Elevance Health (ELV) 10-Q 18 Apr 24 2024 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2024	Apr. 10, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	001-16751
Entity Registrant Name	ELEVANCE HEALTH, INC.
Entity Incorporation, State or Country Code	IN
Entity Tax Identification Number	35-2145715
Entity Address, Address Line One	220 Virginia Avenue
Entity Address, City or Town	Indianapolis
Entity Address, State or Province	IN
Entity Address, Postal Zip Code	46204
City Area Code	833
Local Phone Number	401-1577
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	ELV
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		232,417,867
Amendment Flag	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001156039
Current Fiscal Year End Date	--12-31

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 6,226	$ 6,526
Fixed maturity securities (amortized cost of $30,427 and $30,446; allowance for credit losses of $4 and $4)	29,530	29,614
Equity securities	511	229
Premium receivables	8,931	7,902
Self-funded receivables	4,242	4,558
Other receivables	5,120	5,405
Other current assets	6,388	5,795
Total current assets	60,948	60,029
Long-term investments:
Fixed maturity securities (amortized cost of $902 and $890; allowance for credit losses of $0 and $0)	880	876
Other invested assets	6,713	6,107
Property and equipment, net	4,451	4,359
Goodwill	25,947	25,317
Other intangible assets	10,710	10,273
Other noncurrent assets	2,245	1,967
Total assets	111,894	108,928
Current liabilities:
Medical claims payable	16,459	16,111
Other policyholder liabilities	5,298	5,600
Unearned income	1,474	1,402
Accounts payable and accrued expenses	5,658	6,910
Short-term borrowings	1,575	225
Current portion of long-term debt	2,900	1,649
Other current liabilities	10,970	9,894
Total current liabilities	44,334	41,791
Long-term debt, less current portion	21,976	23,246
Reserves for future policy benefits	765	778
Deferred tax liabilities, net	2,201	1,970
Other noncurrent liabilities	1,908	1,738
Total liabilities	71,184	69,523
Commitments and contingencies – Note 11
Shareholders’ equity
Preferred stock, without par value, shares authorized – 100,000,000; shares issued and outstanding – none	0	0
Common stock, par value $0.01, shares authorized – 900,000,000; shares issued and outstanding – 232,544,717 and 233,071,088	2	2
Additional paid-in capital	8,883	8,868
Retained earnings	33,088	31,749
Accumulated other comprehensive loss	(1,365)	(1,313)
Total shareholders’ equity	40,608	39,306
Noncontrolling interests	102	99
Total equity	40,710	39,405
Total liabilities and equity	$ 111,894	$ 108,928

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Fixed maturities, amortized cost, current	$ 30,427	$ 30,446
Fixed maturities, allowance for credit loss, current	4	4
Fixed maturities, amortized cost, noncurrent	902	890
Fixed maturities, allowance for credit Loss, noncurrent	$ 0	$ 0
Preferred stock, shares authorized (in shares)	100,000,000	100,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	900,000,000	900,000,000
Common stock, shares issued (in shares)	232,544,717	233,071,088
Common stock, shares outstanding (in shares)	232,544,717	233,071,088

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenues
Premiums	$ 35,696	$ 35,868
Total operating revenue	42,273	41,898
Net investment income	465	387
Net losses on financial instruments	(161)	(113)
Total revenues	42,577	42,172
Expenses
Benefit expense	30,546	30,786
Cost of products sold	3,825	3,481
Operating expense	4,886	4,800
Interest expense	265	251
Amortization of other intangible assets	116	235
Total expenses	39,638	39,553
Income before income tax expense	2,939	2,619
Income tax expense	690	615
Net income	2,249	2,004
Net income attributable to noncontrolling interests	(3)	(15)
Shareholders’ net income	$ 2,246	$ 1,989
Shareholders’ net income per share
Basic (in dollars per share)	$ 9.65	$ 8.37
Diluted (in dollars per share)	9.59	8.30
Dividends per share (in dollars per share)	$ 1.63	$ 1.48
Product revenue
Revenues
Product and service revenue	$ 4,499	$ 4,022
Service fees
Revenues
Product and service revenue	$ 2,078	$ 2,008

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ 2,249	$ 2,004
Other comprehensive (loss) income, net of tax:
Change in net unrealized losses/gains on investments	(56)	427
Change in non-credit component of impairment losses on investments	0	(2)
Change in net unrealized gains/losses on cash flow hedges	2	11
Change in net periodic pension and postretirement costs	4	2
Change in future policy benefits	(2)	2
Foreign currency translation adjustments	0	2
Other comprehensive (loss) income	(52)	442
Net income attributable to noncontrolling interests	(3)	(15)
Other comprehensive income attributable to noncontrolling interests	0	(2)
Total shareholders’ comprehensive income	$ 2,194	$ 2,429

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating activities
Net income	$ 2,249	$ 2,004
Adjustments to reconcile net income to net cash provided by operating activities:
Net losses on financial instruments	161	113
Equity in net losses of other invested assets	27	30
Depreciation and amortization	331	462
Deferred income taxes	136	(255)
Share-based compensation	62	61
Changes in operating assets and liabilities:
Receivables, net	(282)	(29)
Other invested assets	(29)	(15)
Other assets	(1,104)	(348)
Policy liabilities	31	306
Unearned income	72	3,282
Accounts payable and other liabilities	(257)	18
Income taxes	581	839
Other, net	0	1
Net cash provided by operating activities	1,978	6,469
Investing activities
Purchases of investments	(6,103)	(7,443)
Proceeds from sale of investments	4,898	2,489
Maturities, calls and redemptions from investments	535	3,533
Changes in securities lending collateral	(212)	204
Purchases of subsidiaries, net of cash acquired	(1,120)	(1,638)
Purchases of property and equipment	(279)	(301)
Other, net	(29)	(28)
Net cash used in investing activities	(2,310)	(3,184)
Financing activities
Proceeds from long-term borrowings	0	2,574
Repayments of long-term borrowings	0	(1,908)
Proceeds from short-term borrowings	1,350	325
Changes in securities lending payable	212	(205)
Changes in bank overdrafts	(586)	(291)
Repurchase and retirement of common stock	(566)	(622)
Cash dividends	(379)	(351)
Proceeds from issuance of common stock under employee stock plans	97	43
Taxes paid through withholding of common stock under employee stock plans	(100)	(98)
Other, net	4	2
Net cash used in financing activities	32	(531)
Effect of foreign exchange rates on cash and cash equivalents	0	1
Change in cash and cash equivalents	(300)	2,755
Cash and cash equivalents at beginning of period	6,526	7,387
Cash and cash equivalents at end of period	$ 6,226	$ 10,142

Consolidated Statements of Chan

Consolidated Statements of Changes in Equity - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Loss	Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2022		238
Beginning balance at Dec. 31, 2022	$ 36,330	$ 2	$ 9,084	$ 29,647	$ (2,490)	$ 87
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	2,004			1,989		15
Other comprehensive income (loss), net of tax	$ 442				440	2
Repurchase and retirement of common stock, including excise tax (in shares)	(1.3)	(1.3)
Repurchase and retirement of common stock, including excise tax	$ (626)		(51)	(575)
Dividends and dividend equivalents	(354)			(354)
Issuance of common stock under employee stock plans, net of related tax benefits (in shares)		0.4
Issuance of common stock under employee stock plans, net of related tax benefits	6		6	0
Convertible debenture repurchases, conversions and tax adjustments	(342)		(342)
Ending balance (in shares) at Mar. 31, 2023		237.1
Ending balance at Mar. 31, 2023	37,460	$ 2	8,697	30,707	(2,050)	104
Beginning balance (in shares) at Dec. 31, 2023		233.1
Beginning balance at Dec. 31, 2023	39,405	$ 2	8,868	31,749	(1,313)	99
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	2,249			2,246		3
Other comprehensive income (loss), net of tax	$ (52)				(52)	0
Repurchase and retirement of common stock, including excise tax (in shares)	(1.1)	(1.1)
Repurchase and retirement of common stock, including excise tax	$ (569)		(44)	(525)
Dividends and dividend equivalents	(382)			(382)
Issuance of common stock under employee stock plans, net of related tax benefits (in shares)		0.5
Issuance of common stock under employee stock plans, net of related tax benefits	59		59	0
Ending balance (in shares) at Mar. 31, 2024		232.5
Ending balance at Mar. 31, 2024	$ 40,710	$ 2	$ 8,883	$ 33,088	$ (1,365)	$ 102

Organization

Organization	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	Organization References to the terms “we,” “our,” “us” or “Elevance Health” used throughout these Notes to Consolidated Financial Statements refer to Elevance Health, Inc., an Indiana corporation, and unless the context otherwise requires, its direct and indirect subsidiaries. References to the “states” include the District of Columbia and Puerto Rico unless the context otherwise requires. Elevance Health is a health company with the purpose of improving the health of humanity. We are one of the largest health insurers in the United States in terms of medical membership, serving over 46 million medical members through our affiliated health plans as of March 31, 2024. We offer a broad spectrum of network-based managed care risk-based plans to Individual, Employer Group, Medicaid and Medicare markets. In addition, we provide a broad array of managed care services to fee-based customers, including claims processing, stop loss insurance, provider network access, medical management, care management, wellness programs, actuarial services and other administrative services. We provide services to the federal government in connection with our Federal Health Products & Services business, which administers the Federal Employees Health Benefits (“FEHB”) Program. We provide an array of specialty services both to customers of our subsidiary health plans and also to unaffiliated health plans, including pharmacy services, dental, vision and supplemental health insurance benefits, as well as integrated health services. We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross and Anthem Blue Cross and Blue Shield. We also conduct business through arrangements with other BCBS licensees as well as other strategic partners. In addition, we serve members in numerous states as Amerigroup, Freedom Health, HealthSun, MMM, Optimum HealthCare, Simply Healthcare and/or Wellpoint. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries. Through various subsidiaries, we also offer pharmacy services through our CarelonRx business, and other healthcare related services as Carelon Insights, Carelon Health, Carelon Behavioral Health and CareMore. We have organized our brand portfolio into the following core go-to-market brands: • Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents our existing Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed plans; • Wellpoint — we are uniting select non-BCBSA licensed Medicare, Medicaid and commercial plans under the Wellpoint name; and • Carelon — this brand brings together our healthcare-related brands and capabilities, including our CarelonRx and Carelon Services businesses, under a single brand name. Our branding strategy reflects the evolution of our business from a traditional health insurance company to a lifetime, trusted health partner. We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other (our businesses that do not individually meet the quantitative thresholds for an operating segment, as well as corporate expenses not allocated to our other reportable segments). During the fourth quarter of 2023, we moved our Carelon Global Solutions international business from the Corporate & Other reportable segment to the Carelon Services reportable segment. All prior period reportable segment information has been reclassified for comparability to conform to the current presentation. For additional discussion regarding our segments, including the changes made, see Note 15 “Segment Information” included in this Quarterly Report on Form 10-Q.

Basis of Presentation and Signi

Basis of Presentation and Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	Basis of Presentation and Significant Accounting Policies Basis of Presentation: The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial reporting. Accordingly, they do not include all of the information and footnotes required by GAAP for annual financial statements. We have omitted certain footnote disclosures that would substantially duplicate the disclosures in our Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Annual Report on Form 10-K”), unless the information contained in those disclosures materially changed or is required by GAAP. In the opinion of management, all adjustments, including normal recurring adjustments, necessary for a fair statement of the consolidated financial statements as of and for the three months ended March 31, 2024 and 2023 have been recorded. The results of operations for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the full year ending December 31, 2024, or any other period. The seasonal nature of portions of our health care and related benefits business, as well as competitive and other market conditions, may cause full-year results to differ from estimates based upon our interim results of operations. These unaudited consolidated financial statements should be read in conjunction with our audited consolidated financial statements as of and for the year ended December 31, 2023 included in our 2023 Annual Report on Form 10-K. Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income. Cash and Cash Equivalents: We control a number of bank accounts that are used exclusively to hold customer funds for the administration of customer benefits, and we have cash and cash equivalents on deposit to meet certain regulatory requirements. These amounts totaled $499 and $294 at March 31, 2024 and December 31, 2023, respectively, and are included in the cash and cash equivalents line on our consolidated balance sheets. Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity. If a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive loss. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive loss. The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default. For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income. The changes in fair value of our marketable equity securities are recognized in our results of operations within net losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations and are reported under the caption “Other invested assets” in our consolidated balance sheets. Mortgage loans on real estate are classified as held for investment and are reported at their amortized cost basis net of allowance under the caption “Other invested assets” in our consolidated balance sheets. Amortized cost is the amount at which the loan is originated, adjusted for accrued interest, amortization of premium, discount and net deferred fees or costs, collection of cash and write-offs. We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets. We use the equity method of accounting for investments in companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company. Our proportionate share of equity in net income of these unconsolidated affiliates is reported within net investment income. The equity method investments are reported under the caption “Other invested assets” in our consolidated balance sheets. Investment income is recorded when earned. All securities sold resulting in investment gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold. We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. We recognize the collateral as an asset, which is reported under the caption “Other current assets” on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive loss as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments. Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts. Premium receivables include the uncollected amounts from employer risk-based groups, individuals and government programs for insurance services. Premium receivables are reported net of an allowance for doubtful accounts of $212 at each of March 31, 2024 and December 31, 2023. Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers for administrative services. Self-funded receivables are reported net of an allowance for doubtful accounts of $89 and $87 at March 31, 2024 and December 31, 2023, respectively. Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades, accrued investment income and other miscellaneous amounts due to us. These receivables are reported net of an allowance for doubtful accounts of $956 and $941 at March 31, 2024 and December 31, 2023, respectively. Revenue Recognition: For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheet at March 31, 2024 or December 31, 2023. For the three months ended March 31, 2024 and 2023, revenue recognized from performance obligations related to prior periods, such as changes in transaction price, were not material. For contracts that have an original, expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material. Recently Adopted Accounting Guidance: In November 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 changed the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts , which was issued in November 2018. The amendments in ASU 2020-11 extended the original effective date by one year to our interim and annual reporting periods beginning after December 15, 2022. This standard requires us to review cash flow assumptions for our long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires us to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other comprehensive income. The rate used to discount our reserves for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of our liabilities. In addition, this standard changes the amortization method for deferred acquisition costs. We adopted these amendments on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and deferred acquisition costs as of the transition date, January 1, 2021. The adoption did not have an overall material impact on our financial statements. Recent Accounting Guidance Not Yet Adopted: In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740) ("ASU 2023-09"). The amendments in ASU 2023-09 are intended to improve income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for our fiscal year beginning after December 15, 2024. The amendments are to be applied on a prospective basis, although retrospective adoption is permitted. We do not believe the adoption of ASU 2023-09 will have a material impact on our consolidated financial statements or disclosures. In November 2023, the FASB issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”). The amendments in ASU 2023-07 are intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for our fiscal year beginning after December 15, 2023, and interim periods within our fiscal year beginning after December 15, 2024. The amendments are to be applied retrospectively to all prior periods presented in the financial statements, and upon transition, the significant segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. We are currently evaluating the effects the adoption of ASU 2023-07 will have on our consolidated financial statements and related disclosures. In August 2023, the FASB issued Accounting Standards Update No. 2023-05, Business Combinations—Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement (“ASU 2023-05”). ASU 2023-05 clarifies existing guidance to reduce diversity in practice and requires a joint venture to recognize and initially measure its assets and liabilities using a new basis of accounting, at fair value, upon formation. These amendments are effective prospectively for all joint venture formations with a formation date on or after January 1, 2025. We do not believe the adoption of ASU 2023-05 will have a material impact on our consolidated financial statements and disclosures. There were no other new accounting pronouncements that were issued or became effective since the issuance of our 2023 Annual Report on Form 10-K that had, or are expected to have, a material impact on our consolidated financial position, results of operations, cash flows or disclosures.

Business Acquisitions and Dives

Business Acquisitions and Divestitures	3 Months Ended
	Mar. 31, 2024
Business Combinations [Abstract]
Business Acquisitions and Divestitures	Business Acquisitions and Divestitures Completed Acquisitions On March 11, 2024, we completed our acquisition of Paragon Healthcare, Inc. (“Paragon”). Paragon, which operates as part of CarelonRx, provides infusion services and injectable therapies through its omnichannel model of ambulatory infusion centers, home infusion pharmacies, and other specialty pharmacy services. This acquisition aligns with our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. As of March 31, 2024, the purchase price was allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values, of which $553 has been allocated to finite-lived intangible assets and $635 to goodwill. The majority of the goodwill is not deductible for income tax purposes. As of March 31, 2024, the initial accounting for the acquisition has not been finalized. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations. On February 15, 2023, we completed our acquisition of BioPlus Parent, LLC and subsidiaries (“BioPlus”) from CarepathRx Aggregator, LLC. Prior to the acquisition, BioPlus was one of the largest independent specialty pharmacy organizations in the United States. BioPlus, which operates as part of CarelonRx, seeks to connect payors and providers of specialty pharmaceuticals to meet the medication therapy needs of patients with complex medical conditions. This acquisition aligns with our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. As of March 31, 2024, the purchase price was allocated to the tangible and intangible net assets acquired based on management’s estimates of their fair values, of which $820 has been allocated to finite-lived intangible assets and $893 to goodwill. Measurement period adjustments during the three months ended March 31, 2024 were $(5). The majority of goodwill is not deductible for income tax purposes. As of March 31, 2024, the initial accounting for the acquisition was finalized. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations. Divestiture On April 1, 2024, we completed the sale of our life and disability businesses to StanCorp Financial Group, Inc. (“The Standard”), a provider of financial protection products and services for employers and individuals. Upon closing, we and The Standard entered into a product distribution partnership. The related net assets held for sale and results of operations for the life and disability businesses to be divested as of and for the three months ending March 31, 2024 were not material. Pending Acquisitions On December 31, 2023, we entered into an agreement to acquire Centers Plan for Healthy Living LLC and Centers for Specialty Care Group IPA, LLC (“Centers”). Centers is a managed long-term care plan that serves New York state Medicaid and dually-eligible Medicaid/Medicare members, enabling adults with long-term care needs and disabilities to live safely and independently in their own home. This acquisition aligns with our strategic plan to grow the Health Benefits segment and leverage industry-leading expertise while serving Medicaid and dually eligible populations. The acquisition is expected to close in the third quarter of 2024 and is subject to standard closing conditions and customary approvals. On January 23, 2023, we announced our entrance into an agreement to acquire Louisiana Health Service & Indemnity Company, d/b/a Blue Cross and Blue Shield of Louisiana, an independent licensee of the BCBSA that provides healthcare plans to the Individual, Employer Group, Medicaid and Medicare markets, primarily in the State of Louisiana. This acquisition aligns with our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. The acquisition is subject to closing conditions and approvals.

Business Optimization Initiativ

Business Optimization Initiatives	3 Months Ended
	Mar. 31, 2024
Restructuring and Related Activities [Abstract]
Business Optimization Initiatives	Business Optimization Initiatives During the third quarter of 2023, based on a strategic review of our operations, assets and investments, management implemented the “2023-2024 Business Efficiency Program” to enhance operating efficiency, refine the focus of our investments and optimize our physical footprint. The 2023-2024 Business Efficiency Program includes the write-off of certain information technology assets and contract exit costs, a reduction in staff including the relocation of certain job functions, and the impairment of assets associated with the closure or partial closure of data centers and offices. The 2023-2024 Business Efficiency Program is expected to be substantially complete by the end of the third quarter of 2024. Cash outlays associated with this program, which primarily relate to the personnel-related costs, are expected to be paid through 2024. The ending balances related to the total liabilities for employee termination costs under the 2023-2024 Business Efficiency Program at March 31, 2024 and December 31, 2023 were $150 and $191, respectively, and were recorded in the Corporate & Other reportable segment. During the quarter ended March 31, 2024 there were no charges or releases related to employee termination costs under the 2023-2024 Business Efficiency Program, and payments were $41.

Investments

Investments	3 Months Ended
	Mar. 31, 2024
Investments [Abstract]
Investments	Investments Fixed Maturity Securities We evaluate our available-for-sale fixed maturity securities for declines based on qualitative and quantitative factors. We have established an allowance for credit loss and recorded credit loss expense as a reflection of our expected impairment losses. We continue to review our investment portfolios under our impairment review policy. Given the inherent uncertainty of changes in market conditions and the significant judgments involved, there is a continuing risk that declines in fair value may occur and additional material impairment losses for credit losses on investments may be recorded in future periods. A summary of current and long-term fixed maturity securities, available-for-sale, at March 31, 2024 and December 31, 2023 is as follows: Cost or Gross Gross Allowance Estimated March 31, 2024 Fixed maturity securities: United States Government securities $ 1,858 $ 6 $ (73) $ — $ 1,791 Government sponsored securities 127 — (4) — 123 Foreign government securities 73 — (1) — 72 States, municipalities and political subdivisions, tax-exempt 3,722 55 (150) — 3,627 Corporate securities 16,099 256 (575) (2) 15,778 Residential mortgage-backed securities 4,204 27 (302) — 3,929 Commercial mortgage-backed securities 1,971 12 (89) (2) 1,892 Other asset-backed securities 3,275 28 (105) — 3,198 Total fixed maturity securities $ 31,329 $ 384 $ (1,299) $ (4) $ 30,410 December 31, 2023 Fixed maturity securities: United States Government securities $ 1,873 $ 25 $ (54) $ — $ 1,844 Government sponsored securities 112 1 (3) — 110 Foreign government securities 5 1 (2) — 4 States, municipalities and political subdivisions, tax-exempt 3,985 69 (152) — 3,902 Corporate securities 14,838 322 (580) (2) 14,578 Residential mortgage-backed securities 4,071 40 (279) — 3,832 Commercial mortgage-backed securities 2,174 13 (138) (2) 2,047 Other asset-backed securities 4,278 25 (130) — 4,173 Total fixed maturity securities $ 31,336 $ 496 $ (1,338) $ (4) $ 30,490 Other asset-backed securities primarily consists of collateralized loan obligations and other debt securities. For fixed maturity securities in an unrealized loss position at March 31, 2024 and December 31, 2023, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position: Less than 12 Months 12 Months or Greater (Securities are whole amounts) Number of Estimated Gross Number of Estimated Gross March 31, 2024 Fixed maturity securities: United States Government securities 46 $ 1,188 $ (29) 48 $ 306 $ (44) Government sponsored securities 4 40 — 39 51 (4) Foreign government securities 5 10 — 2 4 (1) States, municipalities and political subdivisions, tax-exempt 231 449 (4) 1,001 1,656 (146) Corporate securities 906 2,324 (31) 2,422 5,775 (544) Residential mortgage-backed securities 239 1,026 (14) 1,631 1,958 (288) Commercial mortgage-backed securities 84 364 (6) 415 1,059 (83) Other asset-backed securities 126 454 (16) 414 1,288 (89) Total fixed maturity securities 1,641 $ 5,855 $ (100) 5,972 $ 12,097 $ (1,199) December 31, 2023 Fixed maturity securities: United States Government securities 35 $ 552 $ (9) 44 $ 370 $ (45) Government sponsored securities — — — 40 52 (3) Foreign government securities — — — 2 4 (2) States, municipalities and political subdivisions, tax-exempt 203 354 (2) 1,034 1,811 (150) Corporate securities 389 608 (15) 2,624 6,871 (565) Residential mortgage-backed securities 183 438 (5) 1,620 2,075 (274) Commercial mortgage-backed securities 112 353 (6) 534 1,317 (132) Other asset-backed securities 110 394 (18) 761 2,342 (112) Total fixed maturity securities 1,032 $ 2,699 $ (55) 6,659 $ 14,842 $ (1,283) Unrealized losses on our securities shown in the table above have not been recognized into income because, as of March 31, 2024, we do not intend to sell these investments and it is likely that we will not be required to sell these investments prior to their maturity or anticipated recovery. The declines in fair values are largely due to increasing interest rates driven by the higher rate of inflation and other market conditions. Allowances for credit losses have been recorded in the amount of $4 at both March 31, 2024 and December 31, 2023, for declines in fair value due to unfavorable changes in the credit quality characteristics that impact our assessment of collectability of principal and interest. The amortized cost and fair value of fixed maturity securities at March 31, 2024, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations. Amortized Estimated Due in one year or less $ 369 $ 365 Due after one year through five years 6,038 5,900 Due after five years through ten years 11,099 10,864 Due after ten years 7,648 7,460 Mortgage-backed securities 6,175 5,821 Total fixed maturity securities $ 31,329 $ 30,410 During the three months ended March 31, 2024 and 2023, we received total proceeds from sales, maturities, calls or redemptions of fixed maturity securities of $5,401 and $5,410, respectively. In the ordinary course of business, we may sell securities at a loss for a number of reasons, including, but not limited to: (i) changes in the investment environment; (ii) expectation that the fair value could deteriorate further; (iii) desire to reduce exposure to an issuer or an industry; (iv) changes in credit quality; or (v) changes in expected cash flow. All securities sold resulting in investment gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold. Equity Securities A summary of marketable equity securities at March 31, 2024 and December 31, 2023 is as follows: March 31, 2024 December 31, 2023 Equity securities: Exchange traded funds $ 382 $ 106 Common equity securities 52 45 Private equity securities 77 78 Total $ 511 $ 229 Other Invested Assets Other invested assets include primarily our investments in limited partnerships, joint ventures and other non-controlled corporations, mortgage loans and the cash surrender value of corporate-owned life insurance policies. Investments in limited partnerships, joint ventures and other non-controlled corporations are carried at our share in the entities’ undistributed earnings, which approximates fair value. Financial information for certain of these investments is reported on a one or three month lag due to the timing of when we receive financial information from the companies. On April 12, 2024, we entered into an agreement to partner with Clayton, Dubilier & Rice (“CD&R”) to accelerate innovation in care delivery across multiple regions in the United States by bringing together through a new company, (“NewCo”), certain care delivery and enablement assets of Carelon Management Services Inc., a Carelon Health business (“CMSI Assets”), and two CD&R portfolio businesses, apree health and Millennium Physician Group. Our investment in NewCo will be through a combination of cash, an existing equity investment in apree health, and the contribution of CMSI Assets. We will account for our initial minority ownership interest in NewCo as an equity method investment. Further, in connection with our equity investment, each party will have certain rights and obligations, including certain put, call, and purchase price true-up options, for which the estimated value will be determinable at the time of the incremental investments. The contribution of CMSI Assets and businesses to be contributed by CD&R to NewCo are subject to standard closing conditions and customary approvals. Investment (Losses) and Gains Net investment (losses) and gains for the three months ended March 31, 2024 and 2023 are as follows: Three Months Ended 2024 2023 Net (losses) gains: Fixed maturity securities: Gross realized gains from sales $ 22 $ 10 Gross realized losses from sales (159) (115) Impairment losses recognized in income (2) (7) Net realized losses from sales of fixed maturity securities (139) (112) Equity securities: Unrealized gains (losses) recognized on equity securities still held at the end of the period 2 (1) Net realized losses recognized on equity securities sold during the period — (1) Net gains (losses) on equity securities 2 (2) Other investments: Gross gains 16 27 Gross losses (20) (1) Impairment losses recognized in income (25) (3) Net (losses) gains on other investments (29) 23 Net losses on investments $ (166) $ (91) Accrued Investment Income At March 31, 2024 and December 31, 2023, accrued investment income totaled $294 and $301, respectively. We recognize accrued investment income under the caption “Other receivables” on our consolidated balance sheets. Securities Lending Programs We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. The fair value of the collateral received at the time of the transactions amounted to $2,592 and $2,380 at March 31, 2024 and December 31, 2023, respectively. The value of the collateral represented 102% of the market value of the securities on loan at each of March 31, 2024 and December 31, 2023. We recognize the collateral as an asset under the caption “Other current assets” in our consolidated balance sheets, and we recognize a corresponding liability for the obligation to return the collateral to the borrower under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets. At March 31, 2024 and December 31, 2023, the remaining contractual maturity of our securities lending agreements included overnight and continuous transactions of cash for $2,351 and $2,255, respectively, of United States Government securities for $241 and $99, respectively, and of residential mortgage-backed securities for $0 and $26, respectively.

Derivative Financial Instrument

Derivative Financial Instruments	3 Months Ended
	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Financial Instruments	Derivative Financial Instruments We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, swaptions, embedded derivatives and warrants. We also enter into master netting agreements, which reduce credit risk by permitting net settlement of transactions. We have entered into various interest rate swap contracts to convert a portion of our interest rate exposure on our long-term debt from fixed rates to floating rates. The floating rates payable on all of our fair value hedges are benchmarked to the Secured Overnight Financing Rate (“SOFR”). Any amounts recognized for changes in fair value of these derivatives are included in the captions “Other current assets,” “Other noncurrent assets,” “Other current liabilities” or “Other noncurrent liabilities” in our consolidated balance sheets. The unrecognized loss for all expired and terminated cash flow hedges included in accumulated other comprehensive loss, net of tax, was $209 and $211 at March 31, 2024 and December 31, 2023, respectively. During the three months ended March 31, 2024 , we recognized gains of $11 and losses of $6, respectively, on non-hedging derivatives. During the three months ended March 31, 2023 , we recognized gains of $12 and losses of $34 on non-hedging derivatives, respectively. For additional information relating to the fair value of our derivative assets and liabilities, see Note 7, “Fair Value,” included in this Quarterly Report on Form 10-Q.

Fair Value

Fair Value	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value	Fair Value Assets and liabilities recorded at fair value in our consolidated balance sheets are categorized based upon the level of judgment associated with the inputs used to measure their fair value. These assets and liabilities are classified into one of three levels of hierarchy defined by GAAP. For a description of the methods and assumptions that are used to estimate the fair value and determine the fair value hierarchy classification of each class of financial instrument, see Note 7 “Fair Value,” to our audited consolidated financial statements as of and for the year ended December 31, 2023 included in Part II, Item 8 of our 2023 Annual Report on Form 10-K. A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at March 31, 2024 and December 31, 2023 is as follows: Level I Level II Level III Total March 31, 2024 Assets: Cash equivalents $ 1,155 $ — $ — $ 1,155 Fixed maturity securities, available-for-sale: United States Government securities — 1,791 — 1,791 Government sponsored securities — 123 — 123 Foreign government securities — 72 — 72 States, municipalities and political subdivisions, tax-exempt — 3,627 — 3,627 Corporate securities — 15,726 52 15,778 Residential mortgage-backed securities — 3,914 15 3,929 Commercial mortgage-backed securities — 1,881 11 1,892 Other asset-backed securities — 2,478 720 3,198 Total fixed maturity securities, available-for-sale — 29,612 798 30,410 Equity securities: Exchange traded funds 382 — — 382 Common equity securities 15 37 — 52 Private equity securities — — 77 77 Total equity securities 397 37 77 511 Other invested assets - common equity securities 102 — — 102 Securities lending collateral — 2,594 — 2,594 Derivatives - other assets — 2 — 2 Total assets $ 1,654 $ 32,245 $ 875 $ 34,774 Percentage of total assets at fair value 5% 93% 2% 100% Liabilities: Derivatives - other liabilities $ — $ (61) $ — $ (61) Total liabilities $ — $ (61) $ — $ (61) December 31, 2023 Assets: Cash equivalents $ 2,210 $ — $ — $ 2,210 Fixed maturity securities, available-for-sale: United States Government securities — 1,844 — 1,844 Government sponsored securities — 110 — 110 Foreign government securities — 4 — 4 States, municipalities and political subdivisions, tax-exempt — 3,902 — 3,902 Corporate securities — 14,532 46 14,578 Residential mortgage-backed securities — 3,830 2 3,832 Commercial mortgage-backed securities — 2,047 — 2,047 Other asset-backed securities — 3,634 539 4,173 Total fixed maturity securities, available-for-sale — 29,903 587 30,490 Equity securities: Exchange traded funds 106 — — 106 Common equity securities 12 33 — 45 Private equity securities — — 78 78 Total equity securities 118 33 78 229 Other invested assets - common equity securities 111 — — 111 Securities lending collateral — 2,382 — 2,382 Derivatives - other assets — 10 — 10 Total assets $ 2,439 $ 32,328 $ 665 $ 35,432 Percentage of total assets at fair value 7% 91% 2% 100% Liabilities: Derivatives - other liabilities $ — $ (40) $ — $ (40) Total liabilities $ — $ (40) $ — $ (40) There were no individually material transfers into or out of Level III during the three months ended March 31, 2024 or 2023. There were no adjustments to quoted market prices obtained from the pricing services during the three months ended March 31, 2024 or 2023. Certain assets and liabilities are measured at fair value on a nonrecurring basis; that is, the instruments are not measured at fair value on an ongoing basis but are subject to fair value adjustments only in certain circumstances. As disclosed in Note 3, “Business Acquisitions and Divestitures,” we completed our acquisition of Paragon in the first quarter of 2024 and the acquisition of BioPlus in the first quarter of 2023. The net assets acquired in our acquisitions of Paragon and BioPlus and resulting goodwill and other intangible assets were recorded at fair value primarily using Level III inputs. The majority of tangible assets acquired and liabilities assumed were recorded at their carrying values as of the acquisition date, as their carrying values approximated their fair values due to their short-term nature. The fair values of goodwill and other intangible assets acquired in our acquisitions of Paragon and BioPlus were internally estimated based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets could be expected to generate in the future. We developed internal estimates for the expected cash flows and discount rate in the present value calculation. Also in 2023, we entered into a shareholder’s agreement which included certain put and call options on our minority interest ownership of Liberty Dental. The resulting net put option liability was recorded at its fair value measured at the date of acquisition using Level III inputs with an election not to mark the derivative to market. Other than the assets acquired and liabilities assumed in our acquisitions of Paragon and BioPlus and the net put option on Liberty Dental, there were no material assets or liabilities measured at fair value on a nonrecurring basis during the three months ended March 31, 2024 or 2023. In addition to the preceding disclosures on assets recorded at fair value in the consolidated balance sheets, FASB guidance also requires the disclosure of fair values for certain other financial instruments for which it is practicable to estimate fair value, whether or not such values are recognized in our consolidated balance sheets. Non-financial instruments such as property and equipment, other current assets, deferred income taxes, intangible assets and certain financial instruments, such as policy liabilities, are excluded from the fair value disclosures. Therefore, the fair value amounts cannot be aggregated to determine our underlying economic value. The carrying amounts reported in the consolidated balance sheets for cash, premium receivables, self-funded receivables, other receivables, unearned income, accounts payable and accrued expenses, and certain other current liabilities approximate fair value because of the short-term nature of these items. These assets and liabilities are not listed in the table below. See Note 7 “Fair Value,” to our audited consolidated financial statements as of and for the year ended December 31, 2023 included in Part II, Item 8 of our 2023 Annual Report on Form 10-K for details on the methods and assumptions used to estimate the fair value of each class of financial instrument that is recorded at its carrying value in our consolidated balance sheets. A summary of the estimated fair values by level of each class of financial instrument that is recorded at its carrying value on our consolidated balance sheets at March 31, 2024 and December 31, 2023 is as follows: Carrying Estimated Fair Value Level I Level II Level III Total March 31, 2024 Assets: Other invested assets $ 6,611 $ — $ — $ 6,580 $ 6,580 Liabilities: Debt: Short-term borrowings 225 — 225 — 225 Commercial paper 1,350 — 1,350 — 1,350 Notes 24,876 — 23,046 — 23,046 December 31, 2023 Assets: Other invested assets $ 5,996 $ — $ — $ 5,972 $ 5,972 Liabilities: Debt: Short-term borrowings 225 — 225 — 225 Notes 24,895 — 23,569 — 23,569

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes During the three months ended March 31, 2024 and 2023, we recognized income tax expense of $690 an d $615, respectively, which represent an effective income tax rate of 23.5% for both periods. Income taxes payable totaled $38 at March 31, 2024 and income taxes receivable totaled $543 at December 31, 2023. We recognize the income tax payable as a liability under the caption “Other current liabilities” and the income tax receivable as an asset under the caption “Other current assets” in our consolidated balance sheets.

Medical Claims Payable

Medical Claims Payable	3 Months Ended
	Mar. 31, 2024
Liability for Claims and Claims Adjustment Expense [Abstract]
Medical Claims Payable	Medical Claims Payable A reconciliation of the beginning and ending balances for medical claims payable for the three months ended March 31, 2024 and 2023 is as follows: 2024 2023 Gross medical claims payable, beginning of period $ 15,865 $ 15,348 Ceded medical claims payable, beginning of period (7) (6) Net medical claims payable, beginning of period 15,858 15,342 Net incurred medical claims: Current period 30,708 30,751 Prior periods redundancies (1,205) (1,068) Total net incurred medical claims 29,503 29,683 Net payments attributable to: Current period medical claims 19,580 19,948 Prior periods medical claims 9,606 9,593 Total net payments 29,186 29,541 Net medical claims payable, end of period 16,175 15,484 Ceded medical claims payable, end of period 8 7 Gross medical claims payable, end of period $ 16,183 $ 15,491 At March 31, 2024, the total of net incurred but not reported liabilities plus expected development on reported claims was $724, $4,323 and $11,128 for the claim years 2022 and prior, 2023 and 2024, respectively. The favorable development recognized in the three months ended March 31, 2024 resulted from faster than expected development of completion factors from the latter part of 2023 as well as trend factors in late 2023 developing more favorably than originally expected. The favorable development recognized in the three months ended March 31, 2023 resulted primarily from trend factors in late 2022 developing more favorably than expected and favorable development in the completion factors resulting from the latter part of 2022 developing faster than expected. The reconciliation of net incurred medical claims to benefit expense included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: 2024 2023 Total net incurred medical claims $ 29,503 $ 29,683 Quality improvement and other claims expense 1,043 1,103 Benefit expense $ 30,546 $ 30,786 The reconciliation of the medical claims payable reflected in the tables above to the consolidated ending balance for medical claims payable included in the consolidated balance sheet, as of March 31, 2024 is as follows: Total Net medical claims payable, end of period $ 16,175 Ceded medical claims payable, end of period 8 Insurance lines other than short duration 276 Gross medical claims payable, end of period $ 16,459

Debt

Debt	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Debt	Debt We generally issue senior unsecured notes for long-term borrowing purposes. At March 31, 2024 and December 31, 2023, we had $24,851 and $24,870, respectively, outstanding under these notes. We have an unsecured surplus note with an outstanding principal balance of $25 at both March 31, 2024 and December 31, 2023. We have a senior revolving credit facility (the “5-Year Facility”) with a group of lenders for general corporate purposes. The 5-Year Facility provides credit of up to $4,000 and matures in April 2027. Our ability to borrow under the 5-Year Facility is subject to compliance with certain covenants, including covenants requiring us to maintain a defined debt-to-capital ratio of not more than 60%, subject to increase in certain circumstances set forth in the credit agreement for the 5-Year Facility. As of March 31, 2024, our debt-to-capital ratio, as defined and calculated under the 5-Year Facility, was 39.4%. We do not believe the restrictions contained in our 5-Year Facility covenants materially affect our financial or operating flexibility. As of March 31, 2024, we were in compliance with all of our debt covenants under the 5-Year Facility. There were no amounts outstanding under the 5-Year Facility at any time during the three months ended March 31, 2024 or the year ended December 31, 2023. We have an authorized commercial paper program of up to $4,000, the proceeds of which may be used for general corporate purposes. At March 31, 2024 and December 31, 2023, we had $1,350 and $0, respectively, outstanding under this program. Beginning June 30, 2023, we have reclassified our commercial paper balances from long-term debt to short-term debt as our intent is to not replace short-term commercial paper outstanding at expiration with additional short-term commercial paper for an uninterrupted period extending for more than one year. We are a member, through certain subsidiaries, of the Federal Home Loan Bank of Indianapolis, the Federal Home Loan Bank of Cincinnati, the Federal Home Loan Bank of Atlanta and the Federal Home Loan Bank of New York (collectively, the “FHLBs”). As a member, we have the ability to obtain short-term cash advances, subject to certain minimum collateral requirements. We had $225 of outstanding short-term borrowings from the FHLBs at each of March 31, 2024 and December 31, 2023. All debt is a direct obligation of Elevance Health, Inc., except for the surplus note and the FHLBs borrowings.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Litigation and Regulatory Proceedings We are defendants in, or parties to, a number of pending or threatened legal actions or proceedings. To the extent a plaintiff or plaintiffs in the following cases have specified in their complaint or in other court filings the amount of damages being sought, we have noted those alleged damages in the descriptions below. Where available information indicates that it is probable that a loss has been incurred as of the date of the consolidated financial statements and we can reasonably estimate the amount of that loss, we accrue the estimated loss by a charge to income. In many proceedings, however, it is difficult to determine whether any loss is probable or reasonably possible. In addition, even where loss is possible or probable or an exposure to loss exists in excess of the liability already accrued with respect to a previously identified loss contingency, it is not always possible to reasonably estimate the amount of the possible or probable loss or range of losses in excess of the amount, if any, accrued, for various reasons, including but not limited to some or all of the following: (i) there are novel or unsettled legal issues presented, (ii) the proceedings are in early stages, (iii) there is uncertainty as to the likelihood of a class being certified or decertified or the ultimate size and scope of the class, (iv) there is uncertainty as to the outcome of pending appeals or motions, (v) there are significant factual issues to be resolved, and/or (vi) in many cases, the plaintiffs have not specified damages in their complaint or in court filings. With respect to the cases described below, we contest liability and/or the amount of damages in each matter, and we believe we have meritorious defenses. We do not believe the outcome of any known pending or threatened legal actions or proceedings will, in the aggregate, have a material impact on our financial position. However, unanticipated outcomes do sometimes occur, which could result in liabilities in excess of our accruals and could have a material adverse effect on our consolidated financial position or results of operations. In addition to the lawsuits described below, we are also involved in other pending and threatened litigation of the character incidental to our business and are from time to time involved as a party in various governmental investigations, audits, reviews and administrative proceedings (“government actions”). These government actions include routine and special inquiries by and disclosures to state insurance departments, state attorneys general, U.S. Regulatory Agencies, the U.S. Attorney General and subcommittees of the U.S. Congress. Such government actions could result in the imposition of civil or criminal fines, penalties, other sanctions and additional rules, regulations or other restrictions on our business operations. Any liability that may result from any one of these government actions, or in the aggregate, could have a material adverse effect on our consolidated financial position or results of operations. Blue Cross Blue Shield Antitrust Litigation We are a defendant in multiple lawsuits that were initially filed in 2012 against the BCBSA and Blue Cross and/or Blue Shield licensees (the “Blue plans”) across the country. Cases filed in twenty-eight states were consolidated into a single, multi-district proceeding captioned In re Blue Cross Blue Shield Antitrust Litigation that is pending in the U.S. District Court for the Northern District of Alabama (the “Court”). Generally, the suits allege that the BCBSA and the Blue plans have conspired to horizontally allocate geographic markets through license agreements, best efforts rules that limit the percentage of non-Blue revenue of each plan, restrictions on acquisitions, rules governing the BlueCard ® and National Accounts programs and other arrangements in violation of the Sherman Antitrust Act (“Sherman Act”) and related state laws. The cases were brought by two putative nationwide classes of plaintiffs, health plan subscribers and providers. In April 2018, the Court issued an order on the parties’ cross motions for partial summary judgment, determining that the defendants’ aggregation of geographic market allocations and output restrictions are to be analyzed under a per se standard of review, and the BlueCard ® program and other alleged Section 1 Sherman Act violations are to be analyzed under the rule of reason standard of review. With respect to whether the defendants operate as a single entity with regard to the enforcement of the Blue Cross Blue Shield trademarks, the Court found that summary judgment was not appropriate due to the existence of genuine issues of material fact. In April 2019, the plaintiffs filed motions for class certification, which defendants opposed. The BCBSA and Blue plans approved a settlement agreement and release with the subscriber plaintiffs (the “Subscriber Settlement Agreement”), which agreement required the Court’s approval to become effective. The Subscriber Settlement Agreement requires the defendants to make a monetary settlement payment and contains certain terms imposing non-monetary obligations including (i) eliminating the “national best efforts” rule in the BCBSA license agreements (which rule limits the percentage of non-Blue revenue permitted for each Blue plan) and (ii) allowing for some large national employers with self-funded benefit plans to request a bid for insurance coverage from a second Blue plan in addition to the local Blue plan. In November 2020, the Court issued an order preliminarily approving the Subscriber Settlement Agreement, following which members of the subscriber class were provided notice of the Subscriber Settlement Agreement and an opportunity to opt out of the class. A small number of subscribers submitted valid opt-outs by the opt-out deadline. In August 2022, the Court issued a final order approving the Subscriber Settlement Agreement (the “Final Approval Order”). The Court amended its Final Approval Order in September 2022, further clarifying the injunctive relief that may be available to subscribers who submitted valid opt-outs. In compliance with the Subscriber Settlement Agreement, we paid $506 into an escrow account in September 2022, for an aggregate and full settlement payment by us of $596, which was accrued in 2020. Four notices of appeal of the Final Approval Order were heard by a panel of the United States Court of Appeals for the Eleventh Circuit in September 2023 (the “Eleventh Circuit”), and the Eleventh Circuit affirmed the Court’s Final Approval Order approving the Subscriber Settlement Agreement in October 2023. Petitions for rehearing were filed by certain appellants in November 2023 and December 2023 and were denied in January 2024. As a result, the Eleventh Circuit issued a mandate terminating the jurisdiction of the Eleventh Circuit in February 2024. In March 2024, Home Depot, one of the appellants, filed a petition for certiorari to the United States Supreme Court. On the respondents' request, the United States Supreme Court granted an extension to respond until May 2024. In the event that all appellate rights are exhausted in a manner that affirms the Court’s Final Approval Order, the defendants’ payment and non-monetary obligations under the Subscriber Settlement Agreement will become effective and the funds held in escrow will be distributed in accordance with the Subscriber Settlement Agreement. In October 2020, after the Court lifted the stay as to the provider litigation, provider plaintiffs filed a renewed motion for class certification, which defendants opposed. In March 2021, the Court issued an order terminating the pending motion for class certification until the Court determined the standard of review applicable to the providers’ claims. In response to that order, the parties filed renewed standard of review motions in May 2021. In June 2021, the parties filed summary judgment motions not critically dependent on class certification. In February 2022, the Court issued orders (i) granting certain defendants’ motion for partial summary judgment against the provider plaintiffs who had previously released claims against such defendants, and (ii) granting the provider plaintiffs’ motion for partial summary judgment, determining that Ohio v. American Express Co . does not affect the standard of review in this case. In August 2022, the Court issued orders (i) granting in part the defendants’ motion regarding the antitrust standard of review, holding that for the period of time after the elimination of the “national best efforts” rule, the rule of reason applies to the provider plaintiffs’ market allocation conspiracy claims, and (ii) denying the provider plaintiffs’ motion for partial summary judgment on the standard of review, reaffirming its prior holding that the provider groups’ boycott claims are subject to the rule of reason. In December 2023, the Court denied defendants’ motion for summary judgment on providers’ damage claims as time-barred and speculative and provider plaintiffs’ motion for partial summary judgment on the defendants’ single entity defense due to the existence of genuine issues of material fact. In January 2024, the Court issued orders (i) denying defendants’ motion for summary judgment on (a) all claims by certain hospital providers and (b) any claims based on the Blue system's rules other than exclusive serviced areas or BlueCard and (ii) denying provider plaintiffs’ motion for partial summary judgment on defendants’ common law trademark claims. Provider plaintiffs’ motion for class certification, filed in October 2020, remains pending. We intend to continue to vigorously defend the provider litigation, which we believe is without merit; however, its ultimate outcome cannot be presently determined. A number of follow-on cases involving entities that opted out of the Subscriber Settlement Agreement have been filed. Those actions are: Alaska Air Group, Inc., et al. v. Anthem, Inc., et al., No. 2:21-cv-01209-AMM (N.D. Ala.) (“Alaska Air”) ; JetBlue Airways Corp., et al. v. Anthem, Inc., et al. , No. 2:22-cv-00558-GMB (N.D. Ala.) (“Jet Blue”) ; Metropolitan Transportation Authority v. Blue Cross and Blue Shield of Alabama et al. , No. 2:22-cv-00265-RDP (N.D. Ala.) (dismissed without prejudice in June 2023); Bed Bath & Beyond Inc. v. Anthem, Inc. , No. 2:22-cv-01256-SGC (N.D. Ala.); Hoover, et al. v. Blue Cross Blue Shield Association, et al. , No. 2:22-cv-00261-RDP (N.D. Ala.); and VHS Liquidating Trust v. Blue Cross of California, et al. , No. RG21106600 (Cal. Super.) (“VHS”) . In February 2023, the Court denied the defendants’ motion to dismiss based on a statute of limitations defense in Alaska Air and Jet Blue . In September 2023, the California court presiding over the VHS case, upheld its prior order granting in part defendants’ motion to strike based on the statute of limitations. We intend to continue to vigorously defend these follow-on cases, which we believe are without merit; however, their ultimate outcome cannot be presently determined. Express Scripts, Inc. PBM Litigation In March 2016, we filed a lawsuit against Express Scripts, Inc. (“Express Scripts”), our vendor at the time for PBM services, captioned Anthem, Inc. v. Express Scripts, Inc. , in the U.S. District Court for the Southern District of New York (the “District Court”). The lawsuit sought to recover over $14,800 in damages for pharmacy pricing that is higher than competitive benchmark pricing under the agreement between the parties (the “ESI Agreement”), over $158 in damages related to operational breaches, as well as various declarations under the ESI Agreement, including that Express Scripts: (i) breached its obligation to negotiate in good faith and to agree in writing to new pricing terms (the “Pricing Claim”); (ii) was required to provide competitive benchmark pricing to us through the term of the ESI Agreement; (iii) has breached the ESI Agreement; and (iv) is required under the ESI Agreement to provide post-termination services, at competitive benchmark pricing, for one year following any termination. Express Scripts disputed our contractual claims and it sought declaratory judgments: (i) regarding the timing of the periodic pricing review under the ESI Agreement, and (ii) that it has no obligation to ensure that we receive any specific level of pricing, that we have no contractual right to any change in pricing under the ESI Agreement and that its sole obligation is to negotiate proposed pricing terms in good faith. In the alternative, Express Scripts claimed that we have been unjustly enriched by its payment of $4,675 at the time we entered into the ESI Agreement. In March 2017, the District Court granted our motion to dismiss Express Scripts’ counterclaims for (i) breach of the implied covenant of good faith and fair dealing, and (ii) unjust enrichment with prejudice. After such ruling, Express Scripts’ only remaining claims were for breach of contract and declaratory relief. In August 2021, Express Scripts filed a motion for summary judgment, which we opposed. In March 2022, the District Court granted in part and denied in part Express Scripts’ motion for summary judgment. The District Court dismissed our declaratory judgment claim, our breach of contract claim for failure to prove damages and most of our operational breach claims. As a result of the summary judgment decision, the only remaining claims as of the filing of this Quarterly Report on Form 10-Q were (i) our operational breach claim based on Express Scripts’ prior authorization processes and (ii) Express Scripts’ counterclaim for breach of the market check provision of the ESI Agreement. Express Scripts filed a second motion for summary judgment in June 2022, challenging our remaining operational breach claims, which the District Court denied in March 2023. In November 2023, the District Court issued a final judgment ending the lawsuit in the District Court after the parties settled and stipulated to dismiss the only remaining claim that had not been disposed of by the court order or stipulation. In December 2023, we filed a notice of appeal with the United States Court of Appeal for the Second Circuit (the “Second Circuit”), regarding the Pricing Claim. In February 2024, the Second Circuit ordered the parties to participate in mediation. The mediation occurred in March 2024 and was unsuccessful. The ultimate outcome of this appeal cannot be presently determined. Medicare Risk Adjustment Litigation In March 2020, the U.S. Department of Justice (“DOJ”) filed a civil lawsuit against Elevance Health, Inc. in the U.S. District Court for the Southern District of New York (the “New York District Court”) in a case captioned United States v. Anthem, Inc . The DOJ’s suit alleges, among other things, that we falsely certified the accuracy of the diagnosis data we submitted to the Centers for Medicare and Medicaid Services (“CMS”) for risk-adjustment purposes under Medicare Part C and knowingly failed to delete inaccurate diagnosis codes. The DOJ further alleges that, as a result of these purported acts, we caused CMS to calculate the risk-adjustment payments based on inaccurate diagnosis information, which enabled us to obtain unspecified amounts of payments in Medicare funds in violation of the False Claims Act. The DOJ filed an amended complaint in July 2020, alleging the same causes of action but revising some of its factual allegations. In September 2020, we filed a motion to transfer the lawsuit to the Southern District of Ohio, a motion to dismiss part of the lawsuit, and a motion to strike certain allegations in the amended complaint, all of which the New York District Court denied in October 2022. In November 2022, we filed an answer. In March 2023, discovery commenced, and an initial case management conference was held in April 2023. The Court entered a scheduling order requiring fact discovery to be completed by June 2024 and expert discovery to be completed by February 2025. We intend to continue to vigorously defend this suit, which we believe is without merit; however, the ultimate outcome cannot be presently determined. Other Contingencies From time to time, we and certain of our subsidiaries are parties to various legal proceedings, many of which involve claims for coverage encountered in the ordinary course of business. We, like Health Maintenance Organizations (“HMOs”) and health insurers generally, exclude certain healthcare and other services from coverage under our HMO, Preferred Provider Organizations and other plans. We are, in the ordinary course of business, subject to the claims of our enrollees arising out of decisions to restrict or deny reimbursement for uncovered services. The loss of even one such claim, if it results in a significant punitive damage award, could have a material adverse effect on us. In addition, the risk of potential liability under punitive damage theories may increase significantly the difficulty of obtaining reasonable reimbursement of coverage claims. Contractual Obligations and Commitments In March 2020, we entered into an agreement with a vendor for information technology infrastructure and related management and support services through June 2025. Our remaining commitment under this agreement at March 31, 2024 is approximately $432. We will have the ability to terminate the agreement upon the occurrence of certain events, subject to early termination fees. We formed CarelonRx, to market and offer pharmacy services to our affiliated health plan customers, as well as to external customers outside of the health plans we own, starting in the second quarter of 2019. The comprehensive pharmacy services portfolio includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services. CarelonRx delegates certain core pharmacy services to CaremarkPCS Health, L.L.C. (“CVS”), which is a subsidiary of CVS Health Corporation, pursuant to an agreement, that is set to terminate on December 31, 2025. Beginning in the first quarter of 2024, CarelonRx is assuming responsibility for pharmacy mail order front-end intake and member services from CVS.

Capital Stock

Capital Stock	3 Months Ended
	Mar. 31, 2024
Class of Stock Disclosures [Abstract]
Capital Stock	Capital Stock Use of Capital – Dividends and Stock Repurchase Program We regularly review the appropriate use of capital, including acquisitions, common stock and debt security repurchases and dividends to shareholders. The declaration and payment of any dividends or repurchases of our common stock or debt is at the discretion of our Board of Directors and depends upon our financial condition, results of operations, future liquidity needs, regulatory and capital requirements and other factors deemed relevant by our Board of Directors. A summary of our cash dividend activity for the three months ended March 31, 2024 and 2023 is as follows: Declaration Date Record Date Payment Date Cash Dividend per Share Total Three Months Ended March 31, 2024 January 23, 2024 March 8, 2024 March 22, 2024 $1.63 $ 379 Three Months Ended March 31, 2023 January 24, 2023 March 10, 2023 March 24, 2023 $1.48 $ 351 On April 16, 2024, our Audit Committee declared a second quarter 2024 dividend to shareholders of $1.63 per share, payable on June 25, 2024 to shareholders of record at the close of business on June 10, 2024. Under our Board of Directors’ authorization, we maintain a common stock repurchase program. On January 24, 2023, our Audit Committee, pursuant to authorization granted by the Board of Directors, authorized a $5,000 increase to the common stock repurchase program. No duration has been placed on the common stock repurchase program, and we reserve the right to discontinue the program at any time. Repurchases may be made from time to time at prevailing market prices, subject to certain restrictions on volume, pricing and timing. The repurchases are affected from time to time in the open market, through negotiated transactions, including accelerated share repurchase agreements, and through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Our stock repurchase program is discretionary, as we are under no obligation to repurchase shares. We repurchase shares under the program when we believe it is a prudent use of capital. The excess cost of the repurchased shares over par value is charged on a pro rata basis to additional paid-in capital and retained earnings. A summary of common stock repurchases for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended March 31 2024 2023 Shares repurchased 1.1 1.3 Average price per share $ 492.76 $ 476.66 Aggregate cost $ 566 $ 622 Authorization remaining at the end of the period $ 3,633 $ 6,254 For additional information regarding the use of capital for debt security repurchases, see Note 10, “Debt,” included in this Quarterly Report on Form 10-Q and Note 13, “Debt,” to our audited consolidated financial statements as of and for the year ended December 31, 2023 included in Part II, Item 8 of our 2023 Annual Report on Form 10-K. Stock Incentive Plan s A summary of stock option activity for the three months ended March 31, 2024 is as follows: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2024 3.0 $ 327.14 Granted 0.5 499.11 Exercised (0.3) 288.95 Forfeited or expired — 431.01 Outstanding at March 31, 2024 3.2 356.58 6.44 $ 521 Exercisable at March 31, 2024 2.2 297.24 5.23 $ 482 A summary of the status of nonvested restricted stock activity, including restricted stock units and performance units, for the three months ended March 31, 2024 is as follows: Restricted Weighted- Nonvested at January 1, 2024 1.1 $ 423.94 Granted 0.6 499.00 Vested (0.6) 352.33 Forfeited — 456.61 Nonvested at March 31, 2024 1.1 475.31 During the three months ended March 31, 2024, we granted approximately 0.3 restricted stock units that are contingent upon us achieving earnings targets over the three-year period from 2024 to 2026. These grants have been included in the activity shown above but will be subject to adjustment at the end of 2026 based on results in the three-year period. Fair Value We use a binomial lattice valuation model to estimate the fair value of all stock options granted. For a more detailed discussion of our stock incentive plan fair value methodology, see Note 15, “Capital Stock,” to our audited consolidated financial statements as of and for the year ended December 31, 2023 included in Part II, Item 8 of our 2023 Annual Report on Form 10-K. The following weighted-average assumptions were used to estimate the fair values of options granted during the three months ended March 31, 2024 and 2023: Three Months Ended March 31 2024 2023 Risk-free interest rate 4.28 % 3.95 % Volatility factor 28.00 % 29.00 % Quarterly dividend yield 0.327 % 0.316 % Weighted-average expected life (years) 4.40 4.40 The following weighted-average fair values per option or share were determined for the three months ended March 31, 2024 and 2023: Three Months Ended March 31 2024 2023 Options granted during the period $ 134.53 $ 127.14 Restricted stock awards granted during the period 499.00 469.31

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	3 Months Ended
	Mar. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Accumulated Other Comprehensive (Loss) Income	Accumulated Other Comprehensive (Loss) Income A reconciliation of the components of accumulated other comprehensive (loss) income at March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Net unrealized investment (losses) gains: Beginning of period balance $ (632) $ (1,755) Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $50 and $(85), respectively (162) 337 Amounts reclassified from accumulated other comprehensive loss, net of tax benefit of $(33) and $(29), respectively 106 90 Other comprehensive (loss) income (56) 427 Other comprehensive income attributable to noncontrolling interests, net of tax benefit of $0 and $0, respectively — (2) End of period balance (688) (1,330) Non-credit components of impairments on investments: Beginning of period balance (3) (3) Other comprehensive loss, net of tax benefit of $0 and $1, respectively — (2) End of period balance (3) (5) Net cash flow hedges: Beginning of period balance (211) (229) Other comprehensive income, net of tax (expense) benefit of $(1) and $8, respectively 2 11 End of period balance (209) (218) Pension and other postretirement benefits: Beginning of period balance (459) (499) Other comprehensive income, net of tax expense of $(1) and $(1), respectively 4 2 End of period balance (455) (497) Future policy benefits: Beginning of period balance 10 13 Other comprehensive (loss) income, net of tax expense of $0 and $0, respectively (2) 2 End of period balance 8 15 Foreign currency translation adjustments: Beginning of period balance (18) (17) Other comprehensive income, net of tax expense of $0 and $0, respectively — 2 End of period balance (18) (15) Total: Total beginning of period accumulated other comprehensive loss (1,313) (2,490) Total other comprehensive (loss) income, net of tax benefit (expense) of $15, and $(106), respectively (52) 442 Total other comprehensive income attributable to noncontrolling interests, net of tax benefit of $0 and $0 respectively — (2) Total end of period accumulated other comprehensive loss $ (1,365) $ (2,050)

Shareholders' Earnings per Shar

Shareholders' Earnings per Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Shareholders' Earnings per Share	Shareholders' Earnings per Share The denominator for basic and diluted shareholders' earnings per share for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Denominator for basic shareholders' earnings per share – weighted-average shares 232.7 237.5 Effect of dilutive securities – employee stock options, nonvested restricted stock awards and convertible debentures 1.5 2.2 Denominator for diluted shareholders' earnings per share 234.2 239.7 During the three months ended March 31, 2024 and 2023, weighted-average shares related to certain stock options of 0.6 and 0.4 respectively, were excluded from the denominator for diluted shareholders' earnings per share because the stock options were anti-dilutive. During the three months ended March 31, 2024, we issued approximately 0.6 restricted stock units under our stock incentive plans, 0.3 of which vesting is contingent upon us meeting specified annual earnings targets for the three-year period of 2024 through 2026. During the three months ended March 31, 2023, we issued approximately 0.6 restricted stock units under our stock incentive plans, 0.2 of which vesting is contingent upon us meeting specified annual earnings targets for the three-year period of 2023 through 2025. The contingent restricted stock units have been excluded from the denominators for diluted shareholders' earnings per share and will be included only if and when the contingency is met.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Segment Information	Segment Information We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other. During the fourth quarter of 2023, we moved our Carelon Global Solutions international businesses from the Corporate & Other reportable segment to the Carelon Services reportable segment. All prior period reportable segment information has been reclassified for comparability to conform to the current presentation. Our Health Benefits segment offers a comprehensive suite of health plans and services to our Individual, Employer Group risk-based, Employer Group fee-based, BlueCard ® , Medicare, Medicaid and FEHB program members. Our Health Benefits segment also includes our National Government Services business. The Health Benefits segment offers health products on a full-risk basis; provides a broad array of administrative managed care services to our fee-based customers; and provides a variety of specialty and other insurance products and services such as stop loss, dental, vision and supplemental health insurance benefits. Our CarelonRx segment includes our pharmacy services business. CarelonRx markets and offers pharmacy services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. CarelonRx offers a comprehensive pharmacy services portfolio, which includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services. Our Carelon Services segment integrates physical, behavioral, social and pharmacy services to deliver whole health affordably through creating value by offering market-competitive services, powered by analytics. Carelon Services offers a broad array of healthcare related services and capabilities to internal and external customers including utilization management, behavioral health, integrated care delivery, palliative care, payment integrity services and subrogation services, as well as health and wellness programs. At the end of 2023, Carelon Services integrated Carelon Global Solutions into the Carelon family of offerings. The companies under Carelon Global Solutions have been providing services related to data management, information technology and business operations since 2019 and were previously included within our Corporate & Other segment. Our Corporate & Other segment includes our businesses that do not individually meet the quantitative threshold for an operating segment, as well as corporate expenses not allocated to our other reportable segments. We define operating revenues to include premium income, product revenue and service fees. Operating revenues are derived from premiums and fees received, primarily from the sale and administration of health benefits and pharmacy products and services. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and operating expense. Affiliated revenues represent revenues or costs for services provided to our subsidiaries by CarelonRx and Carelon Services, in addition to certain administrative and other services provided by our international businesses, which are recorded at cost or management’s estimate of fair market value. These affiliated revenues are eliminated in consolidation. Financial data by reportable segment for the three months ended March 31, 2024 and 2023 is as follows: Carelon Health CarelonRx Carelon Total Corporate Eliminations Total Three Months Ended March 31, 2024 Premiums $ 35,382 $ — $ 408 $ 408 $ — $ (94) $ 35,696 Product revenue — 4,499 — 4,499 — — 4,499 Service fees 1,876 1 197 198 4 — 2,078 Operating revenue - unaffiliated 37,258 4,500 605 5,105 4 (94) 42,273 Operating revenue - affiliated — 3,567 3,404 6,971 123 (7,094) — Operating revenue - total $ 37,258 $ 8,067 $ 4,009 $ 12,076 $ 127 $ (7,188) $ 42,273 Operating gain (loss) $ 2,287 $ 523 $ 290 $ 813 $ (84) $ — $ 3,016 Three Months Ended March 31, 2023 Premiums $ 35,534 $ — $ 410 $ 410 $ — $ (76) $ 35,868 Product revenue — 4,022 — 4,022 — — 4,022 Service fees 1,746 — 208 208 54 — 2,008 Operating revenue - unaffiliated 37,280 4,022 618 4,640 54 (76) 41,898 Operating revenue - affiliated — 4,002 2,842 6,844 37 (6,881) — Operating revenue - total $ 37,280 $ 8,024 $ 3,460 $ 11,484 $ 91 $ (6,957) $ 41,898 Operating gain (loss) $ 2,149 $ 512 $ 229 $ 741 $ (59) $ — $ 2,831 For segment reporting, we present all capitated risk arrangements on a gross basis; therefore, eliminations also include adjustments for unaffiliated capitated risk arrangements that are recognized on a net basis under GAAP, as well as affiliated eliminations. A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Reportable segments’ operating revenue $ 42,273 $ 41,898 Net investment income 465 387 Net losses on financial instruments (161) (113) Total revenues $ 42,577 $ 42,172 A reconciliation of income before income tax expense to reportable segments’ operating gain included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Income before income tax expense $ 2,939 $ 2,619 Net investment income (465) (387) Net losses on financial instruments 161 113 Interest expense 265 251 Amortization of other intangible assets 116 235 Reportable segments’ operating gain $ 3,016 $ 2,831

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Shareholders' net income	$ 2,246	$ 1,989

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 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

Basis of Presentation and Sig_2

Basis of Presentation and Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation: The accompanying unaudited consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”) for interim financial reporting. Accordingly, they do not include all of the information and footnotes required by GAAP for annual financial statements. We have omitted certain footnote disclosures that would substantially duplicate the disclosures in our Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Annual Report on Form 10-K”), unless the information contained in those disclosures materially changed or is required by GAAP. In the opinion of management, all adjustments, including normal recurring adjustments, necessary for a fair statement of the consolidated financial statements as of and for the three months ended March 31, 2024 and 2023 have been recorded. The results of operations for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the full year ending December 31, 2024, or any other period. The seasonal nature of portions of our health care and related benefits business, as well as competitive and other market conditions, may cause full-year results to differ from estimates based upon our interim results of operations. These unaudited consolidated financial statements should be read in conjunction with our audited consolidated financial statements as of and for the year ended December 31, 2023 included in our 2023 Annual Report on Form 10-K.
Foreign Currency	Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income.
Cash and Cash Equivalents	Cash and Cash Equivalents:
Investments	Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity. If a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive loss. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive loss. The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default. For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income. The changes in fair value of our marketable equity securities are recognized in our results of operations within net losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations and are reported under the caption “Other invested assets” in our consolidated balance sheets. Mortgage loans on real estate are classified as held for investment and are reported at their amortized cost basis net of allowance under the caption “Other invested assets” in our consolidated balance sheets. Amortized cost is the amount at which the loan is originated, adjusted for accrued interest, amortization of premium, discount and net deferred fees or costs, collection of cash and write-offs. We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets. We use the equity method of accounting for investments in companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company. Our proportionate share of equity in net income of these unconsolidated affiliates is reported within net investment income. The equity method investments are reported under the caption “Other invested assets” in our consolidated balance sheets. Investment income is recorded when earned. All securities sold resulting in investment gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold. We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. We recognize the collateral as an asset, which is reported under the caption “Other current assets” on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive loss as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments.
Receivables	Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts. Premium receivables include the uncollected amounts from employer risk-based groups, individuals and government programs for insurance services. Premium receivables are reported net of an allowance for doubtful accounts of $212 at each of March 31, 2024 and December 31, 2023. Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers for administrative services. Self-funded receivables are reported net of an allowance for doubtful accounts of $89 and $87 at March 31, 2024 and December 31, 2023, respectively. Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades, accrued investment income and other miscellaneous amounts due to us. These receivables are reported net of an allowance for doubtful accounts of $956 and $941 at March 31, 2024 and December 31, 2023, respectively.
Revenue Recognition	Revenue Recognition: For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheet at March 31, 2024 or December 31, 2023. For the three months ended March 31, 2024 and 2023, revenue recognized from performance obligations related to prior periods, such as changes in transaction price, were not material. For contracts that have an original, expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material.
Recently Adopted Accounting Guidance and Recent Accounting Guidance Not Yet Adopted	Recently Adopted Accounting Guidance: In November 2020, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 changed the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts , which was issued in November 2018. The amendments in ASU 2020-11 extended the original effective date by one year to our interim and annual reporting periods beginning after December 15, 2022. This standard requires us to review cash flow assumptions for our long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires us to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other comprehensive income. The rate used to discount our reserves for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of our liabilities. In addition, this standard changes the amortization method for deferred acquisition costs. We adopted these amendments on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and deferred acquisition costs as of the transition date, January 1, 2021. The adoption did not have an overall material impact on our financial statements. Recent Accounting Guidance Not Yet Adopted: In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740) ("ASU 2023-09"). The amendments in ASU 2023-09 are intended to improve income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for our fiscal year beginning after December 15, 2024. The amendments are to be applied on a prospective basis, although retrospective adoption is permitted. We do not believe the adoption of ASU 2023-09 will have a material impact on our consolidated financial statements or disclosures. In November 2023, the FASB issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”). The amendments in ASU 2023-07 are intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for our fiscal year beginning after December 15, 2023, and interim periods within our fiscal year beginning after December 15, 2024. The amendments are to be applied retrospectively to all prior periods presented in the financial statements, and upon transition, the significant segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. We are currently evaluating the effects the adoption of ASU 2023-07 will have on our consolidated financial statements and related disclosures. In August 2023, the FASB issued Accounting Standards Update No. 2023-05, Business Combinations—Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement (“ASU 2023-05”). ASU 2023-05 clarifies existing guidance to reduce diversity in practice and requires a joint venture to recognize and initially measure its assets and liabilities using a new basis of accounting, at fair value, upon formation. These amendments are effective prospectively for all joint venture formations with a formation date on or after January 1, 2025. We do not believe the adoption of ASU 2023-05 will have a material impact on our consolidated financial statements and disclosures. There were no other new accounting pronouncements that were issued or became effective since the issuance of our 2023 Annual Report on Form 10-K that had, or are expected to have, a material impact on our consolidated financial position, results of operations, cash flows or disclosures.

Investments (Tables)

Investments (Tables)	3 Months Ended
	Mar. 31, 2024
Investments [Abstract]
Schedule of Current and Long-Term Investments, Available-For-Sale	A summary of current and long-term fixed maturity securities, available-for-sale, at March 31, 2024 and December 31, 2023 is as follows: Cost or Gross Gross Allowance Estimated March 31, 2024 Fixed maturity securities: United States Government securities $ 1,858 $ 6 $ (73) $ — $ 1,791 Government sponsored securities 127 — (4) — 123 Foreign government securities 73 — (1) — 72 States, municipalities and political subdivisions, tax-exempt 3,722 55 (150) — 3,627 Corporate securities 16,099 256 (575) (2) 15,778 Residential mortgage-backed securities 4,204 27 (302) — 3,929 Commercial mortgage-backed securities 1,971 12 (89) (2) 1,892 Other asset-backed securities 3,275 28 (105) — 3,198 Total fixed maturity securities $ 31,329 $ 384 $ (1,299) $ (4) $ 30,410 December 31, 2023 Fixed maturity securities: United States Government securities $ 1,873 $ 25 $ (54) $ — $ 1,844 Government sponsored securities 112 1 (3) — 110 Foreign government securities 5 1 (2) — 4 States, municipalities and political subdivisions, tax-exempt 3,985 69 (152) — 3,902 Corporate securities 14,838 322 (580) (2) 14,578 Residential mortgage-backed securities 4,071 40 (279) — 3,832 Commercial mortgage-backed securities 2,174 13 (138) (2) 2,047 Other asset-backed securities 4,278 25 (130) — 4,173 Total fixed maturity securities $ 31,336 $ 496 $ (1,338) $ (4) $ 30,490
Schedule of Aggregate Fair Value and Gross Unrealized Loss of Fixed Maturity Securities in an Unrealized Loss Position	For fixed maturity securities in an unrealized loss position at March 31, 2024 and December 31, 2023, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position: Less than 12 Months 12 Months or Greater (Securities are whole amounts) Number of Estimated Gross Number of Estimated Gross March 31, 2024 Fixed maturity securities: United States Government securities 46 $ 1,188 $ (29) 48 $ 306 $ (44) Government sponsored securities 4 40 — 39 51 (4) Foreign government securities 5 10 — 2 4 (1) States, municipalities and political subdivisions, tax-exempt 231 449 (4) 1,001 1,656 (146) Corporate securities 906 2,324 (31) 2,422 5,775 (544) Residential mortgage-backed securities 239 1,026 (14) 1,631 1,958 (288) Commercial mortgage-backed securities 84 364 (6) 415 1,059 (83) Other asset-backed securities 126 454 (16) 414 1,288 (89) Total fixed maturity securities 1,641 $ 5,855 $ (100) 5,972 $ 12,097 $ (1,199) December 31, 2023 Fixed maturity securities: United States Government securities 35 $ 552 $ (9) 44 $ 370 $ (45) Government sponsored securities — — — 40 52 (3) Foreign government securities — — — 2 4 (2) States, municipalities and political subdivisions, tax-exempt 203 354 (2) 1,034 1,811 (150) Corporate securities 389 608 (15) 2,624 6,871 (565) Residential mortgage-backed securities 183 438 (5) 1,620 2,075 (274) Commercial mortgage-backed securities 112 353 (6) 534 1,317 (132) Other asset-backed securities 110 394 (18) 761 2,342 (112) Total fixed maturity securities 1,032 $ 2,699 $ (55) 6,659 $ 14,842 $ (1,283)
Schedule of Amortized Cost and Fair Value of Fixed Maturity Securities, By Contractual Maturity	The amortized cost and fair value of fixed maturity securities at March 31, 2024, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations. Amortized Estimated Due in one year or less $ 369 $ 365 Due after one year through five years 6,038 5,900 Due after five years through ten years 11,099 10,864 Due after ten years 7,648 7,460 Mortgage-backed securities 6,175 5,821 Total fixed maturity securities $ 31,329 $ 30,410
Summary of Marketable Equity Securitites	A summary of marketable equity securities at March 31, 2024 and December 31, 2023 is as follows: March 31, 2024 December 31, 2023 Equity securities: Exchange traded funds $ 382 $ 106 Common equity securities 52 45 Private equity securities 77 78 Total $ 511 $ 229
Schedule of Net Investment (Losses) and Gains	Net investment (losses) and gains for the three months ended March 31, 2024 and 2023 are as follows: Three Months Ended 2024 2023 Net (losses) gains: Fixed maturity securities: Gross realized gains from sales $ 22 $ 10 Gross realized losses from sales (159) (115) Impairment losses recognized in income (2) (7) Net realized losses from sales of fixed maturity securities (139) (112) Equity securities: Unrealized gains (losses) recognized on equity securities still held at the end of the period 2 (1) Net realized losses recognized on equity securities sold during the period — (1) Net gains (losses) on equity securities 2 (2) Other investments: Gross gains 16 27 Gross losses (20) (1) Impairment losses recognized in income (25) (3) Net (losses) gains on other investments (29) 23 Net losses on investments $ (166) $ (91)

Fair Value (Tables)

Fair Value (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Summary of Fair Value Measurements by Level	A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at March 31, 2024 and December 31, 2023 is as follows: Level I Level II Level III Total March 31, 2024 Assets: Cash equivalents $ 1,155 $ — $ — $ 1,155 Fixed maturity securities, available-for-sale: United States Government securities — 1,791 — 1,791 Government sponsored securities — 123 — 123 Foreign government securities — 72 — 72 States, municipalities and political subdivisions, tax-exempt — 3,627 — 3,627 Corporate securities — 15,726 52 15,778 Residential mortgage-backed securities — 3,914 15 3,929 Commercial mortgage-backed securities — 1,881 11 1,892 Other asset-backed securities — 2,478 720 3,198 Total fixed maturity securities, available-for-sale — 29,612 798 30,410 Equity securities: Exchange traded funds 382 — — 382 Common equity securities 15 37 — 52 Private equity securities — — 77 77 Total equity securities 397 37 77 511 Other invested assets - common equity securities 102 — — 102 Securities lending collateral — 2,594 — 2,594 Derivatives - other assets — 2 — 2 Total assets $ 1,654 $ 32,245 $ 875 $ 34,774 Percentage of total assets at fair value 5% 93% 2% 100% Liabilities: Derivatives - other liabilities $ — $ (61) $ — $ (61) Total liabilities $ — $ (61) $ — $ (61) December 31, 2023 Assets: Cash equivalents $ 2,210 $ — $ — $ 2,210 Fixed maturity securities, available-for-sale: United States Government securities — 1,844 — 1,844 Government sponsored securities — 110 — 110 Foreign government securities — 4 — 4 States, municipalities and political subdivisions, tax-exempt — 3,902 — 3,902 Corporate securities — 14,532 46 14,578 Residential mortgage-backed securities — 3,830 2 3,832 Commercial mortgage-backed securities — 2,047 — 2,047 Other asset-backed securities — 3,634 539 4,173 Total fixed maturity securities, available-for-sale — 29,903 587 30,490 Equity securities: Exchange traded funds 106 — — 106 Common equity securities 12 33 — 45 Private equity securities — — 78 78 Total equity securities 118 33 78 229 Other invested assets - common equity securities 111 — — 111 Securities lending collateral — 2,382 — 2,382 Derivatives - other assets — 10 — 10 Total assets $ 2,439 $ 32,328 $ 665 $ 35,432 Percentage of total assets at fair value 7% 91% 2% 100% Liabilities: Derivatives - other liabilities $ — $ (40) $ — $ (40) Total liabilities $ — $ (40) $ — $ (40)
Schedule of Estimated Fair Value by Level	A summary of the estimated fair values by level of each class of financial instrument that is recorded at its carrying value on our consolidated balance sheets at March 31, 2024 and December 31, 2023 is as follows: Carrying Estimated Fair Value Level I Level II Level III Total March 31, 2024 Assets: Other invested assets $ 6,611 $ — $ — $ 6,580 $ 6,580 Liabilities: Debt: Short-term borrowings 225 — 225 — 225 Commercial paper 1,350 — 1,350 — 1,350 Notes 24,876 — 23,046 — 23,046 December 31, 2023 Assets: Other invested assets $ 5,996 $ — $ — $ 5,972 $ 5,972 Liabilities: Debt: Short-term borrowings 225 — 225 — 225 Notes 24,895 — 23,569 — 23,569

Medical Claims Payable (Tables)

Medical Claims Payable (Tables)	3 Months Ended
	Mar. 31, 2024
Liability for Claims and Claims Adjustment Expense [Abstract]
Reconciliation of Medical Claims Payable	A reconciliation of the beginning and ending balances for medical claims payable for the three months ended March 31, 2024 and 2023 is as follows: 2024 2023 Gross medical claims payable, beginning of period $ 15,865 $ 15,348 Ceded medical claims payable, beginning of period (7) (6) Net medical claims payable, beginning of period 15,858 15,342 Net incurred medical claims: Current period 30,708 30,751 Prior periods redundancies (1,205) (1,068) Total net incurred medical claims 29,503 29,683 Net payments attributable to: Current period medical claims 19,580 19,948 Prior periods medical claims 9,606 9,593 Total net payments 29,186 29,541 Net medical claims payable, end of period 16,175 15,484 Ceded medical claims payable, end of period 8 7 Gross medical claims payable, end of period $ 16,183 $ 15,491
Reconciliation of Net Incurred Medical Claims to Benefit Expense	The reconciliation of net incurred medical claims to benefit expense included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: 2024 2023 Total net incurred medical claims $ 29,503 $ 29,683 Quality improvement and other claims expense 1,043 1,103 Benefit expense $ 30,546 $ 30,786
Reconciliation of Short Duration Medical Claims Payable to the Consolidated Medical Claims Payable	The reconciliation of the medical claims payable reflected in the tables above to the consolidated ending balance for medical claims payable included in the consolidated balance sheet, as of March 31, 2024 is as follows: Total Net medical claims payable, end of period $ 16,175 Ceded medical claims payable, end of period 8 Insurance lines other than short duration 276 Gross medical claims payable, end of period $ 16,459

Capital Stock (Tables)

Capital Stock (Tables)	3 Months Ended
	Mar. 31, 2024
Class of Stock Disclosures [Abstract]
Summary of Cash Dividend Activity	A summary of our cash dividend activity for the three months ended March 31, 2024 and 2023 is as follows: Declaration Date Record Date Payment Date Cash Dividend per Share Total Three Months Ended March 31, 2024 January 23, 2024 March 8, 2024 March 22, 2024 $1.63 $ 379 Three Months Ended March 31, 2023 January 24, 2023 March 10, 2023 March 24, 2023 $1.48 $ 351
Summary of Share Repurchases	A summary of common stock repurchases for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended March 31 2024 2023 Shares repurchased 1.1 1.3 Average price per share $ 492.76 $ 476.66 Aggregate cost $ 566 $ 622 Authorization remaining at the end of the period $ 3,633 $ 6,254
Summary of Stock Option Activity	A summary of stock option activity for the three months ended March 31, 2024 is as follows: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2024 3.0 $ 327.14 Granted 0.5 499.11 Exercised (0.3) 288.95 Forfeited or expired — 431.01 Outstanding at March 31, 2024 3.2 356.58 6.44 $ 521 Exercisable at March 31, 2024 2.2 297.24 5.23 $ 482
Summary of Nonvested Restricted Stock Activity Including Restricted Stock Units	A summary of the status of nonvested restricted stock activity, including restricted stock units and performance units, for the three months ended March 31, 2024 is as follows: Restricted Weighted- Nonvested at January 1, 2024 1.1 $ 423.94 Granted 0.6 499.00 Vested (0.6) 352.33 Forfeited — 456.61 Nonvested at March 31, 2024 1.1 475.31
Summary of Weighted-Average Assumptions Used to Estimate the Fair Value of Options Granted During the Periods	The following weighted-average assumptions were used to estimate the fair values of options granted during the three months ended March 31, 2024 and 2023: Three Months Ended March 31 2024 2023 Risk-free interest rate 4.28 % 3.95 % Volatility factor 28.00 % 29.00 % Quarterly dividend yield 0.327 % 0.316 % Weighted-average expected life (years) 4.40 4.40
Schedule of Weighted-Average Fair Values Determined for the Periods	The following weighted-average fair values per option or share were determined for the three months ended March 31, 2024 and 2023: Three Months Ended March 31 2024 2023 Options granted during the period $ 134.53 $ 127.14 Restricted stock awards granted during the period 499.00 469.31

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	3 Months Ended
	Mar. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Reconciliation of Components of Accumulated Other Comprehensive Loss	A reconciliation of the components of accumulated other comprehensive (loss) income at March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Net unrealized investment (losses) gains: Beginning of period balance $ (632) $ (1,755) Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $50 and $(85), respectively (162) 337 Amounts reclassified from accumulated other comprehensive loss, net of tax benefit of $(33) and $(29), respectively 106 90 Other comprehensive (loss) income (56) 427 Other comprehensive income attributable to noncontrolling interests, net of tax benefit of $0 and $0, respectively — (2) End of period balance (688) (1,330) Non-credit components of impairments on investments: Beginning of period balance (3) (3) Other comprehensive loss, net of tax benefit of $0 and $1, respectively — (2) End of period balance (3) (5) Net cash flow hedges: Beginning of period balance (211) (229) Other comprehensive income, net of tax (expense) benefit of $(1) and $8, respectively 2 11 End of period balance (209) (218) Pension and other postretirement benefits: Beginning of period balance (459) (499) Other comprehensive income, net of tax expense of $(1) and $(1), respectively 4 2 End of period balance (455) (497) Future policy benefits: Beginning of period balance 10 13 Other comprehensive (loss) income, net of tax expense of $0 and $0, respectively (2) 2 End of period balance 8 15 Foreign currency translation adjustments: Beginning of period balance (18) (17) Other comprehensive income, net of tax expense of $0 and $0, respectively — 2 End of period balance (18) (15) Total: Total beginning of period accumulated other comprehensive loss (1,313) (2,490) Total other comprehensive (loss) income, net of tax benefit (expense) of $15, and $(106), respectively (52) 442 Total other comprehensive income attributable to noncontrolling interests, net of tax benefit of $0 and $0 respectively — (2) Total end of period accumulated other comprehensive loss $ (1,365) $ (2,050)

Shareholders' Earnings per Sh_2

Shareholders' Earnings per Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Denominator for Basic and Diluted Earnings Per Share	The denominator for basic and diluted shareholders' earnings per share for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Denominator for basic shareholders' earnings per share – weighted-average shares 232.7 237.5 Effect of dilutive securities – employee stock options, nonvested restricted stock awards and convertible debentures 1.5 2.2 Denominator for diluted shareholders' earnings per share 234.2 239.7

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Financial Data by Reportable Segment	Financial data by reportable segment for the three months ended March 31, 2024 and 2023 is as follows: Carelon Health CarelonRx Carelon Total Corporate Eliminations Total Three Months Ended March 31, 2024 Premiums $ 35,382 $ — $ 408 $ 408 $ — $ (94) $ 35,696 Product revenue — 4,499 — 4,499 — — 4,499 Service fees 1,876 1 197 198 4 — 2,078 Operating revenue - unaffiliated 37,258 4,500 605 5,105 4 (94) 42,273 Operating revenue - affiliated — 3,567 3,404 6,971 123 (7,094) — Operating revenue - total $ 37,258 $ 8,067 $ 4,009 $ 12,076 $ 127 $ (7,188) $ 42,273 Operating gain (loss) $ 2,287 $ 523 $ 290 $ 813 $ (84) $ — $ 3,016 Three Months Ended March 31, 2023 Premiums $ 35,534 $ — $ 410 $ 410 $ — $ (76) $ 35,868 Product revenue — 4,022 — 4,022 — — 4,022 Service fees 1,746 — 208 208 54 — 2,008 Operating revenue - unaffiliated 37,280 4,022 618 4,640 54 (76) 41,898 Operating revenue - affiliated — 4,002 2,842 6,844 37 (6,881) — Operating revenue - total $ 37,280 $ 8,024 $ 3,460 $ 11,484 $ 91 $ (6,957) $ 41,898 Operating gain (loss) $ 2,149 $ 512 $ 229 $ 741 $ (59) $ — $ 2,831
Reconciliation of Reportable Segments Operating Revenues to Total Revenues Reported in the Consolidated Statements of Income	A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Reportable segments’ operating revenue $ 42,273 $ 41,898 Net investment income 465 387 Net losses on financial instruments (161) (113) Total revenues $ 42,577 $ 42,172
Reconciliation of Income Before Income Tax Expense to Reportable Segments Operating Gain Included in the Consolidated Statements of Income	A reconciliation of income before income tax expense to reportable segments’ operating gain included in our consolidated statements of income for the three months ended March 31, 2024 and 2023 is as follows: Three Months Ended 2024 2023 Income before income tax expense $ 2,939 $ 2,619 Net investment income (465) (387) Net losses on financial instruments 161 113 Interest expense 265 251 Amortization of other intangible assets 116 235 Reportable segments’ operating gain $ 3,016 $ 2,831

Organization (Details)

Organization (Details) individual in Millions	3 Months Ended
	Mar. 31, 2024 individual state segment county
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of medical members served | individual	46
Number of counties in the Kansas City area the Company does not serve | county	30
Number of states in which the Company is licensed to conduct insurance operations | state	50
Number of reportable segments | segment	4

Basis of Presentation and Sig_3

Basis of Presentation and Significant Accounting Policies (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Cash and cash equivalents	$ 499	$ 294
Securities lending transactions, initial collateral percentage value	102%
Premium receivable, allowance for doubtful accounts	$ 212	212
Self-funded receivables, allowance for doubtful accounts	89	87
Other receivables, allowance for doubtful accounts	$ 956	$ 941

Business Acquisitions and Div_2

Business Acquisitions and Divestitures (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 25,947	$ 25,317
Paragon Healthcare, Inc.
Business Acquisition [Line Items]
Finite-lived intangible assets acquired	553
Goodwill	635
BioPlus Parent, LLC and Subsidiaries
Business Acquisition [Line Items]
Finite-lived intangible assets acquired	820
Goodwill	893
Measurement period adjustments	$ (5)

Business Optimization Initiat_2

Business Optimization Initiatives (Details) - 2023-2024 Business Efficiency Program - Employee Termination - Corporate & Other - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Business Optimization Initiatives [Line Items]
Liability for employee termination costs	$ 150	$ 191
Charges or releases related to employee termination costs	0
Payments	$ 41

Investments - Current and Long-

Investments - Current and Long-Term Fixed Maturity Securities, Available-For-Sale (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	$ 31,329	$ 31,336
Gross Unrealized Gains	384	496
Gross Unrealized Losses	(1,299)	(1,338)
Allowance For Credit Losses	(4)	(4)
Estimated Fair Value	30,410	30,490
United States Government securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	1,858	1,873
Gross Unrealized Gains	6	25
Gross Unrealized Losses	(73)	(54)
Allowance For Credit Losses	0	0
Estimated Fair Value	1,791	1,844
Government sponsored securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	127	112
Gross Unrealized Gains	0	1
Gross Unrealized Losses	(4)	(3)
Allowance For Credit Losses	0	0
Estimated Fair Value	123	110
Foreign government securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	73	5
Gross Unrealized Gains	0	1
Gross Unrealized Losses	(1)	(2)
Allowance For Credit Losses	0	0
Estimated Fair Value	72	4
States, municipalities and political subdivisions, tax-exempt
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	3,722	3,985
Gross Unrealized Gains	55	69
Gross Unrealized Losses	(150)	(152)
Allowance For Credit Losses	0	0
Estimated Fair Value	3,627	3,902
Corporate securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	16,099	14,838
Gross Unrealized Gains	256	322
Gross Unrealized Losses	(575)	(580)
Allowance For Credit Losses	(2)	(2)
Estimated Fair Value	15,778	14,578
Residential mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	4,204	4,071
Gross Unrealized Gains	27	40
Gross Unrealized Losses	(302)	(279)
Allowance For Credit Losses	0	0
Estimated Fair Value	3,929	3,832
Commercial mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	1,971	2,174
Gross Unrealized Gains	12	13
Gross Unrealized Losses	(89)	(138)
Allowance For Credit Losses	(2)	(2)
Estimated Fair Value	1,892	2,047
Other asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Cost or Amortized Cost	3,275	4,278
Gross Unrealized Gains	28	25
Gross Unrealized Losses	(105)	(130)
Allowance For Credit Losses	0	0
Estimated Fair Value	$ 3,198	$ 4,173

Investments - Aggregate Fair Va

Investments - Aggregate Fair Value and Gross Unrealized Loss of Fixed Maturity Securities in an Unrealized Loss Position (Details) $ in Millions	Mar. 31, 2024 USD ($) security	Dec. 31, 2023 USD ($) security
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	1,641	1,032,000,000
Estimated fair value, less than 12 months	$ 5,855	$ 2,699
Gross unrealized loss, less than 12 months	$ (100)	$ (55)
Number of securities, 12 months or greater | security	5,972	6,659,000,000
Estimated fair value, 12 months or greater	$ 12,097	$ 14,842
Gross unrealized loss, 12 months or greater	$ (1,199)	$ (1,283)
United States Government securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	46	35,000,000
Estimated fair value, less than 12 months	$ 1,188	$ 552
Gross unrealized loss, less than 12 months	$ (29)	$ (9)
Number of securities, 12 months or greater | security	48	44,000,000
Estimated fair value, 12 months or greater	$ 306	$ 370
Gross unrealized loss, 12 months or greater	$ (44)	$ (45)
Government sponsored securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	4	0
Estimated fair value, less than 12 months	$ 40	$ 0
Gross unrealized loss, less than 12 months	$ 0	$ 0
Number of securities, 12 months or greater | security	39	40,000,000
Estimated fair value, 12 months or greater	$ 51	$ 52
Gross unrealized loss, 12 months or greater	$ (4)	$ (3)
Foreign government securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	5	0
Estimated fair value, less than 12 months	$ 10	$ 0
Gross unrealized loss, less than 12 months	$ 0	$ 0
Number of securities, 12 months or greater | security	2	2,000,000
Estimated fair value, 12 months or greater	$ 4	$ 4
Gross unrealized loss, 12 months or greater	$ (1)	$ (2)
States, municipalities and political subdivisions, tax-exempt
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	231	203,000,000
Estimated fair value, less than 12 months	$ 449	$ 354
Gross unrealized loss, less than 12 months	$ (4)	$ (2)
Number of securities, 12 months or greater | security	1,001	1,034,000,000
Estimated fair value, 12 months or greater	$ 1,656	$ 1,811
Gross unrealized loss, 12 months or greater	$ (146)	$ (150)
Corporate securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	906	389,000,000
Estimated fair value, less than 12 months	$ 2,324	$ 608
Gross unrealized loss, less than 12 months	$ (31)	$ (15)
Number of securities, 12 months or greater | security	2,422	2,624,000,000
Estimated fair value, 12 months or greater	$ 5,775	$ 6,871
Gross unrealized loss, 12 months or greater	$ (544)	$ (565)
Residential mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	239	183,000,000
Estimated fair value, less than 12 months	$ 1,026	$ 438
Gross unrealized loss, less than 12 months	$ (14)	$ (5)
Number of securities, 12 months or greater | security	1,631	1,620,000,000
Estimated fair value, 12 months or greater	$ 1,958	$ 2,075
Gross unrealized loss, 12 months or greater	$ (288)	$ (274)
Commercial mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	84	112,000,000
Estimated fair value, less than 12 months	$ 364	$ 353
Gross unrealized loss, less than 12 months	$ (6)	$ (6)
Number of securities, 12 months or greater | security	415	534,000,000
Estimated fair value, 12 months or greater	$ 1,059	$ 1,317
Gross unrealized loss, 12 months or greater	$ (83)	$ (132)
Other asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Number of securities, less than 12 months | security	126	110,000,000
Estimated fair value, less than 12 months	$ 454	$ 394
Gross unrealized loss, less than 12 months	$ (16)	$ (18)
Number of securities, 12 months or greater | security	414	761,000,000
Estimated fair value, 12 months or greater	$ 1,288	$ 2,342
Gross unrealized loss, 12 months or greater	$ (89)	$ (112)

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Schedule of Investments [Line Items]
Allowance for credit losses	$ 4		$ 4
Proceeds from sales, maturities, calls or redemptions of fixed maturity securities	5,401	$ 5,410
Accrued investment income receivable	294		301
Fair value of collateral received at time of securities lending transactions	$ 2,592		$ 2,380
Securities lending transactions ratio of fair value of collateral held to fair value of securities loaned	102%		102%
United States Government securities
Schedule of Investments [Line Items]
Allowance for credit losses	$ 0		$ 0
Residential mortgage-backed securities
Schedule of Investments [Line Items]
Allowance for credit losses	0		0
States, municipalities and political subdivisions, tax-exempt
Schedule of Investments [Line Items]
Allowance for credit losses	0		0
Overnight and Continuous | Cash
Schedule of Investments [Line Items]
Collateral received for securities loaned, at carrying value	2,351		2,255
Overnight and Continuous | United States Government securities
Schedule of Investments [Line Items]
Collateral received for securities loaned, at carrying value	241		99
Overnight and Continuous | Residential mortgage-backed securities
Schedule of Investments [Line Items]
Collateral received for securities loaned, at carrying value	$ 0		$ 26

Investments - Amortized Cost an

Investments - Amortized Cost and Fair Value of Fixed Maturity Securities, By Contractual Maturity (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Amortized Cost
Due in one year or less	$ 369
Due after one year through five years	6,038
Due after five years through ten years	11,099
Due after ten years	7,648
Mortgage-backed securities	6,175
Total fixed maturity securities	31,329	$ 31,336
Estimated Fair Value
Due in one year or less	365
Due after one year through five years	5,900
Due after five years through ten years	10,864
Due after ten years	7,460
Mortgage-backed securities	5,821
Total fixed maturity securities	$ 30,410	$ 30,490

Investments - Current Equity Se

Investments - Current Equity Securities (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Equity Securities [Line Items]
Equity securities	$ 511	$ 229
Exchange traded funds
Equity Securities [Line Items]
Equity securities	382	106
Common equity securities
Equity Securities [Line Items]
Equity securities	52	45
Private equity securities
Equity Securities [Line Items]
Equity securities	$ 77	$ 78

Investments - Net Investment (L

Investments - Net Investment (Losses) and Gains (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Other investments:
Net losses on investments	$ (166)	$ (91)
Fixed maturity securities:
Fixed maturity securities:
Gross realized gains from sales	22	10
Gross realized losses from sales	(159)	(115)
Impairment losses recognized in income	(2)	(7)
Net realized losses from sales of fixed maturity securities	(139)	(112)
Equity securities:
Equity securities:
Unrealized gains (losses) recognized on equity securities still held at the end of the period	2	(1)
Net realized losses recognized on equity securities sold during the period	0	(1)
Net gains (losses) on equity securities	2	(2)
Other investments:
Fixed maturity securities:
Impairment losses recognized in income	(25)	(3)
Other investments:
Gross gains	16	27
Gross losses	(20)	(1)
Net (losses) gains on other investments	$ (29)	$ 23

Derivative Financial Instrume_2

Derivative Financial Instruments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Derivative [Line Items]
Recognized gain on hedging derivatives	$ 11	$ 12
Recognized loss on hedging derivatives	6	$ 34
Cash Flow Hedging
Derivative [Line Items]
Cash flow hedges included in accumulated other comprehensive loss, net of tax	$ (209)		$ (211)

Fair Value - Summary of Fair Va

Fair Value - Summary of Fair Value Measurements by Level (Details) $ in Millions	Mar. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
(In millions, except share and per share data)
Cash equivalents	$ 1,155	$ 2,210
Fixed maturity securities, available-for-sale:	30,410	30,490
Other invested assets	6,713	6,107
Securities lending collateral	2,594	2,382
Total assets	$ 34,774	$ 35,432
Percentage of total assets at fair value	1	1
Liabilities
Total liabilities	$ (61)	$ (40)
United States Government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	1,791	1,844
Government sponsored securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	123	110
Foreign government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	72	4
States, municipalities and political subdivisions, tax-exempt
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	3,627	3,902
Corporate securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	15,778	14,578
Residential mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	3,929	3,832
Commercial mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	1,892	2,047
Other asset-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	3,198	4,173
Equity securities:
(In millions, except share and per share data)
Equity securities:	511	229
Equity securities: | Exchange traded funds
(In millions, except share and per share data)
Equity securities:	382	106
Equity securities: | Common equity securities
(In millions, except share and per share data)
Equity securities:	52	45
Equity securities: | Private equity securities
(In millions, except share and per share data)
Equity securities:	77	78
Other investments: | Common equity securities
(In millions, except share and per share data)
Other invested assets	102	111
Derivatives
(In millions, except share and per share data)
Derivatives - other assets	2	10
Liabilities
Derivatives - other liabilities	(61)	(40)
Level I
(In millions, except share and per share data)
Cash equivalents	1,155	2,210
Fixed maturity securities, available-for-sale:	0	0
Securities lending collateral	0	0
Total assets	$ 1,654	$ 2,439
Percentage of total assets at fair value	0.05	0.07
Liabilities
Total liabilities	$ 0	$ 0
Level I | United States Government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Government sponsored securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Foreign government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | States, municipalities and political subdivisions, tax-exempt
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Corporate securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Residential mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Commercial mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Other asset-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level I | Equity securities:
(In millions, except share and per share data)
Equity securities:	397	118
Level I | Equity securities: | Exchange traded funds
(In millions, except share and per share data)
Equity securities:	382	106
Level I | Equity securities: | Common equity securities
(In millions, except share and per share data)
Equity securities:	15	12
Level I | Equity securities: | Private equity securities
(In millions, except share and per share data)
Equity securities:	0	0
Level I | Other investments: | Common equity securities
(In millions, except share and per share data)
Other invested assets	102	111
Level I | Derivatives
(In millions, except share and per share data)
Derivatives - other assets	0	0
Liabilities
Derivatives - other liabilities	0	0
Level II
(In millions, except share and per share data)
Cash equivalents	0	0
Fixed maturity securities, available-for-sale:	29,612	29,903
Securities lending collateral	2,594	2,382
Total assets	$ 32,245	$ 32,328
Percentage of total assets at fair value	0.93	0.91
Liabilities
Total liabilities	$ (61)	$ (40)
Level II | United States Government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	1,791	1,844
Level II | Government sponsored securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	123	110
Level II | Foreign government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	72	4
Level II | States, municipalities and political subdivisions, tax-exempt
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	3,627	3,902
Level II | Corporate securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	15,726	14,532
Level II | Residential mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	3,914	3,830
Level II | Commercial mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	1,881	2,047
Level II | Other asset-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	2,478	3,634
Level II | Equity securities:
(In millions, except share and per share data)
Equity securities:	37	33
Level II | Equity securities: | Exchange traded funds
(In millions, except share and per share data)
Equity securities:	0	0
Level II | Equity securities: | Common equity securities
(In millions, except share and per share data)
Equity securities:	37	33
Level II | Equity securities: | Private equity securities
(In millions, except share and per share data)
Equity securities:	0	0
Level II | Other investments: | Common equity securities
(In millions, except share and per share data)
Other invested assets	0	0
Level II | Derivatives
(In millions, except share and per share data)
Derivatives - other assets	2	10
Liabilities
Derivatives - other liabilities	(61)	(40)
Level III
(In millions, except share and per share data)
Cash equivalents	0	0
Fixed maturity securities, available-for-sale:	798	587
Securities lending collateral	0	0
Total assets	$ 875	$ 665
Percentage of total assets at fair value	0.02	0.02
Liabilities
Total liabilities	$ 0	$ 0
Level III | United States Government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level III | Government sponsored securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level III | Foreign government securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level III | States, municipalities and political subdivisions, tax-exempt
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	0	0
Level III | Corporate securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	52	46
Level III | Residential mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	15	2
Level III | Commercial mortgage-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	11	0
Level III | Other asset-backed securities
(In millions, except share and per share data)
Fixed maturity securities, available-for-sale:	720	539
Level III | Equity securities:
(In millions, except share and per share data)
Equity securities:	77	78
Level III | Equity securities: | Exchange traded funds
(In millions, except share and per share data)
Equity securities:	0	0
Level III | Equity securities: | Common equity securities
(In millions, except share and per share data)
Equity securities:	0	0
Level III | Equity securities: | Private equity securities
(In millions, except share and per share data)
Equity securities:	77	78
Level III | Other investments: | Common equity securities
(In millions, except share and per share data)
Other invested assets	0	0
Level III | Derivatives
(In millions, except share and per share data)
Derivatives - other assets	0	0
Liabilities
Derivatives - other liabilities	$ 0	$ 0

Fair Value - Schedule of Estima

Fair Value - Schedule of Estimated Fair Value by Level (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
(In millions, except share and per share data)
Other invested assets	$ 6,713	$ 6,107
Debt:
Short-term borrowings	1,575	225
Estimate of Fair Value Measurement
Debt:
Short-term borrowings	225
Commercial paper	1,350
Fair Value, Nonrecurring | Reported Value Measurement
(In millions, except share and per share data)
Other invested assets	6,611	5,996
Debt:
Short-term borrowings	225	225
Commercial paper	1,350
Notes	24,876	24,895
Fair Value, Recurring | Estimate of Fair Value Measurement
(In millions, except share and per share data)
Other invested assets	6,580	5,972
Debt:
Short-term borrowings		225
Notes	23,046	23,569
Fair Value, Recurring | Level I | Estimate of Fair Value Measurement
(In millions, except share and per share data)
Other invested assets	0	0
Debt:
Short-term borrowings	0	0
Commercial paper	0
Notes	0	0
Fair Value, Recurring | Level II | Estimate of Fair Value Measurement
(In millions, except share and per share data)
Other invested assets	0	0
Debt:
Short-term borrowings	225	225
Commercial paper	1,350
Notes	23,046	23,569
Fair Value, Recurring | Level III | Estimate of Fair Value Measurement
(In millions, except share and per share data)
Other invested assets	6,580	5,972
Debt:
Short-term borrowings	0	0
Commercial paper	0
Notes	$ 0	$ 0

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income taxes payable	$ 38
Income tax expense	$ 690	$ 615
Effective income tax rate	23.50%	23.50%
Income taxes receivable			$ 543

Medical Claims Payable - Reconc

Medical Claims Payable - Reconciliation of Medical Claims Payable (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Gross medical claims payable, beginning of period	$ 15,865	$ 15,348
Ceded medical claims payable, beginning of period	(7)	(6)
Net medical claims payable, beginning of period	15,858	15,342
Net incurred medical claims:
Current period	30,708	30,751
Prior periods redundancies	(1,205)	(1,068)
Total net incurred medical claims	29,503	29,683
Net payments attributable to:
Current period medical claims	19,580	19,948
Prior periods medical claims	9,606	9,593
Total net payments	29,186	29,541
Net medical claims payable, end of period	16,175	15,484
Ceded medical claims payable, end of period	8	7
Gross medical claims payable, end of period	$ 16,183	$ 15,491

Medical Claims Payable - Narrat

Medical Claims Payable - Narrative (Details) $ in Millions	Mar. 31, 2024 USD ($)
2022
Claims Development [Line Items]
Net incurred but not reported liabilities plus expected development on reported claims	$ 724
2023
Claims Development [Line Items]
Net incurred but not reported liabilities plus expected development on reported claims	4,323
2024
Claims Development [Line Items]
Net incurred but not reported liabilities plus expected development on reported claims	$ 11,128

Medical Claims Payable - Reco_2

Medical Claims Payable - Reconciliation of Net Incurred Medical Claims to Benefit Expense (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Liability for Claims and Claims Adjustment Expense [Abstract]
Total net incurred medical claims	$ 29,503	$ 29,683
Quality improvement and other claims expense	1,043	1,103
Benefit expense	$ 30,546	$ 30,786

Medical Claims Payable - Reco_3

Medical Claims Payable - Reconciliation of the Claims Development to the Claims Liability (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Liability for Claims and Claims Adjustment Expense [Abstract]
Net medical claims payable, end of period	$ 16,175
Ceded medical claims payable, end of period	8
Insurance lines other than short duration	276
Gross medical claims payable, end of period	$ 16,459	$ 16,111

Debt (Details)

Debt (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 4,000
Commercial paper	1,350	$ 0
Surplus Notes
Debt Instrument [Line Items]
Long-term debt	25	25
Federal Home Loan Bank Advances
Debt Instrument [Line Items]
Short-term borrowings from the FHLB	225	225
Senior Notes | Senior Unsecured Notes
Debt Instrument [Line Items]
Long-term debt	$ 24,851	24,870
Line of Credit | 5-Year Facility | Revolving Credit Facility
Debt Instrument [Line Items]
Senior revolving credit facility term	5 years
Maximum borrowing capacity	$ 4,000
Covenant, debt-to-capital ratio (not more than)	0.60
Debt-to-capital ratio	0.394
Amounts outstanding	$ 0	$ 0

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	1 Months Ended		3 Months Ended
	Sep. 30, 2022 USD ($) appeal	Mar. 31, 2016 USD ($)	Mar. 31, 2024 USD ($)
Commitments and Contingencies [Line Items]
Payments	$ 506
Number of notices of appeal | appeal	4
Technology Infrastructure and Related Management and Support Services
Commitments and Contingencies [Line Items]
Long-term purchase commitment, amount			$ 432
Anthem, Inc. v. Express Scripts, Inc.
Commitments and Contingencies [Line Items]
Proceeds originally received at time of divestiture		$ 4,675
Anthem, Inc. v. Express Scripts, Inc. | Damages for Pharmacy Pricing
Commitments and Contingencies [Line Items]
Approximate amount of damages sought for breaches		14,800
Anthem, Inc. v. Express Scripts, Inc. | Damages for Operational Breaches
Commitments and Contingencies [Line Items]
Approximate amount of damages sought for breaches		$ 158
BCBS Antitrust Litigation
Commitments and Contingencies [Line Items]
Payments	$ 596

Capital Stock - Summary of Cash

Capital Stock - Summary of Cash Dividend Activity (Details) - USD ($) $ / shares in Units, $ in Millions			3 Months Ended
	Mar. 22, 2024	Mar. 24, 2023	Mar. 31, 2024	Mar. 31, 2023
Class of Stock Disclosures [Abstract]
Cash Dividend per Share (in dollars per share)	$ 1.63	$ 1.48
Total			$ 379	$ 351

Capital Stock - Narrative (Deta

Capital Stock - Narrative (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Apr. 16, 2024	Jan. 24, 2023
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Increase in amount of stock authorized in the Stock Repurchase Program			$ 5,000
Grants (in shares)	0.6
Restricted Stock Units
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Grants (in shares)	0.3
Subsequent Event
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Dividends payable (in dollars per share)		$ 1.63

Capital Stock - Summary of Shar

Capital Stock - Summary of Share Repurchases (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Class of Stock Disclosures [Abstract]
Shares repurchased (in shares)	1.1	1.3
Average price per share (in dollars per share)	$ 492.76	$ 476.66
Aggregate cost	$ 566	$ 622
Authorization remaining at the end of the period	$ 3,633	$ 6,254

Capital Stock - Summary of Stoc

Capital Stock - Summary of Stock Option Activity (Details) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($) $ / shares shares
Number of Shares
Outstanding at beginning of period (in shares) | shares	3
Granted (in shares) | shares	0.5
Exercised (in shares) | shares	(0.3)
Forfeited or expired (in shares) | shares	0
Outstanding at end of period (in shares) | shares	3.2
Weighted- Average Option Price per Share
Outstanding at beginning of period (in dollars per share) | $ / shares	$ 327.14
Granted (in dollars per share) | $ / shares	499.11
Exercised (in dollars per share) | $ / shares	288.95
Forfeited or expired (in dollars per share) | $ / shares	431.01
Outstanding at end of period (in dollars per share) | $ / shares	$ 356.58
Stock Options, Additional Disclosures
Exercisable at end of period (in shares) | shares	2.2
Exercisable at end of period (in dollars per share) | $ / shares	$ 297.24
Outstanding at end of period, Weighted-Average Remaining Contractual Life	6 years 5 months 8 days
Exercisable at end of period, Weighted-Average Remaining Contractual Life	5 years 2 months 23 days
Outstanding at end of period, Aggregate Intrinsic Value | $	$ 521
Exercisable at end of period, Aggregate Intrinsic Value | $	$ 482

Capital Stock - Nonvested Restr

Capital Stock - Nonvested Restricted Stock Activity Including Restricted Stock Units (Details) - $ / shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restricted Stock Shares and Units
Nonvested at beginning of period (in shares)	1.1
Grants (in shares)	0.6
Vested (in shares)	(0.6)
Forfeited (in shares)	0
Nonvested at end of period (in shares)	1.1
Weighted- Average Grant Date Fair Value per Share
Nonvested at beginning of period (in dollars per share)	$ 423.94
Granted (in dollars per share)	499	$ 469.31
Vested (in dollars per share)	352.33
Forfeited (in dollars per share)	456.61
Nonvested at end of period (in dollars per share)	$ 475.31

Capital Stock - Fair Values of

Capital Stock - Fair Values of Options Granted During the Period Estimated Using Weighted-Average Assumptions (Details)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Class of Stock Disclosures [Abstract]
Risk-free interest rate	4.28%	3.95%
Volatility factor	28%	29%
Quarterly dividend yield	0.327%	0.316%
Weighted-average expected life (years)	4 years 4 months 24 days	4 years 4 months 24 days

Capital Stock - Schedule of Wei

Capital Stock - Schedule of Weighted-Average Fair Values Determined for the Periods (Details) - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Class of Stock Disclosures [Abstract]
Options granted during the period (in dollars per share)	$ 134.53	$ 127.14
Restricted stock awards granted during the period (in dollars per share)	$ 499	$ 469.31

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income - Reconciliation of the Components of Accumulated Other Comprehensive Loss (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	$ 39,405	$ 36,330
Other comprehensive income (loss), net of tax	(52)	442
Other comprehensive income attributable to noncontrolling interests	0	(2)
Ending balance	40,710	37,460
AOCI Including Portion Attributable to Noncontrolling Interest
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(1,313)	(2,490)
Ending balance	(1,365)	(2,050)
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Including Noncontrolling Interest
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(632)	(1,755)
Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $50 and $(85), respectively	(162)	337
Amounts reclassified from accumulated other comprehensive loss, net of tax benefit of $(33) and $(29), respectively	106	90
Other comprehensive income (loss), net of tax	(56)	427
Ending balance	(688)	(1,330)
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Noncontrolling Interest
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Other comprehensive income attributable to noncontrolling interests	0	(2)
Non-credit components of impairments on investments:
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(3)	(3)
Other comprehensive income (loss), net of tax	0	(2)
Ending balance	(3)	(5)
Net cash flow hedges:
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(211)	(229)
Other comprehensive income (loss), net of tax	2	11
Ending balance	(209)	(218)
Pension and other postretirement benefits:
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(459)	(499)
Other comprehensive income (loss), net of tax	4	2
Ending balance	(455)	(497)
Future policy benefits:
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	10	13
Other comprehensive income (loss), net of tax	(2)	2
Ending balance	8	15
Foreign currency translation adjustments:
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]
Beginning balance	(18)	(17)
Other comprehensive income (loss), net of tax	0	2
Ending balance	$ (18)	$ (15)

Accumulated Other Comprehensi_4

Accumulated Other Comprehensive (Loss) Income - Reconciliation of the Components of Accumulated Other Comprehensive Loss (Parenthetical) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income attributable to noncontrolling interests, tax	$ 0	$ 0
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	15	(106)
Other comprehensive income attributable to noncontrolling interests	0	(2)
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Including Noncontrolling Interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, tax	50	(85)
Reclassification from AOCI, current period, tax	33	29
Non-credit components of impairments on investments:
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	0	1
Net cash flow hedges:
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	(1)	8
Pension and other postretirement benefits:
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	(1)	(1)
Future policy benefits:
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	0	0
Foreign currency translation adjustments:
Accumulated Other Comprehensive Income (Loss) [Line Items]
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit	0	0
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Noncontrolling Interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income attributable to noncontrolling interests, tax	0	0
Other comprehensive income attributable to noncontrolling interests	$ 0	$ (2)

Shareholders' Earnings per Sh_3

Shareholders' Earnings per Share - Denominator for Basic and Diluted Earnings per Share (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Denominator for basic shareholders' earnings per share - weighted-average shares	232.7	237.5
Effect of dilutive securities – employee stock options, nonvested restricted stock awards and convertible debentures	1.5	2.2
Denominator for diluted shareholders' earnings per share	234.2	239.7

Shareholders' Earnings per Sh_4

Shareholders' Earnings per Share - Narrative (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Employee Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive shares (in shares)	0.6	0.4
Restricted Stock Units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive shares (in shares)	0.6	0.6
Restricted Stock Units - Contingent
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive shares (in shares)	0.3	0.2

Segment Information - Narrative

Segment Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2024 segment
Segment Reporting [Abstract]
Number of reportable segments	4

Segment Information - Financial

Segment Information - Financial Data by Reportable Segment (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Premiums	$ 35,696	$ 35,868
Operating revenue	42,273	41,898
Operating gain (loss)	3,016	2,831
Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	4,499	4,022
Service fees
Segment Reporting Information [Line Items]
Product and service revenue	2,078	2,008
Eliminations
Segment Reporting Information [Line Items]
Premiums	(94)	(76)
Operating revenue	(7,188)	(6,957)
Operating gain (loss)	0	0
Eliminations | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	0	0
Eliminations | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	0	0
Health Benefits | Operating Segments
Segment Reporting Information [Line Items]
Premiums	35,382	35,534
Operating revenue	37,258	37,280
Operating gain (loss)	2,287	2,149
Health Benefits | Operating Segments | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	0	0
Health Benefits | Operating Segments | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	1,876	1,746
Carelon Total | Operating Segments
Segment Reporting Information [Line Items]
Premiums	408	410
Operating revenue	12,076	11,484
Operating gain (loss)	813	741
Carelon Total | Operating Segments | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	4,499	4,022
Carelon Total | Operating Segments | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	198	208
CarelonRx | Operating Segments
Segment Reporting Information [Line Items]
Premiums	0	0
Operating revenue	8,067	8,024
Operating gain (loss)	523	512
CarelonRx | Operating Segments | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	4,499	4,022
CarelonRx | Operating Segments | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	1	0
Carelon Services | Operating Segments
Segment Reporting Information [Line Items]
Premiums	408	410
Operating revenue	4,009	3,460
Operating gain (loss)	290	229
Carelon Services | Operating Segments | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	0	0
Carelon Services | Operating Segments | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	197	208
Corporate & Other | Operating Segments
Segment Reporting Information [Line Items]
Premiums	0	0
Operating revenue	127	91
Operating gain (loss)	(84)	(59)
Corporate & Other | Operating Segments | Product revenue
Segment Reporting Information [Line Items]
Product and service revenue	0	0
Corporate & Other | Operating Segments | Service fees
Segment Reporting Information [Line Items]
Product and service revenue	4	54
Operating revenue - unaffiliated
Segment Reporting Information [Line Items]
Operating revenue	42,273	41,898
Operating revenue - unaffiliated | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	(94)	(76)
Operating revenue - unaffiliated | Health Benefits | Operating Segments
Segment Reporting Information [Line Items]
Operating revenue	37,258	37,280
Operating revenue - unaffiliated | Carelon Total | Operating Segments
Segment Reporting Information [Line Items]
Operating revenue	5,105	4,640
Operating revenue - unaffiliated | CarelonRx | Operating Segments
Segment Reporting Information [Line Items]
Operating revenue	4,500	4,022
Operating revenue - unaffiliated | Carelon Services | Operating Segments
Segment Reporting Information [Line Items]
Operating revenue	605	618
Operating revenue - unaffiliated | Corporate & Other | Operating Segments
Segment Reporting Information [Line Items]
Operating revenue	4	54
Operating revenue - affiliated | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	(7,094)	(6,881)
Operating revenue - affiliated | Health Benefits | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	0	0
Operating revenue - affiliated | Carelon Total | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	6,971	6,844
Operating revenue - affiliated | CarelonRx | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	3,567	4,002
Operating revenue - affiliated | Carelon Services | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	3,404	2,842
Operating revenue - affiliated | Corporate & Other | Eliminations
Segment Reporting Information [Line Items]
Operating revenue	$ 123	$ 37

Segment Information - Reconcili

Segment Information - Reconciliation of Reportable Segments Operating Revenues to Total Revenues Reported in the Consolidated Statements of Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting [Abstract]
Total operating revenue	$ 42,273	$ 41,898
Net investment income	465	387
Net losses on financial instruments	(161)	(113)
Total revenues	$ 42,577	$ 42,172

Segment Information - Reconci_2

Segment Information - Reconciliation of Income Before Income Tax Expense to Reportable Segments Operating Gain Included in the Consolidated Statements of Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting [Abstract]
Income before income tax expense	$ 2,939	$ 2,619
Net investment income	(465)	(387)
Net losses (gains) on financial instruments	161	113
Interest expense	265	251
Amortization of other intangible assets	116	235
Reportable segments operating gain	$ 3,016	$ 2,831