Centene (CNC) 10-Q 24 Oct 24 2024 Q3 Quarterly report Financial data

Cover

Cover - shares shares in Thousands	9 Months Ended
	Sep. 30, 2024	Oct. 23, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-31826
Entity Registrant Name	CENTENE CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	42-1406317
Entity Address, Address Line One	7700 Forsyth Boulevard
Entity Address, City or Town	St. Louis,
Entity Address, State or Province	MO
Entity Address, Postal Zip Code	63105
City Area Code	314
Local Phone Number	725-4477
Title of 12(b) Security	Common Stock $0.001 Par Value
Trading Symbol	CNC
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		504,865
Entity Central Index Key	0001071739
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 14,577	$ 17,193
Premium and trade receivables	18,281	15,532
Short-term investments	2,992	2,459
Other current assets	1,559	5,572
Total current assets	37,409	40,756
Long-term investments	17,691	16,286
Restricted deposits	1,452	1,386
Property, software and equipment, net	2,042	2,019
Goodwill	17,558	17,558
Intangible assets, net	5,582	6,101
Other long-term assets	617	535
Total assets	82,351	84,641
Current liabilities:
Medical claims liability	17,995	18,000
Accounts payable and accrued expenses	13,338	16,420
Return of premium payable	1,959	1,462
Unearned revenue	658	715
Current portion of long-term debt	111	119
Total current liabilities	34,061	36,716
Long-term debt	17,494	17,710
Deferred tax liability	769	641
Other long-term liabilities	2,618	3,618
Total liabilities	54,942	58,685
Commitments and contingencies
Redeemable noncontrolling interests	13	19
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at September 30, 2024 and December 31, 2023	0	0
Common stock, $0.001 par value; authorized 800,000 shares; 619,945 issued and 510,078 outstanding at September 30, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023	1	1
Additional paid-in capital	20,522	20,304
Accumulated other comprehensive (loss)	(226)	(652)
Retained earnings	15,065	12,043
Treasury stock, at cost (109,867 and 80,807 shares, respectively)	(8,055)	(5,856)
Total Centene stockholders' equity	27,307	25,840
Nonredeemable noncontrolling interest	89	97
Total stockholders' equity	27,396	25,937
Total liabilities, redeemable noncontrolling interests and stockholders' equity	$ 82,351	$ 84,641

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	800,000,000	800,000,000
Common stock, shares issued (in shares)	619,945,000	615,291,000
Common stock, shares outstanding (in shares)	510,078,000	534,484,000
Treasury stock (in shares)	109,867,000	80,807,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenues:
Premium and service revenues	$ 36,899	$ 34,967	$ 109,209	$ 104,757
Premium tax	5,124	3,075	13,057	9,782
Total revenues	42,023	38,042	122,266	114,539
Expenses:
Medical costs	32,201	29,479	93,898	88,260
Cost of services	692	856	2,041	2,603
Selling, general and administrative expenses	3,057	3,048	9,169	9,075
Depreciation expense	140	148	408	436
Amortization of acquired intangible assets	173	180	519	542
Premium tax expense	5,095	3,156	13,218	10,021
Impairment	0	440	13	478
Total operating expenses	41,358	37,307	119,266	111,415
Earnings from operations	665	735	3,000	3,124
Other income (expense):
Investment and other income	432	214	1,440	992
Interest expense	(176)	(181)	(530)	(542)
Earnings before income tax	921	768	3,910	3,574
Income tax expense	211	293	896	914
Net earnings	710	475	3,014	2,660
(Earnings) loss attributable to noncontrolling interests	3	(6)	8	(3)
Net earnings attributable to Centene Corporation	$ 713	$ 469	$ 3,022	$ 2,657
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in dollars per share)	$ 1.37	$ 0.87	$ 5.71	$ 4.86
Diluted earnings per common share (in dollars per share)	$ 1.36	$ 0.87	$ 5.69	$ 4.85
Weighted average number of common shares outstanding:
Basic (in shares)	521,965	539,535	528,912	546,374
Diluted (in shares)	523,542	541,270	530,915	548,412
Premium
Revenues:
Premium and service revenues	$ 36,115	$ 33,866	$ 106,784	$ 101,404
Service
Revenues:
Premium and service revenues	$ 784	$ 1,101	$ 2,425	$ 3,353

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Net earnings	$ 710	$ 475	$ 3,014	$ 2,660
Change in unrealized gain (loss) on investments	549	(235)	442	(124)
Change in unrealized gain (loss) on investments, tax effect	(130)	56	(109)	29
Change in unrealized gain (loss) on investments, net of tax	419	(179)	333	(95)
Reclassification adjustment, net of tax	1	57	93	61
Foreign currency translation adjustments, net of tax	0	(22)	0	24
Net unrealized gain on cash flow hedge, net of tax	0	20	0	20
Other comprehensive earnings (loss)	420	(124)	426	10
Comprehensive earnings	1,130	351	3,440	2,670
Comprehensive (earnings) loss attributable to noncontrolling interests	3	(6)	8	(3)
Comprehensive earnings attributable to Centene Corporation	$ 1,133	$ 345	$ 3,448	$ 2,667

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Earnings (Loss)	Retained Earnings	Treasury Stock	Noncontrolling Interest
Balance (in shares) at Dec. 31, 2022		607,847
Treasury stock (in shares) at Dec. 31, 2022						57,093
Balance at Dec. 31, 2022	$ 24,181	$ 1	$ 20,060	$ (1,132)	$ 9,341	$ (4,213)	$ 124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,130				1,130
Other comprehensive earnings (loss), net of tax	217			217
Common stock issued for employee benefit plans (in shares)		6,508
Common stock issued for employee benefit plans	12		12
Common stock repurchases (in shares)						5,548
Common stock repurchases	(423)					$ (423)
Stock compensation expense	61		61
Purchase of redeemable noncontrolling interest	(12)		(12)
Balance (in shares) at Mar. 31, 2023		614,355
Treasury stock (in shares) at Mar. 31, 2023						62,641
Balance at Mar. 31, 2023	25,166	$ 1	20,121	(915)	10,471	$ (4,636)	124
Balance (in shares) at Dec. 31, 2022		607,847
Treasury stock (in shares) at Dec. 31, 2022						57,093
Balance at Dec. 31, 2022	24,181	$ 1	20,060	(1,132)	9,341	$ (4,213)	124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Other comprehensive earnings (loss), net of tax	10
Balance (in shares) at Sep. 30, 2023		614,956
Treasury stock (in shares) at Sep. 30, 2023						80,360
Balance at Sep. 30, 2023	25,395	$ 1	20,243	(1,122)	11,998	$ (5,825)	100
Balance (in shares) at Mar. 31, 2023		614,355
Treasury stock (in shares) at Mar. 31, 2023						62,641
Balance at Mar. 31, 2023	25,166	$ 1	20,121	(915)	10,471	$ (4,636)	124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,055				1,058		(3)
Other comprehensive earnings (loss), net of tax	(83)			(83)
Common stock issued for employee benefit plans (in shares)		388
Common stock issued for employee benefit plans	9		9
Common stock repurchases (in shares)						6,099
Common stock repurchases	(408)					$ (408)
Stock compensation expense	56		56
Purchase of redeemable noncontrolling interest	(27)		(3)				(24)
Balance (in shares) at Jun. 30, 2023		614,743
Treasury stock (in shares) at Jun. 30, 2023						68,740
Balance at Jun. 30, 2023	25,768	$ 1	20,183	(998)	11,529	$ (5,044)	97
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	472				469		3
Other comprehensive earnings (loss), net of tax	(124)			(124)
Common stock issued for employee benefit plans (in shares)		213
Common stock issued for employee benefit plans	11		11
Common stock repurchases (in shares)						11,620
Common stock repurchases	(781)					$ (781)
Stock compensation expense	50		50
Purchase of redeemable noncontrolling interest	(1)		(1)
Balance (in shares) at Sep. 30, 2023		614,956
Treasury stock (in shares) at Sep. 30, 2023						80,360
Balance at Sep. 30, 2023	$ 25,395	$ 1	20,243	(1,122)	11,998	$ (5,825)	100
Balance (in shares) at Dec. 31, 2023	534,484	615,291
Treasury stock (in shares) at Dec. 31, 2023	80,807					80,807
Balance at Dec. 31, 2023	$ 25,937	$ 1	20,304	(652)	12,043	$ (5,856)	97
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,159				1,163		(4)
Other comprehensive earnings (loss), net of tax	22			22
Common stock issued for employee benefit plans (in shares)		3,882
Common stock issued for employee benefit plans	14		14
Common stock repurchases (in shares)						1,983
Common stock repurchases	(151)					$ (151)
Stock compensation expense	70		70
Divestiture of non-controlling interest	(3)						(3)
Balance (in shares) at Mar. 31, 2024		619,173
Treasury stock (in shares) at Mar. 31, 2024						82,790
Balance at Mar. 31, 2024	$ 27,048	$ 1	20,388	(630)	13,206	$ (6,007)	90
Balance (in shares) at Dec. 31, 2023	534,484	615,291
Treasury stock (in shares) at Dec. 31, 2023	80,807					80,807
Balance at Dec. 31, 2023	$ 25,937	$ 1	20,304	(652)	12,043	$ (5,856)	97
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Other comprehensive earnings (loss), net of tax	$ 426
Balance (in shares) at Sep. 30, 2024	510,078	619,945
Treasury stock (in shares) at Sep. 30, 2024	109,867					109,867
Balance at Sep. 30, 2024	$ 27,396	$ 1	20,522	(226)	15,065	$ (8,055)	89
Balance (in shares) at Mar. 31, 2024		619,173
Treasury stock (in shares) at Mar. 31, 2024						82,790
Balance at Mar. 31, 2024	27,048	$ 1	20,388	(630)	13,206	$ (6,007)	90
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,146				1,146
Other comprehensive earnings (loss), net of tax	(16)			(16)
Common stock issued for employee benefit plans (in shares)		322
Common stock issued for employee benefit plans	11		11
Common stock repurchases (in shares)						10,704
Common stock repurchases	(810)					$ (810)
Stock compensation expense	62		62
Balance (in shares) at Jun. 30, 2024		619,495
Treasury stock (in shares) at Jun. 30, 2024						93,494
Balance at Jun. 30, 2024	27,441	$ 1	20,461	(646)	14,352	$ (6,817)	90
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	712				713		(1)
Other comprehensive earnings (loss), net of tax	420			420
Common stock issued for employee benefit plans (in shares)		450
Common stock issued for employee benefit plans	12		12
Common stock repurchases (in shares)						16,373
Common stock repurchases	(1,238)					$ (1,238)
Stock compensation expense	$ 49		49
Balance (in shares) at Sep. 30, 2024	510,078	619,945
Treasury stock (in shares) at Sep. 30, 2024	109,867					109,867
Balance at Sep. 30, 2024	$ 27,396	$ 1	$ 20,522	$ (226)	$ 15,065	$ (8,055)	$ 89

CONSOLIDATED STATEMENTS OF ST_2

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions	3 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2023	Dec. 31, 2022
Par value (in dollars per share)	$ 0.001						$ 0.001
Other comprehensive earning (loss), tax	$ 131	$ (5)	$ (12)	$ (34)	$ (34)	$ 61
Common Stock
Par value (in dollars per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	0.001	$ 0.001
Treasury Stock
Par value (in dollars per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net earnings	$ 3,014	$ 2,660
Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization	927	978
Stock compensation expense	181	167
Impairment	13	478
Deferred income taxes	14	14
(Gain) loss on divestitures, net	(103)	(172)
Other adjustments, net	(2)	158
Changes in assets and liabilities
Premium and trade receivables	(2,737)	(2,329)
Other assets	78	(103)
Medical claims liabilities	(5)	401
Unearned revenue	(58)	1,878
Accounts payable and accrued expenses	(503)	3,127
Other long-term liabilities	(84)	583
Other operating activities, net	6	(4)
Net cash provided by operating activities	741	7,836
Cash flows from investing activities:
Capital expenditures	(490)	(576)
Purchases of investments	(5,770)	(4,729)
Sales and maturities of investments	4,147	4,373
Divestiture proceeds, net of divested cash	959	690
Net cash used in investing activities	(1,154)	(242)
Cash flows from financing activities:
Proceeds from long-term debt	350	2,170
Payments and repurchases of long-term debt	(594)	(1,970)
Common stock repurchases	(2,181)	(1,602)
Proceeds from common stock issuances	37	32
Purchase of noncontrolling interest	0	(87)
Other financing activities, net	(5)	0
Net cash used in financing activities	(2,393)	(1,457)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	7	19
Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents	(2,799)	6,156
Cash and cash equivalents reclassified (to) from held for sale	(3)	(36)
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period	17,452	12,330
Cash, cash equivalents and restricted cash and cash equivalents, end of period	14,650	18,450
Supplemental disclosures of cash flow information:
Interest paid	495	496
Income taxes paid	821	759
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:
Cash and cash equivalents	14,577	18,190
Restricted cash and cash equivalents, included in restricted deposits	73	260
Total cash, cash equivalents and restricted cash and cash equivalents	$ 14,650	$ 18,450

Organization and Operations

Organization and Operations	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Operations	Organization and Operations Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2023. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2023 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. Accounting Guidance Not Yet Adopted In November 2023, the Financial Accounting Standards Board (FASB) issued an Accounting Standards Update (ASU) which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The new guidance is not expected to have a significant impact on the Company's consolidated financial statements or segment disclosures. In December 2023, the FASB issued an ASU which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In March 2024, the SEC adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule will require disclosure of material climate-related risks and material direct greenhouse gas emissions from operations owned or controlled (Scope 1) and/or material indirect greenhouse gas emissions from purchased energy consumed in owned or controlled operations (Scope 2). Additionally, the rules require disclosure in the notes to the financial statements of the effects of severe weather events and other natural conditions, subject to certain materiality thresholds. The disclosure requirements will begin phasing in for reports and registration statements including financial information with respect to annual periods beginning in 2025. In April 2024, the SEC voluntarily stayed the final rule pending the completion of judicial review by the Court of Appeals for the Eighth Circuit. The Company is monitoring the development of litigation related to the SEC's rule, and is currently evaluating the effect of the new disclosure requirements.

Acquisitions and Divestitures

Acquisitions and Divestitures	9 Months Ended
	Sep. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Acquisitions and Divestitures	Acquisitions and Divestitures Magellan Specialty Health Divestiture For the nine months ended September 30, 2024, the Company recorded an additional gain on the previously reported divestiture of Magellan Specialty Health of $83 million for achievement of contingent consideration related to the sale and finalization of working capital adjustments, which is included in investment and other income in the Consolidated Statements of Operations. Circle Health Group Divestiture On August 28, 2023, the Company signed a definitive agreement to sell Circle Health Group (Circle Health), one of the U.K.'s largest independent hospital operators, which is included in the Other segment. In accordance with the signed definitive agreement in the third quarter of 2023, and subsequently updated in the fourth quarter of 2023, the Company recorded impairment charges related to goodwill associated with the pending divestiture totaling $292 million, or $258 million after-tax. In order to manage the foreign exchange risk on the sale price associated with the pending divestiture of Circle Health, in August 2023 the Company entered into a foreign currency swap agreement for a notional amount of $931 million, to sell £740 million. The swap agreement was formally designated and qualified as a cash flow hedge. The swap expired on the earlier of the divestiture closing date or March 28, 2024. The gain or loss due to changes in the fair value of the foreign currency swap was recorded in other comprehensive income until the Circle Health divestiture closed, at which time the gain or loss was recorded in earnings to the same line in the Consolidated Statement of Operations as the gain or loss on sale. On January 12, 2024, the Company completed the divestiture for $931 million. Upon closing the divestiture, the Company settled the foreign currency swap and recorded a corresponding gain of $20 million, which includes the cumulative translation adjustment previously recorded in accumulated other comprehensive income in the Consolidated Balance Sheet. The gain is included in investment and other income in the Consolidated Statements of Operations. During the nine months ended September 30, 2024, the Company realized a net tax benefit of approximately $40 million on the loss recognized on the divestiture. Collaborative Health Systems Divestiture In July 2024, the Company entered into a definitive agreement to sell Collaborative Health Systems (CHS), a management services organization, which is included in the Other segment. As of September 30, 2024, the assets and liabilities of CHS were considered held for sale resulting in $16 million of assets held for sale in other current assets and $2 million of liabilities held for sale in accounts payable and accrued expenses on the Consolidated Balance Sheet. The majority of the held for sale assets were previously reported as investments, cash and receivables. On October 4, 2024, the Company completed the previously announced sale of CHS. The Company estimates that it will recognize an after-tax gain of approximately $0 million to $20 million in the fourth quarter of 2024, subject to purchase price adjustments.

Short-term and Long-term Invest

Short-term and Long-term Investments, Restricted Deposits	9 Months Ended
	Sep. 30, 2024
Investments, Debt and Equity Securities [Abstract]
Short-term and Long-term Investments, Restricted Deposits	Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): September 30, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 592 $ 6 $ (4) $ 594 $ 403 $ — $ (8) $ 395 Corporate securities 10,808 158 (277) 10,689 9,984 78 (461) 9,601 Restricted certificates of deposit 3 — — 3 4 — — 4 Restricted cash equivalents 73 — — 73 259 — — 259 Short-term time deposits 875 — — 875 746 — — 746 Municipal securities 4,224 32 (114) 4,142 4,135 21 (171) 3,985 Asset-backed securities 1,773 22 (17) 1,778 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,725 24 (81) 1,668 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,231 10 (52) 1,189 1,149 5 (82) 1,072 Equity securities 15 — — 15 17 — — 17 Private equity investments 913 — — 913 833 — — 833 Life insurance contracts 196 — — 196 174 — — 174 Total $ 22,428 $ 252 $ (545) $ 22,135 $ 20,872 $ 119 $ (860) $ 20,131 The Company's investments are debt securities classified as available-for-sale with the exception of equity securities, certain private equity investments and life insurance contracts. Private equity investments include direct investments in private equity securities as well as private equity funds. The Company's investment policies are designed to provide liquidity, preserve capital and maximize total return on invested assets with a focus on high credit quality securities. The Company limits the size of investment in any single issuer other than U.S. treasury securities and obligations of U.S. government corporations and agencies. As of September 30, 2024, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At September 30, 2024, the Company held certificates of deposit, equity securities, private equity investments and life insurance contracts, which did not carry a credit rating. Accrued interest income on available-for-sale debt securities was $171 million and $153 million at September 30, 2024 and December 31, 2023, respectively, and is included in other current assets in the Consolidated Balance Sheets. The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AA+ and a weighted average duration of 3 years at September 30, 2024. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): September 30, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ — $ 11 $ (4) $ 163 $ — $ 79 $ (8) $ 232 Corporate securities (1) 437 (276) 5,025 (6) 658 (455) 6,260 Municipal securities (1) 287 (113) 2,176 (4) 553 (167) 2,237 Asset-backed securities — 43 (17) 381 (2) 197 (33) 855 Residential mortgage-backed securities — 41 (81) 795 (2) 153 (101) 814 Commercial mortgage-backed securities — 38 (52) 714 (2) 114 (80) 754 Short-term time deposits — — — — — 31 — — Total $ (2) $ 857 $ (543) $ 9,254 $ (16) $ 1,785 $ (844) $ 11,152 As of September 30, 2024, the gross unrealized losses were generated from 4,332 positions out of a total of 6,813 positions. The change in fair value of available-for-sale debt securities is primarily a result of movement in interest rates subsequent to the purchase of the security. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings. The Company does not intend to sell these securities prior to maturity and it is not likely that the Company will be required to sell these securities prior to maturity; therefore, the Company did not record an impairment for these securities. In addition, the Company monitors available-for-sale debt securities for credit losses. Certain investments have experienced a decline in fair value due to changes in credit quality, market interest rates and/or general economic conditions. The Company recognizes an allowance when evidence demonstrates that the decline in fair value is credit related. Evidence of a credit-related loss may include rating agency actions, adverse conditions specifically related to the security or failure of the issuer of the security to make scheduled payments. The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): September 30, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,751 $ 2,733 $ 400 $ 399 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,795 7,667 685 677 7,738 7,431 527 504 Five years through ten years 4,354 4,318 311 306 3,905 3,735 298 283 Greater than ten years 209 206 70 70 155 154 34 35 Asset-backed securities 4,729 4,635 — — 4,317 4,117 — — Total $ 19,838 $ 19,559 $ 1,466 $ 1,452 $ 18,423 $ 17,721 $ 1,425 $ 1,386 Actual maturities may differ from contractual maturities due to call or prepayment options. Equity securities, private equity investments and life insurance contracts are excluded from the table above because they do not have a contractual maturity. The Company has an option to redeem substantially all of the securities included in the greater than ten years category listed above at amortized cost.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table summarizes fair value measurements by level at September 30, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 14,577 $ — $ — $ 14,577 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 56 $ — $ — $ 56 Corporate securities — 10,649 — 10,649 Municipal securities — 3,344 — 3,344 Short-term time deposits — 875 — 875 Asset-backed securities — 1,778 — 1,778 Residential mortgage-backed securities — 1,668 — 1,668 Commercial mortgage-backed securities — 1,189 — 1,189 Equity securities 14 1 — 15 Total investments $ 70 $ 19,504 $ — $ 19,574 Restricted deposits: Cash and cash equivalents $ 73 $ — $ — $ 73 U.S. Treasury securities and obligations of U.S. government corporations and agencies 538 — — 538 Corporate securities — 40 — 40 Certificates of deposit — 3 — 3 Municipal securities — 798 — 798 Total restricted deposits $ 611 $ 841 $ — $ 1,452 Total assets at fair value $ 15,258 $ 20,345 $ — $ 35,603 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13 The Company utilizes matrix-pricing services to estimate fair value for securities which are not actively traded on the measurement date. The Company designates these securities as Level II fair value measurements. In addition, the aggregate carrying amount of the Company's private equity investments and life insurance contracts, which approximates fair value, was $1,109 million and $1,007 million as of September 30, 2024 and December 31, 2023, respectively.

Medical Claims Liability

Medical Claims Liability	9 Months Ended
	Sep. 30, 2024
Insurance [Abstract]
Medical Claims Liability	Medical Claims Liability The following table summarizes the change in medical claims liability for the nine months ended September 30, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverable 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 59,327 16,134 19,211 1,216 95,888 Prior years (1,247) (439) (306) 7 (1,985) Total incurred 58,080 15,695 18,905 1,223 93,903 Paid related to: Current year 50,198 13,006 15,773 1,040 80,017 Prior years 8,543 2,713 2,523 120 13,899 Total paid 58,741 15,719 18,296 1,160 93,916 Plus: Premium deficiency reserve — (5) — — (5) Balance, September 30, 2024, net 10,148 3,583 4,025 177 17,933 Plus: Reinsurance recoverable 20 — 42 — 62 Balance, September 30, 2024 $ 10,168 $ 3,583 $ 4,067 $ 177 $ 17,995 The following table summarizes the change in medical claims liability for the nine months ended September 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 60,379 14,680 13,994 1,095 90,148 Prior years (1,303) (326) (256) (3) (1,888) Total incurred 59,076 14,354 13,738 1,092 88,260 Paid related to: Current year 50,774 12,069 11,575 984 75,402 Prior years 8,517 2,452 1,376 136 12,481 Total paid 59,291 14,521 12,951 1,120 87,883 Balance, September 30, 2023, net 11,031 3,264 2,689 112 17,096 Plus: Reinsurance recoverable 4 — 41 — 45 Balance, September 30, 2023 $ 11,035 $ 3,264 $ 2,730 $ 112 $ 17,141 Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of development within "Incurred related to: Prior years," the Company recorded $236 million and $341 million as a reduction to premium revenue in the nine months ended September 30, 2024 and 2023, respectively, for minimum health benefits ratio (HBR) and other return of premium programs. Incurred but not reported (IBNR) plus expected development on reported claims as of September 30, 2024 was $12,654 million. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors. The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year, which was increased to $300 million in the first quarter of 2024, to $335 million in the second quarter of 2024 and decreased by $90 million to $245 million in the third quarter of 2024 consistent with the intra-year flow of seasonality.

Affordable Care Act

Affordable Care Act	9 Months Ended
	Sep. 30, 2024
Affordable Care Act [Abstract]
Affordable Care Act	Affordable Care Act The Affordable Care Act established risk spreading premium stabilization programs as well as a minimum annual medical loss ratio (MLR) and cost sharing reductions. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): September 30, 2024 December 31, 2023 Risk adjustment receivable $ 1,805 $ 893 Risk adjustment payable (1,705) (2,553) Minimum medical loss ratio (586) (164) Cost sharing reduction receivable 10 — Cost sharing reduction payable (68) (114) In July 2024, the Centers for Medicare and Medicaid Services (CMS) announced the final risk adjustment transfers for the 2023 benefit year. As a result of the announcement, the risk adjustment net payable was decreased by $131 million in the third quarter of 2024, with a total impact of $1,475 million for the nine months ended September 30, 2024. After consideration of minimum MLR and other related impacts, which includes the effect to the 2024 benefit year, the net pre-tax benefit recognized was $920 million in the nine months ended September 30, 2024.

Debt

Debt	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Debt	Debt Debt consists of the following ($ in millions): September 30, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,397 $ 2,395 $2,300 million 2.45% Senior Notes due July 15, 2028 2,302 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,676 15,675 Term Loan Facility 2,033 2,115 Revolving Credit Agreement — 150 Finance leases and other 1 11 Debt issuance costs (105) (122) Total debt 17,605 17,829 Less: current portion (111) (119) Long-term debt $ 17,494 $ 17,710

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity The Company's Board of Directors has authorized a stock repurchase program of the Company's common stock from time to time on the open market or through privately negotiated transactions. The Company is authorized to repurchase up to $10,000 million, inclusive of past authorizations. As of September 30, 2024, the Company had a remaining amount of $3,160 million available under the stock repurchase program. In October 2024, the Company repurchased an additional 5.2 million shares for $380 million. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 16,254 $ 1,218 11,609 $ 773 27,595 $ 2,069 22,489 $ 1,550 Income tax withholding 119 9 11 1 1,465 112 778 52 Total share repurchases (1) 16,373 $ 1,227 11,620 $ 774 29,060 $ 2,181 23,267 $ 1,602 (1) Excludes year-to-date share repurchase excise tax of approximately $18 million and $10 million accrued as of September 30, 2024 and 2023, respectively. Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Earnings attributable to Centene Corporation $ 713 $ 469 $ 3,022 $ 2,657 Shares used in computing per share amounts: Weighted average number of common shares outstanding 521,965 539,535 528,912 546,374 Common stock equivalents (as determined by applying the treasury stock method) 1,577 1,735 2,003 2,038 Weighted average number of common shares and potential dilutive common shares outstanding 523,542 541,270 530,915 548,412 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 1.37 $ 0.87 $ 5.71 $ 4.86 Diluted earnings per common share $ 1.36 $ 0.87 $ 5.69 $ 4.85 The calculation of diluted earnings per common share for the three months ended September 30, 2024 and 2023 excludes 273 thousand shares and 1,313 thousand shares, respectively, related to anti-dilutive stock options, restricted stock and restricted stock units. The calculation of diluted earnings per common share for the nine months ended September 30, 2024 and 2023 excludes 266 thousand shares and 1,383 thousand shares, respectively, related to anti-dilutive stock options, restricted stock and restricted stock units.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Segment Information	Segment Information The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Medicaid, Medicare and Commercial segments primarily represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. The Company's international businesses, Operose Health Group (Operose Health) and Circle Health, were divested in December 2023 and January 2024, respectively. Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams and the type of information presented to the Company's chief operating decision-maker to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance. Segment information for the three months ended September 30, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,291 $ 5,643 $ 8,693 $ 488 $ 36,115 Service 25 — — 759 784 Premium and service revenues 21,316 5,643 8,693 1,247 36,899 Premium tax 5,124 — — — 5,124 Total external revenues 26,440 5,643 8,693 1,247 42,023 Internal revenues — — — 4,290 4,290 Eliminations — — — (4,290) (4,290) Total revenues $ 26,440 $ 5,643 $ 8,693 $ 1,247 $ 42,023 Medical costs $ 19,818 $ 4,968 $ 6,957 $ 458 $ 32,201 Cost of services $ 23 $ — $ — $ 669 $ 692 Gross margin (1) $ 1,475 $ 675 $ 1,736 $ 120 $ 4,006 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,619 $ 5,430 $ 6,451 $ 366 $ 33,866 Service — — 2 1,099 1,101 Premium and service revenues 21,619 5,430 6,453 1,465 34,967 Premium tax 3,075 — — — 3,075 Total external revenues 24,694 5,430 6,453 1,465 38,042 Internal revenues — — — 3,978 3,978 Eliminations — — — (3,978) (3,978) Total revenues $ 24,694 $ 5,430 $ 6,453 $ 1,465 $ 38,042 Medical costs $ 19,607 $ 4,462 $ 5,089 $ 321 $ 29,479 Cost of services $ — $ — $ — $ 856 $ 856 Gross margin (1) $ 2,012 $ 968 $ 1,364 $ 288 $ 4,632 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 62,958 $ 17,556 $ 24,977 $ 1,293 $ 106,784 Service 68 — 2 2,355 2,425 Premium and service revenues 63,026 17,556 24,979 3,648 109,209 Premium tax 13,057 — — — 13,057 Total external revenues 76,083 17,556 24,979 3,648 122,266 Internal revenues — — — 12,451 12,451 Eliminations — — — (12,451) (12,451) Total revenues $ 76,083 $ 17,556 $ 24,979 $ 3,648 $ 122,266 Medical costs $ 58,080 $ 15,690 $ 18,905 $ 1,223 $ 93,898 Cost of services $ 66 $ — $ — $ 1,975 $ 2,041 Gross margin (1) $ 4,880 $ 1,866 $ 6,074 $ 450 $ 13,270 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 65,741 $ 16,971 $ 17,437 $ 1,255 $ 101,404 Service — — 2 3,351 3,353 Premium and service revenues 65,741 16,971 17,439 4,606 104,757 Premium tax 9,782 — — — 9,782 Total external revenues 75,523 16,971 17,439 4,606 114,539 Internal revenues — — — 11,634 11,634 Eliminations — — — (11,634) (11,634) Total revenues $ 75,523 $ 16,971 $ 17,439 $ 4,606 $ 114,539 Medical costs $ 59,076 $ 14,354 $ 13,738 $ 1,092 $ 88,260 Cost of services $ 2 $ — $ — $ 2,601 $ 2,603 Gross margin (1) $ 6,663 $ 2,617 $ 3,701 $ 913 $ 13,894 (1) Gross margin represents premium and service revenues less medical costs and cost of services.

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The Company is routinely subjected to legal and regulatory proceedings in the normal course of business. These matters can include, without limitation: • periodic compliance and other reviews and investigations by various federal and state regulatory agencies with respect to requirements applicable to the Company's business, including, without limitation, those related to payment of out-of-network claims, compliance with CMS Medicare and Marketplace regulations, including risk adjustment and broker compensation, compliance with the False Claims Act, the calculation of minimum MLR and rebates related thereto, submissions to state agencies related to payments or state false claims acts, pre-authorization penalties, timely review of grievances and appeals, timely and accurate payment of claims, cybersecurity issues, including those related to the Company's or the Company's third-party vendors' information systems, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other federal and state fraud, waste and abuse laws; • litigation arising out of general business activities, such as tax matters, disputes related to healthcare benefits coverage or reimbursement, putative securities class actions, and medical malpractice, privacy, real estate, intellectual property, vendor disputes and employment-related claims; and • disputes regarding reinsurance arrangements, claims arising out of the acquisition or divestiture of various assets, class actions and claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups, vendors and others, including, but not limited to, the alleged failure to properly pay claims and challenges to the manner in which the Company processes claims, claims related to network adequacy and claims alleging that the Company has engaged in unfair business practices. Among other things, these matters may result in awards of damages, fines or penalties, which could be substantial, and/or could require changes to the Company's business. The Company intends to vigorously defend itself against legal and regulatory proceedings to which it is currently a party; however, these proceedings are subject to many uncertainties. In some of the cases pending against the Company, substantial non-economic or punitive damages are being sought. The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company's best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices. As of the date of this report, amounts accrued for legal proceedings and regulatory matters were not material, except for the reserve estimate as previously disclosed in the Company's 2023 Annual Report on Form 10-K with respect to claims or potential claims involving services provided by Envolve Pharmacy Solutions, Inc. (Envolve), as the Company's pharmacy benefits management (PBM) subsidiary. The Company has reached no-fault settlement agreements related to services previously provided by Envolve with the vast majority of states impacted. Such agreements have provided for payment amounts consistent with the initial reserve estimate established in the second quarter of 2021 related to this issue. It is possible that in a particular quarter or annual period the Company's financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of or development in legal and/or regulatory proceedings. The Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow or liquidity.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net earnings (loss)	$ 713	$ 469	$ 3,022	$ 2,657

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Organization and Operations (Po

Organization and Operations (Policies)	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Annual Report on Form 10-K for the fiscal year ended December 31, 2023. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2023 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported.
Accounting Guidance Not Yet Adopted	Accounting Guidance Not Yet Adopted In November 2023, the Financial Accounting Standards Board (FASB) issued an Accounting Standards Update (ASU) which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The new guidance is not expected to have a significant impact on the Company's consolidated financial statements or segment disclosures. In December 2023, the FASB issued an ASU which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company is currently evaluating the effect of the new disclosure requirements. In March 2024, the SEC adopted the final rule under SEC Release No. 33-11275, The Enhancement and Standardization of Climate-Related Disclosures for Investors. This rule will require disclosure of material climate-related risks and material direct greenhouse gas emissions from operations owned or controlled (Scope 1) and/or material indirect greenhouse gas emissions from purchased energy consumed in owned or controlled operations (Scope 2). Additionally, the rules require disclosure in the notes to the financial statements of the effects of severe weather events and other natural conditions, subject to certain materiality thresholds. The disclosure requirements will begin phasing in for reports and registration statements including financial information with respect to annual periods beginning in 2025. In April 2024, the SEC voluntarily stayed the final rule pending the completion of judicial review by the Court of Appeals for the Eighth Circuit. The Company is monitoring the development of litigation related to the SEC's rule, and is currently evaluating the effect of the new disclosure requirements.

Short-term and Long-term Inve_2

Short-term and Long-term Investments, Restricted Deposits (Tables)	9 Months Ended
	Sep. 30, 2024
Investments, Debt and Equity Securities [Abstract]
Short-term and long-term investments and restricted deposits by investment type	Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): September 30, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 592 $ 6 $ (4) $ 594 $ 403 $ — $ (8) $ 395 Corporate securities 10,808 158 (277) 10,689 9,984 78 (461) 9,601 Restricted certificates of deposit 3 — — 3 4 — — 4 Restricted cash equivalents 73 — — 73 259 — — 259 Short-term time deposits 875 — — 875 746 — — 746 Municipal securities 4,224 32 (114) 4,142 4,135 21 (171) 3,985 Asset-backed securities 1,773 22 (17) 1,778 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,725 24 (81) 1,668 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,231 10 (52) 1,189 1,149 5 (82) 1,072 Equity securities 15 — — 15 17 — — 17 Private equity investments 913 — — 913 833 — — 833 Life insurance contracts 196 — — 196 174 — — 174 Total $ 22,428 $ 252 $ (545) $ 22,135 $ 20,872 $ 119 $ (860) $ 20,131
Fair value of available-for-sale investments with gross unrealized losses by investment type and length of time	The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): September 30, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ — $ 11 $ (4) $ 163 $ — $ 79 $ (8) $ 232 Corporate securities (1) 437 (276) 5,025 (6) 658 (455) 6,260 Municipal securities (1) 287 (113) 2,176 (4) 553 (167) 2,237 Asset-backed securities — 43 (17) 381 (2) 197 (33) 855 Residential mortgage-backed securities — 41 (81) 795 (2) 153 (101) 814 Commercial mortgage-backed securities — 38 (52) 714 (2) 114 (80) 754 Short-term time deposits — — — — — 31 — — Total $ (2) $ 857 $ (543) $ 9,254 $ (16) $ 1,785 $ (844) $ 11,152
Contractual maturities of short-term and long-term investments and restricted deposits	The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): September 30, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,751 $ 2,733 $ 400 $ 399 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,795 7,667 685 677 7,738 7,431 527 504 Five years through ten years 4,354 4,318 311 306 3,905 3,735 298 283 Greater than ten years 209 206 70 70 155 154 34 35 Asset-backed securities 4,729 4,635 — — 4,317 4,117 — — Total $ 19,838 $ 19,559 $ 1,466 $ 1,452 $ 18,423 $ 17,721 $ 1,425 $ 1,386

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Assets and Liabilities, Based Upon Observable or Unobservable Inputs, Level Input Definitions	Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date.
Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis	The following table summarizes fair value measurements by level at September 30, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 14,577 $ — $ — $ 14,577 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 56 $ — $ — $ 56 Corporate securities — 10,649 — 10,649 Municipal securities — 3,344 — 3,344 Short-term time deposits — 875 — 875 Asset-backed securities — 1,778 — 1,778 Residential mortgage-backed securities — 1,668 — 1,668 Commercial mortgage-backed securities — 1,189 — 1,189 Equity securities 14 1 — 15 Total investments $ 70 $ 19,504 $ — $ 19,574 Restricted deposits: Cash and cash equivalents $ 73 $ — $ — $ 73 U.S. Treasury securities and obligations of U.S. government corporations and agencies 538 — — 538 Corporate securities — 40 — 40 Certificates of deposit — 3 — 3 Municipal securities — 798 — 798 Total restricted deposits $ 611 $ 841 $ — $ 1,452 Total assets at fair value $ 15,258 $ 20,345 $ — $ 35,603 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13

Medical Claims Liability (Table

Medical Claims Liability (Tables)	9 Months Ended
	Sep. 30, 2024
Insurance [Abstract]
Schedule of change in medical claims liability	The following table summarizes the change in medical claims liability for the nine months ended September 30, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverable 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 59,327 16,134 19,211 1,216 95,888 Prior years (1,247) (439) (306) 7 (1,985) Total incurred 58,080 15,695 18,905 1,223 93,903 Paid related to: Current year 50,198 13,006 15,773 1,040 80,017 Prior years 8,543 2,713 2,523 120 13,899 Total paid 58,741 15,719 18,296 1,160 93,916 Plus: Premium deficiency reserve — (5) — — (5) Balance, September 30, 2024, net 10,148 3,583 4,025 177 17,933 Plus: Reinsurance recoverable 20 — 42 — 62 Balance, September 30, 2024 $ 10,168 $ 3,583 $ 4,067 $ 177 $ 17,995 The following table summarizes the change in medical claims liability for the nine months ended September 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 60,379 14,680 13,994 1,095 90,148 Prior years (1,303) (326) (256) (3) (1,888) Total incurred 59,076 14,354 13,738 1,092 88,260 Paid related to: Current year 50,774 12,069 11,575 984 75,402 Prior years 8,517 2,452 1,376 136 12,481 Total paid 59,291 14,521 12,951 1,120 87,883 Balance, September 30, 2023, net 11,031 3,264 2,689 112 17,096 Plus: Reinsurance recoverable 4 — 41 — 45 Balance, September 30, 2023 $ 11,035 $ 3,264 $ 2,730 $ 112 $ 17,141

Affordable Care Act (Tables)

Affordable Care Act (Tables)	9 Months Ended
	Sep. 30, 2024
Affordable Care Act [Abstract]
Schedule of net receivables (payables) related to the Affordable Care Act Programs	The Company's net receivables (payables) for each of the programs are as follows ($ in millions): September 30, 2024 December 31, 2023 Risk adjustment receivable $ 1,805 $ 893 Risk adjustment payable (1,705) (2,553) Minimum medical loss ratio (586) (164) Cost sharing reduction receivable 10 — Cost sharing reduction payable (68) (114)

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Debt	Debt consists of the following ($ in millions): September 30, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,397 $ 2,395 $2,300 million 2.45% Senior Notes due July 15, 2028 2,302 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,676 15,675 Term Loan Facility 2,033 2,115 Revolving Credit Agreement — 150 Finance leases and other 1 11 Debt issuance costs (105) (122) Total debt 17,605 17,829 Less: current portion (111) (119) Long-term debt $ 17,494 $ 17,710

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Share Repurchase Activity	The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 16,254 $ 1,218 11,609 $ 773 27,595 $ 2,069 22,489 $ 1,550 Income tax withholding 119 9 11 1 1,465 112 778 52 Total share repurchases (1) 16,373 $ 1,227 11,620 $ 774 29,060 $ 2,181 23,267 $ 1,602 (1) Excludes year-to-date share repurchase excise tax of approximately $18 million and $10 million accrued as of September 30, 2024 and 2023, respectively.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Calculation of Basic and Diluted Net Earnings Per Common Share	The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Earnings attributable to Centene Corporation $ 713 $ 469 $ 3,022 $ 2,657 Shares used in computing per share amounts: Weighted average number of common shares outstanding 521,965 539,535 528,912 546,374 Common stock equivalents (as determined by applying the treasury stock method) 1,577 1,735 2,003 2,038 Weighted average number of common shares and potential dilutive common shares outstanding 523,542 541,270 530,915 548,412 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 1.37 $ 0.87 $ 5.71 $ 4.86 Diluted earnings per common share $ 1.36 $ 0.87 $ 5.69 $ 4.85

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Segment Information	Segment information for the three months ended September 30, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,291 $ 5,643 $ 8,693 $ 488 $ 36,115 Service 25 — — 759 784 Premium and service revenues 21,316 5,643 8,693 1,247 36,899 Premium tax 5,124 — — — 5,124 Total external revenues 26,440 5,643 8,693 1,247 42,023 Internal revenues — — — 4,290 4,290 Eliminations — — — (4,290) (4,290) Total revenues $ 26,440 $ 5,643 $ 8,693 $ 1,247 $ 42,023 Medical costs $ 19,818 $ 4,968 $ 6,957 $ 458 $ 32,201 Cost of services $ 23 $ — $ — $ 669 $ 692 Gross margin (1) $ 1,475 $ 675 $ 1,736 $ 120 $ 4,006 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,619 $ 5,430 $ 6,451 $ 366 $ 33,866 Service — — 2 1,099 1,101 Premium and service revenues 21,619 5,430 6,453 1,465 34,967 Premium tax 3,075 — — — 3,075 Total external revenues 24,694 5,430 6,453 1,465 38,042 Internal revenues — — — 3,978 3,978 Eliminations — — — (3,978) (3,978) Total revenues $ 24,694 $ 5,430 $ 6,453 $ 1,465 $ 38,042 Medical costs $ 19,607 $ 4,462 $ 5,089 $ 321 $ 29,479 Cost of services $ — $ — $ — $ 856 $ 856 Gross margin (1) $ 2,012 $ 968 $ 1,364 $ 288 $ 4,632 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 62,958 $ 17,556 $ 24,977 $ 1,293 $ 106,784 Service 68 — 2 2,355 2,425 Premium and service revenues 63,026 17,556 24,979 3,648 109,209 Premium tax 13,057 — — — 13,057 Total external revenues 76,083 17,556 24,979 3,648 122,266 Internal revenues — — — 12,451 12,451 Eliminations — — — (12,451) (12,451) Total revenues $ 76,083 $ 17,556 $ 24,979 $ 3,648 $ 122,266 Medical costs $ 58,080 $ 15,690 $ 18,905 $ 1,223 $ 93,898 Cost of services $ 66 $ — $ — $ 1,975 $ 2,041 Gross margin (1) $ 4,880 $ 1,866 $ 6,074 $ 450 $ 13,270 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the nine months ended September 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 65,741 $ 16,971 $ 17,437 $ 1,255 $ 101,404 Service — — 2 3,351 3,353 Premium and service revenues 65,741 16,971 17,439 4,606 104,757 Premium tax 9,782 — — — 9,782 Total external revenues 75,523 16,971 17,439 4,606 114,539 Internal revenues — — — 11,634 11,634 Eliminations — — — (11,634) (11,634) Total revenues $ 75,523 $ 16,971 $ 17,439 $ 4,606 $ 114,539 Medical costs $ 59,076 $ 14,354 $ 13,738 $ 1,092 $ 88,260 Cost of services $ 2 $ — $ — $ 2,601 $ 2,603 Gross margin (1) $ 6,663 $ 2,617 $ 3,701 $ 913 $ 13,894 (1) Gross margin represents premium and service revenues less medical costs and cost of services.

Acquisitions and Divestitures -

Acquisitions and Divestitures - Divestiture (Details) £ in Millions, $ in Millions		3 Months Ended			9 Months Ended		12 Months Ended
	Jan. 12, 2024 USD ($)	Dec. 31, 2024 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)	Aug. 31, 2023 USD ($)	Aug. 31, 2023 GBP (£)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestitures					$ 103	$ 172
Income tax expense (benefit)			$ 211	$ 293	896	$ 914
Currency Swap
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Notional amount								$ 931	£ 740
Magellan Rx | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestitures					83
Circle Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestitures					20
Proceeds from sale of business	$ 931
Income tax expense (benefit)					(40)
Circle Health | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill impairment							$ 292
Goodwill, impairment, net of tax							$ 258
Collaborative Health Systems | Disposal Group, Held-for-sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Assets held for sale included in other current assets			16		16
Liabilities held for sale in accounts payable and accrued expenses			$ 2		$ 2
Collaborative Health Systems | Disposal Group, Held-for-sale, Not Discontinued Operations | Subsequent Event | Forecast | Minimum
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
After-tax gain		$ 0
Collaborative Health Systems | Disposal Group, Held-for-sale, Not Discontinued Operations | Subsequent Event | Forecast | Maximum
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
After-tax gain		$ 20

Short-term and Long-term Inve_3

Short-term and Long-term Investments, Restricted Deposits - By Investment Type (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Debt Securities
Gross Unrealized Gains	$ 252	$ 119
Gross Unrealized Losses	(545)	(860)
Equity securities	15	17
Private equity investments	913	833
Life insurance contracts	196	174
Total, Amortized Cost	22,428	20,872
Total, Fair Value	22,135	20,131
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Debt Securities
Amortized Cost	592	403
Gross Unrealized Gains	6	0
Gross Unrealized Losses	(4)	(8)
Fair Value	594	395
Corporate securities
Debt Securities
Amortized Cost	10,808	9,984
Gross Unrealized Gains	158	78
Gross Unrealized Losses	(277)	(461)
Fair Value	10,689	9,601
Restricted certificates of deposit
Debt Securities
Amortized Cost	3	4
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	3	4
Restricted cash equivalents
Debt Securities
Amortized Cost	73	259
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	73	259
Short-term time deposits
Debt Securities
Amortized Cost	875	746
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	875	746
Municipal securities
Debt Securities
Amortized Cost	4,224	4,135
Gross Unrealized Gains	32	21
Gross Unrealized Losses	(114)	(171)
Fair Value	4,142	3,985
Asset-backed securities
Debt Securities
Amortized Cost	1,773	1,665
Gross Unrealized Gains	22	8
Gross Unrealized Losses	(17)	(35)
Fair Value	1,778	1,638
Residential mortgage-backed securities
Debt Securities
Amortized Cost	1,725	1,503
Gross Unrealized Gains	24	7
Gross Unrealized Losses	(81)	(103)
Fair Value	1,668	1,407
Commercial mortgage-backed securities
Debt Securities
Amortized Cost	1,231	1,149
Gross Unrealized Gains	10	5
Gross Unrealized Losses	(52)	(82)
Fair Value	$ 1,189	$ 1,072

Short-term and Long-term Inve_4

Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions	9 Months Ended
	Sep. 30, 2024 USD ($) position	Dec. 31, 2023 USD ($)
Schedule of Investments and Restricted Deposits by Type [Line Items]
Accrued interest income | $	$ 171	$ 153
Positions from which gross unrealized losses were generated	4,332
Total investment positions	6,813
Commercial mortgage-backed securities
Schedule of Investments and Restricted Deposits by Type [Line Items]
Investments recorded at fair value that carry rating of AAA Plus, weighted average (in years)	3 years
Rated Securities | External Credit Rating, Investment Grade | Investment Securities
Schedule of Investments and Restricted Deposits by Type [Line Items]
Percentage of investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations	99%

Short-term and Long-term Inve_5

Short-term and Long-term Investments, Restricted Deposits - Fair Value of Available-For-Sale Investments with Gross Unrealized Losses by Investment Type and Length of Time (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Unrealized Losses
Less Than 12 Months	$ (2)	$ (16)
12 Months or More	(543)	(844)
Fair Value
Fair Value, Less Than 12 Months	857	1,785
Fair Value, 12 Months or More	9,254	11,152
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Unrealized Losses
Less Than 12 Months	0	0
12 Months or More	(4)	(8)
Fair Value
Fair Value, Less Than 12 Months	11	79
Fair Value, 12 Months or More	163	232
Corporate securities
Unrealized Losses
Less Than 12 Months	(1)	(6)
12 Months or More	(276)	(455)
Fair Value
Fair Value, Less Than 12 Months	437	658
Fair Value, 12 Months or More	5,025	6,260
Municipal securities
Unrealized Losses
Less Than 12 Months	(1)	(4)
12 Months or More	(113)	(167)
Fair Value
Fair Value, Less Than 12 Months	287	553
Fair Value, 12 Months or More	2,176	2,237
Asset-backed securities
Unrealized Losses
Less Than 12 Months	0	(2)
12 Months or More	(17)	(33)
Fair Value
Fair Value, Less Than 12 Months	43	197
Fair Value, 12 Months or More	381	855
Residential mortgage-backed securities
Unrealized Losses
Less Than 12 Months	0	(2)
12 Months or More	(81)	(101)
Fair Value
Fair Value, Less Than 12 Months	41	153
Fair Value, 12 Months or More	795	814
Commercial mortgage-backed securities
Unrealized Losses
Less Than 12 Months	0	(2)
12 Months or More	(52)	(80)
Fair Value
Fair Value, Less Than 12 Months	38	114
Fair Value, 12 Months or More	714	754
Short-term time deposits
Unrealized Losses
Less Than 12 Months	0	0
12 Months or More	0	0
Fair Value
Fair Value, Less Than 12 Months	0	31
Fair Value, 12 Months or More	$ 0	$ 0

Short-term and Long-term Inve_6

Short-term and Long-term Investments, Restricted Deposits - Contractual Maturities of Short-Term and Long-Term Investments and Restricted Deposits (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Investments
Amortized Cost
One year or less	$ 2,751	$ 2,308
One year through five years	7,795	7,738
Five years through ten years	4,354	3,905
Greater than ten years	209	155
Asset-backed securities	4,729	4,317
Amortized Cost	19,838	18,423
Fair Value
One year or less	2,733	2,284
One year through five years	7,667	7,431
Five years through ten years	4,318	3,735
Greater than ten years	206	154
Asset-backed securities	4,635	4,117
Fair Value	19,559	17,721
Restricted Deposits
Amortized Cost
One year or less	400	566
One year through five years	685	527
Five years through ten years	311	298
Greater than ten years	70	34
Asset-backed securities	0	0
Amortized Cost	1,466	1,425
Fair Value
One year or less	399	564
One year through five years	677	504
Five years through ten years	306	283
Greater than ten years	70	35
Asset-backed securities	0	0
Fair Value	$ 1,452	$ 1,386

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Assets
Cash and cash equivalents	$ 14,577	$ 17,193
Investments:
Equity securities	15	17
Total assets at fair value	35,603	36,317
Total liabilities at fair value		13
Accounts payable and accrued expenses: | Currency Swap
Investments:
Derivative liability		13
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	594	395
Corporate securities
Investments:
Fair value	10,689	9,601
Municipal securities
Investments:
Fair value	4,142	3,985
Short-term time deposits
Investments:
Fair value	875	746
Asset-backed securities
Investments:
Fair value	1,778	1,638
Residential mortgage-backed securities
Investments:
Fair value	1,668	1,407
Commercial mortgage-backed securities
Investments:
Fair value	1,189	1,072
Level I
Assets
Cash and cash equivalents	14,577	17,193
Investments:
Total assets at fair value	15,258	17,862
Total liabilities at fair value		0
Level I | Accounts payable and accrued expenses: | Currency Swap
Investments:
Derivative liability		0
Level II
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	20,345	18,455
Total liabilities at fair value		13
Level II | Accounts payable and accrued expenses: | Currency Swap
Investments:
Derivative liability		13
Level III
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	0	0
Total liabilities at fair value		0
Level III | Accounts payable and accrued expenses: | Currency Swap
Investments:
Derivative liability		0
Investments
Investments:
Fair value	19,559	17,721
Total investments	19,574	17,738
Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	56	62
Investments | Corporate securities
Investments:
Fair value	10,649	9,564
Investments | Municipal securities
Investments:
Fair value	3,344	3,232
Investments | Short-term time deposits
Investments:
Fair value	875	746
Investments | Asset-backed securities
Investments:
Fair value	1,778	1,638
Investments | Residential mortgage-backed securities
Investments:
Fair value	1,668	1,407
Investments | Commercial mortgage-backed securities
Investments:
Fair value	1,189	1,072
Investments | Equity securities
Investments:
Equity securities	15	17
Investments | Level I
Investments:
Total investments	70	77
Investments | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	56	62
Investments | Level I | Corporate securities
Investments:
Fair value	0	0
Investments | Level I | Municipal securities
Investments:
Fair value	0	0
Investments | Level I | Short-term time deposits
Investments:
Fair value	0	0
Investments | Level I | Asset-backed securities
Investments:
Fair value	0	0
Investments | Level I | Residential mortgage-backed securities
Investments:
Fair value	0	0
Investments | Level I | Commercial mortgage-backed securities
Investments:
Fair value	0	0
Investments | Level I | Equity securities
Investments:
Equity securities	14	15
Investments | Level II
Investments:
Total investments	19,504	17,661
Investments | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Investments | Level II | Corporate securities
Investments:
Fair value	10,649	9,564
Investments | Level II | Municipal securities
Investments:
Fair value	3,344	3,232
Investments | Level II | Short-term time deposits
Investments:
Fair value	875	746
Investments | Level II | Asset-backed securities
Investments:
Fair value	1,778	1,638
Investments | Level II | Residential mortgage-backed securities
Investments:
Fair value	1,668	1,407
Investments | Level II | Commercial mortgage-backed securities
Investments:
Fair value	1,189	1,072
Investments | Level II | Equity securities
Investments:
Equity securities	1	2
Investments | Level III
Investments:
Total investments	0	0
Investments | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Investments | Level III | Corporate securities
Investments:
Fair value	0	0
Investments | Level III | Municipal securities
Investments:
Fair value	0	0
Investments | Level III | Short-term time deposits
Investments:
Fair value	0	0
Investments | Level III | Asset-backed securities
Investments:
Fair value	0	0
Investments | Level III | Residential mortgage-backed securities
Investments:
Fair value	0	0
Investments | Level III | Commercial mortgage-backed securities
Investments:
Fair value	0	0
Investments | Level III | Equity securities
Investments:
Equity securities	0	0
Restricted Deposits
Investments:
Fair value	1,452	1,386
Restricted Deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	538	333
Restricted Deposits | Corporate securities
Investments:
Fair value	40	37
Restricted Deposits | Municipal securities
Investments:
Fair value	798	753
Restricted Deposits | Cash and cash equivalents
Investments:
Fair value	73	259
Restricted Deposits | Certificates of deposit
Investments:
Fair value	3	4
Restricted Deposits | Level I
Investments:
Fair value	611	592
Restricted Deposits | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	538	333
Restricted Deposits | Level I | Corporate securities
Investments:
Fair value	0	0
Restricted Deposits | Level I | Municipal securities
Investments:
Fair value	0	0
Restricted Deposits | Level I | Cash and cash equivalents
Investments:
Fair value	73	259
Restricted Deposits | Level I | Certificates of deposit
Investments:
Fair value	0	0
Restricted Deposits | Level II
Investments:
Fair value	841	794
Restricted Deposits | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Restricted Deposits | Level II | Corporate securities
Investments:
Fair value	40	37
Restricted Deposits | Level II | Municipal securities
Investments:
Fair value	798	753
Restricted Deposits | Level II | Cash and cash equivalents
Investments:
Fair value	0	0
Restricted Deposits | Level II | Certificates of deposit
Investments:
Fair value	3	4
Restricted Deposits | Level III
Investments:
Fair value	0	0
Restricted Deposits | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Restricted Deposits | Level III | Corporate securities
Investments:
Fair value	0	0
Restricted Deposits | Level III | Municipal securities
Investments:
Fair value	0	0
Restricted Deposits | Level III | Cash and cash equivalents
Investments:
Fair value	0	0
Restricted Deposits | Level III | Certificates of deposit
Investments:
Fair value	$ 0	$ 0

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Aggregate carrying amount of life insurance contracts and equity investments, fair value	$ 1,109	$ 1,007

Medical Claims Liability - Sche

Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2024	Sep. 30, 2023
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1		$ 18,000	$ 16,745
Less: Reinsurance recoverable		49	26
Balance, January 1, net		17,951	16,719
Incurred related to:
Current year		95,888	90,148
Prior years		(1,985)	(1,888)
Total incurred		93,903	88,260
Paid related to:
Current year		80,017	75,402
Prior years		13,899	12,481
Total paid		93,916	87,883
Plus: Premium deficiency reserve		(5)
Balance, September 30, net	$ 17,933	17,933	17,096
Plus: Reinsurance recoverable	62	62	45
Balance, September 30	17,995	17,995	17,141
Medicaid
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1		10,814	11,253
Less: Reinsurance recoverable		5	7
Balance, January 1, net		10,809	11,246
Incurred related to:
Current year		59,327	60,379
Prior years		(1,247)	(1,303)
Total incurred		58,080	59,076
Paid related to:
Current year		50,198	50,774
Prior years		8,543	8,517
Total paid		58,741	59,291
Plus: Premium deficiency reserve		0
Balance, September 30, net	10,148	10,148	11,031
Plus: Reinsurance recoverable	20	20	4
Balance, September 30	10,168	10,168	11,035
Medicare
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1		3,612	3,431
Less: Reinsurance recoverable		0	0
Balance, January 1, net		3,612	3,431
Incurred related to:
Current year		16,134	14,680
Prior years		(439)	(326)
Total incurred		15,695	14,354
Paid related to:
Current year		13,006	12,069
Prior years		2,713	2,452
Total paid		15,719	14,521
Plus: Premium deficiency reserve	(90)	(5)
Balance, September 30, net	3,583	3,583	3,264
Plus: Reinsurance recoverable	0	0	0
Balance, September 30	3,583	3,583	3,264
Commercial
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1		3,460	1,921
Less: Reinsurance recoverable		44	19
Balance, January 1, net		3,416	1,902
Incurred related to:
Current year		19,211	13,994
Prior years		(306)	(256)
Total incurred		18,905	13,738
Paid related to:
Current year		15,773	11,575
Prior years		2,523	1,376
Total paid		18,296	12,951
Plus: Premium deficiency reserve		0
Balance, September 30, net	4,025	4,025	2,689
Plus: Reinsurance recoverable	42	42	41
Balance, September 30	4,067	4,067	2,730
Other
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1		114	140
Less: Reinsurance recoverable		0	0
Balance, January 1, net		114	140
Incurred related to:
Current year		1,216	1,095
Prior years		7	(3)
Total incurred		1,223	1,092
Paid related to:
Current year		1,040	984
Prior years		120	136
Total paid		1,160	1,120
Plus: Premium deficiency reserve		0
Balance, September 30, net	177	177	112
Plus: Reinsurance recoverable	0	0	0
Balance, September 30	$ 177	$ 177	$ 112

Medical Claims Liability - Narr

Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024	Mar. 31, 2024	Dec. 31, 2023
Insurance [Abstract]
Amounts recorded as an adjustment to premium revenues related to minimum HBR and return of premium programs		$ 236	$ 341
Short-duration insurance contracts, Incurred but not reported and expected development on reported claims	$ 12,654	12,654
Segment Reporting Information [Line Items]
Premium deficiency reserve liability increase (decrease)		(5)
Medicare
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	245	245		$ 335	$ 300	$ 250
Premium deficiency reserve liability increase (decrease)	$ (90)	$ (5)

Affordable Care Act - Net Recei

Affordable Care Act - Net Receivables (Payables) for Each of the Ongoing Programs (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Affordable Care Act [Abstract]
Risk adjustment receivable	$ 1,805	$ 893
Risk adjustment payable	(1,705)	(2,553)
Minimum medical loss ratio	(586)	(164)
Cost sharing reduction receivable	10	0
Cost sharing reduction payable	$ (68)	$ (114)

Affordable Care Act - Narrative

Affordable Care Act - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2024
Affordable Care Act [Abstract]
Risk adjustment, increase (decrease) to net payable	$ (131)	$ (1,475)
Risk adjustment and reinsurance pre-tax benefit		$ 920

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total senior notes	$ 15,676,000,000	$ 15,675,000,000
Finance leases and other	1,000,000	11,000,000
Debt issuance costs	(105,000,000)	(122,000,000)
Total debt	17,605,000,000	17,829,000,000
Less: current portion	(111,000,000)	(119,000,000)
Long-term debt	17,494,000,000	17,710,000,000
Revolving Credit Agreement
Debt Instrument [Line Items]
Credit facility	0	150,000,000
Term Loan Facility
Debt Instrument [Line Items]
Credit facility	2,033,000,000	2,115,000,000
$2,500 million 4.25% Senior Notes due December 15, 2027 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,500,000,000
Interest rate	4.25%
Senior notes	$ 2,397,000,000	2,395,000,000
$2,300 million 2.45% Senior Notes due July 15, 2028 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,300,000,000
Interest rate	2.45%
Senior notes	$ 2,302,000,000	2,303,000,000
$3,500 million 4.625% Senior Notes due December 15, 2029 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 3,500,000,000
Interest rate	4.625%
Senior notes	$ 3,277,000,000	3,277,000,000
$2,000 million 3.375% Senior Notes due February 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,000,000,000
Interest rate	3.375%
Senior notes	$ 2,000,000,000	2,000,000,000
$2,200 million 3.00% Senior Notes due October 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,200,000,000
Interest rate	3%
Senior notes	$ 2,200,000,000	2,200,000,000
$2,200 million 2.50% Senior Notes due March 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,200,000,000
Interest rate	2.50%
Senior notes	$ 2,200,000,000	2,200,000,000
$1,300 million 2.625% Senior Notes due August 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 1,300,000,000
Interest rate	2.625%
Senior notes	$ 1,300,000,000	$ 1,300,000,000

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) - USD ($) shares in Millions, $ in Millions	1 Months Ended	3 Months Ended
	Oct. 25, 2024	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023
Class of Stock [Line Items]
Stock repurchase program, authorized amount		$ 10,000
Stock repurchase program, remaining available		3,160
Common stock repurchases		$ 1,238	$ 810	$ 151	$ 781	$ 408	$ 423
Subsequent Event
Class of Stock [Line Items]
Common stock repurchases (in shares)	5.2
Common stock repurchases	$ 380

Stockholders' Equity - Share Re

Stockholders' Equity - Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Subsidiary, Sale of Stock [Line Items]
Total share repurchases	$ 1,238	$ 810	$ 151	$ 781	$ 408	$ 423
Share repurchase program, excise tax, payable	$ 18			$ 10			$ 18	$ 10
Employee Stock Compensation Plan
Subsidiary, Sale of Stock [Line Items]
Income tax withholding (in shares)	119			11			1,465	778
Income tax withholding	$ 9			$ 1			$ 112	$ 52
Common Stock
Subsidiary, Sale of Stock [Line Items]
Share buybacks (in shares)	16,254			11,609			27,595	22,489
Total share repurchases (in shares)	16,373			11,620			29,060	23,267
Share buybacks	$ 1,218			$ 773			$ 2,069	$ 1,550
Total share repurchases	$ 1,227			$ 774			$ 2,181	$ 1,602

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Net Income (Loss) Attributable to Parent [Abstract]
Earnings attributable to Centene Corporation	$ 713	$ 469	$ 3,022	$ 2,657
Shares used in computing per share amounts:
Weighted average number of common shares outstanding (in shares)	521,965	539,535	528,912	546,374
Common stock equivalents (as determined by applying the treasury stock method) (in shares)	1,577	1,735	2,003	2,038
Weighted average number of common shares and potential dilutive common shares outstanding (in shares)	523,542	541,270	530,915	548,412
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in dollars per share)	$ 1.37	$ 0.87	$ 5.71	$ 4.86
Diluted earnings per common share (in dollars per share)	$ 1.36	$ 0.87	$ 5.69	$ 4.85
Anti-dilutive restricted stock and restricted stock units excluded from the calculation of diluted earnings (loss) per common share (in shares)	273	1,313	266	1,383

Segment Information (Details)

Segment Information (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) segment	Sep. 30, 2023 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment			4
Segment Reporting Information [Line Items]
Premium and service revenues	$ 36,899	$ 34,967	$ 109,209	$ 104,757
Premium tax	5,124	3,075	13,057	9,782
Total external revenues	42,023	38,042	122,266	114,539
Revenues	42,023	38,042	122,266	114,539
Medical costs	32,201	29,479	93,898	88,260
Cost of services	692	856	2,041	2,603
Gross margin	4,006	4,632	13,270	13,894
Operating Segments
Segment Reporting Information [Line Items]
Revenues	4,290	3,978	12,451	11,634
Eliminations
Segment Reporting Information [Line Items]
Revenues	(4,290)	(3,978)	(12,451)	(11,634)
Premium
Segment Reporting Information [Line Items]
Premium and service revenues	36,115	33,866	106,784	101,404
Service
Segment Reporting Information [Line Items]
Premium and service revenues	784	1,101	2,425	3,353
Premium and service revenues
Segment Reporting Information [Line Items]
Premium and service revenues	36,899	34,967	109,209	104,757
Medicaid
Segment Reporting Information [Line Items]
Revenues	26,440	24,694	76,083	75,523
Medical costs	19,818	19,607	58,080	59,076
Cost of services	23	0	66	2
Gross margin	1,475	2,012	4,880	6,663
Medicaid | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	5,124	3,075	13,057	9,782
Total external revenues	26,440	24,694	76,083	75,523
Revenues	0	0	0	0
Medicaid | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Medicaid | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	21,291	21,619	62,958	65,741
Medicaid | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	25	0	68	0
Medicaid | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	21,316	21,619	63,026	65,741
Medicare
Segment Reporting Information [Line Items]
Revenues	5,643	5,430	17,556	16,971
Medical costs	4,968	4,462	15,690	14,354
Cost of services	0	0	0	0
Gross margin	675	968	1,866	2,617
Medicare | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	5,643	5,430	17,556	16,971
Revenues	0	0	0	0
Medicare | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Medicare | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	5,643	5,430	17,556	16,971
Medicare | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	0	0	0
Medicare | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	5,643	5,430	17,556	16,971
Commercial
Segment Reporting Information [Line Items]
Revenues	8,693	6,453	24,979	17,439
Medical costs	6,957	5,089	18,905	13,738
Cost of services	0	0	0	0
Gross margin	1,736	1,364	6,074	3,701
Commercial | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	8,693	6,453	24,979	17,439
Revenues	0	0	0	0
Commercial | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Commercial | Premium
Segment Reporting Information [Line Items]
Premium and service revenues	8,693	6,451	24,977	17,437
Commercial | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	2	2	2
Commercial | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	8,693	6,453	24,979	17,439
Other/Eliminations
Segment Reporting Information [Line Items]
Revenues	1,247	1,465	3,648	4,606
Medical costs	458	321	1,223	1,092
Cost of services	669	856	1,975	2,601
Gross margin	120	288	450	913
Other/Eliminations | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	1,247	1,465	3,648	4,606
Revenues	4,290	3,978	12,451	11,634
Other/Eliminations | Eliminations
Segment Reporting Information [Line Items]
Revenues	(4,290)	(3,978)	(12,451)	(11,634)
Other/Eliminations | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	488	366	1,293	1,255
Other/Eliminations | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	759	1,099	2,355	3,351
Other/Eliminations | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	$ 1,247	$ 1,465	$ 3,648	$ 4,606