months 
Total (1)
Less than 12 months Greater than 12 months 
Total (1)
(Millions)
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

March 31, 2016           
(Millions, except number of securities)Number of Securities
 
Fair
Value

 
Unrealized
Losses

 Number of Securities
 
Fair
Value

 
Unrealized
Losses

 Number of Securities
 
Fair
Value

 
Unrealized
Losses

March 31, 2017                 
Debt securities:                            
U.S. government securities$5.5
 $.1
 $10.5
 $.3
 $16.0
 $.4
32
 $59
 $
 
 $
 $
 32
 $59
 $
States, municipalities and political subdivisions385.5
 2.1
 121.4
 3.1
 506.9
 5.2
530
 1,539
 38
 45
 87
 3
 575
 1,626
 41
U.S. corporate securities779.1
 27.5
 406.4
 23.2
 1,185.5
 50.7
1,210
 1,965
 35
 79
 78
 9
 1,289
 2,043
 44
Foreign securities376.7
 14.2
 211.3
 14.1
 588.0
 28.3
421
 693
 15
 42
 57
 2
 463
 750
 17
Residential mortgage-backed securities43.2
 .1
 124.4
 1.6
 167.6
 1.7
194
 431
 7
 102
 16
 
 296
 447
 7
Commercial mortgage-backed securities198.8
 1.0
 48.5
 .3
 247.3
 1.3
280
 1,025
 36
 
 
 
 280
 1,025
 36
Other asset-backed securities429.3
 22.8
 63.6
 6.2
 492.9
 29.0
239
 449
 3
 114
 102
 2
 353
 551
 5
Redeemable preferred securities1.4
 
 
 
 1.4
 
Total debt securities2,219.5
 67.8
 986.1
 48.8
 3,205.6
 116.6
2,906
 6,161
 134
 382
 340
 16
 3,288
 6,501
 150
Equity securities16.5
 2.6
 1.5
 .8
 18.0
 3.4
1
 4
 
 10
 2
 2
 11
 6
 2
Total debt and equity securities (1)
$2,236.0
 $70.4
 $987.6
 $49.6
 $3,223.6
 $120.0
2,907
 $6,165
 $134
 392
 $342
 $18
 3,299
 $6,507
 $152
December 31, 2015 
  
  
  
  
  
December 31, 2016   
  
    
  
    
  
Debt securities: 
  
  
  
  
  
   
  
    
  
    
  
U.S. government securities$66.8
 $.2
 $12.6
 $.4
 $79.4
 $.6
26
 $39
 $
 1
 $1
 $
 27
 $40
 $
States, municipalities and political subdivisions714.2
 6.1
 91.6
 3.2
 805.8
 9.3
865
 2,228
 58
 37
 75
 3
 902
 2,303
 61
U.S. corporate securities3,168.7
 130.8
 144.3
 15.8
 3,313.0
 146.6
1,428
 2,277
 44
 114
 101
 11
 1,542
 2,378
 55
Foreign securities1,102.4
 50.4
 89.2
 11.0
 1,191.6
 61.4
649
 970
 27
 62
 76
 6
 711
 1,046
 33
Residential mortgage-backed securities328.7
 2.9
 89.5
 3.4
 418.2
 6.3
188
 455
 8
 104
 17
 1
 292
 472
 9
Commercial mortgage-backed securities562.0
 8.6
 23.8
 .4
 585.8
 9.0
285
 1,038
 39
 3
 3
 
 288
 1,041
 39
Other asset-backed securities653.5
 15.6
 67.1
 3.6
 720.6
 19.2
226
 403
 4
 208
 177
 5
 434
 580
 9
Total debt securities6,596.3
 214.6
 518.1
 37.8
 7,114.4
 252.4
3,667
 7,410
 180
 529
 450
 26
 4,196
 7,860
 206
Equity securities
 5.0
 1.3
 .9
 1.3
 5.9
2
 3
 
 8
 3
 2
 10
 6
 2
Total debt and equity securities (1)
$6,596.3
 $219.6
 $519.4
 $38.7
 $7,115.7
 $258.3
3,669
 $7,413
 $180
 537
 $453
 $28
 4,206
 $7,866
 $208
                            
(1) 
At March 31, 20162017 and December 31, 20152016, debt and equity securities in an unrealized capital loss position of $27.129 million and $68.035 million, respectively, and with related fair value of $426.4794 million and $966.2890 million, respectively, related to experience-rated and discontinued products.

We reviewed the securities in the tables above and concluded that these are performing assets generating investment income to support the needs of our business. In performing this review, we considered factors such as the quality of the investment security based on research performed by our internal credit analysts and external rating agencies and the prospects of realizing the carrying value of the security based on the investment’s current prospects for recovery.  At March 31, 2016,2017, we did not intend to sell these securities, and we did not believe it was more likely than not that we would be required to sell these securities prior to anticipated recovery of their amortized cost basis.




The maturity dates for debt securities in an unrealized capital loss position at March 31, 20162017 were as follows:
 
Supporting discontinued and
experience-rated products
 
Supporting remaining
products
 Total
(Millions)
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

Due to mature:           
Less than one year$
 $
 $166.9
 $.6
 $166.9
 $.6
One year through five years26.6
 .5
 647.1
 9.0
 673.7
 9.5
After five years through ten years148.9
 5.9
 557.2
 20.3
 706.1
 26.2
Greater than ten years223.8
 18.5
 527.3
 29.8
 751.1
 48.3
Residential mortgage-backed securities
 
 167.6
 1.7
 167.6
 1.7
Commercial mortgage-backed securities19.9
 
 227.4
 1.3
 247.3
 1.3
Other asset-backed securities3.0
 
 489.9
 29.0
 492.9
 29.0
Total$422.2
 $24.9
 $2,783.4
 $91.7
 $3,205.6
 $116.6
            

Net realized capital (losses) gains for the three months ended March 31, 2016 and 2015, excluding amounts related to experience-rated contract holders and discontinued products, were as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
OTTI losses on debt securities recognized in earnings$(9.1) $(2.4)
Other net realized capital gains8.7
 10.5
Net realized capital (losses) gains$(.4) $8.1
The net realized capital losses for the three months ended March 31, 2016 were primarily attributable to yield-related OTTI on debt securities, substantially offset by gains from the sales of other investments. The net realized capital gains for the three months ended March 31, 2015 were primarily attributable to gains from the sales of debt securities.

We had no individually material realized capital losses on debt or equity securities that impacted our operating results during three months ended March 31, 2016 or 2015.

Excluding amounts related to experience-rated and discontinued products, proceeds from the sale of debt securities and the related gross realized capital gains and losses for the three months ended March 31, 2016 and 2015 were as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Proceeds on sales$1,582.4
 $945.9
Gross realized capital gains32.3
 24.9
Gross realized capital losses31.3
 8.8
    


 
Supporting discontinued and
experience-rated products
 
Supporting remaining
products
 Total
(Millions)
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

 
Fair
Value

 
Unrealized
Losses

Due to mature:           
Less than one year$7
 $
 $207
 $
 $214
 $
One year through five years47
 1
 1,612
 19
 1,659
 20
After five years through ten years252
 6
 1,095
 25
 1,347
 31
Greater than ten years261
 14
 997
 37
 1,258
 51
Residential mortgage-backed securities17
 
 430
 7
 447
 7
Commercial mortgage-backed securities182
 6
 843
 30
 1,025
 36
Other asset-backed securities27
 
 524
 5
 551
 5
Total$793
 $27
 $5,708
 $123
 $6,501
 $150
            

Mortgage Loans
Our mortgage loans are collateralized by commercial real estate.  During the three months ended March 31, 20162017 and 20152016 we had the following activity in our mortgage loan portfolio:
 Three Months Ended
 March 31,
(Millions)2016
 2015
New mortgage loans$12.2
 $12.7
Mortgage loans fully repaid48.3
 39.5
Mortgage loans foreclosed
 9.0
    

At March 31, 2016 and December 31, 2015, we had no material problem, restructured or potential problem mortgage loans. We also had no material impairment reserves on these loans at March 31, 2016 or December 31, 2015.
 Three Months Ended
 March 31,
(Millions)2017
 2016
New mortgage loans$54
 $12
Mortgage loans fully repaid48
 48
    
 
We assess our mortgage loans on a regular basis for credit impairments, and annually assign a credit quality indicator to each loan.  Our credit quality indicator is internally developed and categorizes our portfolio on a scale from 1 to 7.  Category 1 represents loans of superior quality, and Category 7 represents loans where collections are potentially at risk.  The vast majority of our mortgage loans fall into the Category 2 to 4 ratings.  These ratings represent loans where credit risk is minimal to acceptable; however, these loans may display some susceptibility to economic changes.  Categories 5 and 6 represent loans where credit risk is not substantial, but these loans warrant management’s close attention.  These indicators are based upon several factors, including current loan to value ratios, property condition, market trends, creditworthiness of the borrower and deal structure. At both March 31, 2016The vast majority of our mortgage loans fall into categories 2 to 4.
Category 1 - Represents loans of superior quality
Category 2 to 4 - Represents loans where credit risk is minimal to acceptable; however, these loans may display some susceptibility to economic changes.
Categories 5 and December 31, 2015 we did6 - Represents loans where credit risk is not have anysubstantial, but these loans in warrant management’s close attention.
Category 7. 7 - Represents loans where collections are potentially at risk and if necessary, an impairment is recorded.
Based upon our most recent assessments at March 31, 20162017 and December 31, 2015,2016, our mortgage loans were given the following credit quality indicators:
(In Millions, except credit ratings indicator)March 31, 2017
 December 31, 2016
1$44
 $45
2 to 41,446
 1,449
5 and 617
 17
7
 
Total$1,507
 $1,511
    



Net Investment Income
Sources of net investment income for the three months ended March 31, 2017 and 2016 were as follows:
 Three Months Ended
 March 31,
(Millions)2017
 2016
Debt securities$190
 $195
Mortgage loans22
 29
Other investments58
 4
Gross investment income270
 228
Investment expenses(10) (10)
Net investment income (1)
$260
 $218
    
(1)
Net investment income includes $66 million and $45 million for the three months ended March 31, 2017 and 2016, respectively, related to investments supporting our experience-rated and discontinued products.

Realized Capital Gains/Losses
Net realized capital losses for the three months ended March 31, 2017 and 2016, excluding amounts related to experience-rated contract holders and discontinued products, were as follows:
 Three Months Ended
 March 31,
(Millions)2017
 2016
Other-than-temporary impairment (“OTTI”) losses on debt securities recognized in earnings$(2) $(9)
Other net realized capital (losses) gains(331) 8
Net realized capital losses$(333) $(1)
The net realized capital losses for the three months ended March 31, 2017 were primarily attributable to the recognition into earnings of the entire unamortized effective portion of the related hedge losses upon the mandatory redemption of $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes and the redemption of $750 million aggregate principal amount of senior notes due 2020. The net realized capital losses for the three months ended March 31, 2016 were primarily attributable to yield-related OTTI on debt securities, substantially offset by gains from the sales of other investments.

We had no individually material realized capital losses on debt or equity securities that impacted our operating results during three months ended March 31, 2017 or 2016.

Excluding amounts related to experience-rated and discontinued products, proceeds from the sale of available for sale debt and equity securities and the related gross realized capital gains and losses for the three months ended March 31, 2017 and 2016 were as follows(1):
(In Millions, except credit ratings indicator)March 31,
2016

 December 31,
2015

1$50.7
 $65.8
2 to 41,434.7
 1,466.9
5 and 620.8
 21.0
Total$1,506.2
 $1,553.7
    
��Three Months Ended
 March 31,
(Millions)2017
 2016
Proceeds on sales$1,110
 $1,546
Gross realized capital gains21
 32
Gross realized capital losses14
 31
    
(1)
The proceeds on sales and gross realized capital gains and losses exclude the impact of the sales of short-term debt securities which primarily relate to our investments in mutual funds. These investments were excluded from the disclosed amounts because they represent an immaterial amount of aggregate gross realized capital gains or losses and have a high volume of sales activity.

Variable Interest Entities
As discussed in Note 2 beginning on page 6, we adopted the guidance of Accounting Standards Update (ASU) No. 2015-02, Amendments to the Consolidation Analysis (Topic 810) effective January 1, 2016. As a result of adopting the new guidance, weWe have investments in certain hedge fund and private equity investments and real estate partnerships that are considered Variable Interest Entities (“VIE’s”). We do not have a future obligation to fund losses or debts on behalf of these investments; however, we may voluntarily contribute funds.

In evaluating whether we are the primary beneficiary of a VIE, we considered several factors, including whether we (a) have the power to direct the activities that most significantly impact the VIE’s


economic performance and (b) the obligation to absorb losses and the right to receive benefits that could potentially be significant to the VIE.

Variable Interest Entities - Primary Beneficiary
Upon adoption of the new guidance, we identifiedWe have one hedge fund investment previously consolidated as a Voting Interest Entity in our statement of financial position and operating results that is determined to be a VIE under the new guidance. The investment represents a majority owned hedge fund investment where we are the investment manager and have the power to direct the activities that most significantly impact the VIE’s economic performance, including determining the hedge fund’s investment strategy. Accordingly, we are the primary beneficiary and will continue to consolidate the investment in our financialoperating results. The fund invests in additional hedge funds that are VIEs; however, we are not the primary beneficiary of these underlying funds as discussed in further detail below.



Substantially all of the assets of the VIE hedge fund are comprised of hedge fund investments reported as long-term investments on our balance sheets.Consolidated Balance Sheets. The VIE hedge fund had no material liabilities at March 31, 20162017 or December 31, 2015.2016. The total amount of the VIE hedge fund’s assets included in long term investments on our balance sheetsConsolidated Balance Sheets at March 31, 20162017 and December 31, 20152016 were $494$459 million and $477$472 million, respectively.

Variable Interest Entities - Other Variable Interest Holder
Our involvement with VIEs where we are not determined to be the primary beneficiary consistconsists of the following:

Hedge fund and private equity investments - We invest in hedge fund and private equity investments in order to generate investment returns for our investment portfolio supporting our businesses.

Real estate partnerships - We invest in various real estate partnerships including those that construct, own and manage low-income housing developments. For the low income housing development investments, substantially all of the projected benefits to us are from tax credits and other tax benefits.

We are not the primary beneficiary of these investments because the nature of our involvement with the activities of thethese VIEs does not give us the power to direct the activities that most significantly impact their economic performance. We record the amount of our investment in these VIEs as long-term investments on our balance sheetsConsolidated Balance Sheets and recognize our share of each VIE’s income or losses in earnings.  Our maximum exposure to loss from these VIEs is limited to our investment balances as disclosed below and the risk of recapture of tax credits related to the real estate partnerships previously recognized, which we do not consider significant.

The total amount of other variable interest holder VIE assets included in long term investments on our balance sheetsConsolidated Balance Sheets at March 31, 20162017 and December 31, 20152016 were as follows:
(Millions) March 31, 2016
 December 31, 2015
 March 31, 2017
 December 31, 2016
Hedge fund investments $425.1
 $418.1
 $355
 $384
Private equity investments 438.8
 443.3
 497
 454
Real estate partnerships 264.5
 253.3
 263
 278
Total $1,128.4
 $1,114.7
 $1,115
 $1,116



The carrying value of the total assets and liabilities of our other variable interest holder VIE investments at March 31, 20162017 and December 31, 20152016 were as follows:
(Millions) March 31, 2016
 December 31, 2015
Assets:    
Hedge fund investments $34,375.0
 $33,065.7
Private equity investments 28,075.4
 28,552.5
Real estate partnerships 6,699.3
 6,808.7
Total $69,149.7
 $68,426.9
     
Liabilities:    
Hedge fund investments $4,048.4
 $3,535.3
Private equity investments 3,236.0
 3,235.7
Real estate partnerships 5,005.1
 5,044.5
Total $12,289.5
 $11,815.5


(Millions) March 31, 2017
 December 31, 2016
Assets:    
Hedge fund investments $34,203
 $32,926
Private equity investments 26,819
 25,368
Real estate partnerships 6,549
 6,743
Total $67,571
 $65,037
     
Liabilities:    
Hedge fund investments $3,464
 $2,819
Private equity investments 3,353
 2,354
Real estate partnerships 4,727
 4,938
Total $11,544
 $10,111

Non-controlling (Minority) Interests
At March 31, 20162017 and December 31, 2015,2016, continuing business non-controlling interests were $65$77 million and $64$62 million, respectively, primarily related to third party interests in our investment holdings as well as third party interests in certain of our operating entities. The non-controlling entities’ share was included in total equity. Net income attributable to non-controlling interests was $1.3$2 million for the three months ended March 31, 2016. Net loss attributable to non-controlling interests was $1.2and $1 million for the three months ended March 31, 2015.2017 and 2016, respectively. These non-controlling interests did not have a material impact on our financial position or operating results.

Net Investment Income
Sources of net investment income for the three months ended March 31, 2016 and 2015 were as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Debt securities$194.9
 $196.4
Mortgage loans29.1
 21.9
Other investments3.8
 23.9
Gross investment income227.8
 242.2
Investment expenses(10.1) (9.3)
Net investment income (1)
$217.7
 $232.9
    
(1)
Net investment income includes $44.7 million and $66.6 million for the three months ended March 31, 2016 and 2015, respectively, related to investments supporting our experience-rated and discontinued products.

7.    Health Care Reform’s Reinsurance, Risk Adjustment and Risk Corridor (the “3Rs”)

We participate in certain public health insurance exchanges (“Public Exchanges”) established pursuant to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (as amended, collectively, “Health Care Reform” or the “ACA”). Under regulations established by the U.S. Department of Health and Human Services (“HHS”), HHS pays us a portion of the premium (“Premium Subsidy”) and a portion of the health care costs (“Cost Sharing Subsidy”) for low-income individual Public Exchange members. In addition, HHS administers the 3Rs risk management programs.

Our net receivable (payable) related to the 3Rs risk management programs at March 31, 2016 and December 31, 2015 were as follows:
  As of March 31, 2016 As of December 31, 2015
(Millions) Reinsurance Risk Adjustment Risk Corridor Reinsurance Risk Adjustment Risk Corridor
Current $291.9
 $(698.9) $(.7) $394.5
 $(710.2) $(8.1)
Long-term 1.9
 (177.7) 
 
 
 
Total net receivable (payable)$293.8
 $(876.6) $(.7) $394.5
 $(710.2) $(8.1)
             

At March 31, 2016, we did not record any ACA risk corridor receivables related to the 2016 or 2015 program years or any amount in excess of the prorated 12.6% HHS funding amount received for the 2014 program year, because payments from HHS are uncertain.

We expect to perform an annual final reconciliation and settlement with HHS of the Cost Sharing Subsidy and the 3Rs in each subsequent year.



8.    Other Comprehensive (Loss) Income

Shareholders’ equity included the following activity in accumulated other comprehensive loss for the three months ended March 31, 2016 and 2015:
 Net Unrealized Gains (Losses) Pension and OPEB Plans Total
Accumulated
Other
Comprehensive
(Loss) Income

 Securities Foreign
Currency
and
Derivatives

     
(Millions)
Previously
Impaired (1)

 All Other
 
Unrecognized
Net Actuarial
Losses
 
Unrecognized
Prior Service
Credit
  
Three months ended March 31, 2016          
Balance at December 31, 2015$18.7
 $312.4
 $(74.0) $(1,602.3) $14.9
 $(1,330.3)
Other comprehensive (loss) income           
  before reclassifications(2.7) 206.3
 (160.1) 
 
 43.5
Amounts reclassified from accumulated          
  other comprehensive income3.4
(2 
) 
15.2
(2 
) 
3.6
(3 
) 
10.4
(4 
) 
(.7)
(4 
) 
31.9
Other comprehensive income (loss).7
 221.5
 (156.5) 10.4
 (.7) 75.4
Balance at March 31, 2016$19.4
 $533.9
 $(230.5) $(1,591.9) $14.2
 $(1,254.9)
Three months ended March 31, 2015  
  
  
  
  
Balance at December 31, 2014$34.9
 $568.0
 $(60.9) $(1,670.9) $17.6
 $(1,111.3)
Other comprehensive (loss) income           
  before reclassifications(2.2) 77.9
 (13.9) 
 
 61.8
Amounts reclassified from accumulated          
  other comprehensive income(1.6)
(2 
) 
7.2
(2 
) 
1.0
(3 
) 
10.5
(4 
) 
(.7)
(4 
) 
16.4
Other comprehensive (loss) income(3.8) 85.1
 (12.9) 10.5
 (.7) 78.2
Balance at March 31, 2015$31.1
 $653.1
 $(73.8) $(1,660.4) $16.9
 $(1,033.1)
            
(1)
Represents unrealized gains on the non-credit related component of impaired debt securities that we do not intend to sell and subsequent changes in the fair value of any previously impaired security.
(2)
Reclassifications out of accumulated other comprehensive income for previously impaired debt securities and all other securities are reflected in net realized capital gains (losses) within the Consolidated Statements of Income.
(3)
Reclassifications out of accumulated other comprehensive income for foreign currency gains (losses) and derivatives are reflected in net realized capital gains (losses) within the Consolidated Statements of Income, except for the effective portion of derivatives related to interest rate swaps which are reflected in interest expense and were not material during the three months ended March 31, 2016 or 2015. Refer to Note 11 beginning on page 26 for additional information.
(4)
Reclassifications out of accumulated other comprehensive income for pension and OPEB plan expenses are reflected in general and administrative expenses within the Consolidated Statements of Income. Refer to Note 10 beginning on page 26 for additional information.

Refer to the Consolidated Statements of Comprehensive Income on page 2 for additional information regarding reclassifications out of accumulated other comprehensive income on a pretax basis.

9.    Financial Instruments5.    Fair Value

The preparation of our consolidated financial statements in accordance with GAAP requires certain of our assets and liabilities to be reflected at their fair value, and others on another basis, such as an adjusted historical cost basis.  In this note, we provide details on the fair value of financial assets and liabilities and how we determine those fair values.  We present this information for those financial instruments that are measured at fair value for which the change in fair value impacts net income attributable to Aetna or other comprehensive income separately from other financial assets and liabilities.



Financial Instruments Measured at Fair Value in our Balance Sheets
Certain of our financial instruments are measured at fair value in our balance sheets.Consolidated Balance Sheets.  The fair values of these instruments are based on valuations that include inputs that can be classified within one of three levels of a hierarchy established by GAAP.  The following are the levels of the hierarchy and a brief description of the type of valuation information (“inputs”) that qualifies a financial asset or liability for each level:
Level 1 – Unadjusted quoted prices for identical assets or liabilities in active markets.
Level 2 – Inputs other than Level 1 that are based on observable market data.  These include: quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets, inputs that are observable that are not prices (such as interest rates and credit risks) and inputs that are derived from or corroborated by observable markets.
Level 3 – Developed from unobservable data, reflecting our own assumptions.

Financial assets and liabilities are classified based upon the lowest level of input that is significant to the valuation.  When quoted prices in active markets for identical assets and liabilities are available, we use these quoted market prices to determine the fair value of financial assets and liabilities and classify these assets and liabilities in Level 1.  In other cases where a quoted market price for identical assets and liabilities in an active market is either not available or not observable, we estimate fair value using valuation methodologies based on available and observable market information or by using a matrix pricing model.  These financial assets and liabilities would then be classified in Level 2.  If quoted market prices are not available, we determine fair value using broker quotes or an internal analysis of each investment’s financial performance and cash flow projections.  Thus, financial assets and liabilities may be classified in Level 3 even though there may be some significant inputs that may be observable.



The following is a description of the valuation methodologies used for our financial assets and liabilities that are measured at fair value, including the general classification of such assets and liabilities pursuant to the valuation hierarchy.

Debt Securities – Where quoted prices are available in an active market, our debt securities are classified in Level 1 of the fair value hierarchy.  Our Level 1 debt securities are comprised primarily of U.S. Treasury securities.

The fair values of our Level 2 debt securities are obtained using models such as matrix pricing, which use quoted market prices of debt securities with similar characteristics, or discounted cash flows to estimate fair value. We review these prices to ensure they are based on observable market inputs that include, but are not limited to, quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets and inputs that are observable but not prices (for example, interest rates and credit risks). We also review the methodologies and the assumptions used to calculate prices from these observable inputs. On a quarterly basis, we select a sample of our Level 2 debt securities’ prices and compare them to prices provided by a secondary source. Variances over a specified threshold are identified and reviewed to confirm the price provided by the primary source represents an appropriate estimate of fair value. In addition, our internal investment team consistently compares the prices obtained for select Level 2 debt securities to the team’s own independent estimates of fair value for those securities. We obtained one price for each of our Level 2 debt securities and did not adjust any of these prices at March 31, 20162017 or December 31, 2015.2016.



We also value certain debt securities using Level 3 inputs.  For Level 3 debt securities, fair values are determined by outside brokers or, in the case of certain private placement securities, are priced internally.  Outside brokers determine the value of these debt securities through a combination of their knowledge of the current pricing environment and market flows.  We obtained one non-binding broker quote for each of these Level 3 debt securities and did not adjust any of these quotes at March 31, 20162017 or December 31, 2015.2016.  The total fair value of our broker quoted debt securities was $79$110 million at March 31, 20162017 and $78$80 million at December 31, 2015.2016.  Examples of these broker quoted Level 3 debt securities include certain U.S. and foreign corporate securities and certain of our commercial mortgage-backed securities as well as other asset-backed securities.  For some of our private placement securities, our internal staff determines the value of these debt securities by analyzing spreads of corporate and sector indices as well as interest spreads of comparable public bonds.  Examples of these private placement Level 3 debt securities include certain U.S. and foreign securities and certain tax-exempt municipal securities.

Equity Securities – We currently have two classifications of equity securities: those that are publicly traded and those that are privately placed.  Our publicly-traded securities are classified in Level 1 because quoted prices are available for these securities in an active market. For privately-placed equity securities, there is no active market; therefore, we classify these securities in Level 3 because we price these securities through an internal analysis of each investment’s financial statements and cash flow projections. Significant unobservable inputs consist of earnings and revenue multiples, discount for lack of marketability and comparability adjustments. An increase or decrease in any of these unobservable inputs would result in a change in the fair value measurement, which may be significant.

Derivatives – Where quoted prices are available in an active market, our derivatives are classified in Level 1.  Certain of our derivative instruments are valued using models that primarily use market observable inputs and therefore are classified in Level 2 because they are traded in markets where quoted market prices are not readily available.



Financial assets and



There were no financial liabilities measured at fair value on a recurring basis in our balance sheetsConsolidated Balance Sheets at March 31, 20162017 and December 31, 20152016. Financial assets measured at fair value on a recurring basis in our Consolidated Balance Sheets at March 31, 2017 and December 31, 2016 were as follows:
              
(Millions)Level 1
 Level 2
 Level 3
 Total
Level 1
 Level 2
 Level 3
 Total
March 31, 2016       
March 31, 2017       
Assets:              
Debt securities:              
U.S. government securities$1,690.9
 $183.8
 $
 $1,874.7
$1,482
 $162
 $
 $1,644
States, municipalities and political subdivisions
 5,244.9
 1.0
 5,245.9

 5,014
 1
 5,015
U.S. corporate securities
 8,610.2
 62.8
 8,673.0

 8,671
 79
 8,750
Foreign securities
 2,993.3
 25.9
 3,019.2

 3,146
 21
 3,167
Residential mortgage-backed securities
 956.2
 
 956.2

 762
 
 762
Commercial mortgage-backed securities
 1,301.6
 
 1,301.6

 1,267
 31
 1,298
Other asset-backed securities
 888.1
 
 888.1

 1,106
 6
 1,112
Redeemable preferred securities
 38.9
 2.6
 41.5

 27
 
 27
Total debt securities1,690.9
 20,217.0
 92.3
 22,000.2
1,482
 20,155
 138
 21,775
Equity securities76.6
 
 30.8
 107.4
47
 
 31
 78
Derivatives
 .9
 
 .9
Total$1,767.5
 $20,217.9
 $123.1
 $22,108.5
$1,529
 $20,155
 $169
 $21,853
Liabilities: 
  
  
  
Derivatives$
 $324.4
 $
 $324.4
December 31, 2015 
  
  
  
December 31, 2016 
  
  
  
Assets: 
  
  
  
 
  
  
  
Debt securities: 
  
  
  
 
  
  
  
U.S. government securities$1,671.0
 $200.7
 $
 $1,871.7
$1,514
 $180
 $
 $1,694
States, municipalities and political subdivisions
 5,123.4
 1.1
 5,124.5

 5,137
 1
 5,138
U.S. corporate securities
 8,110.5
 63.9
 8,174.4

 8,395
 80
 8,475
Foreign securities
 2,972.3
 24.8
 2,997.1

 3,067
 21
 3,088
Residential mortgage-backed securities
 924.9
 
 924.9

 795
 
 795
Commercial mortgage-backed securities
 1,270.6
 
 1,270.6

 1,348
 
 1,348
Other asset-backed securities
 894.3
 
 894.3

 1,075
 
 1,075
Redeemable preferred securities
 39.0
 5.5
 44.5

 26
 1
 27
Total debt securities1,671.0
 19,535.7
 95.3
 21,302.0
1,514
 20,023
 103
 21,640
Equity securities1.7
 
 19.3
 21.0
59
 
 43
 102
Derivatives
 19.7
 
 19.7
Total$1,672.7
 $19,555.4
 $114.6
 $21,342.7
$1,573
 $20,023
 $146
 $21,742
Liabilities: 
  
  
  
Derivatives$
 $88.3
 $
 $88.3

There were no transfers between Levels 1 and 2 during the three months ended March 31, 20162017 or 2015.2016. During the three months ended March 31, 20162017 and 2015,2016, we had an immaterial amount of gross transfers into and out of Level 3.

3 financial assets.


Financial Instruments Not Measured at Fair Value in our Balance Sheets
The following is a description of the valuation methodologies used for estimating the fair value of our financial assets and liabilities that are carried on our balance sheetsConsolidated Balance Sheets at adjusted cost or contract value.

Mortgage loans: Fair values are estimated by discounting expected mortgage loan cash flows at market rates that reflect the rates at which similar loans would be made to similar borrowers.  These rates reflect our assessment of the creditworthiness of the borrower and the remaining duration of the loans.  The fair value estimates of mortgage loans of lower credit quality, including problem and restructured loans, are based on the estimated fair value of the underlying collateral.

Bank loans: Where fair value is determined by quoted market prices of bank loans with similar characteristics, our bank loans are classified in Level 2. For bank loans classified in Level 3, fair value is determined by outside brokers using their internal analyses through a combination of their knowledge of the current pricing environment and market flows.

Equity securities: Certain of our equity securities are carried at cost. The fair values of our cost-method investments are not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment.

Investment contract liabilities:
With a fixed maturity:  Fair value is estimated by discounting cash flows at interest rates currently
being offered by, or available to, us for similar contracts.
Without a fixed maturity:  Fair value is estimated as the amount payable to the contract holder upon
demand.  However, we have the right under such contracts to delay payment of withdrawals that
may ultimately result in paying an amount different than that determined to be payable on demand.

Long-term debt: Fair values are based on quoted market prices for the same or similar issued debt or, if no quoted market prices are available, on the current rates estimated to be available to us for debt of similar terms and remaining maturities.



The carrying value and estimated fair value classified by level of fair value hierarchy for our financial instruments carried on our Consolidated Balance Sheets at adjusted cost or contract value at March 31, 20162017 and December 31, 20152016 were as follows:
Carrying
Value

  Estimated Fair Value
Carrying
Value

  Estimated Fair Value
(Millions) Level 1
Level 2
Level 3
Total
 Level 1
 Level 2
 Level 3
 Total
March 31, 2016   
March 31, 2017         
Assets:            
Mortgage loans$1,506.2
 $
$
$1,562.2
$1,562.2
$1,507
 $
 $
 $1,539
 $1,539
Bank loans11.1
 
1.9
8.1
10.0
8
 
 
 8
 8
Equity securities (1)
34.9
 N/A
N/A
N/A
N/A
45
 N/A
 N/A
 N/A
 N/A
Liabilities:            
Investment contract liabilities:            
With a fixed maturity8.7
 

8.7
8.7
8
 
 
 8
 8
Without a fixed maturity380.7
 

366.5
366.5
370
 
 
 354
 354
Long-term debt7,780.9
 
8,427.2

8,427.2
9,423
 
 10,128
 
 10,128
            
December 31, 2015    
(Millions)         
December 31, 2016         
Assets:             
Mortgage loans$1,553.7
 $
$
$1,598.7
1,598.7
$1,511
 $
 $
 $1,540
 $1,540
Bank loans192.8
 
179.9
7.6
187.5
8
 
 
 8
 8
Equity securities (1)
34.9
 N/A
N/A
N/A
N/A
35
 N/A
 N/A
 N/A
 N/A
Liabilities: 
   
 
        
Investment contract liabilities: 
   
 
        
With a fixed maturity8.6
 

8.6
8.6
8
 
 
 8
 8
Without a fixed maturity371.3
 

351.1
351.1
378
 
 
 364
 364
Long-term debt7,785.4
 
8,227.3

8,227.3
20,661
 
 21,468
 
 21,468
             
(1)  
It was not practical to estimate the fair value of these cost-method investments as it represents shares of unlisted companies.

Separate Accounts Measured at Fair Value in our Balance Sheets
Separate Accounts assets in our Large Case Pensions businesssegment represent funds maintained to meet specific objectives of contract holders.  Since contract holders bear the investment risk of these assets, a corresponding Separate Accounts liability has been established equal to the assets.  These assets and liabilities are carried at fair value.  Net investment income and capital gains and losses accrue directly to such contract holders.  The assets of each account are legally segregated and are not subject to claims arising from our other businesses.  Deposits, withdrawals, net investment income and realized and unrealized capital gains and losses on Separate Accounts assets are not reflected in our statementsConsolidated Statements of income, shareholders’ equityIncome, Shareholders’ Equity or cash flows.Cash Flows.

Separate Accounts assets include debt and equity securities and derivative instruments.  The valuation methodologies used for these assets are similar to the methodologies described beginning on page 20.in this Note 5.  Separate Accounts assets also include investments in common/collective trusts that are carried at fair value. Common/collective trusts invest in other investment funds otherwise known as the underlying funds. The Separate Accounts’ interests in the common/collective trust funds are based on the fair values of the investments of the underlying funds and therefore are classified in Level 2. The assets in the underlying funds primarily consist of equity securities. Investments in common/collective trust funds are valued at their respective net asset value per share/unit on the valuation date.



Separate Accounts financial assets at March 31, 20162017 and December 31, 20152016 were as follows:
March 31, 2016 December 31, 2015March 31, 2017 December 31, 2016
(Millions)Level 1
 Level 2
 Level 3
 Total
 Level 1
 Level 2
 Level 3
 Total
Level 1
 Level 2
 Level 3
 Total
 Level 1
 Level 2
 Level 3
 Total
Debt securities$778.4
 $2,305.4
 $4.4
 $3,088.2
 $750.4
 $2,382.0
 $3.8
 $3,136.2
$784
 $2,488
 $2
 $3,274
 $766
 $2,378
 $
 $3,144
Equity securities166.0
 5.5
 
 171.5
 169.8
 5.2
 
 175.0
147
 6
 
 153
 166
 6
 
 172
Derivatives
 (1.2) 
 (1.2) 
 .2
 
 .2
Common/collective trusts
 533.7
 
 533.7
 
 540.2
 
 540.2

 589
 
 589
 
 582
 
 582
Total (1)
$944.4
 $2,843.4
 $4.4
 $3,792.2
 $920.2
 $2,927.6
 $3.8
 $3,851.6
$931
 $3,083
 $2
 $4,016
 $932
 $2,966
 $
 $3,898
                              
(1) 
Excludes $225.7228 million and $183.593 million of cash and cash equivalents and other receivables at March 31, 20162017 and December 31, 20152016, respectively.

During the three months ended March 31, 20162017 and 2015,2016, we had an immaterial amount of Level 3 Separate Accounts financial assets.

Offsetting Financial Assets and Liabilities
Certain financial assets and liabilities are offset in our balance sheetsConsolidated Balance Sheets or are subject to master netting arrangements or similar agreements with the applicable counterparty. Financial assets, including derivative assets, subject to offsetting and enforceable master netting arrangements as of at March 31, 20162017 and December 31, 20152016 were as follows:
Gross Amounts of
Recognized Assets (1)
Gross Amounts Not Offset
in the Balance Sheets
 
Gross Amounts of
Recognized Assets (1)
 
Gross Amounts Not Offset
in the Balance Sheets
  
Financial InstrumentsCash Collateral Received  Financial Instruments Cash Collateral Received  
(Millions)Net Amount Net Amount
March 31, 2016 
March 31, 2017       
Derivatives$.9
$11.1
$(2.8)$9.2
$
 $17
 $
 $17
Total$.9
$11.1
$(2.8)$9.2
$
 $17
 $
 $17
        
December 31, 2015 
December 31, 2016       
Derivatives$19.7
$11.8
$(16.4)$15.1
$
 $17
 $
 $17
Total$19.7
$11.8
$(16.4)$15.1
$
 $17
 $
 $17
        
(1) There were no amounts offset in our balance sheetsConsolidated Balance Sheets at March 31, 20162017 or December 31, 20152016.

FinancialThere were no financial liabilities, including derivative liabilities, subject to offsetting and enforceable master netting arrangements as of at March 31, 20162017 and December 31, 2015 were as follows:2016.



6.     Health Care and Other Insurance Liabilities

Health Care Costs Payable
The following table shows the components of the change in health care costs payable during the three months ended March 31, 2017 and 2016:
 
Gross Amounts of
Recognized Liabilities (1)
Gross Amounts Not Offset
in the Balance Sheets
 
 Financial InstrumentsCash Collateral Paid 
(Millions)Net Amount
March 31, 2016    
Derivatives$324.4
$
$(282.7)$41.7
Total$324.4
$
$(282.7)$41.7
     
December 31, 2015    
Derivatives$88.3
$
$(90.7)$(2.4)
Total$88.3
$
$(90.7)$(2.4)
     
 Three Months Ended
 March 31,
(Millions)2017
 2016
Health care costs payable, beginning of the period$6,558
 $6,306
Less: Reinsurance recoverables5
 4
Health care costs payable, beginning of the period, net6,553
 6,302
Add: Components of incurred health care costs   
  Current year11,420
 11,475
  Prior years(614) (627)
Total incurred health care costs (1)
10,806
 10,848
    
Less: Claims paid   
  Current year6,298
 5,929
  Prior years4,742
 4,398
Total claims paid11,040
 10,327
    
Health care costs payable, end of period, net6,319
 6,823
Add: Premium deficiency reserve110
 
Add: Reinsurance recoverables3
 2
Health care costs payable, end of period$6,432
 $6,825
    
(1)
There were no amounts offset in our balance sheets atTotal incurred health care costs exclude from the table above $110 million related to the premium deficiency reserve recorded during the three months ended March 31, 2016 or December 31, 2015.2017 for the 2017 coverage year on our individual Commercial products.

Our estimates of prior years’ health care costs payable decreased by $614 million and $627 million in the three months ended March 31, 2017 and 2016, respectively, resulting from claims settled for amounts less than originally estimated, primarily due to lower health care cost trends as well as the actual claim submission time being faster than we assumed in establishing our health care costs payable in the prior year. This development does not directly correspond to an increase in our current year operating results as these reductions were offset by estimated current period health care costs when we established our estimate of the current year health care costs payable.

At March 31, 2017, total Health Care liabilities for the ultimate cost of medical claims that have been incurred but not yet reported to us and of those which have been reported to us but not yet paid (collectively, “IBNR”) plus expected development on reported claims totaled approximately $5.5 billion. The substantial majority of the total Health Care IBNR liabilities plus expected development on reported claims at March 31, 2017 related to the current year.


10.    Pension
Long-Term Disability Unpaid Claims
The following table shows the components of the change in unpaid long-term disability claims during the three months ended March 31, 2017 and Other Postretirement Plans2016:
  Three Months Ended
  March 31,
(Millions) 2017
 2016
Long-term disability unpaid claims beginning of the period $1,904
 $1,819
Less: Reinsurance recoverables 26
 27
Long-term disability unpaid claims, beginning of the period, net 1,878
 1,792
Add: Components of incurred claims    
  Current year 131
 137
  Prior years 5
 4
Total incurred claims 136
 141
Less: Claims paid    
  Current year 1
 1
  Prior years 134
 119
Total claims paid 135
 120
Long-term disability unpaid claims, end of period, net 1,879
 1,813
Add: Reinsurance recoverables 26
 27
Long-term disability unpaid claims, end of period $1,905
 $1,840

Defined Benefit Retirement Plans
ComponentsOur estimates of prior years’ long-term disability unpaid claims liability were relatively consistent with actual results in each of the three month periods ended March 31, 2017 and 2016.

The reconciliation of the long-term disability unpaid claims liability to the total unpaid claims liability in our Consolidated Balance Sheets is as follows at March 31, 2017 and 2016:
   At March 31,
(Millions) 2017
 2016
Long-term disability unpaid claims $1,905
 $1,840
Term life unpaid claims 472
 485
Other unpaid claims 118
 122
Total unpaid claims $2,495
 $2,447

7.    The ACA’s Reinsurance, Risk Adjustment and Risk Corridor (the “3Rs”)

We participate in certain public health insurance exchanges (“Public Exchanges”) established pursuant to the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (as amended, collectively, the “ACA”). Under regulations established by the U.S. Department of Health and Human Services (“HHS”), HHS pays us a portion of the premium (“Premium Subsidy”) and a portion of the health care costs (“Cost Sharing Subsidy”) for low-income individual Public Exchange members. In addition, HHS administers the 3Rs risk management programs. The ACA’s temporary Reinsurance and Risk Corridor programs expired at the end of 2016.

Our net periodic benefit (income) costreceivable (payable) related to the 3Rs risk management programs at March 31, 2017 and December 31, 2016 were as follows:
 At March 31, 2017 At December 31, 2016
(Millions)Reinsurance Risk Adjustment Risk Corridor Reinsurance Risk Adjustment Risk Corridor
Current$166
 $(696) $1
 $202
 $(690) $(10)
Long-term12
 (38) 
 
 
 
Total net receivable (payable)$178
 $(734) $1
 $202
 $(690) $(10)
            



At March 31, 2017, we estimate that we are entitled to receive a total of our defined benefit pension plans$529 million from HHS under the three-year ACA risk corridor program for the 2014 through 2016 program years. In November 2016, HHS announced that all 2015 ACA risk corridor collections will be used to pay a portion of the balances on the 2014 ACA risk corridor payments. At March 31, 2017 and other postretirement employee benefitDecember 31, 2016, we did not record any ACA risk corridor receivables related to the 2016 or 2015 program years or any amount in excess of the HHS’s announced pro-rated funding amount for the 2014 program year because payments from HHS are uncertain.

We expect to perform an annual final reconciliation and settlement with HHS of the Cost Sharing Subsidy and 3Rs in each subsequent year, except for the final reconciliation and settlement of the 2014 Cost Sharing Subsidy which occurred in 2016.

Fees Mandated by the ACA
Beginning January 1, 2014, the ACA imposes an annual premium-based health insurer fee (“OPEB”HIF”) plansfor each calendar year payable in September which is not deductible for tax purposes. In December 2015, the Consolidated Appropriation Act was enacted which included a one year suspension in 2017 of the HIF. Accordingly, there was no expense related to the HIF for the three months ended March 31, 2016 and 2015 were as follows:2017 compared with an expense of $214 million for the three months ended March 31, 2016.

 Pension Plans OPEB Plans
 Three Months Ended Three Months Ended
 March 31, March 31,
(Millions)2016
 2015
 2016
 2015
Amortization of prior service credit$(.1) $(.1) $(.9) $(.9)
Interest cost64.9
 65.2
 2.7
 2.7
Expected return on plan assets(97.3) (104.8) (.6) (.8)
Recognized net actuarial losses15.4
 15.4
 .6
 .7
Net periodic benefit (income) cost$(17.1) $(24.3) $1.8
 $1.7
        
Beginning January 1, 2014, the ACA established a temporary reinsurance program that expired at the end of 2016. Accordingly, there was no expense related to our estimated contribution for the funding of the ACA’s reinsurance program for the three months ended March 31, 2017 compared with an expense of $29 million for the three months ended March 31, 2016.

11.8.    Debt

Long Term Debt
The carrying value of our long-term debt at March 31, 20162017 and December 31, 20152016 was as follows:
(Millions)March 31,
2016

 December 31,
2015

Senior notes, 5.95%, due 2017 (1)
$398.4
 $402.4
Senior notes, 1.75%, due 2017249.3
 249.1
Senior notes, 1.5%, due 2017498.0
 497.7
Senior notes, 2.2%, due 2019373.1
 372.9
Senior notes, 3.95%, due 2020743.7
 743.4
Senior notes, 5.45%, due 2021671.5
 674.9
Senior notes, 4.125%, due 2021494.4
 494.1
Senior notes, 2.75%, due 2022983.8
 983.1
Senior notes, 3.5%, due 2024741.8
 741.6
Senior notes, 6.625%, due 2036765.0
 765.0
Senior notes, 6.75%, due 2037527.1
 527.0
Senior notes, 4.5%, due 2042477.3
 477.1
Senior notes, 4.125%, due 2042488.7
 488.6
Senior notes, 4.75%, due 2044370.5
 370.5
Total long-term debt7,782.6
 7,787.4
Less current portion of long-term debt398.4
 
Less credit facility issuance costs1.7
 2.0
Total long-term debt, less current portion and credit facility issuance costs$7,382.5
 $7,785.4
    
(Millions)March 31,
2017

 December 31,
2016

Senior notes, 5.95% due March 2017 (1)
$
 $386
Senior notes, 1.75% due May 2017 (1)
250
 250
Senior notes, 1.5% due November 2017 (1)
499
 499
Senior notes, floating rate due December 2017 (1)
499
 499
Senior notes, 1.7% due June 2018998
 997
Senior notes, 2.2% due March 2019374
 374
Senior notes, 1.9% due June 2019
 1,642
Senior notes, 3.95% due September 2020
 745
Senior notes, 2.4% due June 2021
 1,839
Senior notes, 5.45% due June 2021658
 661
Senior notes, 4.125% due June 2021496
 495
Senior notes, 2.75% due November 2022986
 986
Senior notes, 2.8% due June 20231,290
 1,290
Senior notes, 3.5% due November 2024743
 742
Senior notes, 3.2% due June 2026
 2,771
Senior notes, 4.25% due June 2036
 1,480
Senior notes, 6.625% due June 2036765
 765
Senior notes, 6.75% due December 2037527
 527
Senior notes, 4.5% due May 2042478
 478
Senior notes, 4.125% due November 2042489
 489
Senior notes, 4.75% due March 2044371
 371
Senior notes, 4.375% due June 2046
 2,375
Total long-term debt9,423
 20,661
Less current portion of long-term debt1,249
 1,634
Total long-term debt, less current portion$8,174
 $19,027
    


(1)
At March 31, 2017, our 1.75% senior notes due May 2017, 1.5% senior notes due November 2017 and our floating rate senior notes, due December 2017 are each classified as current in our Consolidated Balance Sheet. At December 31, 2016, our 5.95% senior notes due March 2017, 1.75% senior notes due May 2017, 1.5% senior notes due November 2017 and floating rate senior notes due December 2017 are each classified as current in our consolidated balance sheet.Consolidated Balance Sheet.

We are2016 Senior Notes
In June 2016, in connection with the Humana Transaction, we issued the 2016 senior notes, which were comprised of: $500 million of floating rate senior notes due December 2017, $1.0 billion of 1.7% senior notes due June 2018, approximately $1.7 billion of 1.9% senior notes due June 2019, approximately $1.9 billion of 2.4% senior notes due June 2021, $1.3 billion of 2.8% senior notes due June 2023, $2.8 billion of 3.2% senior notes due June 2026, $1.5 billion of 4.25% senior notes due June 2036 and $2.4 billion of 4.375% senior notes due June 2046.

Early Extinguishment of Long-Term Debt
Special Mandatory Redemption Notes
As a memberresult of the Federal Home Loan Banktermination of Boston (the “FHLBB”),the Merger Agreement, we redeemed the entire $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes, which were due in 2019, 2021, 2026, 2036 and as2046 at a memberredemption price equal to 101% of the aggregate principal amount of those notes plus accrued and unpaid interest. We redeemed those notes on March 16, 2017, and we havefunded the ability to obtain cash advances, subject to certain minimum collateral requirements. Our maximum borrowing capacity available fromredemption with the FHLBB at proceeds of the 2016 senior notes. As a result of the redemption, we recorded a loss on early extinguishment of long-term debt of $125 million ($192 million pretax) in the three months ended March 31, 2016 was $813 million. At both March 31, 2016 and December 31, 2015, we did not have any outstanding borrowings from the FHLBB.2017.

Cash Flow Hedges
DuringPrior to issuing the 2016 senior notes, during 2015 and the first quarter of 2016 we entered into various interest rate swaps and treasury rate locks with an aggregate notional value of $3.5 billion. We designated these swaps and treasury rate locks as cash flow hedges against interest rate exposure related to the forecasted future issuance of fixed-rate debt to be primarily used to finance a portion of the purchase price of the Humana Acquisition. At March 31, 2016, these interest rate swaps and


treasury rate locks had a pretax fair value loss of $223 million, which was reflected net of tax in accumulated other comprehensive loss within shareholders’ equity.

During the second quarter of 2016, we terminated interest rate swaps with an aggregate notional value of $750 million and paid an aggregate of $66 million to the swap counterparties upon termination. We performed a final effectiveness test upon the termination of each swap, and the effective portion of the hedge loss will remain in accumulated other comprehensive loss, net of tax, as the forecasted future issuance of fixed-rate debt associated with the Humana Acquisition remains probable of occurring. The hedge loss will be amortized as an increase to interest expense over a period consistent with the term of the hedged fixed-rate debt. Upon termination of the interest rate swaps, we concurrently entered into treasury rate locks with an aggregate notional value of $750 million to replace the vacated hedged positions. The treasury rate locksthat were designated as cash flow hedges against interest rate exposure related to the forecasted future issuance of fixed-rate debt to be primarily used to finance a portion of the purchase price of the Humana Acquisition.

Transaction. In March 2014,addition, we entered into tworedesignated existing interest rate swaps with an aggregate notional value of $500 million. We designated these swapsmillion as cash flow hedges against interest rate exposure related to the forecasted future issuance of fixed-rate debtfixed rate debt.

Prior to be primarily used to refinance long-term debt maturing in 2017. On September 30, 2015, we modified the timingissuance of the forecasted future issuance2016 senior notes in June 2016, we terminated all outstanding hedges and paid an aggregate of fixed-rate debt in conjunction with the expected timing of the financing of the Humana Acquisition and, as a result, we de-designated these swaps and re-designated them as cash flow hedges against interest rate exposure related$348 million to the forecasted future issuance of fixed-rate debt.hedge counter parties upon termination. The aggregate effective portion of the hedge loss of $73$342 million pretax remainswas recorded in accumulated other comprehensive loss, net of tax, and will be amortized as an increase to interest expense overtax. Upon the first 20 semi-annual interest payments related toredemption of the fixed-rate debt. At March 31, 2016, we performed a quarterly effectiveness testSpecial Mandatory Redemption Notes, the entire remaining unamortized effective portion of these swaps and determined there was $4the hedge loss of $323 million pretax of ineffectiveness. The ineffectivenessrecorded in accumulated other comprehensive loss was recordedrecognized as a realized capital loss in the first quarterthree months ended March 31, 2017.

2020 Notes
On February 27, 2017, we announced the redemption for cash of 2016.the entire $750 million aggregate principal amount outstanding of our 3.95% senior notes due September 1, 2020 (the “2020 Notes”). The redemption of these notes occurred on March 29, 2017 at a redemption price that included a make-whole premium, plus accrued and unpaid interest. We funded the redemption from available cash and short-term debt. As a result of the redemption, we recognized a loss on the early extinguishment of long-term debt of $35 million ($54 million pretax) in the three months ended March 31, 2017. Upon redemption of the 2020 Notes, the entire remaining unamortized effective portion of the re-designated swaps had a pretax fair valuehedge loss of $24$13 million at March 31, 2016, which was reflected netrelated to the issuance of taxthe 2020 Notes recorded in accumulated other comprehensive loss within shareholders’ equity.was recognized as a realized capital loss in the three months ended March 31, 2017.

Refer to Note 11 for additional information regarding hedge losses reclassified from accumulated other comprehensive loss to net income during the three months ended March 31, 2017.



Revolving Credit Facility
On March 27, 2012, we entered into an unsecured $1.5$1.5 billion five-year revolving credit agreement (the “Credit Agreement”) with several financial institutions. On September 24, 2012, and in connection with the acquisition of Coventry Health Care, Inc. (“Coventry”), we entered into a First Amendment (the “First Amendment”) to the Credit Agreement and also entered into an Incremental Commitment Agreement (the “Incremental Commitment Agreement”). On March 2, 2015, we entered into a Second Amendment to the Credit Agreement (the “Second Amendment”). On July 30, 2015, in connection with the Humana Acquisition,Transaction, we entered into a Third Amendment (the “Third Amendment”). On March 17, 2017 we entered into a Fourth Amendment to the Credit Agreement (the “Fourth Amendment,” and together with the First Amendment, the Incremental Commitment Agreement, the Second Amendment, the Third Amendment and the Credit Agreement, resulting in the “Facility”). The Facility is an unsecured $2.0 billion revolving credit agreement.agreement that matures on March 27, 2021. The Third Amendment permits us to increase the commitments available under the Facility from $2.0 billion to $3.0 billion upon our request and the satisfaction of certain conditions, including the completion of the transactions contemplated by the Merger Agreement and the termination of Humana’s existing credit agreement dated as of July 9, 2013 (“Humana’s Existing Credit Agreement”). The Third Amendment also modified the calculation of total debt for purposes of determining compliance prior to the closing date of the Humana AcquisitionTransaction (the “Closing Date”) with certain covenants to exclude debt incurred by us to finance the Humana Acquisition,Transaction, the other financing transactions related to the Humana AcquisitionTransaction and/or the payment of fees and expenses incurred in connection therewith so long as either (A) the net proceeds of such debt arewere set aside to finance the Humana Acquisition,Transaction, the other financing transactions related to the Humana AcquisitionTransaction and/or the payment of fees and expenses incurred in connection therewith or (B) such debt iswas subject to mandatory redemption in the event that the Merger Agreement is terminated or expires. Among other things, the Fourth Amendment extended the maturity date of the existing Credit Agreement to March 27, 2021, eliminated the availability of swingline loans, provided us with additional time on each business day to provide notice of borrowings and added customary provisions to reflect European Union “bail-in” directive legislation.

In addition, upon our agreement with one or more financial institutions, we may expand the commitments under the Facility by an additional $500 million. The Facility also provides for the issuance of up to $200$200 million of letters of credit at our request, which count as usage of the available commitments under the Facility. In each of 2013, 2014


and 2015 we extended the maturity date of the Facility by one year. The maturity date of the Facility is March 27, 2020.

Various interest rate options are available under the Facility.  Any revolving borrowings mature on the termination date of the Facility.  We pay facility fees on the Facility ranging from .050% to .150% per annum, depending upon our long-term senior unsecured debt rating.  The facility fee was .100% at March 31, 2016.2017.  The Facility contains a financial covenant that requires us to maintain a ratio of total debt to consolidated capitalization as of the end of each fiscal quarter at or below 50%.  For this purpose, consolidated capitalization equals the sum of total shareholders’ equity, excluding any overfunded or underfunded status of our pension and OPEB plans and any net unrealized capital gains and losses, and total debt (as defined in the Facility).  We met this requirement at March 31, 2016.  There were no amounts outstanding under the Facility at any time during the three months ended March 31, 2016 or 2015.

Bridge Credit Agreement
On July 30, 2015, we entered into a 364-day senior unsecured bridge credit agreement (the “Bridge Credit Agreement”) with a group of fifteen lenders. Under the Bridge Credit Agreement, we may borrow on an unsecured basis an aggregate principal amount of up to $13.0 billion, to the extent that we have not received $13.0 billion of net cash proceeds from issuing senior notes or from certain other transactions on or prior to the Closing Date. Any proceeds of the Bridge Credit Agreement are required to be used to fund the Humana Acquisition and to pay fees and expenses in connection with the Humana Acquisition. The lenders' undrawn commitments under the Bridge Credit Agreement will be automatically and permanently reduced in an amount equal to, and we also will be required to make prepayments of any outstanding loans under the Bridge Credit Agreement with, the (i) net cash proceeds from the issuance of debt of Aetna or any of its subsidiaries, (ii) net cash proceeds from the issuance of equity of Aetna and (iii) net cash proceeds in excess of $300 million we receive from non-ordinary course asset sales, in each case subject to certain exceptions. The lenders’ obligation to fund the loans under the Bridge Credit Agreement is subject to the satisfaction of certain conditions, including the completion of the transactions contemplated by the Merger Agreement, the termination of Humana’s Existing Credit Agreement and our having used commercially reasonable efforts to issue senior notes to provide funds to pay for the cash portion of the consideration payable under the Merger Agreement, to pay Aetna’s fees and expenses related to the Humana Acquisition and/or to refinance any loans made under the Bridge Credit Agreement. Any borrowings under the Bridge Credit Agreement mature 364 days after the Closing Date. The Bridge Credit Agreement contains a financial covenant that requires us to maintain a ratio of total debt to consolidated capitalization as of the end of each fiscal quarter at or below 50%.  For this purpose, consolidated capitalization equals the sum of total shareholders’ equity, excluding any overfunded or underfunded status of our pension and OPEB plans and any net unrealized capital gains and losses, and total debt (as defined in the Bridge Credit Agreement). For purposes of determining compliance prior to the Closing Date with certain covenants, total debt also excludes debt incurred by us to finance the Humana Acquisition, the other financing transactions related to the Humana Acquisition and/or the payment of fees and expenses incurred in connection therewith so long as either (A) the net proceeds of such debt are set aside to finance the Humana Acquisition, the other financing transactions related to the Humana Acquisition and/or the payment of fees and expenses incurred in connection therewith or (B) such debt is subject to mandatory redemption in the event that the Merger Agreement is terminated or expires. The Bridge Credit Agreement also contains a covenant limiting “Restricted Payments” (as defined in the Bridge Credit Agreement) by Aetna, subject to certain exceptions and baskets, including an exception permitting the payment of regular cash dividends.

Amounts outstanding under the Bridge Credit Agreement will bear interest, at our option, either (a) at the London Interbank Offered Rate (“LIBOR”); or (b) at the base rate (defined as the highest of (i) the prime rate, (ii) the federal funds effective rate plus 0.50% per annum and (iii) LIBOR for an interest period of one month plus 1.00% per annum), plus, in each case, the applicable LIBOR margin or base rate margin depending upon the ratings of our long-term senior unsecured debt. The minimum and maximum LIBOR margins are 0.75% and 1.25% per annum, respectively, and the minimum and maximum base rate margins are 0% and 0.25% per annum, respectively, provided, however, that the applicable margins will increase by 0.25% per annum on the 90th day following the Closing Date and by an additional 0.25% per annum each 90th day thereafter while loans remain outstanding under the Bridge Credit Agreement. We will also pay to each lender on each of the following dates a duration fee equal to


the following applicable percentages of the aggregate principal amount of such lender's loans outstanding under the Bridge Credit Agreement on such date: (i) 90 days after the Closing Date, 0.50%; (ii) 180 days after the Closing Date, 0.75%; and (iii) 270 days after the Closing Date, 1.00%Facility).  We will also pay the lenders certain other fees.met this requirement at March 31, 2017.  There were no amounts outstanding under the Bridge Credit AgreementFacility at any time during the three months ended March 31, 2017 or 2016.

Term Loan Agreement
On July 30, 2015, in connection with the Humana Transaction, we entered into a senior three-year $3.2 billion term loan credit agreement (the “Term Loan Agreement”) with a group of seventeen lenders. Under the Term Loan Agreement, we may borrow on an unsecured basis an aggregate principal amount of up to $3.2 billion. Any proceeds of the Term Loan Agreement are required to be used to fund the Humana Acquisition and to pay fees and expenses in connection with the Humana Acquisition. The lenders’ obligation to fund the loanscommitments under the Term Loan Agreement is subject to the satisfactionterminated on February 14, 2017, as a result of certain conditions, including the completion of the transactions contemplated by the Merger Agreement and the termination of Humana’s Existing Creditthe Merger Agreement. Any

Commercial Paper
At both March 31, 2017 and December 31, 2016, we did not have any commercial paper outstanding.

Federal Home Loan Bank of Boston
We are a member of the Federal Home Loan Bank of Boston (the “FHLBB”), and as a member we have the ability to obtain cash advances, subject to certain minimum collateral requirements. Our maximum borrowing capacity available from the FHLBB at March 31, 2017 was $801 million. At both March 31, 2017 and December 31, 2016, we did not have any outstanding borrowings underfrom the Term Loan Agreement matureFHLBB.



9.    Pension and Other Postretirement Plans

Defined Benefit Retirement Plans
Components of the net periodic benefit (income) cost of our defined benefit pension plans and other postretirement employee benefit (“OPEB”) plans for the three years after the Closing Date. The Term Loan Agreement contains a financial covenant that requires us to maintain a ratio of total debt to consolidated capitalizationmonths ended March 31, 2017 and 2016 were as follows:
 Pension Plans OPEB Plans
 Three Months Ended Three Months Ended
 March 31, March 31,
(Millions)2017
 2016
 2017
 2016
Amortization of prior service credit$
 $
 $(1) $(1)
Interest cost51
 65
 2
 3
Expected return on plan assets(95) (97) (1) (1)
Recognized net actuarial losses16
 15
 1
 1
Net periodic benefit (income) cost$(28) $(17) $1
 $2
        

Effective as of the endbeginning of each fiscal quarter at or below 50%. For this purpose, consolidated capitalization equals2017, we changed the sumapproach used to estimate the interest cost component of total shareholders’ equity, excluding any overfunded or underfunded status of ournet periodic benefit cost for pension and OPEB plans that utilize a yield curve approach. Historically, we estimated the interest cost using a single weighted average discount rate derived from the yield curve used to measure the projected benefit obligation. We have now elected to measure interest cost by applying the specific spot rates along that yield curve to the relevant projected cash flows for each component. We believe the new approach provides a more precise estimate of such interest cost. This refinement has no effect on the estimation of our plan obligations. We have accounted for this as a change in accounting estimate and, anyaccordingly, have accounted for it on a prospective basis beginning in 2017. The reduction in net unrealized capital gains and losses, and total debt (as definedperiodic benefit cost associated with this change in the Term Loan Agreement). For purposes of determining compliance prior to the Closing Date with certain covenants, total debt also excludes debt incurred by us to finance the Humana Acquisition, the other financing transactions related to the Humana Acquisition and/or the payment of fees and expenses incurred in connection therewith so long as either (A) the net proceeds of such debt are set aside to finance the Humana Acquisition, the other financing transactions related to the Humana Acquisition and/or the payment of fees and expenses incurred in connection therewith or (B) such debt is subject to mandatory redemption in the event that the Merger Agreement is terminated or expires. The Term Loan Agreement also contains a covenant limiting “Restricted Payments” (as defined in the Term Loan Agreement) by Aetna, subject to certain exceptions and baskets, including an exception permitting the payment of regular cash dividends.

Amounts outstanding under the Term Loan Agreement will bear interest, at our option, either (a) at LIBOR; or (b) at the base rate (defined as the highest of (i) the prime rate, (ii) the federal funds effective rate plus 0.50% per annum and (iii) LIBOR for an interest period of one month plus 1.00% per annum), plus, in each case, the applicable LIBOR margin or base rate margin depending upon the ratings of our long-term senior unsecured debt. The minimum and maximum LIBOR margins are 0.75% and 1.50% per annum, respectively, and the minimum and maximum base rate margins are 0.0% and 0.50% per annum, respectively. We will also pay the lenders certain other fees. There were no amounts outstanding under the Term Loan Agreement at any time during the three months ended March 31, 2016.2017 was $6 million ($10 million pre-tax). We expect this change to result in a reduction in net periodic benefit cost of approximately $26 million ($41 million pre-tax) for the full year 2017. For our pension benefits, the 2017 weighted-average discount rate for interest costs under the new approach adopted as of the beginning of 2017 is 3.51%. Under the prior methodology, the 2017 weighted-average discount rate would have been 4.22%.


12.    Capital Stock10.    Shareholders’ Equity

Share Repurchases
On November 21, 2014 and February 28, 2014, our Board of Directors (our “Board”) authorized two separate share repurchase programs of our common stock of up to $1.0 billion each.  We did notOn February 17, 2017, our Board approved a new share repurchase any sharesprogram that authorized us to repurchase up to $4.0 billion of our common stock during the three months ended March 31, 2016.  

stock. At March 31, 2016,2017, we had remaining authorization to repurchase an aggregate of up to approximately $1.1$1.8 billion of common stock under the November 21, 2014 and February 28, 2014 programs.17, 2017 program. The repurchases are effected from time to time in the open market, through negotiated transactions, including accelerated share repurchase agreements, and through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended.

On February 22, 2017, we entered into accelerated share repurchase (“ASR”) agreements with two unrelated third party financial institutions to repurchase an aggregate of $3.3 billion of Aetna’s common shares. Under the terms of the ASR agreements, we made an approximately $1.7 billion payment to each unrelated third party financial institution on February 22, 2017 and received from each of them an initial delivery of approximately 10.4 million of our common shares on the same day, which represents approximately 80 percent of the total common shares expected to be repurchased under the ASR agreements based on the closing price of $126.34 per share on the day before we entered into the ASR agreements. The final number of our common shares to be repurchased pursuant to the agreements will be based on the volume-weighted average share price of our common shares during the term of the applicable transaction, less a discount and subject to adjustments pursuant to the terms of the applicable ASR agreement. The final settlement of the transactions under the ASR agreements is expected to occur during or prior to the third quarter of 2017.

We recorded the initial delivery of our common shares as a decrease to retained earnings of approximately $2.6 billion, and recorded the remaining approximately $0.7 billion as a decrease to additional paid-in capital on our Consolidated Balance Sheets. We will reclassify the approximately $0.7 billion recorded as a reduction to additional paid-in capital to a reduction of retained earnings upon final settlement of the ASR agreements. The ASR agreements met all of the applicable criteria for equity classification, and therefore were not accounted for as derivative instruments.



Dividends
During the three months ended March 31, 20162017 our Board declared the following cash dividends:
Date Declared
Dividend Amount
Per Share
 
Stockholders of
Record Date
Date Paid/
To be Paid
Total Dividends
(Millions)
  
Dividend Amount
Per Share

 
Shareholders of
Record Date
 
Date Paid/
To be Paid
 
Total Dividends
(Millions)

February 19, 2016 $.25
April 14, 2016April 29, 2016 $87.6
February 17, 2017 $.50
 April 13, 2017 April 28, 2017 $166

Prior to completion of the Humana Acquisition, pursuant to the Merger Agreement, our regular quarterly cash dividend will not exceed $.25 per share. Our dividend policy following the completion of the Humana Acquisition will be determined by our Board. Declaration and payment of future dividends is at the discretion of our Board and may be adjusted as business needs or market conditions change.

Stock-based Employee Incentive Plans
On February 19, 2016, .317, 2017, 0.3 million PSUs, .9performance stock units (“PSUs”), 0.4 million restricted stock units (“RSUs”) and 2.22.1 million SARsstock appreciation rights (“SARs”) were granted to certain employees.  The number of vested PSUs (which could range from zero to 200% of the original number of units granted) is dependent upon the degree to which we achieve certain operating performance goals, as determined by our Board’s Committee on Compensation and Talent Management, during a three-year performance period which began January 1, 20162017 and ends on December 31, 2018.2019.  The vesting period for the PSUs ends on February 19, 2019.17, 2020. Each vested PSU and RSU represents one share of common stock and will be paid in shares of common stock, net of taxes, at the end of the applicable vesting period.  The RSUs generally will become 100% vested approximately three years from the grant date, with one-third vesting each December. The SARs, if exercised by the employee, will be settled in common stock, net of taxes, based on the appreciation of our common stock price over $103.45$125.27 per share, the closing price of our common stock on the grant date. SARs will generally become 100% vested approximately three years from the grant date, with one-third vesting on each anniversary of the grant date.

The SARs granted to certain employees during first quarters of 20162017 and 20152016 had an estimated fair market value of $34.33$32.30 and $32.13$34.33 per unit, respectively. The fair value per unit was calculated on each respective grant date using a modified Black-Scholes option pricing model using the following assumptions during the first quarters of 20162017 and 2015:2016:
2016
 2015
2017
 2016
Expected term (in years)7.11
 6.48
7.21
 7.11
Volatility32.9% 33.4%26.52% 32.9%
Risk-free interest rate1.52% 1.81%2.22% 1.52%
Dividend yield.91% 1.13%1.71% 0.91%
Initial price$103.45
 $100.50
$125.27
 $103.45
      

The expected term is based on historical equity award activity. Volatility is based on a weighted average of the historical volatility of our stock price and implied volatility from traded options on our stock. The risk-free interest rate is based on a U.S. Treasury rate with a life equal to the expected life of the SARs grant. This rate was calculated by interpolating between the 7-year and 10-year U.S. Treasury rates for both the first quarter of2017 and 2016 and the 5-year and 10-year U.S. Treasury rates for the first quarter of 2015.SARs grants. The dividend yield is based on our historicalexpected dividends infor the upcoming 12 months priorsubsequent to the grant date.

13.    Dividend Restrictions and Statutory Surplus

Regulatory Requirements
Under applicable regulatory requirements at March 31, 2016,2017, the amount of dividends that may be paid through the end of 20162017 by our insurance and HMO subsidiaries without prior approval by regulatory authorities was $1.4 billion in the aggregate. There are no such regulatory restrictions on distributions from Aetna to its shareholders. Prior to completion of the Humana Acquisition, pursuant to the Merger Agreement, Aetna is not permitted to declare, set aside or pay any dividend or other distribution other than a regular quarterly cash dividend in the ordinary course of business, which will not exceed $.25 per share. In addition, the Bridge Credit Agreement and Term Loan Agreement each contain a covenant limiting “Restricted Payments” (as defined in the applicable agreement) by Aetna, subject to certain exceptions and baskets, including an exception permitting the payment of


regular cash dividends. During the first quarter of 2016,2017, our insurance and HMO subsidiaries paid $635$460 million of dividends to the Company.

The aggregate statutory capital and surplus of our insurance and HMO subsidiaries was $10.0$10.3 billion and $9.9$10.4 billion at March 31, 20162017 and December 31, 2015,2016, respectively.




11.    Other Comprehensive (Loss) Income

Shareholders’ equity included the following activity in accumulated other comprehensive loss for three months ended March 31, 2017 and 2016:
  Three Months Ended
  March 31,
(Millions) 2017 2016
Previously impaired debt securities: (1)
    
Beginning of period balance $16
 $19
Net unrealized losses ($(2) and $(4) pretax)
 (1) (3)
Less: Net reclassification of losses to earnings ($(2) and $(5) pretax) (2)
 (1) (4)
Other comprehensive income 
 1
End of period balance 16
 20
     
All other securities:    
Beginning of period balance 297
 312
Net unrealized gains ($92 and $317 pretax)
 60
 206
Less: Net reclassification of gains (losses) to earnings ($25 and $(23) pretax) (2)
 16
 (15)
Other comprehensive income 44
 221
End of period balance 341
 533
     
Derivatives and foreign currency:    
Beginning of period balance (235) (74)
Net unrealized losses ($(2) and $(246) pretax)
 (1) (160)
Less: Net reclassification of losses to earnings ($(343) and $(6) pretax) (3)
 (223) (3)
Other comprehensive income (loss) 222
 (157)
End of period balance (13) (231)
     
Pension and OPEB plans:   
Beginning of period balance (1,630) (1,587)
Less: Net amortization of net actuarial losses ($(17) and $(16) pretax) (4)
 (11) (11)
Less: Net amortization of prior service credit ($2 and $1 pretax) (4)
 1
 1
Other comprehensive income 10
 10
End of period balance (1,620) (1,577)
     
Total beginning of period accumulated other comprehensive loss (1,552) (1,330)
Total other comprehensive loss 276
 75
Total end of period accumulated other comprehensive loss $(1,276) $(1,255)
(1)
Represents specifically identified unrealized gains and losses on the non-credit related component of impaired debt securities that we do not intend to sell and subsequent changes in the fair value of any previously impaired security.
(2)
Reclassifications out of accumulated other comprehensive income for specifically identified previously impaired debt securities and all other securities are reflected in net realized capital gains (losses) within the Consolidated Statements of Income.
(3)
Reclassifications out of accumulated other comprehensive income for specifically identified foreign currency gains (losses) and derivatives are reflected in net realized capital gains (losses) within the Consolidated Statements of Income, except for the specifically identified effective portion of derivatives related to interest rate swaps which are reflected in interest expense. During the three months ended March 31, 2017, we redeemed the entire $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes and the entire $750 million aggregate principal amount outstanding of the senior notes due 2020 and reclassified out of accumulated other comprehensive income the remaining $336 million pre-tax unrealized hedge losses as a realized capital loss within the Consolidated Statements of Income. Refer to Note 8 for additional information.
(4)
Reclassifications out of accumulated other comprehensive income for specifically identified pension and OPEB plan expenses are reflected in general and administrative expenses within the Consolidated Statements of Income. Refer to Note 9 for additional information.




12.Earnings Per Common Share

Basic earnings per common share (“EPS”) is computed by dividing net (loss) income attributable to Aetna by the weighted average number of common shares outstanding during the reporting period.  Diluted EPS is computed in a similar manner, except that the weighted average number of common shares outstanding is adjusted for the dilutive effects of our outstanding stock-based compensation awards, but only if the effect is dilutive.

The computations of basic and diluted EPS for the three months ended March 31, 2017 and 2016 are as follows:
 Three Months Ended
 March 31,
(Millions, except per common share data)2017
 2016
Net (loss) income attributable to Aetna$(381) $737
Weighted average shares used to compute basic EPS343.8
 350.7
Dilutive effect of outstanding stock-based compensation awards
 3.1
Weighted average shares used to compute diluted EPS343.8
 353.8
Basic EPS$(1.11) $2.10
Diluted EPS$(1.11) $2.08
    

The stock-based compensation awards excluded from the calculation of diluted EPS for the three months ended March 31, 2017 and 2016 are as follows:
 Three Months Ended
 March 31,
(Millions)2017
 2016
SARs (1)

 .2
Other stock-based compensation awards (2)
.9
 .8
In-the-money anti-dilutive stock-based compensation awards (3)
10.6
 
    
(1)
SARs are excluded from the calculation of diluted EPS if the exercise price is greater than the average market price of Aetna common shares during the period (i.e., the awards are anti-dilutive).
(2)
PSUs, certain market stock units with performance conditions, and performance stock appreciation rights are excluded from the calculation of diluted EPS if all necessary performance conditions have not been satisfied at the end of the reporting period.
(3)
In periods when we report a net loss attributable to Aetna, in-the-money stock-based compensation awards are excluded from our calculation of diluted EPS because their inclusion would have an anti-dilutive effect. Therefore we excluded from our calculation of diluted EPS for the three months ended March 31, 2017 in-the-money stock-based compensation awards which would have increased our weighted-average shares used to compute diluted EPS by 2.4 million shares.

13.     Reinsurance

In January 2017, we entered into two four-year reinsurance agreements with an unrelated reinsurer. The agreements allow us to reduce our required capital and provide collateralized excess of loss reinsurance coverage on a portion of our group Commercial Insured Health Care business.

14.    Commitments and Contingencies

Guaranty Fund Assessments, Market Stabilization and Other Non-Voluntary Risk Sharing Pools
Under guaranty fund laws existing in all states, insurers doing business in those states can be assessed (up(in most states up to prescribed limits) for certain obligations of insolvent insurance companies to policyholders and claimants. The life and health insurance guaranty associations in which we participate that operate under these laws respond to insolvencies of long-term care insurers as well as health insurers. Our assessments generally are based on a formula relating to our health care premiums in the state compared to the premiums of other insurers. Certain states allow assessments to be recovered over time as offsets to premium taxes. Some states have similar laws relating to HMOs and/or other payors such as not-for-profit consumer-governed health plans established under the ACA.



In 2009, the Pennsylvania Insurance Commissioner (the “Commissioner”) placed long-term care insurer Penn Treaty Network America Insurance Company and one of its subsidiaries (collectively, “Penn Treaty”) in rehabilitation, an intermediate action before insolvency, and subsequently petitioned a state court to convert the rehabilitation into a liquidation. In 2012, the state court denied the Commissioner’s petition for liquidation. The Pennsylvania Supreme Court affirmed that ruling in July 2015. The state court’s 2012 order directed the Commissioner to develop a plan of rehabilitation. The Commissioner filed an initial rehabilitation plan in April 2013, and filed amended plans in August 2014 and October 2014. The state court began a hearing in July 2015, which is scheduled to continue in the second quarter of 2016, to consider the Commissioner’s most recent proposed rehabilitation plan, which contemplates a partial liquidation of Penn Treaty. If Penn Treaty iswas placed in liquidation wein March 2017. We recorded a discounted estimated liability and expense of $231 million pretax during the three months ended March 31, 2017 for our estimated share of future assessments by applicable life and health guaranty associations which reflects a 3.5% discount rate. The undiscounted estimated liability at March 31, 2017 was $347 million. The expense was recorded in general and administrative expenses in our Consolidated Statements of Income, and the liability was recorded in accrued expenses and other insurers likely would be assessed immediately or over a period of years by guaranty associationscurrent liabilities in our Consolidated Balance Sheets. We did not record an asset for the payments the guaranty associations are required to make to Penn Treaty policyholders. We are currently unable to predict the ultimate outcome of, or reasonably estimate the loss or range of losses resulting from, this potential insolvency because we cannot predict when or to what extent Penn Treaty ultimately will be declared insolvent,expected premium tax offsets for our in force business at March 31, 2017 as the amount of the insolvency, the amount and timing of associated future guaranty association assessments or the amount or availability of potential offsets, such as premium tax offsets.was not material. It is reasonably possible that during 2016in the future we may record a liability and expense relating to Penn Treaty and/or other insolvencies which could have a material adverse effect on our operating results, financial position and cash flows. While historically we have historicallyultimately recovered more than half of guaranty fund assessments through statutorily permitted premium tax offsets, significant increases in assessments could lead to legislative and/or regulatory actions that may limit future offsets.

HMOs in certain states in which we do business are subject to assessments, including market stabilization and other risk-sharing pools, for which we are assessed charges based on incurred claims, demographic membership mix and other factors. We establish liabilities for these assessments based on applicable laws and regulations. In certain states, the ultimate assessments we pay are dependent upon our experience relative to other entities subject to the assessment, and the ultimate liability is not known at the balance sheet date. While the ultimate amount of the assessment is dependent upon the experience of all pool participants, we believe we have adequate reserves to cover such assessments.

Litigation and Regulatory Proceedings
Out-of-Network Benefit Proceedings
We are named as a defendant in several purported class actions and individual lawsuits arising out of our practices related to the payment of claims for services rendered to our members by health care providers with whom we do not have a contract (“out-of-network providers”). Among other things, these lawsuits allege that we paid too little to our health plan members and/or providers for these services, among other reasons, because of our use of data provided by Ingenix, Inc., a subsidiary of one of our competitors (“Ingenix”). Other major health insurers are the subject of similar litigation or have settled similar litigation.  



Various plaintiffs who are health care providers or medical associations seek to represent nationwide classes of out-of-network providers who provided services to our members during the period from 2001 to the present.  Various plaintiffs who are members in our health plans seek to represent nationwide classes of our members who received services from out-of-network providers during the period from 2001 to the present.  Taken together, these lawsuits allege that we violated state law, the Employee Retirement Income Security Act of 1974, as amended (“ERISA”), the Racketeer Influenced and Corrupt Organizations Act (“RICO”) and federal antitrust laws, either acting alone or in concert with our competitors.  The purported classes seek reimbursement of all unpaid benefits, recalculation and repayment of deductible and coinsurance amounts, unspecified damages and treble damages, statutory penalties, injunctive and declaratory relief, plus interest, costs and attorneys’ fees, and seek to disqualify us from acting as a fiduciary of any benefit plan that is subject to ERISA.  Individual lawsuits that generally contain similar allegations and seek similar relief have been brought by health plan members and out-of-network providers.

The first class action case was commenced on July 30, 2007.  The federal Judicial Panel on Multi-District Litigation (the “MDL Panel”) has consolidated these class action cases in the U.S. District Court for the District of New Jersey (the “New Jersey District Court”) under the caption In re: Aetna UCR Litigation, MDL No. 2020 (“MDL 2020”).   In addition, the MDL Panel has transferred the individual lawsuits to MDL 2020.  On May 9, 2011, the New Jersey District Court dismissed the physician plaintiffs from MDL 2020 without prejudice.  The New Jersey District Court’s action followed a ruling by the United States District Court for the Southern District of Florida (the “Florida District Court”) that the physician plaintiffs were enjoined from participating in MDL 2020 due to a prior settlement and release.  The United States Court of Appeals for the Eleventh Circuit has dismissed the physician plaintiffs’ appeal of the Florida District Court’s ruling.

On December 6, 2012, we entered into an agreement to settle MDL 2020. Under the terms of the proposed nationwide settlement, we would have been released from claims relating to our out-of-network reimbursement practices from the beginning of the applicable settlement class period through August 30, 2013. The settlement agreement did not contain an admission of wrongdoing. The medical associations were not parties to the settlement agreement.

Under the settlement agreement, we would have paid up to $120 million to fund claims submitted by health plan members and health care providers who were members of the settlement classes. These payments also would have funded the legal fees of plaintiffs’ counsel and the costs of administering the settlement. In connection with the proposed settlement, the Company recorded an after-tax charge to net income attributable to Aetna of $78 million in the fourth quarter of 2012.



The settlement agreement provided us the right to terminate the agreement under certain conditions related to settlement class members who opted out of the settlement. Based on a report provided to the parties by the settlement administrator, the conditions permitting us to terminate the settlement agreement were satisfied. On March 13, 2014, we notified the New Jersey District Court and plaintiffs’ counsel that we were terminating the settlement agreement. Various legal and factual developments since the date of the settlement agreement led us to believe terminating the settlement agreement was in our best interests. As a result of this termination, we released the reserve established in connection with the settlement agreement, net of amounts due to the settlement administrator, which reduced first quarter 2014 other general and administrative expenses by $67.0by$103 million ($103.0 million pretax).pretax.

On June 30, 2015, the New Jersey District Court granted in part our motion to dismiss the proceeding. The New Jersey District Court dismissed with prejudice the plaintiffs’ RICO and federal antitrust claims; their ERISA claims that are based on our disclosures and our purported breach of fiduciary duties; and certain of their state law claims. The New Jersey District Court also dismissed with prejudice all claims asserted by several medical association plaintiffs. The plaintiffs’ remaining claims are for ERISA benefits and breach of contract. We intend to vigorously defend ourselves vigorously against the plaintiffs’ remaining claims.

We also have received subpoenas and/or requests for documents and other information from, and been investigated by, attorneys general and other state and/or federal regulators, legislators and agencies relating to, and we are involved in other litigation regarding, our out-of-network benefit payment and administration practices.  It is


reasonably possible that others could initiate additional litigation or additional regulatory action against us with respect to our out-of-network benefit payment and/or administration practices.

CMS Actions
The Centers for Medicare & Medicaid Services (“CMS”) regularly audits our performance to determine our compliance with CMS’s regulations and our contracts with CMS and to assess the quality of services we provide to Medicare beneficiaries.  CMS uses various payment mechanisms to allocate and adjust premium payments to our and other companies’ Medicare plans by considering the applicable health status of Medicare members as supported by information prepared, maintained and provided by health care providers.  We collect claim and encounter data from providers and generally rely on providers to appropriately code their submissions to us and document their medical records, including the diagnosis data submitted to us with claims.  CMS pays increased premiums to Medicare Advantage plans and prescription drug program plans for members who have certain medical conditions identified with specific diagnosis codes.  Federal regulators review and audit the providers’ medical records to determine whether those records support the related diagnosis codes that determine the members’ health status and the resulting risk-adjusted premium payments to us.  In that regard, CMS has instituted risk adjustment data validation (“RADV”) audits of various Medicare Advantage plans, including certain of the Company’s plans, to validate coding practices and supporting medical record documentation maintained by health care providers and the resulting risk adjusted premium payments to the plans. CMS may require us to refund premium payments if our risk adjusted premiums are not properly supported by medical record data. The Office of Inspector General (the “OIG”) also is auditing risk adjustment data of other companies, and we expect CMS and the OIG to continue auditing risk adjustment data.

CMS revised its audit methodology for RADV audits to determine refunds payable by Medicare Advantage plans for contract year 2011 and forward. Under the revised methodology, among other things, CMS will project the error rate identified in the audit sample of approximately 200 members to all risk adjusted premium payments made under the contract being audited.  Historically, CMS did not project sample error rates to the entire contract.  As a result, the revised methodology may increase our exposure to premium refunds to CMS based on incomplete medical records maintained by providers.  Since 2013, CMS has selected certain of our Medicare Advantage contracts for various contract years 2011 and 2012 for RADV audit.  We are currently unable to predict which of our Medicare Advantage contracts will be selected for future audit, the amounts of any retroactive refunds of, or prospective adjustments to, Medicare Advantage premium payments made to us, the effect of any such refunds or adjustments on the actuarial soundness of our Medicare Advantage bids, or whether any RADV audit findings would cause a change to our method of estimating future premium revenue in future bid submissions to CMS or compromise premium assumptions made in our bids for prior contract years or the current contract year.  Any premium or fee refunds or adjustments resulting from regulatory audits, whether as a result of RADV, Public Exchange related or other audits by CMS, the OIG, HHS or otherwise, including audits of our minimum medical loss ratio rebates, methodology and/or reports, could be material and could adversely affect our operating results, financial position and cash flows.

Other Litigation and Regulatory Proceedings
We are involved in numerous other lawsuits arising, for the most part, in the ordinary course of our business operations, including claims of or relating to bad faith, medical malpractice, non-compliance with state and federal regulatory regimes, marketing misconduct, failure to timely or appropriately pay or administer claims and benefits in our Health Care and Group Insurance businesses (including our post-payment audit and collection practices and reductions in payments to providers due to


sequestration), provider network structure (including the use of performance-based networks and termination of provider contracts), provider directory accuracy, rescission of insurance coverage, improper disclosure of personal information, anticompetitive practices, patent infringement and other intellectual property litigation, other legal proceedings in our Health Care and Group Insurance businesses and employment litigation.  Some of these other lawsuits are or are purported to be class actions.  We intend to vigorously defend ourselves vigorously against the claims brought in these matters.

Awards to us and others of certain government contracts, particularly Medicaid contracts and contracts with government customers in our MedicaidCommercial business, are subject to increasingly frequent protests by unsuccessful bidders. These protests may result in awards to us being reversed,


delayed or modified. The loss or delay in implementation of any government contract could adversely affect our operating results. We will continue to defend vigorously contract awards we receive.

In addition, our operations, current and past business practices, current and past contracts, and accounts and other books and records are subject to routine, regular and special investigations, audits, examinations and reviews by, and from time to time we receive subpoenas and other requests for information from, CMS, the U.S. Department of Health and Human Services, various state insurance and health care regulatory authorities, state attorneys general, treasurers and offices of inspector general, the Center for Consumer Information and Insurance Oversight, OIG, the Office of Personnel Management, the U.S. Department of Labor, the U.S. Department of the Treasury, the U.S. Food and Drug Administration, committees, subcommittees and members of the U.S. Congress, the U.S. Department of Justice (the “DOJ”), the Federal Trade Commission, U.S. attorneys and other state, federal and international governmental authorities. These government actions include inquiries by, and testimony before, certain members, committees and subcommittees of the U.S. Congress regarding our withdrawal from certain states’ Public Exchanges for 2017, certain of our current and past business practices, including our overall claims processing and payment practices, our business practices with respect to our small group products, student health products or individual customers (such as market withdrawals, rating information, premium increases and medical benefit ratios), executive compensation matters and travel and entertainment expenses, as well as the investigations by, and subpoenas and requests from, attorneys general and others described above under “Out-of-Network Benefit Proceedings.”  We also have produced documents and information to the Civil Division of the DOJ in cooperation with a current investigation of our patient chart review processes in connection with risk adjustment data submissions under Parts C and D of the Medicare program.

A significant number of states are investigating life insurers’ claims payment and related escheat practices, and thesepractices. These investigations have resulted in significant charges to earnings by other life insurers in connection with related settlements. We have received requests for information from a number of states, and certain of our subsidiaries are being audited, with respect to our life insurance claim payment and related escheat practices.  In the fourth quarter of 2013, we made changes to our life insurance claim payment practices (including related escheatment practices) based on evolving industry practices and regulatory expectations and interpretations, including expanding our existing use of the Social Security Administration’s Death Master File to identify additional potentially unclaimed death benefits and locate applicable beneficiaries. As a result of these changes, in the fourth quarter of 2013, we increased our estimated liability for unpaid life insurance claims with respect to insureds who passed away on or before December 31, 2013, and recorded in current and future benefits a charge of $35.7$36 million ($55.055 million pretax). Given the judicial, legislative and regulatory uncertainty with respect to life insurance claim payment and related escheat practices, it is reasonably possible that we may incur additional liability related to those practices, whether as a result of further changes in our business practices, litigation, government actions or otherwise, which could adversely affect our operating results and cash flows.

There also continues to be a heightened level of review and/or audit by regulatory authorities of, and increased litigation regarding, our and the rest of the health care and related benefits industry’s business and reporting practices, including premium rate increases, utilization management, development and application of medical policies, complaint, grievance and appeal processing, information privacy, provider network structure (including provider network adequacy, the use of performance-based networks and termination of provider contracts), provider directory accuracy, calculation of minimum medical loss ratios and/or payment of related rebates, delegated arrangements, rescission of insurance coverage, limited benefit health products, student health products, pharmacy benefit management practices (including the use of narrow networks and the placement of drugs in formulary tiers), sales practices, customer service practices, vendor oversight and claim payment practices (including payments to out-of-network providers and payments on life insurance policies).

As a leading national health and related benefits company, we regularly are the subject of government actions of the types described above.  These government actions may prevent or delay us from implementing planned premium rate increases and may result, and have resulted, in restrictions on our business, changes to or clarifications of our business practices, retroactive adjustments to premiums, refunds or other payments to members, beneficiaries, states or the federal government, withholding of premium payments to us by government agencies, assessments of damages, civil or criminal fines or penalties, or other sanctions, including the possible suspension or loss of licensure and/or suspension or exclusion from participation in government programs.



Estimating the probable losses or a range of probable losses resulting from litigation, government actions and other legal proceedings is inherently difficult and requires an extensive degree of judgment, particularly where the matters involve indeterminate claims for monetary damages, involve claims for injunctive relief, may involve fines, penalties or punitive damages that are discretionary in amount, involve a large number of claimants or regulatory authorities, represent a change in regulatory policy, present novel legal theories, are in the early stages of the proceedings, are subject to appeal or could result in a changechanges in business practices.  In addition, because most legal proceedings are resolved over long periods of time, potential losses are subject to change due to, among other things, new developments, changes in litigation strategy, the outcome of intermediate procedural and substantive rulings and other parties’ settlement posture and their evaluation of the strength or weakness of their case against us. Except as specifically noted above under “Other Litigation and Regulatory Proceedings,” we are currently unable to predict the ultimate outcome of, or reasonably estimate the losses or a range of losses resulting from, the matters described above under “Litigation and Regulatory Proceedings”, and it is reasonably possible that their outcome could be material to us.

15.    Segment Information

Our operations are conducted in three business segments:  Health Care, Group Insurance and Large Case Pensions.  Our Corporate Financing segment is not a business segment; itsegment. It is added to our business segments to reconcile our segment reporting to our consolidated results.  The Corporate Financing segment includes transaction and integration-related costs, income taxes, interest expense on our outstanding debt and the financing components of our pension and OPEB plan expense (the service cost and prior service cost components of this expense are allocated to our business segments).

Effective March 31, 2017, to more clearly differentiate between the GAAP and non-GAAP financial measures used in this Quarterly Report on Form 10-Q and our other disclosures, we changed the naming convention for our non-GAAP financial measures from "operating" measures to "adjusted" measures. The underlying calculations of our consolidated non-GAAP financial measures did not change. Prior to March 31, 2017, operating earnings was the measure reported to the chief executive officer for purposes of assessing financial performance and making operating decisions, such as the allocation of resources among our business segments. Effective March 31, 2017, the chief executive officer assesses our consolidated results based on adjusted earnings and assesses business segment results based on pre-tax adjusted earnings because income taxes are recorded in our Corporate Financing segment and are not allocated to our business segments. Also effective March 31, 2017, transaction and integration-related costs were reclassified to our Corporate Financing segment because they do not reflect our underlying business performance. The prior period has been restated to reflect this presentation. Non-GAAP financial measures we disclose, such as operatingadjusted earnings and pre-tax adjusted earnings, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

Summarized financial information of our segment operations for the three months ended March 31, 20162017 and 20152016 were as follows:
(Millions)
Health
Care

 
Group
Insurance

 
Large Case
Pensions

 
Corporate
Financing

 Total Company
Health
Care

 
Group
Insurance

 
Large Case
Pensions

 
Corporate
Financing

 Total Company
Three Months Ended March 31, 2017         
Revenue from external customers$14,667
 $556
 $15
 $
 $15,238
Pre-tax adjusted earnings (loss)(1)
1,476
 33
 4
 (62) 1,451
Three Months Ended March 31, 2016          
  
  
  
  
Revenue from external customers$14,907.7
 $551.1
 $17.3
 $
 $15,476.1
$14,908
 $551
 $17
 $
 $15,476
Operating earnings (loss) (1)
832.0
 21.3
 (.3) (42.2) 810.8
Three Months Ended March 31, 2015 
  
  
  
  
Revenue from external customers$14,285.8
 $554.5
 $12.8
 $
 $14,853.1
Operating earnings (loss) (1)
835.6
 43.9
 2.1
 (37.3) 844.3
Pre-tax adjusted earnings (loss) (1)
1,456
 25
 1
 (65) 1,417
                  
(1) 
OperatingPre-tax adjusted earnings (loss) excludes net realized capital gains or losses, amortization of other acquired intangible assets and the other items described in the reconciliation below.



A reconciliation of operating(loss) income before income taxes to pre-tax adjusted earnings (1) to net income attributable to Aetna for the three months ended March 31, 20162017 and 20152016 was as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Operating earnings (1)
$810.8
 $844.3
Transaction and integration-related costs, net of tax(42.9) (30.7)
Amortization of other acquired intangible assets, net of tax(40.8) (41.1)
Net realized capital (losses) gains, net of tax(.5) 5.0
Net income attributable to Aetna$726.6
 $777.5
    
 Three Months Ended
 March 31,
(Millions)2017
 2016
(Loss) income before income taxes (GAAP measure)$(628) $1,289
Less: Income before income taxes attributable to non-controlling interests (GAAP measure)3
 1
(Loss) income before income taxes attributable to Aetna (GAAP measure)(631) 1,288
Loss on early extinguishment of long-term debt246
 
Penn Treaty-related guaranty fund assessments231
 
Transaction and integration-related costs1,212
 66
Amortization of other acquired intangible assets60
 62
Net realized capital losses333
 1
Pre-tax adjusted earnings (1)
$1,451
 $1,417
    
(1) 
In addition to net realized capital losses and gains and amortization of other acquired intangible assets, the following other items are excluded from operatingadjusted earnings and pre-tax adjusted earnings because we believe they neither relate to the ordinary course of our business nor reflect our underlying business performance:
In the three months ended March 31, 2017, we incurred losses on the early extinguishment of long-term debt due to (a) the mandatory redemption of the $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes following the termination of the Merger Agreement and (b) the early redemption of $750 million aggregate principal amount of our outstanding senior notes due 2020.
In the three months ended March 31, 2017, we recorded an expense for estimated future guaranty fund assessments related to Penn Treaty, which was placed in rehabilitation in 2009 and placed in liquidation in March 2017. This expense does not directly relate to the underwriting or servicing of products for customers and is not directly related to the core performance of our business operations.
We incurred transaction and integration-related costs of $42.9 million ($65.4 million pretax) during the three months ended March 31, 2017 and 2016 primarily related to the acquisitions of Coventry and bswift LLC (“bswift”) and the Humana Acquisition, and transaction and integration-related costs of $30.7 million ($45.6 million pretax) during the three months ended March 31, 2015, related to the acquisitions of Coventry, the InterGlobal Group (“InterGlobal”) and bswift.Transaction. Transaction costs include costs associated with the termination of the Merger Agreement, the termination of our agreement to sell certain assets to Molina Healthcare, Inc. and advisory, legal and other professional fees which are not deductible for tax purposes and are reflected in our GAAP Consolidated Statements of Income in general and administrative expenses, as well asexpenses. Transaction costs also include the negative cost of the Bridge Credit Agreement and the Term Loan Agreement executed in connectioncarry associated with the debt financing that we obtained in June 2016 for the Humana Acquisition, whichTransaction. Prior to the mandatory redemption of the Special Mandatory Redemption Notes, the negative cost of carry associated with these senior notes was excluded from adjusted earnings and pre-tax adjusted earnings. The negative cost of carry associated with the $2.8 billion aggregate principal amount of our senior notes issued in June 2016 that are not subject to mandatory redemption (the “Other 2016 Senior Notes”) was excluded from adjusted earnings and pre-tax adjusted earnings through the date of the termination of the Merger Agreement. The components of the negative cost of carry are reflected in our GAAP Consolidated Statements of Income in interest expense.

16.     Reinsurance

In Januaryexpense and net investment income. Subsequent to the termination of the Merger Agreement, the interest expense and net investment income associated with the Other 2016 we entered into four-year reinsurance agreements with Vitality Re VII Limited, an unrelated reinsurer. The agreements allow us to reduce our required capitalSenior Notes were no longer excluded from adjusted earnings and provide $200 million of collateralized excess of loss reinsurance coverage on a portion of our group Commercial Insured Health Care business.pre-tax adjusted earnings.

17.16.Discontinued Products

Prior to 1993, we sold single-premium annuities (“SPAs”) and guaranteed investment contracts (“GICs”), primarily to employer sponsored pension plans.  In 1993, we discontinued selling these products to Large Case Pensions customers, and now we refer to these products as discontinued products. In November 2016, the last outstanding GIC matured.

We discontinued selling these products because they were generating losses for us, and we projected that they would continue to generate losses over their life (which is currently greater than 30 years for SPAs)years); so we established a reserve for anticipated future losses at the time of discontinuance. At both March 31, 2016 and December 31, 2015, our remaining GIC liability was not material. This reserve represents the present value (at the risk-free rate of return at the time of discontinuance, consistent with the duration of the liabilities) of the difference between the expected cash flows from the assets supporting these products and the cash flows expected to be required to meet the obligations of the outstanding contracts. 

Key assumptions in setting the reserve for anticipated future losses include future investment results, payments to retirees, mortality and retirement rates and the cost of asset management and customer service.  In 2014, we modified the mortality tables used in order to reflect the more up-to-date 2014 Retired Pensioner’s Mortality table. The mortality tables were previously modified in 2012, in order to reflect the more up-to-date 2000 Retired Pensioner’s Mortality table, and in 1995, in order to reflect the more up-to-date 1994 Uninsured Pensioner’s Mortality table. In 1997, we began the use of a bond default assumption to reflect historical default experience. Other than these changes, since 1993 there have been no significant changes to the assumptions underlying the reserve.



We review the adequacy of this reserve quarterly based on actual experience. As long as our expected future losses remain consistent with prior projections, the results of the discontinued products are applied against the reserve and do not impact net income attributable to Aetna. If actual or expected future losses are greater than we currently


estimate, we may increase the reserve, which could adversely impact net income attributable to Aetna. If actual or expected future losses are less than we currently estimate, we may decrease the reserve, which could favorably impact net income attributable to Aetna. The reserve at each of March 31, 20162017 and December 31, 20152016 reflects management’s best estimate of anticipated future losses, and is included in future policy benefits on our balance sheets.Consolidated Balance Sheets.

The activity in the reserve for anticipated future losses on discontinued products for the three months ended March 31, 20162017 and 20152016 was as follows (pretax):
(Millions)2016
 2015
2017
 2016
Reserve, beginning of period$1,067.2
 $1,014.7
$962
 $1,067
Operating (loss) income(13.4) 3.1
Operating income (loss)16
 (13)
Net realized capital gains12.5
 19.0
14
 12
Reserve, end of period$1,066.3
 $1,036.8
$992
 $1,066

During the three months ended March 31, 2017, our discontinued products reflected operating income and net realized capital gains, primarily attributable to gains from the sale of investment real estate and debt securities. During the three months ended March 31, 2016,, our discontinued products reflected an operating loss and net realized capital gains, primarily attributable to gains from the sale of debt securities and investment real estate. During the three months ended March 31, 2015, our discontinued products reflected operating income and net realized capital gains, primarily attributable to gains from the sale of debt securities and investment real estate. We evaluated these 2016 results against the expectations of future cash flows assumed in estimating the reserve for anticipated future losses and did not believe that an adjustment to the reserve was required at March 31, 2016.

Assets and liabilities supporting discontinued products (1) at March 31, 20162017 and December 31, 20152016 were as follows:
(Millions)2016
 2015
2017
 2016
Assets:      
Debt and equity securities available for sale$2,092.3
 $2,019.6
$1,872
 $1,913
Mortgage loans382.2
 396.0
369
 370
Other investments651.2
 643.5
615
 646
Total investments3,125.7
 3,059.1
2,856
 2,929
Other assets100.5
 128.9
109
 104
Current and deferred income taxes23.6
 20.5
Receivable from continuing products (2)
611.2
 602.0
562
 554
Total assets$3,861.0
 $3,810.5
$3,527
 $3,587
Liabilities: 
  
 
  
Future policy benefits$2,450.0
 $2,493.5
$2,282
 $2,326
Reserve for anticipated future losses on discontinued products1,066.3
 1,067.2
992
 962
Current and deferred income taxes38
 42
Other liabilities (3)
344.7
 249.8
215
 257
Total liabilities$3,861.0
 $3,810.5
$3,527
 $3,587
      
(1) 
Assets supporting the discontinued products are distinguished from assets supporting continuing products.
(2) 
At the time of discontinuance, a receivable from Large Case Pensions’ continuing products was established on the discontinued products balance sheet.Balance Sheet. This receivable represented the net present value of anticipated cash shortfalls in the discontinued products, which will be funded from continuing products. Interest on the receivable is accrued at the discount rate that was used to calculate the reserve. The offsetting payable, on which interest is similarly accrued, is reflected in continuing products. Interest on the payable generally offsets investment income on the assets available to fund the shortfall. These amounts are eliminated in consolidation.
(3) 
Net unrealized capital gains on the available-for-sale debt securities are included in other liabilities and are not reflected in consolidated shareholders’ equity.

The distributions on our discontinued products consisted of scheduled contract maturities, settlements and benefit payments of $94$84 million and $91$94 million for the three months ended March 31, 20162017, and 2015,2016, respectively. Participant-directed withdrawals from our discontinued products were not significant during the three months ended


March 31, 20162017 or 2015.2016.  Cash required to fund these distributions was provided by earnings and scheduled payments on, and sales of, invested assets.



Index to Consolidated Financial Statements



Report of Independent Registered Public Accounting Firm

The Board of Directors and Shareholders
Aetna Inc.:
We have reviewed the accompanying consolidated balance sheet of Aetna Inc. and subsidiaries as of March 31, 2016,2017, and the related consolidated statements of income, comprehensive income, shareholders’ equity and cash flows for the three monththree-month periods ended March 31, 20162017 and 2015.2016. These consolidated financial statements are the responsibility of the Company’s management.
We conducted our review in accordance with the standards of the Public Company Accounting Oversight Board (United States). A review of interim financial information consists principally of applying analytical procedures and making inquiries of persons responsible for financial and accounting matters. It is substantially less in scope than an audit conducted in accordance with the standards of the Public Company Accounting Oversight Board (United States), the objective of which is the expression of an opinion regarding the financial statements taken as a whole. Accordingly, we do not express such an opinion.
Based on our review, we are not aware of any material modifications that should be made to the consolidated financial statements referred to above for them to be in conformity with U.S. generally accepted accounting principles.
We have previously audited, in accordance with standards of the Public Company Accounting Oversight Board (United States), the consolidated balance sheet of Aetna Inc. and subsidiaries as of December 31, 2015,2016, and the related consolidated statements of income, comprehensive income, shareholders’ equity, and cash flows for the year then ended (not presented herein); and in our report dated February 19, 2016,17, 2017, we expressed an unqualified opinion on those consolidated financial statements. In our opinion, the information set forth in the accompanying consolidated balance sheet as of December 31, 2015,2016, is fairly stated, in all material respects, in relation to the consolidated balance sheet from which it has been derived.
/s/ KPMG LLP
 
Hartford, Connecticut
April 28, 2016May 2, 2017
 

Form 10-Q Table of Contents

Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”)

OVERVIEW

We are one of the nation’s leading diversified health care benefits companies, serving an estimated 46.544.9 million people withpeople. We have the information and resources to help themour members, in consultation with their health care professionals, make better informed decisions about their health care. We offer a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, medical management capabilities, Medicaid health care management services, Medicare Advantage and Medicare supplementSupplement plans, workers’ compensation administrative services and health information technology products and services, such as Accountable Care Solutions (“ACS”).services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers (“providers”), governmental units, government-sponsored plans, labor groups and expatriates.  Our operations are conducted in three business segments:  Health Care, Group Insurance and Large Case Pensions.

The following MD&A provides a review of our financial condition at March 31, 20162017 and December 31, 20152016 and operating results for the three months ended March 31, 20162017 and 2015.2016. This Overview should be read in conjunction with the entire MD&A, which contains detailed information that is important to understanding our operating results and financial condition, the consolidated financial statements and other data presented in this Quarterly Report on Form 10-Q as well as the MD&A contained in our 20152016 Annual Report on Form 10-K (the “2015(our “2016 Annual Report”).  This Overview is qualified in its entirety by the full MD&A.

Summarized Results for the Three Months Ended March 31, 20162017 and 2015:2016:
Three Months EndedThree Months Ended    
March 31,March 31, Change
(Millions, except where indicated)2016
 2015
2017
 2016
 $ %
Total revenue$15,693.4
 $15,094.1
$15,165
 $15,693
 $(528) (3)%
Net income attributable to Aetna726.6
 777.5
Operating earnings (1)
810.8
 844.3
Net (loss) income attributable to Aetna(381) 737
 (1,118) (152)%
Adjusted earnings (1)
939
 821
 118
 14 %
Total medical membership (in thousands)22,989
 23,670
22,446
 22,989
 (543) (2)%
Cash flows from operations1,780.9
 1,473.4
Cash flows provided by operations899
 1,791
 (892) (50)%
          

A reconciliation of net (loss) income attributable to Aetna to adjusted earnings (1) for the three months ended March 31, 2017 and 2016 was as follows:
 Three Months Ended
 March 31,
(Millions)2017
 2016
Net (loss) income attributable to Aetna (GAAP measure)$(381) $737
Loss on extinguishment of debt246
 
Penn Treaty-related guaranty fund assessments231
 
Transaction and integration-related costs1,212
 66
Amortization of other acquired intangible assets60
 62
Net realized capital losses333
 1
Income tax benefit(762) (45)
Adjusted earnings (1)
$939
 $821
    
(1) 
Our discussion of operating results for our reportable business segments is based on operatingAdjusted earnings which is a non-GAAP measure ofexcludes from net (loss) income attributable to Aetna (the term “GAAP” refers to U.S. generally accepted accounting principles).  Non-GAAP financial measures we disclose, such as operatingnet realized capital gains and losses, amortization of other acquired intangible assets and the other items described in the reconciliation in Note 15. In addition, adjusted earnings should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP. Refer to “Segment Results and Use of Non-GAAP Measures in this Document” beginning on page 42 for a discussion of non-GAAP measures.  Refer to Note 15 beginning on page 35 for a reconciliation of our operating earnings toexcludes from net (loss) income attributable to Aetna.Aetna the corresponding tax benefit or expense related to the items excluded from adjusted earnings discussed above. The tax benefit or expense was calculated utilizing the appropriate tax rate for each individual item excluded from adjusted earnings.

Effective March 31, 2017, to more clearly differentiate between the GAAP and non-GAAP financial measures used in this Quarterly Report on Form 10-Q and our other disclosures, we changed the naming convention for our non-GAAP financial measures from "operating" measures to "adjusted" measures. The underlying calculations of our consolidated non-GAAP


financial measures did not change.Our discussion of consolidated operating results is based on adjusted earnings, decreasedwhich is a non-GAAP measure of net income attributable to Aetna (the term “GAAP” refers to U.S. generally accepted accounting principles). Effective March 31, 2017, we began recording income taxes in our Corporate Financing segment and no longer allocated income taxes to our business segments. Accordingly, our discussion of operating results for our reportable business segments is based on pre-tax adjusted earnings which is a non-GAAP measure of income before income taxes attributable to Aetna. Effective March 31, 2017, transaction and integration-related costs were reclassified to our Corporate Financing segment. The prior period has been restated to reflect this presentation. Non-GAAP financial measures we disclose, such as adjusted earnings and pre-tax adjusted earnings, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP. Refer to “Segment Results and Use of Non-GAAP Measures in this Document” for a discussion of non-GAAP measures.  

Commentary
Our results for the three months ended March 31, 2016 compared to2017 include several items that impact comparability with results in prior periods. The impact of these items resulted in a net loss for the corresponding period, in 2015, primarily due to lower operating earningsdespite strong overall results in our Group Insurance segment primarilyunderlying businesses, with the exception of our individual Commercial products. These items include costs associated with the termination of the Merger Agreement (as defined below) and an expense related to estimated future guaranty fund assessments as a result of lower underwriting marginsPenn Treaty (as defined below) being placed in liquidation. In addition, results for the three months ended March 31, 2017 reflect the temporary suspension of the health insurer fee ("HIF"). Pricing actions designed to recover the HIF and other ACA mandated fees represented approximately 3 percent of our Disability products.Health Care premiums in 2016. Our results for the three months ended March 31, 2017 also include the impact of reduced participation on the ACA's individual public health insurance exchanges. We expect to significantly reduce our exposure to individual Commercial products in 2018.

Total revenue increased Net loss attributable to Aetna was $381 millionduring the three months ended March 31, 2017 compared to net income attributable to Aetna of $737 million for the corresponding period in 2016. The net loss during the three months ended March 31, 2017 compared to net income during the corresponding period in 2016 was primarily due to the three months ended March 31, 2017 reflecting costs associated with the termination of the Merger Agreement.
Adjusted earnings increased $118 million during the three months ended March 31, 2017 compared to the corresponding period in 20152016 primarily due to higherstrong performance in our Health Care segment, despite the continued pressure in our individual Commercial products described below.
Total revenue decreased $528 million during the three months ended March 31, 2017 compared to the corresponding period in 2016. The decrease was primarily due to lower premiums in our Health Care segment, including lower membership in our ACA compliant individual and small group products and the temporary suspension of the HIF in 2017, partially offset by higher premium yields in our Commercial business and membership growth in our Government business, each in our Health Care Segment. The decrease in total revenue also reflects a realized capital loss during the three months ended March 31, 2017 of $336 million pre-tax due to the unamortized effective portion of cash flow hedge losses being recognized into earnings upon the mandatory redemption of $10.2 billion aggregate principal amount of senior notes issued in 2016 and the redemption of $750 million aggregate principal amount of senior notes due in 2020.
Our effective tax rate was 39.6 percent and 42.7 percent for the three months ended March 31, 2017 and 2016, respectively. The decrease in our effective tax rate for the three months ended March 31, 2017 compared to the corresponding period in 2016 was primarily due to the temporary suspension of the non-deductible HIF in 2017. Because we were in a pre-tax loss position for the three months ended March 31, 2017, the decrease was partially offset by membership losses in our group Commercial Insured products.the deduction of transaction-related costs during the three months ended March 31, 2017.

Total medical membership at March 31, 20162017 decreased 543 thousand compared to March 31, 2015,2016, primarily reflecting declines in our Commercial business,Insured products primarily in our ACA compliant individual and small group products, partially offset by growthincreases in our Commercial ASC products and Government business.business. Refer to “Health Care - Membership” beginning on page 45below in this MD&A for additionalfurther information on our medical membership.

We continued to generate strong cash flows
Cash flow from operations in 2016 and 2015, generating $1.8 billion and $1.6 billion of cash flows from operations in our Health Care and Group Insurance businesses decreased $892 million during the three months ended March 31, 2017 compared to the corresponding period in 2016 primarily due to cash payments associated with the termination of the Merger Agreement in 2017 and a decrease in income taxes payable due to a loss before income taxes for the three months ended March 31, 2017 compared with income before income taxes for the three months ended March 31, 2016. The decrease was partially offset by the timing of Medicare premium receipts, as we received an advanced payment associated with April 2017 in March 2017.


ended March 31, 2016 and 2015, respectively.  During 2016, these cash flows funded our ordinary course operating activities, increased cash and cash equivalents in preparation for our proposed acquisition of Humana Inc. (“Humana”) and the payment of cash dividends to shareholders of $87 million.

Refer to “Liquidity and Capital Resources” beginning on page 51 and Note 12 of beginning on page 29 for additional information.

ProposedTerminated Acquisition of Humana Inc.and Terminated Divestiture to Molina
On July 2, 2015, we entered into a definitive agreement (as it may be amended, the "Merger Agreement"(the “Merger Agreement”) to acquire Humana Inc. (“Humana”). On July 21, 2016, the U.S. Department of Justice (the “DOJ”) and certain state attorneys general filed a civil complaint in a transaction valued at approximately $37 billion, based on the closing priceU.S. District Court for the District of Aetna common shares on July 2, 2015, including the assumption of Humana debtColumbia (the “District Court”) against us and Humana cash and cash equivalents. We expect to finance the cash portion of the purchase price ofcharging that our proposed acquisition of Humana (the “Humana Acquisition”Transaction”) throughwould violate Section 7 of the Clayton Antitrust Act, and seeking a combination of cash on handpermanent injunction to prevent Aetna from acquiring Humana. On January 23, 2017, the District Court granted the DOJ’s request to enjoin the Humana Transaction.

On February 14, 2017, Aetna and by issuing approximately $16.2 billion of new debt, including senior notes, term loans and commercial paper. We made customary representations, warranties and covenants inHumana entered into a mutual termination agreement (the “Termination Agreement”) pursuant to which the parties thereto (collectively, the “Parties”) agreed to terminate the Merger Agreement, including among others, a covenant, subject toall schedules and exhibits thereto, and all ancillary agreements contemplated thereby, entered pursuant thereto or entered in connection therewith (other than certain exceptions, to conduct our business in the ordinary course between the execution ofconfidentiality agreements) (collectively with the Merger Agreement, the “Transaction Documents”), effective immediately as of February 14, 2017 (the “Termination Date”). Under the Termination Agreement, Aetna agreed to pay Humana the Regulatory Termination Fee (as defined in the Merger Agreement) of $1.0 billion in cash in full satisfaction of any amounts required to be paid by Aetna under the Merger Agreement. The Parties also agreed to release each other from any and all liability, claims, rights, actions, causes of action, suits, liens, obligations, accounts, debts, demands, agreements, promises, liabilities, controversies, costs, charges, damages, expenses and fees, however arising, in connection with, arising out of or related to the closingTransaction Documents, the transactions contemplated therein or thereby or certain related matters. We paid Humana the Regulatory Termination Fee on February 16, 2017 and funded that payment with the proceeds of the transaction.2016 senior notes (as defined below).

In June 2016, we issued $13.0 billion of senior notes to partially fund the Humana Transaction (collectively, the “2016 senior notes”). In accordance with the terms of the 2016 senior notes, on February 14, 2017, we issued a notice of redemption for $10.2 billion aggregate principal amount of certain of the 2016 senior notes (collectively, the “Special Mandatory Redemption Notes”) at a redemption price equal to 101% of the aggregate principal amount of those notes plus accrued and unpaid interest. We redeemed the Special Mandatory Redemption Notes on March 16, 2017, and we funded the redemption with the proceeds of the 2016 senior notes. As a result of the redemption of the Special Mandatory Redemption Notes, we recognized on a pretax basis in our net income during the three months ended March 31, 2017 a loss on early extinguishment of long-term debt of $192 million and a realized capital loss for the remaining unrealized hedge loss of $323 million that was previously recorded in accumulated other comprehensive income.

In order to address the DOJ’s perceived competitive concerns regarding Medicare Advantage relating to the Humana Transaction, on August 2, 2016, we entered into a definitive agreement (the “Aetna APA”) to sell for cash to Molina Healthcare, Inc. (“Molina”) certain of our Medicare Advantage assets. On October 19, 2015,February 14, 2017, Aetna and Humana each obtainedMolina entered into a Termination Agreement (the “APA Termination Agreement”) pursuant to which Aetna terminated the approvalAetna APA, including all schedules and exhibits thereto, and all ancillary agreements contemplated thereby or entered pursuant thereto. Under the APA Termination Agreement, Aetna agreed to pay Molina in cash (a) a termination fee of their respective shareholders necessary for$53 million and (b) approximately 70% of Molina’s transaction costs. We paid Molina the Humana Acquisition.

We continue to worktermination fee on February 16, 2017 and the applicable transaction costs of $7 million on February 27, 2017 and recorded the expense in general and administrative expenses. The payments were funded with the U.S. Department of Justice to obtain clearance for the Humana Acquisition, and as of April 27, 2016, we had obtained approvals in fourteenproceeds of the twenty states in which change of control regulatory approvals are necessary to close the transaction. The Humana Acquisition is currently projected to close in the second half of 2016 and remains subject to customary closing conditions, including expiration of the federal Hart-Scott-Rodino Antitrust Improvements Act of 1976 (the “HSR Act”) waiting period and approvals of state departments of insurance and other regulators, and therefore has not been reflected in this Quarterly Report on Form 10-Q unless expressly stated otherwise.senior notes.

Refer to Notes 3 and 11 beginning on pages 9 and 26,8, respectively, and “Forward-Looking Information/Risk Factors” beginning on page 53 for additional information on the Humana Acquisition.Transaction.



Health Care Reform
The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (as amended, collectively, the “ACA”) has changed and will continue to makemade broad-based changes to the U.S. health care system. We expectThe future of the ACA is uncertain. A bill that would have repealed or amended key provisions of the ACA was presented to the House of Representatives in March 2017 but not voted on. The administration has not decided whether to continue paying the ACA’s cost sharing subsidies, and changesthe practical implications of the President’s January 2017 executive order giving the regulatory agencies that enforce the ACA the authority to interpret regulations issued under the ACA in a way that limits fiscal burdens on states and financial or regulatory burdens on individuals, providers, health insurers and others remain unclear.
While we anticipate continued efforts in 2017 and beyond to substantially modify, repeal or replace the ACA, we expect aspects of the ACA to continue to significantly impact our business operations and financialoperating results, including our pricing, our medical benefit ratios (“MBRs”) and the geographies in which our products are available. The ACA presentshas presented us with business opportunities, but also with financial and regulatory challenges. Most of the ACA’s key components of the ACA were phased in during or prior to 2014, including public health insurance exchanges (“Public Exchanges”), required minimum MLRs in Commercial and Medicare products, the individual coverage mandate, guaranteed issue, rating limits in individualACA’s temporary Reinsurance and small group products, significant new industry-wide fees, assessments and taxes, enhanced premium rate review and disclosure processes, reduced Medicare Advantage payment rates to insurers, and linking Medicare Advantage payments to a plan’s CMS quality performance ratings or “star ratings.”Risk Corridor programs expired at the end of 2016. The effects of these changesexisting provisions of the ACA are reflected in our financialoperating results. Certain components ofIf the ACA is not amended, repealed or replaced, certain of its components will continue to be phased in until 2020. It is reasonably possible that the ACA and/or changes to the ACA, in the aggregate, could have a significant adverse effect on our business operations and financial results.

We continue to expectIf the industry-wide $14.3 billion 2018 HIF (as currently enacted) is repealed or suspended, our 2017 suspension ofresults may be adversely affected. If the ACA’s non tax-deductible health insurer fee (the “HIF”) to adversely affect our 2016 operating earnings, revenues and medical benefit ratios as this change begins to be reflected in reduced premiums for 2016 medical customer renewals that have member months in 2017. In addition, there2018 HIF is some uncertainty whethernot repealed or suspended, we willmay not be able to include all of our portion of the industry-wide $14.3 billion 2018 HIF in our premium rates beginning with 2017 medical customer renewals that have member months in 2018, particularly following the temporary suspension of the HIF suspension forin 2017.



The HIF applicablefederal and state governments also continue to 2016 is payable in September 2016enact and is being recorded within operating expensesseriously consider many other broad-based legislative and regulatory proposals that have had a material impact on a straight-line basis in our 2016 financial results. We expect that our expense for this fee in 2016 will be $855 million. In aggregate, we expect our portionor could materially impact various aspects of the total fees, taxeshealth care and assessments imposed byrelated benefits system. We cannot predict whether pending or future federal or state legislative or court proceedings, including Federal budget negotiations and future U.S. Congressional appropriations, will change various aspects of the health care and related benefits system or the ACA toor the impact those changes will have on our business operations or operating results, but the effects could be approximately $1 billion in 2016.materially adverse.

For additional information on the ACA, refer to “MD&A-Overview-Healththe “Overview - Health Care Reform,” “MD&A-Outlook“Outlook for 2016,2017, and “Regulatory Environment” sections in Part II, Item 7 of our 2016 Annual Report and “Forward-Looking Information/Risk“Risk Factors” in Part I, Item 1A of our 20152016 Annual Report.

Medicare Update
On April 5, 2016, the Centers for Medicare & Medicaid Services (“CMS”)3, 2017, CMS issued its Final Noticefinal notice detailing final 20172018 Medicare Advantage benchmark payment rates (the “Final Notice”). The Final Notice provides for rate cuts to the employer group waiver program that will begin in 2017 and be fully phased in for 2018 as well as adverse changes to the risk adjustment mechanism for dual eligible beneficiaries and the Medicare Advantage star rating program. Overall, we project the benchmark rates in the Final Notice will decreaseincrease funding for our Medicare Advantage business by less than 1one percent in 20172018 compared to 2016.

Management Update
Thomas J. Sabatino, Jr., Executive Vice President and General Counsel, joined Aetna in April 2016 and succeeded William J. Casazza who will continue to serve as a strategic advisor to Aetna in connection with the Humana Acquisition. Mr. Casazza has decided to retire upon the close of the Humana Acquisition.2017.

Segment Results and Use of Non-GAAP Measures in this Document
The following discussion of operating results is presented based on our reportable segments in accordance with the accounting guidance for segment reporting and is consistent with our segment disclosure included in Note 15 beginning on page 35.15. Our operations are conducted in three business segments: Health Care, Group Insurance and Large Case Pensions. Our Corporate Financing segment is not a business segment; it is added to our business segments to reconcile our segment reporting to our consolidated results.  The Corporate Financing segment includes transaction and integration-related costs, income taxes, interest expense on our outstanding debt and the financing components of our pension and other postretirement employee benefit plans (“OPEB”) expense (the service cost and prior service cost components of this expense are allocated to our business segments).  

Our discussion of operating results is based on operating earnings. OperatingAdjusted earnings and pre-tax adjusted earnings discussed in this quarterly report exclude from net income attributable to Aetna and income before income taxes attributable to Aetna reported in accordance with GAAP net realized capital gains or losses, amortization of other acquired intangible assets and other items, if any, that neither relate to the ordinary course of our business nor reflect our underlying business performance. Although the excluded items may recur, we believe excluding them from income before income taxes attributable to Aetna and net income attributable to Aetna to arrive at operatingpre-tax adjusted earnings and adjusted earnings provides a more useful comparison of our underlying business performance from period to period.  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 liabilities. Amortization of other acquired intangible assets relates to our acquisition activities, including Coventry Health Care, Inc. (“Coventry”), the InterGlobal Group (“InterGlobal”) and bswift LLC (“bswift”).activities. These transactions and amortization do not directly relate to the underwriting or servicing of products for our customers and are not directly related to the core performance of our business operations. OperatingEffective March 31, 2017, pre-tax adjusted earnings is the measure reported to our Chief Executive Officerchief executive officer for purposes of assessing business segment financial performance and making operating decisions, such as the allocation of resources among our business segments. In each


business segment discussion in this MD&A, we provide a table that reconciles operating earnings to net income before income taxes attributable to Aetna.Aetna to pre-tax adjusted earnings.  Each table details the net realized capital gains or losses, amortization of other acquired intangible assets and any other items excluded from net income before income taxes attributable to Aetna, and the footnotes to each table describe the nature of each other item and the reason we believe it is appropriate to exclude that item from net income before income taxes attributable to Aetna. Non-GAAP financial measures we disclose, such as operatingpre-tax adjusted earnings and adjusted earnings, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.



HEALTH CARE

Health Care consists of medical, pharmacy benefit management services, dental, behavioral health and vision plans offered on both an Insured basis (where we assume all or a majority of the risk for medical and dental care costs) and an employer-funded basis (where the plan sponsor under an administrative services contract (“ASC”) assumes all or a majority of this risk) and emerging businesses products and services such as Accountable Care Solutions, that complement and enhance our medical products.  We also offer Medicare and Medicaid products and services and other medical products, such as medical management and data analytics services, medical stop loss insurance, workers’ compensation administrative services and products that provide access to our provider networks in select geographies.  We separately track premiums and health care costs for Government businesses (which represent our combined Medicare and Medicaid products). All other medical, dental and other Health Care products are referred to as Commercial.

Operating Summary:Summary for the Three Months Ended March 31, 2017 and 2016:
Three Months EndedThree Months Ended    
March 31,March 31, Change
(Millions)2016
 2015
2017
 2016
 $ %
Premiums:          
Commercial$6,964.3
 $7,209.7
$6,109
 $6,964
 $(855) (12)%
Government6,504.7
 5,730.4
7,110
 6,505
 605
 9 %
Total premiums13,469.0
 12,940.1
13,219
 13,469
 (250) (2)%
Fees and other revenue1,438.7
 1,345.7
1,448
 1,439
 9
 1 %
Net investment income112.6
 97.5
115
 112
 3
 3 %
Net realized capital (losses) gains(6.0) 4.6
Net realized capital gains (losses)1
 (6) 7
 (117)%
Total revenue15,014.3
 14,387.9
14,783
 15,014
 (231) (2)%
Health care costs10,847.7
 10,240.5
Health care costs:       
Commercial4,848
 5,420
 (572) (11)%
Government6,068
 5,428
 640
 12 %
Total health care costs10,916
 10,848
 68
 1 %
Operating expenses:       

 

Selling expenses389.8
 386.3
384
 390
 (6) (2)%
General and administrative expenses2,366.3
 2,335.9
2,235
 2,323
 (88) (4)%
Total operating expenses2,756.1
 2,722.2
2,619
 2,713
 (94) (3)%
Amortization of other acquired intangible assets62.8
 63.2
60
 62
 (2) (3)%
Total benefits and expenses13,666.6
 13,025.9
13,595
 13,623
 (28)  %
Income before income taxes1,347.7
 1,362.0
Income taxes586.2
 597.7
Net income including non-controlling interests761.5
 764.3
Less: Net income (loss) attributable to non-controlling interests2.7
 (2.2)
Net income attributable to Aetna for Health Care$758.8
 $766.5
Income before income taxes including non-controlling interests1,188
 1,391
 (203) (15)%
Less: Income before income taxes attributable to non-controlling interests2
 3
 (1) (33)%
Income before income taxes attributable to Aetna for Health Care$1,186
 $1,388
 $(202) (15)%
          



We calculate our medical benefit ratio MBRs by dividing health care costs by health care premiums.  For the three months ended March 31, 2017 and 2016, our Commercial, Government and Total Health Care MBRs were:
 Three Months Ended  
 March 31, Change
 2017
 2016
 basis points
Commercial79.4% 77.8% 160
Government85.3% 83.4% 190
Total Health Care82.6% 80.5% 210

The table presented below reconciles net income attributablebefore income taxes to Aetna to operatingpre-tax adjusted earnings (1) for our Health Care segment:segment for the three months ended March 31, 2017 and 2016:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Net income attributable to Aetna for Health Care$758.8
 $766.5
Transaction and integration-related costs, net of tax28.2
 30.7
Amortization of other acquired intangible assets, net of tax40.8
 41.1
Net realized capital losses (gains), net of tax4.2
 (2.7)
Operating earnings for Health Care$832.0
 $835.6
    
 Three Months Ended
 March 31,
(Millions)2017
 2016
Income before income taxes (GAAP measure)$1,188
 $1,391
Less: Income before income taxes attributable to non-controlling interests (GAAP measure)2
 3
Income before income taxes attributable to Aetna for Health Care (GAAP measure)1,186
 1,388
Penn Treaty-related guaranty fund assessments231
 
Amortization of other acquired intangible assets60
 62
Net realized capital (gains) losses(1) 6
Pre-tax adjusted earnings for Health Care$1,476
 $1,456
    
(1) 
OperatingPre-tax adjusted earnings excludes net realized capital gains and losses, amortization of other acquired intangible assets and the other itemsitem described in the reconciliation in Note 15 beginning on page 35. Of the total transaction and integration-related costs described in the reconciliation in Note 15 beginning on page 35, $28.2 million ($42.8 million pretax) and $30.7 million ($45.6 million pretax) were recorded in the Health Care segment in the three months ended March 31, 2016 and 2015, respectively.15.

OperatingCommentary
Income before income taxes attributable to Aetna for Health Care decreased $202 million during the three months ended March 31, 2017 compared to the corresponding period in 2016. The decrease was primarily due to the three months ended March 31, 2017 reflecting a $231 million pre-tax expense related to estimated future guaranty fund assessments as a result of Penn Treaty Network America Insurance Company and one of its subsidiaries (collectively, “Penn Treaty”) being placed in liquidation. The decrease in income before incomes taxes in three months ended March 31, 2017 also reflects the changes in pre-tax adjusted earnings described below.
Pre-tax adjusted earnings for Health Care remained relatively flat at approximately $1.5 billion for the three months ended March 31, 2017 and 2016, remained relatively flat compared todespite the corresponding period in 2015, primarily as a result of lower underwriting margins in our Commercial business, substantially offset by higher fees and other revenue.

We calculate our medical benefit ratio (“MBR”) by dividing health care costs by health care premiums.  For the three months ended March 31, 2016 and 2015, our MBRs by product were:
 Three Months Ended
 March 31,
 2016
 2015
Commercial77.8% 77.4%
Government83.4% 81.3%
Total Health Care80.5% 79.1%

Refer to our discussion of Commercial and Government results below for an explanationnegative impact of the changestemporary suspension of the HIF in our premiums and MBRs.

Commercial operating2017. Our results for the three months ended March 31, 20162017 reflect strong performance across all of our Health Care businesses, with the exception of our individual Commercial products. During the three months ended March 31, 2017, we recorded a decline$110 million premium deficiency reserve that reflects anticipated future losses for the 2017 coverage year in membership and lower underwriting margins compared to the corresponding period in 2015.our individual Commercial products.
Commercial premiums decreased $245$855 million for the three months ended March 31, 20162017 compared to the corresponding period in 2015,2016, primarily due to lower membership losses in our ACA compliant individual and small group Commercial Insured products and the temporary suspension of the HIF in 2017, partially offset by higher premium yields.

Our Commercial MBR increased 40160 basis points for the three months ended March 31, 20162017 compared to the corresponding period in 2015.2016, primarily due to the temporary suspension of the HIF in 2017 and higher medical costs in our individual Commercial products during the three months ended March 31, 2017, including a $110 million premium deficiency reserve. The increase was partially offset by improved performance in our group Commercial MBRInsured products.
Government premiums increased $605 million for the three months ended March 31, 2016 is primarily due to the extra calendar day of service in the first quarter of 2016.

Government operating results for the three months ended March 31, 2016 reflect an increase in membership and steady underwriting margins2017 compared to the corresponding period in 2015.
Government premiums increased $774 million for the three months ended March 31, 2016, comparedprimarily due to the corresponding period in 2015, primarily as a result of membership growth in our Government business.business, partially offset by the temporary suspension of the HIF in 2017.

Our Government MBR increased 210190 basis points for the three months ended March 31, 20162017 compared to the corresponding period in 2015. The increase2016, primarily due to the temporary suspension of the HIF in our Government MBR2017.


Health Care fees and other revenue remained relatively flat at $1.4 billion for for the three months ended March 31, 2016 is primarily a result of lower favorable development of prior-years’ health care cost estimates in 2016.



Fees and Other Revenue
Health Care fees and other revenue increased $93 million for the three months ended March 31, 20162017 compared to the corresponding period in 2015, primarily as a result of higher average fee yields.2016.

Income Taxes
Our effective tax rate remained relatively flat at 43.5 percent for the threeGeneral and administrative expenses months ended March 31, 2016 compared with 43.9 percent fordecreased by $88 million primarily due to the temporary suspension of the HIF in 2017 and the execution of our expense management initiatives, partially offset by the expense recorded during the three months ended March 31, 2015.2017 for estimated future guaranty fund assessments related to Penn Treaty described above.

Membership
Health Care’s membership at March 31, 20162017 and 20152016 was:
2016 2015 2017 2016 Change
(Thousands)Insured ASC Total Insured ASC Total Insured ASC Total Insured ASC Total Insured ASC Total
Medical:                             
Commercial5,792
 12,931
 18,723
 6,363
 13,496
 19,859
 4,557
 13,351
 17,908
 5,792
 12,931
 18,723
 (1,235) 420
 (815)
Medicare Advantage1,332
 
 1,332
 1,228
 
 1,228
 1,443
 
 1,443
 1,332
 
 1,332
 111
 
 111
Medicare Supplement612
 
 612
 488
 
 488
 711
 
 711
 612
 
 612
 99
 
 99
Medicaid (1)
1,549
 773
 2,322
 1,338
 757
 2,095
 1,570
 814
 2,384
 1,549
 773
 2,322
 21
 41
 62
Total Medical Membership9,285
 13,704
 22,989
 9,417
 14,253
 23,670
 8,281
 14,165
 22,446
 9,285
 13,704
 22,989
 (1,004) 461
 (543)
                             
            
Consumer-Directed Health Plans (2)
    4,320
     3,981
 
            
Dually-Eligible for Medicare and Medicaid (1)
   26
     23
 
            
Dental: 
  
  
        
  
  
            
Total Dental Membership5,913
 8,392
 14,305
 6,182
 8,413
 14,595
(3) 
5,898
 8,116
 14,014
 5,913
 8,392
 14,305
 (15) (276) (291)
                             
Pharmacy: 
  
  
  
  
    
  
  
  
  
        
Commercial 
  
 9,767
  
  
 10,789
  
  
 8,217
  
  
 9,767
     (1,550)
Medicare PDP (stand-alone) 
  
 1,939
  
  
 1,435
  
  
 2,064
  
  
 1,939
     125
Medicare Advantage PDP 
  
 934
  
  
 850
  
  
 1,106
  
  
 934
     172
Medicaid (1)
 
  
 2,602
  
  
 2,351
  
  
 2,817
  
  
 2,602
     215
Total Pharmacy Benefit Management Services   15,242
     15,425
 
Total Pharmacy Benefit Management Services MembershipTotal Pharmacy Benefit Management Services Membership   14,204
     15,242
     (1,038)
                             
(1)
(1) Medicaid membership includes members who are dually-eligible for both Medicare and Medicaid.
Medicaid membership includes members who are dually-eligible for both Medicare and Medicaid.
(2)
Represents members in consumer-directed health plans who also are included in Commercial medical membership above.
(3)
Dental ASC membership at March 31, 2015 has been revised to reflect a reduction of approximately 1 million Dental ASC members, as applicable Medicaid ASC members did not have a Dental ASC product at such date. This revision did not affect our financial statements.

Commentary
Total medical membership at March 31, 2017 decreased 543 thousand members compared to March 31, 2016, primarily reflecting declines in our Commercial Insured products primarily in our ACA compliant individual and small group products, partially offset by increases in our Commercial ASC products and Government business.
Total dental membership at March 31, 2017 decreased 291 thousand members compared to March 31, 20152016, primarily reflecting declines in our dental ASC products.
Total pharmacy benefit management services membership ,at March 31, 2017 decreased 1 million members compared to March 31, 2016, primarily reflecting declines in our Commercial business partially offset by growth inprimarily attributable to our Government business.ACA compliant individual and small group products.

Total dental membership at March 31, 2016 decreased slightly compared to March 31, 2015, primarily reflecting declines in our Insured dental products.

Total pharmacy benefit management services membership decreased slightly at March 31, 2016 compared to March 31, 2015, primarily reflecting declines in our Commercial business, partially offset by growth in our Government business.



Health Care Costs Payable
The following table shows the components of the change in health care costs payable during the three months ended March 31, 2016 and 2015:
(Millions)2016
 2015
Health care costs payable, beginning of period$6,305.7
 $5,621.1
Less: reinsurance recoverables4.1
 5.8
Health care costs payable, beginning of period, net6,301.6
 5,615.3
Add: Components of incurred health care costs:   
Current year11,474.5
 10,893.6
Prior years(626.8) (653.1)
Total incurred health care costs10,847.7
 10,240.5
    
Less: Claims paid   
Current year5,929.2
 5,929.8
Prior years4,398.2
 3,841.5
Total claims paid10,327.4
 9,771.3
    
Health care costs payable, end of period, net6,821.9
 6,084.5
Add: reinsurance recoverables2.9
 2.7
Health care costs payable, end of period$6,824.8
 $6,087.2
    

Our estimates of prior years’ health care costs payable decreased by $627 million and $653 million in the three months ended March 31, 2016 and 2015, respectively, resulting from claims being settled for amounts less than originally estimated, primarily due to lower health care cost trends than we assumed in establishing our health care costs payable in the prior years. This development does not directly correspond to an increase in our current year operating results as these reductions were offset by estimated current period health care costs when we established our estimate of current year health care costs payable.

GROUP INSURANCE

Group Insurance primarily includes group life insurance and group disability products. Group life insurance products are offered on an Insured basis. Group disability products are offered to employers on both an Insured and an ASC basis. Group Insurance also includes long-term care products that were offered primarily on an Insured basis.  We no longer solicit or accept new long-term care customers.



Operating Summary:Summary for the Three Months Ended March 31, 2017 and 2016:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Premiums:   
Life$280.0
 $301.8
Disability234.2
 214.7
Long-term care10.8
 11.1
Total premiums525.0
 527.6
Fees and other revenue26.1
 26.9
Net investment income57.7
 62.5
Net realized capital gains3.2
 2.9
Total revenue612.0
 619.9
Current and future benefits465.8
 448.1
Operating expenses:   
Selling expenses31.3
 28.6
General and administrative expenses87.3
 84.4
Total operating expenses118.6
 113.0
Total benefits and expenses584.4
 561.1
Income before income taxes27.6
 58.8
Income taxes4.2
 13.0
Net income attributable to Aetna for Group Insurance$23.4
 $45.8
    

The table presented below reconciles net income attributable to Aetna to operating earnings for our Group Insurance segment:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Net income attributable to Aetna for Group Insurance$23.4
 $45.8
Net realized capital gains, net of tax(2.1) (1.9)
Operating earnings for Group Insurance$21.3
 $43.9
    

Operating earnings for the three months ended March 31, 2016 decreased by $23 million when compared to the corresponding period in 2015, primarily due to lower underwriting margins in our Disability products.
 Three Months Ended    
 March 31, Change
(Millions)2017
 2016
 $ %
Premiums:       
Life$283
 $280
 $3
 1 %
Disability237
 234
 3
 1 %
Long-term care11
 11
 
  %
Total premiums531
 525
 6
 1 %
Fees and other revenue25
 26
 (1) (4)%
Net investment income63
 58
 5
 9 %
Net realized capital gains2
 3
 (1) (33)%
Total revenue621
 612
 9
 1 %
Current and future benefits467
 466
 1
  %
Operating expenses:    

 

Selling expenses37
 31
 6
 19 %
General and administrative expenses82
 87
 (5) (6)%
Total operating expenses119
 118
 1
 1 %
Total benefits and expenses586
 584
 2
  %
Income before income taxes attributable to Aetna for Group Insurance$35
 $28
 $7
 25 %
        

We calculate our group benefit ratio by dividing current and future benefits by total premiums.  Our group benefit ratios were:
 Three Months Ended
 March 31,
 2016
 2015
Group benefit ratio88.7% 84.9%
 Three Months Ended  
 March 31, Change
 2017
 2016
 basis points
Group benefit ratio87.9% 88.7% (80)

The 380 basis point increase in our group benefit ratiotable presented below reconciles income before income taxes attributable to Aetna to pre-tax adjusted earnings (1) for the three months ended March 31, 2017 and 2016 for our Group Insurance segment:
 Three Months Ended
 March 31,
(Millions)2017
 2016
Income before income taxes attributable to Aetna for Group Insurance (GAAP measure)$35
 $28
Net realized capital gains(2) (3)
Pre-tax adjusted earnings for Group Insurance$33
 $25
    
(1)
Pre-tax adjusted earnings excludes net realized capital gains and losses.

Commentary
Total revenue increased $9 million for the three months ended March 31, 2017 compared to the corresponding period in 2015 is2016 primarily due to lowerhigher premiums in our life and disability products and higher net investment income.
Income before income taxes attributable to Aetna for Group Insurance increased $7 million for the three months ended March 31, 2017 compared to the corresponding period in 2016. Pre-tax adjusted earnings for Group Insurance increased $8 million for the three months ended March 31, 2017 compared to the corresponding period in 2016. Income before income taxes and pre-tax adjusted earnings increased primarily due to higher net investment income.
Our group benefit ratio decreased 80 basis points for the three months ended March 31, 2017 compared to the corresponding period in 2016, primarily due to higher underwriting margins in our Disabilitylife products.






LARGE CASE PENSIONS

Large Case Pensions manages a variety of retirement products (including pension and annuity products) primarily for tax-qualified pension plans.  These products provide a variety of funding and benefit payment distribution options and other services.  The Large Case Pensions segment includes certain discontinued products.

Operating Summary:Summary for the Three Months Ended March 31, 2017 and 2016:
Three Months EndedThree Months Ended    
March 31,March 31, Change
(Millions)2016
 2015
2017
 2016
 $ %
Premiums$15.1
 $10.4
$13
 $15
 $(2) (13)%
Net investment income47.4
 72.9
71
 48
 23
 48 %
Other revenue2.2
 2.4
2
 2
 
  %
Net realized capital gains2.4
 .6

 2
 (2) (100)%
Total revenue67.1
 86.3
86
 67
 19
 28 %
Current and future benefits63.1
 80.0
78
 63
 15
 24 %
General and administrative expenses3.2
 3.1
3
 3
 
  %
Total benefits and expenses66.3
 83.1
81
 66
 15
 23 %
Income before income taxes (benefits).8
 3.2
Income taxes (benefits).9
 (.3)
Net (loss) income including non-controlling interests(.1) 3.5
Less: Net (loss) income attributable to non-controlling interests(1.4) 1.0
Net income attributable to Aetna for Large Case Pensions$1.3
 $2.5
Income before income tax expense including non-controlling interests5
 1
 4
 400 %
Less: Income (loss) before income taxes attributable to non-controlling interests1
 (2) 3
 (150)%
Income before income taxes attributable to Aetna for Large Care Pensions$4
 $3
 $1
 33 %
          

The table presented below reconciles net income attributablebefore income taxes to Aetna to operating (loss)pre-tax adjusted earnings(1) for the three months ended March 31, 2017 and 2016 for our Large Case Pensions segment:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Net income attributable to Aetna for Large Case Pensions$1.3
 $2.5
Net realized capital gains, net of tax(1.6) (.4)
Operating (loss) earnings for Large Case Pensions$(.3) $2.1
    
 Three Months Ended
 March 31,
(Millions)2017
 2016
Income before income taxes for Large Case Pensions (GAAP measure)$5
 $1
Less: Income (loss) before income taxes attributable to non-controlling interests (GAAP measure)1
 (2)
Income before income taxes attributable to Aetna for Large Case Pensions (GAAP measure)4
 3
Net realized capital gains
 (2)
Pre-tax adjusted earnings for Large Case Pensions$4
 $1
    
(1)
Pre-tax adjusted earnings excludes net realized capital gains and losses.

Commentary
Total revenue decreased byincreased $19 million for the three months ended March 31, 2016, when2017 compared to the corresponding period in 2015,2016, primarily as a result of lowerdue to higher net investment income.
Income before income taxes attributable to Aetna for Large Care Pensions and pre-tax adjusted earnings for Large Case Pensions both remained relatively flat for the three months ended March 31, 2017 compared to the corresponding period in 2016.

Discontinued Products
Prior to 1993, we sold single-premium annuities (“SPAs”) and guaranteed investment contracts (“GICs”), primarily to employer sponsored pension plans.  In 1993, we discontinued selling these products to Large Case Pensions customers, and now we refer to these products as discontinued products.

In November 2016, the last outstanding GIC matured. We discontinued selling these products because they were generating losses for us, and we projected that they would continue to generate losses over their life (which is currently greater than 30 years for SPAs)years); so we established a reserve for anticipated future losses at the time of discontinuance.  At both March 31, 2016 and December 31, 2015, our remaining GIC liability was not material. We provide additional information on the reserve for anticipated future losses, including key assumptions and other important information, in Note 17 beginning on page 36.



The operating summary for Large Case Pensions above includes revenues and expenses related to our discontinued products, with the exception of net realized capital gains and losses which are recorded as part of current and future


benefits.  Since we established a reserve for anticipated future losses on discontinued products, as long as our expected future losses remain consistent with prior projections, the results of our discontinued products are applied against the reserve and do not impact net income attributable to Aetna. If actual or expected future losses are greater than we currently estimate, we may increase the reserve, which could adversely impact net income attributable to Aetna. If actual or expected future losses are less than we currently estimate, we may decrease the reserve, which could favorably impact net income attributable to Aetna. In those cases, we disclose such adjustment separately in the operating summary.  Management reviews the adequacy of the discontinued products reserve quarterly. The current reserve reflects management’s best estimate of anticipated future losses, and is included in future policy benefits on our balance sheets.Balance Sheets.

Refer to Note 17 of beginning on page 3616 for additional information on the activity in the reserve for anticipated future losses on discontinued products during the three months ended March 31, 20162017 and 2015.

INVESTMENTS

Our investment portfolio supported the following products at March 31, 2016 and December 31, 2015:
(Millions)March 31,
2016

 December 31,
2015

Experience-rated products (1)
$1,175.4
 $1,156.7
Discontinued products (1)
3,125.7
 3,059.1
Remaining products20,938.9
 20,463.8
Total investments$25,240.0
 $24,679.6
    
(1)
Investment risks associated with our experience-rated and discontinued products generally do not impact our operating results.

The risks associated with investments supporting experience-rated pension and annuity products in our Large Case Pensions business are assumed by the contract holders and not by us (subject to, among other things, certain minimum guarantees). Assets supporting experience-rated products may be subject to contract holder or participant withdrawals. Experience-rated contract holder and participant-directed withdrawals for the three months ended March 31, 2016 and 2015 were as follows:
 Three Months Ended
 March 31,
(Millions)2016
 2015
Scheduled contract maturities and benefit payments (1)
$18.0
 $20.2
Contract holder withdrawals other than scheduled contract   
maturities and benefit payments.7
 8.8
Participant-directed withdrawals.4
 1.0
    
(1)
Includes payments made upon contract maturity and other amounts distributed in accordance with contract schedules.

Debt and Equity Securities
The debt securities in our investment portfolio had an average credit quality rating of A at both March 31, 2016 and December 31, 2015, with approximately $5.2 billion and $5.0 billion rated AAA at March 31, 2016 and December 31, 2015, respectively.  The debt securities that were rated below investment grade (that is, having a credit quality rating below BBB-/Baa3) were $1.5 billion and $1.4 billion at March 31, 2016 and December 31, 2015, respectively (of which 13% at both March 31, 2016 and December 31, 2015, supported our experience-rated and discontinued products).

At March 31, 2016 and December 31, 2015, we held $973 million and $956 million, respectively, of municipal debt securities that were guaranteed by third parties, representing 4% of our total investments at each date.  These securities had an average credit quality rating of AA at both March 31, 2016 and December 31, 2015, with the guarantee.  These securities had an average credit quality rating of A+ and A at March 31, 2016 and December 31,


2015, respectively, without the guarantee.  We do not have any significant concentration of investments with third party guarantors (either direct or indirect).

At both March 31, 2016 and December 31, 2015, less than 1% of our investment portfolio was comprised of investments that were either European sovereign, agency, or local government debt of countries which, in our judgment based on an analysis of market-yields, are experiencing economic, fiscal or political strains such that the likelihood of default may be higher than if those factors did not exist.

Additionally, at both March 31, 2016 and December 31, 2015, less than 7% of our investment portfolio was comprised of investments that have exposure to the oil and gas industry, with more than half that amount comprised of investment grade rated debt securities. These exposures are experiencing varied degrees of financial strains in the current depressed oil and gas price environment, and the likelihood of our portfolio incurring realized capital losses on these exposures may increase if such depressed prices persist and/or decline further. 

We generally classify our debt and equity securities as available for sale, and carry them at fair value on our balance sheets.  At both March 31, 2016 and December 31, 2015, 1% of our debt and equity securities were valued using inputs that reflect our own assumptions (categorized as Level 3 inputs in accordance with GAAP).  Refer to Note 9 beginning on page 19 for additional information on the methodologies and key assumptions we use to determine the fair value of investments.

Refer to Note 6 beginning on page 11 for details related to:
Our investment portfolio balances at March 31, 2016 and December 31, 2015;
Gross unrealized capital gains and losses by major security type;
Debt securities with unrealized capital losses (including the amounts related to experience-rated and discontinued products);
Our net realized capital gains and losses; and
Our mortgage loan portfolio.

We regularly review our debt securities to determine if a decline in fair value below the carrying value is other-than-temporary.  If we determine a decline in fair value is other-than-temporary, we will write down the carrying value of the security.  The amount of the credit-related impairment is included in our operating results, and the non-credit related component is included in other comprehensive income unless we intend to sell the security or it is more likely than not that we will be required to sell the debt security prior to its anticipated recovery of its amortized cost basis.  Accounting for other-than-temporary impairment (“OTTI”) of our debt securities is considered a critical accounting estimate.  Refer to “Critical Accounting Estimates - Other-Than-Temporary Impairment of Debt Securities” in our 2015 Annual Report for additional information.

Risk Management and Market-Sensitive Instruments
We manage interest rate risk by seeking to maintain a tight match between the durations of our assets and liabilities when appropriate.  We manage credit risk by seeking to maintain high average credit quality ratings and diversified sector exposure within our debt securities portfolio.  In connection with our investment and risk management objectives, we also use derivative financial instruments whose market value is at least partially determined by, among other things, levels of or changes in interest rates (short-term or long-term), duration, prepayment rates, equity markets or credit ratings/spreads.  Our use of these derivatives is generally limited to hedging risk and has principally consisted of using interest rate swaps, treasury rate locks, forward contracts, futures contracts, warrants, put options and credit default swaps.  These instruments, viewed separately, subject us to varying degrees of interest rate, equity price and credit risk.  However, when used for hedging, we expect these instruments to reduce overall risk.

We regularly evaluate our risk from market-sensitive instruments by examining, among other things, levels of or changes in interest rates (short-term or long-term), duration, prepayment rates, equity markets or credit ratings/spreads.  We also regularly evaluate the appropriateness of investments relative to our management-approved investment guidelines (and operate within those guidelines) and the business objectives of our portfolios.



On a quarterly basis, we review the impact of hypothetical net losses in our investment portfolio on our consolidated near-term financial position, operating results and cash flows assuming the occurrence of certain reasonably possible changes in near-term market rates and prices. Interest rate changes (whether resulting from changes in treasury yields or credit spreads or other factors) represent the most material risk exposure category for us.  Based upon this analysis, there have been no material changes in our exposure to these risks since December 31, 2015. Refer to the MD&A in our 2015 Annual Report for a more complete discussion of risk management and market-sensitive instruments.2016.

LIQUIDITY AND CAPITAL RESOURCES

Cash Flows
We meet our operating cash requirements by maintaining liquidity in our investment portfolio, using overall cash flows from premiums, fees and other revenue, deposits and income received on investments, issuing commercial paper, takingentering into repurchase agreements and obtaining cash advances from the Federal Home Loan Bank of Boston (“FHLBB”) and entering into repurchase agreements from time to time.  We monitor the duration of our investment portfolio of highly marketable debt securities and mortgage loans, and execute purchases and sales of these investments with the objective of having adequate funds available to satisfy our maturing liabilities.  Overall cash flows are used primarily for claim and benefit payments, operating expenses, share and debt repurchases, repayment of debt, acquisitions, contract withdrawals and shareholder dividends and to increase cash and cash equivalents in anticipation of the Humana Acquisition.dividends.  We have committed short-term borrowing capacity of $2.0 billion through a revolving credit facility agreement that expires in March 2020.2021.

Presented below is a condensed statementStatement of cash flowsCash Flows for the three months ended March 31, 20162017 and 2015.2016. We present net cash flows used for operating activities and net cash flows provided by investing activities separately for our Large Case Pensions segment because changes in the insurance reserves for the Large Case Pensions segment (which are reported as cash used for operating activities) are funded from the sale of investments (which are reported as cash provided by investing activities). Refer to the Consolidated Statements of Cash Flows on page 5for additional information.
Three Months EndedThree Months Ended    
March 31,March 31, Change
(Millions)2016
 2015
2017
 2016
 $
 %
Cash flows from operating activities          
Health Care and Group Insurance$1,843.7
 $1,556.2
$983
 $1,854
 $(871) (47)%
Large Case Pensions(62.8) (82.8)(84) (63) (21) 33 %
Net cash provided by operating activities1,780.9
 1,473.4
899
 1,791
 (892) (50)%
Cash flows from investing activities 
  
 
  
    
Health Care and Group Insurance(203.8) (92.3)(228) (204) (24) 12 %
Large Case Pensions27.1
 114.1
172
 27
 145
 537 %
Net cash (used for) provided by investing activities(176.7) 21.8
Net cash used for investing activities(56) (177) 121
 (68)%
Net cash used for financing activities(362.1) (999.8)(14,962) (372) (14,590) 3,922 %
Net increase in cash and cash equivalents$1,242.1
 $495.4
Net (decrease) increase in cash and cash equivalents$(14,119) $1,242
 $(15,361) (1,237)%
 
Cash Flow AnalysisCommentary
Cash flows provided by operating activities for Health Care and Group Insurance were approximately $1.8 billion decreased $871 million during the three months ended March 31, 2017 compared to the corresponding period in 2016 primarily due to cash payments associated with the termination of the Merger Agreement in 2017 and $1.6 billiona decrease in income taxes payable due to a loss before income taxes for the three months ended March 31, 2016 and 2015, respectively. The increase in cash flows provided by operating activities2017 compared with income before income taxes for the three months ended March 31, 2016 compared with the corresponding period in 2015 is primarily attributable to2016. The decrease was partially offset by the timing of collections ofMedicare premium and other receivables.receipts, as we received an advanced payment associated with April 2017 in March 2017.



Cash flows used for investing activities were $177 decreased $121 million for the three months ended March 31, 2017 compared to the corresponding period in 2016, compared with cash flows provided by investing activitiesprimarily due to net sales and maturities of $22 millioninvestments for the three months ended March 31, 2015.  The increase in cash used for investing activities2017 compared with net purchases of investments for the three months ended March 31, 2016 compared with2016.
Cash flows used for financing activities increased $14.6 billion primarily due to the corresponding period in 2015 is primarily attributable to higher net purchasesrepayment of investments.

Duringlong-term debt and share repurchases during the three months ended March 31, 2016, our cash flows used for financing activities reflect collateral paid on interest rate hedges, dividends paid to our shareholders and the issuance of common shares under benefit plans. During the three months ended March 31, 2015, our cash flows used for financing activities reflect the repayment of debt, settlements from repurchase agreements, share repurchases, dividends paid to our shareholders and the issuance of common shares under benefit plans. 2017.

Refer to Note 12 beginning on page 29Notes 8 and 10 for more information about debt issuances, debt repayments, share repurchases and dividend payments.

Long-Term Debt, Revolving Credit Facility; Bridge Credit Agreement;Termination of Merger Agreement and Term Loan AgreementAetna APA
In support of our capital management goals, during 2015 we repaid maturing long-term debt and extended the maturity date of our revolving credit facility. Additionally, in July 2015 and in connection with the Humana Acquisition, we entered intoAs a $13.0 billion 364-day senior unsecured bridge credit agreement (the “Bridge Credit Agreement”) and a $3.2 billion three-year term loan credit agreement (the “Term Loan Agreement”). In addition, in July 2015, we amended our revolving credit facility to increase the commitments available from $2.0 billion to $3.0 billion upon our request and the satisfaction of certain conditions, including the completionresult of the transactions contemplated bytermination of the Merger Agreement, we paid Humana the applicable $1.0 billion Regulatory Termination Fee on February 16, 2017. As a result of the APA Termination Agreement, we paid Molina the applicable termination fee of $53 million on February 16, 2017 and paid Molina the applicable transaction costs of $7 million on February 27, 2017. We funded these payments with the proceeds of the 2016 senior notes.

2016 Senior Notes
In June 2016, we issued $13 billion of 2016 senior notes. In accordance with the terms of the 2016 senior notes, on February 14, 2017, following the termination of Humana’s existing credit agreement dated asthe Merger Agreement, we issued a notice of July 9, 2013. Referredemption for the entire $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes at a redemption price equal to Note 11 beginning101% of the aggregate principal amount of those notes plus accrued and unpaid interest. We redeemed the Special Mandatory Redemption Notes on page 26March 16, 2017, and we funded the redemption with the proceeds of the 2016 senior notes. As a result of the redemption, we recognized on a pretax basis in our net income a loss on early extinguishment of long-term debt of $192 million and a realized capital loss for additional information on these transactions.

Cash Flow Hedges
We have entered into various interest rate swaps and treasury rate locks that are designated as cash flow hedges against interest rate exposure related to the forecasted future issuance of fixed-rate debt to be primarily used to finance aremaining unamortized effective portion of the purchase pricerelated hedge loss of the Humana Acquisition.$323 million that was previously recorded in accumulated other comprehensive income. Refer to Note 11 beginning on page 26Notes 3 and 8 for additional information on these transactions.

Other Liquidity Information
From time to time, we use short-term commercial paper borrowings, repurchase agreements and cash advances from the FHLBB to address timing differences between cash receipts and disbursements. At both March 31, 20162017 and December 31, 2015,2016, we did not have any commercial paper outstanding. There were nooutstanding or outstanding advances from the FHLBB. The maximum amount of commercial paper borrowings outstanding during the three months ended March 31, 2016.2017 was approximately $450 million.

Our debt to capital ratio (calculated as the sum of all short- and long-term debt outstanding (“total debt”) divided by the sum of total Aetna shareholders’ equity plus total debt) was approximately 32%39.8% at March 31, 2016. At the completion of the Humana Acquisition, we currently project our debt to capital ratio will be approximately 46% as we expect to issue approximately $16.2 billion of new debt, including senior notes, term loans and commercial paper, to partially finance the cash portion of the purchase price. Following the announcement of the Humana Acquisition in July 2015, each of Standard & Poor’s Rating Services, A.M. Best, Fitch Ratings and Moody’s Investors Service placed certain of our debt, financial strength and other credit ratings under review for a possible downgrade. We currently project that our debt to capital ratio will decrease below 40% over the 24 months following the completion of the Humana Acquisition.2017. We continually monitor existing and alternative financing sources to support our capital and liquidity needs, including, but not limited to, debt issuance, preferred or common stock issuance, reinsurance and pledging or selling of assets.

Interest expense was $102$173 million and $80$102 million for the three months ended March 31, 20162017 and 2015,2016, respectively. The increase in interest expense during 20162017 compared to 20152016 reflects the impact offinancing activity associated with the Bridge Credit Agreement and the Term Loan Agreement.Humana Transaction.

Refer to Notes 118 and 12 beginning on pages 26 and 29, respectively,10 for information on our FHLBB membership and our stock-based compensation awards granted during 2017, respectively.

Contractual Obligations
The following table summarizes certain estimated future obligations by period under certain of our contractual obligations at March 31, 2017. The table below does not include all future obligations by period; it only includes those future obligations that have changed materially from those presented in our 2016 respectively.Annual Report as a result of the redemption of the $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes and the redemption of the $750 million aggregate principal amount of the 2020 Notes in March 2017. We believe that funds from future operating cash flows, together with cash, investments and other funds available under the Facility; from the FHLBB; and from public or private financing sources, will be sufficient to meet our existing commitments as well as our liquidity needs associated with future operations, including our strategic growth initiatives.
(Millions)2017
 2018-2019
 2020-2021
 Thereafter
 Total
Long-term debt obligations, including interest$1,572
 $1,983
 $1,660
 $8,505
 $13,720
          




CRITICAL ACCOUNTING ESTIMATES

Refer to “Critical Accounting Estimates” in our 20152016 Annual Report for information on accounting policies that we consider critical in preparing our consolidated financial statements.  These policies include significant estimates we make using information available at the time the estimates are made.  However, these estimates could change materially if different information or assumptions were used, and these estimates may not ultimately reflect the actual amounts that occur.

REGULATORY ENVIRONMENT
ThereExcept as described in the “Health Care Reform” section of the MD&A, there were no material changes in the regulation of our business since December 31, 2015.2016.  Refer to the “Regulatory Environment” section in our 20152016 Annual Report for information on the regulation of our business.

FORWARD-LOOKING INFORMATION/RISK FACTORSINFORMATION

Certain information in this MD&A is forward-looking within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are subject to uncertainties that are outside our control and could cause actual future results to differ materially from those statements. You should not place undue reliance on forward-looking statements, and we disclaim any intention or obligation to update or revise forward-looking statements, whether as a result of new information, future events or otherwise.

You should read the Forward Looking Information/Risk Factors section of our 2015 Annual Report. You should read that section of our 2015 Annual Report and the information below carefully because each of them contains a discussion of important risk factors that could adversely affect our business as well as the market price for our common stock.

Risks relating to Humana.
Following completion of the Merger, Aetna will be subject to the risks described in (i) Part I, Item 1A in Humana's Annual Report on Form 10-K for the year ended December 31, 2015, filed with the SEC on February 18, 2016, and incorporated by reference into our 2015 Annual Report.

Item 3.Quantitative and Qualitative Disclosures About Market Risk

We have not experienced any material changes in exposuresOur earnings and financial position are exposed to interest rate risk, credit quality risk and market risk since December 31, 2015.  Refer to the information contained in the “Risk Management and Market-Sensitive Instruments” section of the MD&A beginning on page 50 forvaluation risk.

For a discussion of these risks, refer to Item 7A “Quantitative and Qualitative Disclosures About Market Risk” included in our exposures2016 Annual Report on form 10-K. The market risk information below does not include all market risks; it only includes the market risks that have changed materially from those presented in our 2016 Annual Report as a result of the redemption of the $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes and the redemption of the $750 million aggregate principal amount of the 2020 Notes in March 2017.

Evaluation of Market Risks
We regularly evaluate our risk from market-sensitive instruments by examining, among other things, levels of or changes in interest rates (short-term or long-term), duration, prepayment rates, equity markets or credit ratings/spreads.  We also regularly evaluate the appropriateness of investments relative to our management-approved investment guidelines (and operate within those guidelines) and the business objectives of our portfolios.

On a quarterly basis, we review the impact of hypothetical net losses in our investment portfolio on our consolidated near-term financial position, operating results and cash flows assuming the occurrence of certain reasonably possible changes in near-term market risk.rates and prices. Interest rate changes (whether resulting from changes in treasury yields or credit spreads or other factors) represent the most material risk exposure category for us. In March 2017, following the termination of the Merger Agreement, we redeemed $10.2 billion aggregate principal amount of the Special Mandatory Redemption Notes and also redeemed $750 million aggregate principal amount of the 2020 Notes. We have estimated the impact on the fair value of our market sensitive instruments based on the net present value of cash flows using a representative set of likely future interest rate scenarios. The assumptions used were as follows: an immediate increase of 100 basis points in interest rates (which we believe represents a moderately adverse scenario and is approximately equal to the historical annual volatility of interest rate movements for our intermediate-term available-for-sale debt securities) and an immediate decrease of 15% in prices for domestic equity securities.

Assuming an immediate 100 basis point increase in interest rates and immediate decrease of 15% in the prices for domestic equity securities, the theoretical decline in the fair values of our market sensitive instruments at March 31, 2017 is as follows:
The fair value of our long-term debt would decline by $433 million ($667 million pretax). Changes in the fair value of our long-term debt do not impact our financial position or operating results.
The theoretical reduction in the fair value of our investment securities partially offset by the theoretical reduction in the fair value of our interest rate sensitive liabilities would result in a net decline in fair value of $315 million ($484 million pretax) related to our continuing non-experience-rated products. Reductions in the fair value of our investment securities would be reflected as an unrealized loss in equity, as we classify these securities as available for sale. We do not record our liabilities at fair value.


Based on our overall exposure to interest rate risk and equity price risk, we believe that these changes in market rates and prices would not materially affect our consolidated near-term financial position, operating results or cash flows at March 31, 2017.

Item 4.Controls and Procedures

Disclosure Controls and Procedures
We maintain disclosure controls and procedures, which are designed to ensure that information that we are required to disclose in the reports we file or submit under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions regarding required disclosure.



An evaluation of the effectiveness of our disclosure controls and procedures as of March 31, 20162017 was conducted under the supervision and with the participation of our Chief Executive Officer and Chief Financial Officer.  Based on that evaluation, our Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures as of March 31, 20162017 were designed to ensure that material information relating to Aetna Inc. and its consolidated subsidiaries would be made known to the Chief Executive Officer and Chief Financial Officer by others within those entities, particularly during the periods when periodic reports under the Exchange Act are being prepared and were effective.  Refer to the Certifications by our Chief Executive Officer and Chief Financial Officer filed as Exhibits 31.1 and 31.2 to this report.Quarterly Report on Form 10-Q.

Changes in Internal Control over Financial Reporting
There has been no change in our internal control over financial reporting identified in connection with the evaluation of such control that occurred during our most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

Part II.Other Information

Item 1.Legal Proceedings

The information contained in Note 14 of Condensed Notes to Consolidated Financial Statements beginning on page 31is incorporated herein by reference.

Item 1A.Risk Factors

The information contained underExcept as disclosed in MD&A “Overview - Health Care Reform” in this Quarterly Report, there have been no material changes to the heading “Forward-Looking Information/Risk“Risk Factors” disclosed in Part I, Item 1A of our 2016 Annual Report. Those risk factors could adversely affect our business, financial condition and operating results as well as the MD&A, beginning on page 53 is incorporated herein by reference.market price for our common shares.

Item 2.Unregistered Sales of Equity Securities and Use of Proceeds

DuringThe following table provides information about our monthly share repurchases, all of which were purchased as part of a publicly-announced program, for the three months ended March 31, 2016, we did not repurchase any shares of common stock. At March 31, 2016, we had remaining authorization to repurchase an aggregate of up to approximately $1.1 billion of common stock under our November 21, 2014 and February 28, 2014 programs. Prior to the closing of the Humana Acquisition, our ability to repurchase shares of common stock will be limited. We expect to suspend our share repurchase programs for approximately six months following the closing of the transaction.2017:
Issuer Purchases of Equity Securities (1)
(Millions, except per share amounts)
Total Number of
Shares Purchased

 
 Average Price
Paid Per Share

 Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs
 Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs
January 1, 2017 - January 31, 2017
 $
 
 $1,083
February 1, 2017 - February 28, 201720.9
 126.34
 20.9
 1,783
March 1, 2017 - March 31, 2017
 
 
 1,783
Total20.9
 $126.34
 20.9
 N/A
(1)
The remaining share repurchase authorization as of February 28, 2017 has been reduced for the entire $3.3 billion paid in connection with an accelerated share repurchase program. The number of shares purchased under the accelerated share repurchase program is presented in February 2017 and the remaining number of shares to be repurchased will be presented in the second and/or third quarter of 2017, based upon when the shares were ultimately delivered to the Company.

The information contained in Note 1210 of Condensed Notes to Consolidated Financial Statements beginning on page 29is incorporated herein by reference.


Item 3.        Defaults Upon Senior Securities

None.

Item 4.        Mine Safety Disclosures

Not Applicable.

Item 5.        Other Information

None.



Item 6. Exhibits

Exhibits to this Form 10-Q are as follows:
10Material Contracts
  
10.1Letter AgreementMaster Confirmation - Accelerated Share Repurchase dated September 17, 2015February 22, 2017 between Aetna Inc. and Gary W. Loveman. JPMorgan Chase Bank, National Association, London Branch, incorporated herein by reference to Exhibit 10.1 to Aetna Inc.’s Form 8-K filed on February 22, 2017.
10.2Master Confirmation - Accelerated Share Repurchase dated February 22, 2017 between Aetna Inc. and Bank of American, N.A., incorporated herein by reference to Exhibit 10.2 to Aetna Inc.’s Form 8-K filed on February 22, 2017.
10.3Fourth Amendment dated as of March 17, 2017, to the Five-Year Credit Agreement dated as of March 27, 2012, incorporated herein by reference to Exhibit 99.1 to Aetna Inc.’s Form 8-K filed on March 21, 2017.
10.4Notice of closing (Fourth Amendment) dated March 17, 2017 incorporated herein by reference to Exhibit 99.2 to Aetna Inc.’s Form 8-K filed on March 21, 2017.
10.5Letter agreement dated March 31, 2016, between Aetna Inc. and Thomas J. Sabatino, Jr.*
  
11Statement re: computation of per share earnings
  
11.1“Computation of per share earnings” is incorporated herein by reference to Note 412 of Condensed Notes to Consolidated Financial Statements beginning on page 10 in this Form 10-Q.
  
12Statements re: computation of ratios
  
12.1Computation of ratio of earnings to fixed charges.
  
15Letter re: unaudited interim financial information
  
15.1Letter from KPMG LLP acknowledging awareness of the use of a report dated April 28, 2016May 2, 2017 related to their review of interim financial information.
  
31Rule 13a-14(a)/15d-14(a) Certifications
  
31.1Certification.
  
31.2Certification.
  
32Section 1350 Certifications
  
32.1Certification.
  
32.2Certification.
  
101XBRL Documents
  
101.INSXBRL Instance Document.
  
101.SCHXBRL Taxonomy Extension Schema.
  
101.CALXBRL Taxonomy Extension Calculation Linkbase.
  
101.DEFXBRL Taxonomy Extension Definition Linkbase.
  
101.LABXBRL Taxonomy Extension Label Linkbase.
  
101.PREXBRL Taxonomy Extension Presentation Linkbase.

* Management contract or compensatory plan or arrangement.




SIGNATURES




Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.


 Aetna Inc.
 Registrant


Date:April 28, 2016May 2, 2017   By/s/ Sharon A. Virag
   Sharon A. Virag
   Vice President, Controller and
   Chief Accounting Officer
 


INDEX TO EXHIBITS

Exhibit  Filing
Number DescriptionMethod
10 Material Contractscontracts 
    
10.1 Letter Agreementagreement dated September 17, 2015March 31, 2016 between Aetna Inc. and Gary W. Loveman.Thomas J. Sabatino, Jr.Electronic
    
12 Statements re: computation of ratios 
    
 Computation of ratio of earnings to fixed charges.Electronic
    
15 Letter re: unaudited interim financial information 
    
 Letter from KPMG LLP acknowledging awareness of the use of a report dated April 28, 2016May 2, 2017 related to their review of interim financial information.Electronic
    
31 Rule 13a-14(a)/15d-14(a) Certifications 
    
 Certification.Electronic
    
 Certification.Electronic
    
32 Section 1350 Certifications 
    
 Certification.Electronic
    
 Certification.Electronic
    
101 XBRL Documents 
    
101.INS XBRL Instance Document.Electronic
    
101.SCH XBRL Taxonomy Extension Schema.Electronic
    
101.CAL XBRL Taxonomy Extension Calculation Linkbase.Electronic
    
101.DEF XBRL Taxonomy Extension Definition Linkbase.Electronic
    
101.LAB XBRL Taxonomy Extension Label Linkbase.Electronic
    
101.PRE XBRL Taxonomy Extension Presentation Linkbase.Electronic
    


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