Cigna (CI) 10-Q 5 Nov 20 2020 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2020	Oct. 16, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2020
Document Transition Report	false
Entity File Number	1-38769
Entity Registrant Name	Cigna Corporation
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-4991898
Entity Address, Address Line One	900 Cottage Grove Road
Entity Address, City or Town	Bloomfield
Entity Address, State or Province	CT
Entity Address, Postal Zip Code	06002
City Area Code	860
Local Phone Number	226-6000
Title of 12(b) Security	Common Stock, Par Value $0.01
Trading Symbol	CI
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		361,267,280
Amendment Flag	false
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2020
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001739940

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenues
Premiums	$ 10,682	$ 9,935	$ 31,928	$ 29,709
Net investment income	297	349	873	1,035
Total revenues	40,955	38,556	118,689	115,321
Benefits and expenses
Pharmacy and other service costs	26,624	24,552	76,425	73,565
Medical costs and other benefit expenses	8,429	7,734	23,863	22,930
Selling, general and administrative expenses	3,301	3,413	10,106	10,096
Amortization of acquired intangible assets	493	734	1,487	2,214
Total benefits and expenses	38,847	36,433	111,881	108,805
Income from operations	2,108	2,123	6,808	6,516
Interest expense and other	(336)	(411)	(1,101)	(1,291)
Debt extinguishment costs	0	0	(199)	0
Net realized investment gains (losses)	32	51	(18)	84
Income before income taxes	1,804	1,763	5,490	5,309
Total income taxes	406	409	1,143	1,173
Net income	1,398	1,354	4,347	4,136
Less: Net income attributable to noncontrolling interests	10	3	24	9
Shareholders’ net income	$ 1,388	$ 1,351	$ 4,323	$ 4,127
Shareholders’ net income per share
Basic (in dollars per share)	$ 3.81	$ 3.60	$ 11.77	$ 10.94
Diluted (in dollars per share)	$ 3.78	$ 3.57	$ 11.66	$ 10.83
Pharmacy revenues
Revenues
Revenues	$ 27,802	$ 25,987	$ 79,464	$ 77,454
Fees and other revenues
Revenues
Revenues	$ 2,174	$ 2,285	$ 6,424	$ 7,123

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement of Comprehensive Income [Abstract]
Net income	$ 1,398	$ 1,354	$ 4,347	$ 4,136
Other comprehensive income, net of tax
Net unrealized appreciation on securities and derivatives	120	223	401	1,008
Net translation gains (losses) on foreign currencies	109	(127)	4	(195)
Postretirement benefits liability adjustment	14	12	(15)	37
Other comprehensive income, net of tax	243	108	390	850
Total comprehensive income	1,641	1,462	4,737	4,986
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interest	4	3	12	8
Net income attributable to other noncontrolling interests	6	0	12	1
Other comprehensive (loss) attributable to redeemable noncontrolling interest	(4)	1	(10)	(3)
Total comprehensive income attributable to noncontrolling interests	6	4	14	6
SHAREHOLDERS' COMPREHENSIVE INCOME	$ 1,635	$ 1,458	$ 4,723	$ 4,980

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions		Sep. 30, 2020	Dec. 31, 2019
Assets
Cash and cash equivalents		$ 5,344	$ 4,619
Investments		1,324	937
Accounts receivable, net		13,488	10,716
Inventories		2,657	2,661
Other current assets		1,722	1,400
Assets of business held for sale		10,022	9,512
Total current assets		34,557	29,845
Long-term investments		21,952	21,542
Reinsurance recoverables		4,898	5,100
Deferred policy acquisition costs		3,161	2,958
Property and equipment		4,203	4,417
Goodwill		44,685	44,602
Other intangible assets		35,492	36,562
Other assets		2,480	2,283
Separate account assets		8,616	8,465
TOTAL ASSETS		160,044	155,774
Liabilities
Current insurance and contractholder liabilities		5,223	4,921
Pharmacy and service costs payable		12,539	10,454
Accounts payable		5,327	5,090
Accrued expenses and other liabilities		7,153	7,347
Short-term debt		6,449	5,514
Liabilities of business held for sale		7,195	6,812
Total current liabilities		43,886	40,138
Non-current insurance and contractholder liabilities		16,213	16,052
Deferred tax liabilities, net		9,142	9,387
Other non-current liabilities		4,552	4,460
Long-term debt		29,537	31,893
Separate account liabilities		8,616	8,465
TOTAL LIABILITIES		111,946	110,395
Contingencies — Note 18
Redeemable noncontrolling interests		59	35
Shareholders’ equity
Common stock	[1]	4	4
Additional paid-in capital		28,777	28,306
Accumulated other comprehensive loss		(541)	(941)
Retained earnings		24,440	20,162
Less: treasury stock, at cost		(4,648)	(2,193)
TOTAL SHAREHOLDERS’ EQUITY		48,032	45,338
Other noncontrolling interests		7	6
Total equity		48,039	45,344
Total liabilities and equity		$ 160,044	$ 155,774
[1]	Par value per share, $0.01; shares issued, 389 million as of September 30, 2020 and 386 million as of December 31, 2019; authorized shares, 600 million.

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	389,000,000	386,000,000
Common stock, shares authorized (in shares)	600,000,000	600,000,000

Consolidated Statements of Chan

Consolidated Statements of Changes in Total Equity - USD ($) $ in Millions	Total	Adjustment upon Adoption		Shareholders’ Equity	Shareholders’ EquityAdjustment upon Adoption		Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive (Loss)	Retained Earnings	Retained EarningsAdjustment upon Adoption		Treasury Stock	Other Non- controlling Interests
Balance at Dec. 31, 2018	$ 41,035	$ (15)		$ 41,028	$ (15)		$ 4	$ 27,751	$ (1,711)	$ 15,088	$ (15)		$ (104)	$ 7
Changes in Total Equity
Effect of issuing stock for employee benefit plans	262			262				364					(102)
Other comprehensive income (loss)	853			853					853
Net income	4,128			4,127						4,127				1
Common dividends declared	(15)			(15)						(15)
Repurchase of common stock	(1,544)			(1,544)									(1,544)
Other transactions impacting noncontrolling interests	(5)													(5)
Balance at Sep. 30, 2019	44,699			44,696			4	28,115	(858)	19,185			(1,750)	3
Balance at Dec. 31, 2018	37
Change in Redeemable Noncontrolling Interests
Other comprehensive income (loss)	(3)
Net income	8
Other transactions impacting noncontrolling interests	(8)
Balance at Sep. 30, 2019	$ 34
Change in Redeemable Noncontrolling Interests
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201602Member
Balance at Jun. 30, 2019	$ 43,818			43,815			4	27,891	(965)	17,834			(949)	3
Changes in Total Equity
Effect of issuing stock for employee benefit plans	99			99				224					(125)
Other comprehensive income (loss)	107			107					107
Net income	1,351			1,351						1,351
Repurchase of common stock	(676)			(676)									(676)
Other transactions impacting noncontrolling interests
Balance at Sep. 30, 2019	44,699			44,696			4	28,115	(858)	19,185			(1,750)	3
Balance at Jun. 30, 2019	31
Change in Redeemable Noncontrolling Interests
Other comprehensive income (loss)	1
Net income	3
Other transactions impacting noncontrolling interests	(1)
Balance at Sep. 30, 2019	34
Balance at Dec. 31, 2019	45,344	$ (30)	[1]	45,338	$ (30)	[1]	4	28,306	(941)	20,162	$ (30)	[1]	(2,193)	6
Changes in Total Equity
Effect of issuing stock for employee benefit plans	385			385				471					(86)
Other comprehensive income (loss)	400			400					400
Net income	4,335			4,323						4,323				12
Common dividends declared	(15)			(15)						(15)
Repurchase of common stock	(2,369)			(2,369)									(2,369)
Other transactions impacting noncontrolling interests	(11)													(11)
Balance at Sep. 30, 2020	48,039			48,032			4	28,777	(541)	24,440			(4,648)	7
Balance at Dec. 31, 2019	35
Change in Redeemable Noncontrolling Interests
Other comprehensive income (loss)	(10)
Net income	12
Other transactions impacting noncontrolling interests	22
Balance at Sep. 30, 2020	$ 59
Change in Redeemable Noncontrolling Interests
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member
Balance at Jun. 30, 2020	$ 47,371			47,366			4	28,699	(788)	23,052			(3,601)	5
Changes in Total Equity
Effect of issuing stock for employee benefit plans	76			76				78					(2)
Other comprehensive income (loss)	247			247					247
Net income	1,394			1,388						1,388				6
Repurchase of common stock	(1,045)			(1,045)									(1,045)
Other transactions impacting noncontrolling interests	(4)			0										(4)
Balance at Sep. 30, 2020	48,039			$ 48,032			$ 4	$ 28,777	$ (541)	$ 24,440			$ (4,648)	$ 7
Balance at Jun. 30, 2020	34
Change in Redeemable Noncontrolling Interests
Other comprehensive income (loss)	(4)
Net income	4
Other transactions impacting noncontrolling interests	25
Balance at Sep. 30, 2020	$ 59
[1]	See Note 3 for further information about the Company's adoption of new credit loss guidance (ASU 2016-13).

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 0.04	$ 0.04

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Millions		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019
Cash Flows from Operating Activities
Net income		$ 4,347	$ 4,136
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		2,089	2,724
Realized investment losses (gains), net		18	(84)
Deferred income tax (benefit)		(340)	(400)
Debt extinguishment costs		199	0
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable		(2,810)	(1,171)
Inventories		5	661
Deferred policy acquisition costs		(244)	(162)
Reinsurance recoverable and Other assets		(468)	(92)
Insurance liabilities		740	590
Pharmacy and service costs payable		2,084	210
Accounts payable and Accrued expenses and other liabilities		(32)	23
Other, net		468	257
NET CASH PROVIDED BY OPERATING ACTIVITIES		6,056	6,692
Proceeds from investments sold:
Debt securities and equity securities		2,038	2,639
Investment maturities and repayments:
Debt securities and equity securities		1,097	1,281
Commercial mortgage loans		14	174
Other sales, maturities and repayments (primarily short-term and other long-term investments)		1,086	978
Investments purchased or originated:
Debt securities and equity securities		(3,317)	(3,347)
Commercial mortgage loans		(55)	(221)
Other (primarily short-term and other long-term investments)		(1,434)	(1,214)
Property and equipment purchases, net		(775)	(740)
Acquisitions, net of cash acquired		(135)	(6)
Other, net		37	(7)
NET CASH (USED IN) INVESTING ACTIVITIES		(1,444)	(463)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		769	731
Withdrawals and benefit payments from contractholder deposit funds		(736)	(845)
Net change in short-term debt		592	(479)
Net proceeds on issuance of term loan		1,398	0
Payments for debt extinguishment		(212)	0
Repayment of long-term debt		(6,897)	(3,340)
Net proceeds on issuance of long-term debt		3,465	0
Repurchase of common stock		(2,352)	(1,540)
Issuance of common stock		239	101
Other, net		(78)	(108)
NET CASH (USED IN) FINANCING ACTIVITIES		(3,812)	(5,480)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		(7)	(27)
Net increase in cash, cash equivalents and restricted cash		793	722
Cash, cash equivalents and restricted cash January 1,	[1]	5,411	3,855
Cash, cash equivalents and restricted cash, September 30,		6,204	4,577
Cash reclassified to assets of business held for sale		(798)	0
Cash, cash equivalents, and restricted cash September 30, per Consolidated Balance Sheets	[2]	5,406	4,577
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		1,408	1,607
Interest paid		$ 1,112	$ 1,257
[1]	Includes restricted cash of $26 million reported in Other assets, $23 million in Long-term investments, and $743 million reported in Assets of business held for sale as of January 1, 2020.
[2]	See table below for Cash, cash equivalents and restricted cash reconciliation as of September 30, 2020 and September 30, 2019.

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Millions		Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019
Cash and cash equivalents		$ 5,344	$ 4,619	$ 4,577
Restricted cash and cash equivalents, included in other long-term investments		62		0
Total cash, cash equivalents, and restricted cash and cash equivalents	[1]	$ 5,406		$ 4,577
Other Assets
Restricted cash and cash equivalents, included in other long-term investments			26
Long-Term Investments
Restricted cash and cash equivalents, included in other long-term investments			23
Assets Held for Sale
Restricted cash and cash equivalents, included in other long-term investments			$ 743
[1]	See table below for Cash, cash equivalents and restricted cash reconciliation as of September 30, 2020 and September 30, 2019.

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	Description of Business Cigna Corporation, together with its subsidiaries (either individually or collectively referred to as “Cigna,” the “Company,” “we,” “our” or “us”) is a global health services organization with a mission of helping those we serve improve their health, well-being and peace of mind. We offer a differentiated set of pharmacy, medical, dental, disability, life and accident insurance and related products and services offered by our subsidiaries. The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna also offers commercial health and dental insurance, Medicare and Medicaid products and health, life and accident insurance coverages to individuals in the United States and selected international markets. In addition to these ongoing operations, Cigna also has certain run-off operations. The Company reports its results in the following segments. As of the third quarter 2020, two reporting segments were re-named: Health Services to Evernorth and Integrated Medical to U.S. Medical. In addition, two of our operating segments were re-named: Commercial and Government to U.S. Commercial and U.S. Government, respectively. There were no changes to the underlying businesses reported in the segments. Evernorth includes a broad range of coordinated and point solution health services, including pharmacy services, benefits management, care solutions and data and analytics, which are provided to health plans, employers, government organizations, and health care providers. U.S. Medical offers a variety of health care solutions to employers and individuals. • The U.S. Commercial operating segment serves employers (also referred to as “clients”) and their employees (also referred to as “customers”) and other groups. This segment's products and services include medical, pharmacy, dental, behavioral health, vision, health advocacy programs and other products and services for insured and self-insured clients. • The U.S. Government operating segment offers Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors (including the acquired Express Scripts' Medicare Part D business), Medicaid plans, and individual health insurance plans both on and off the public exchanges. International Markets includes supplemental health, life and accident insurance products and health care coverage in our international markets, as well as health care benefits to globally mobile employees of multinational organizations. The remainder of our business operations are reported in Group Disability and Other, consisting of the following: • Group Disability and Life provides group long-term and short-term disability, group life, accident, voluntary and specialty insurance products and related services. In December 2019, Cigna entered into a definitive agreement to sell the U.S. Group Disability and Life insurance business to New York Life Insurance Company. See Note 6 for further information on the classification of this business as held for sale. • Corporate-Owned Life Insurance (“COLI”) offers permanent insurance contracts sold to corporations to provide coverage on the lives of certain employees for the purpose of financing employer-paid future benefit obligations. • Run-off businesses: • Reinsurance: predominantly comprised of guaranteed minimum death benefit (“GMDB”) and guaranteed minimum income benefit (“GMIB”) business effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska (“Berkshire”) in 2013. • Settlement Annuity business in run-off. • Individual Life Insurance and Annuity and Retirement Benefits Businesses: deferred gains from the sales of these businesses. Corporate reflects amounts not allocated to operating segments, including interest expense, net investment income on investments not supporting segment and other operations, interest on uncertain tax positions, certain litigation matters, expense associated with our frozen pension plans, severance, certain enterprise-wide projects and intersegment eliminations for products and services sold between segments.

COVID-19 and Related Economic I

COVID-19 and Related Economic Impact	9 Months Ended
	Sep. 30, 2020
Unusual or Infrequent Items, or Both [Abstract]
COVID-19 and Related Economic Impact	COVID-19 and Related Economic Impact Cigna continues to actively monitor all aspects of our business in light of the ongoing coronavirus ("COVID-19") pandemic. The Company also initiated several actions to assist our customers, clients, health care providers, and employees in this time of crisis. As described below, management has taken a number of steps to assess the impact on our business, including the financial reporting implications associated with this pandemic. The COVID-19 pandemic has pervasively impacted the economy, financial markets and the global health care delivery systems. The effects of the COVID-19 pandemic on the Company began to emerge in the U.S. at the end of the first quarter and were not material to the Company's results of operations or financial condition for that period. Beginning in April, we experienced a significant deferral of care by our customers. The deferral of care moderated over the course of the second quarter with utilization levels eventually returning to nearly normal levels by the end of June. As expected, in the third quarter we experienced medical utilization at more typical levels as we observed a reduction to the level of deferred care and our customers sought care for COVID-19 testing and treatment. These impacts were most prevalent in the U.S. Medical segment where quarterly earnings reflect the impacts of COVID-19 including the return of medical utilization to more typical levels, costs of COVID-19 care as well as the costs of actions we have taken to support customers and providers, decreased contributions from our specialty products, and lower net investment income. Higher year to date U.S. Medical results reflect deferral of care by our customers in April and May that exceeded the cost of COVID-19 testing and treatment, the cost of COVID-19 related actions including premium relief programs for employer clients as well as cost share waivers for customers, and lower net investment income. Our Group Disability and Other results reflect significantly elevated life insurance claims related to the COVID-19 pandemic and its effects in the third quarter. Quarterly and year to date earnings in our Evernorth segment also reflected effects of the pandemic, specifically, a favorable mix of claims as a result of both the type of drugs dispensed as well as the distribution method used for dispensing and fulfilling, partially offset by lower non-specialty, 30-day retail script volume. The Company conducted its annual quantitative evaluation of goodwill impairment during the third quarter of 2020. These evaluations were performed at the reporting unit level, based on discounted cash flow analyses and market data. The estimated fair value of each of our reporting units exceeded their carrying values by significant margins. For all other long-lived assets, including intangible assets, the Company conducted its normal quarterly qualitative impairment assessment and concluded that the current economic and business conditions did not result in a triggering event requiring a quantitative impairment analysis. There were no material impairments recorded for the nine months ended September 30, 2020.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The Consolidated Financial Statements include the accounts of Cigna Corporation and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”). Amounts recorded in the Consolidated Financial Statements necessarily reflect management’s estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment. These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2019 Annual Report on Form 10-K (“2019 Form 10-K”). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, competitive and other market conditions, as well as COVID-19 related impacts, call for caution in estimating full-year results based on interim results of operations. Recent Accounting Pronouncements The Company's 2019 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted our financial statements or may impact them in the future. The following information provides updates on recently adopted or recently issued accounting pronouncements that have occurred since the Company filed its 2019 Form 10-K. Recently Adopted Accounting Guidance Accounting Standard and Adoption Date Requirements and Effects of Adopting New Guidance Measurement of Credit Losses on Financial Instruments (Accounting Standards Update (ASU) 2016-13 and related amendments) Requires: • A new approach using expected credit losses to estimate and recognize credit losses for certain financial instruments (such as mortgage loans, reinsurance recoverables and other receivables) when such instruments are first originated or acquired, and in each subsequent reporting period, compared with the incurred loss model previously followed under GAAP. At adoption, the Company recorded an allowance for estimated credit losses and subsequent changes in the allowance will be reported in current period earnings. • Changes in the criteria for impairment of available-for-sale debt securities Effects of adoption: • Adopted using a modified retrospective approach • Cumulative effect adjustment of $30 million after-tax was recorded as a reduction to retained earnings as of January 1, 2020, reflecting an additional allowance for future expected credit losses required under the new model, primarily related to reinsurance recoverables. • See additional information regarding the Company’s accounting policy for establishing the allowance for credit losses in Note 4, Accounts Receivable, Net, Note 10, Reinsurance, and Note 11, Investments. Simplifying the Test for Goodwill Impairment (ASU 2017-04) Requires: • A simplified approach to the accounting for goodwill impairment by eliminating the need to determine the fair value of individual assets and liabilities of a reporting unit to measure a goodwill impairment • The amount of goodwill impairment to equal the amount by which a reporting unit’s carrying value exceeds its fair value, limited to the total amount of goodwill of the reporting unit Effects of adoption: • Adopted on a prospective basis • There was no impact of adopting this new standard to the Company’s financial statements because our quarterly qualitative assessments did not result in a triggering event for impairment of goodwill, and the results of our annual quantitative evaluation performed in the third quarter of 2020 indicated that the estimated fair value of each of our reporting units exceeded their carrying values by significant margins. Accounting Guidance Not Yet Adopted Accounting Standard and Effective Date Requirements and Expected Effects of New Guidance Not Yet Adopted Facilitation of the Effects of Reference Rate Reform on Financial Reporting (ASU 2020-04) Optional, effective upon issuance (March 12, 2020) through December 31, 2022 Guidance: • Provides temporary optional relief to ease the potential burden of accounting for reference rate reform under existing GAAP. Amendments are elective and apply to all entities that have contracts, hedging relationships and other transactions that reference interbank offered rates, including LIBOR, expected to be discontinued by December 31, 2021. • Permits optional expedients and exceptions to simplify the accounting for contract modifications, hedging arrangements and held-to-maturity investments, when certain changes are made to a contract or instrument to facilitate reference rate reform. • An entity may elect to apply the amendments, by topic or subsection, at any point prospectively through December 31, 2022. When elected, the optional expedients must be applied consistently for all eligible contracts or transactions. Expected effects: • To date, the Company has identified minimal exposure to LIBOR and does not anticipate that LIBOR’s phase-out will have a material impact on its operations or financial results. The Financial Accounting Standards Board voted to propose the deferral of the effective date of ASU 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounting policy. The Company's accounts receivable balances primarily include amounts due from clients, third-party payors, customers and pharmaceutical manufacturers, and are presented net of allowances. The Company's adoption of ASU 2016-13, Measurement of Credit Losses on Financial Instruments (ASU 2016-13), as of January 1, 2020 did not have a material impact on our accounts receivable credit loss allowance, as there were no substantive changes to our methodology for this class of assets. The allowance for expected credit losses for current accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due; however, when available evidence reasonably supports an assumption that counterparty credit risk over the expected payment period will differ from current and historical payment collections, a forecasting adjustment is reflected in the allowance for expected credit losses. All other (non-credit) allowances are based on the current status of each customer's receivable balance as well as current economic and market conditions and a variety of other factors, including the length of time the receivables are past due, the financial health of customers and our past experience. We bill pharmaceutical manufacturers based on management's interpretation of contractual terms and estimate a contractual allowance based on the best information available at the time a claim is processed. Contractual allowances for certain rebates receivable from pharmaceutical manufacturers are determined by reviewing payment experience and specific known items that could be adjusted under contract terms. The Company's estimation process for contractual allowances for pharmaceutical manufacturer receivables generally results in an allowance for balances outstanding greater than 90 days. Contractual allowances for certain receivables from third-party payors are based on their contractual terms and are estimates based on the Company's best information available at the time revenue is recognized. Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted. The following amounts were included within accounts receivable, net: (In millions) September 30, 2020 December 31, 2019 Noninsurance customer receivables $ 5,688 $ 5,143 Pharmaceutical manufacturers receivable 5,433 3,439 Insurance customer receivables 2,575 2,321 Other receivables 368 334 Total 14,064 11,237 Accounts receivable, net classified as assets of business held for sale (576) (521) Accounts receivable, net per Consolidated Balance Sheets $ 13,488 $ 10,716 These receivables are reported net of our allowances of $1.2 billion as of September 30, 2020 and $778 million as of December 31, 2019. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain receivables from third-party payors, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments. The Company's allowance for current expected credit losses was $69 million as of September 30, 2020 and $39 million as of January 1, 2020 (no change to allowance for credit losses from December 31, 2019). The allowance for current expected credit losses as of September 30, 2020 includes an additional forecasting adjustment of $11 million related to COVID-19.

Mergers and Acquisitions

Mergers and Acquisitions	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Mergers and Acquisitions	Mergers and Acquisitions Integration and Transaction-related Costs The Company incurred integration and transaction costs related to the acquisition and integration of Express Scripts, the terminated merger with Anthem, Inc. (“Anthem”), the sale of the U.S. Group Disability and Life insurance business, and other transactions. These costs were $112 million pre-tax ($83 million after-tax) for the three months and $339 million pre-tax ($256 million after-tax) for the nine months ended September 30, 2020, compared with $114 million pre-tax ($88 million after-tax) for the three months and $405 million pre-tax ($311 million after-tax) for the nine months ended September 30, 2019. These costs consisted primarily of certain projects to integrate or separate the Company’s systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.

Assets and Liabilities of Busin

Assets and Liabilities of Business Held for Sale	9 Months Ended
	Sep. 30, 2020
Discontinued Operations and Disposal Groups [Abstract]
Assets and Liabilities of Business Held for Sale	Assets and Liabilities of Business Held for Sale In December 2019, Cigna entered into a definitive agreement to sell its U.S. Group Disability and Life insurance business to New York Life Insurance Company for $6.3 billion. The sale is expected to close in the fourth quarter of 2020 following applicable regulatory approvals and other customary closing conditions. The Company believes this sale is probable and has aggregated and classified the assets and liabilities directly associated with the pending sale of its Group Disability and Life insurance business as held for sale and has reported them separately on our Consolidated Balance Sheets as of September 30, 2020 and December 31, 2019. The assets and liabilities of business held for sale were as follows: (In millions) September 30, 2020 December 31, 2019 Cash and cash equivalents $ 798 $ 743 Accounts receivable, net 576 521 Investments 8,258 7,709 Other assets 390 539 Total assets of business held for sale 10,022 9,512 Insurance and contractholder liabilities 6,591 6,308 Other liabilities 604 504 Total liabilities of business held for sale $ 7,195 $ 6,812

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share (“EPS”) Basic and diluted earnings per share were computed as follows: Three Months Ended September 30, 2020 September 30, 2019 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Dilution Diluted Basic Effect of Dilution Diluted Shareholders’ net income $ 1,388 $ 1,388 $ 1,351 $ 1,351 Shares: Weighted average 364,427 364,427 374,842 374,842 Common stock equivalents 2,763 2,763 3,479 3,479 Total shares 364,427 2,763 367,190 374,842 3,479 378,321 EPS $ 3.81 $ (0.03) $ 3.78 $ 3.60 $ (0.03) $ 3.57 Nine Months Ended September 30, 2020 September 30, 2019 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 4,323 $ 4,323 $ 4,127 $ 4,127 Shares: Weighted average 367,410 367,410 377,381 377,381 Common stock equivalents 3,421 3,421 3,710 3,710 Total shares 367,410 3,421 370,831 377,381 3,710 381,091 EPS $ 11.77 $ (0.11) $ 11.66 $ 10.94 $ (0.11) $ 10.83 The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Anti-dilutive options 4.6 3.6 4.2 3.9 The Company held approximately 26.7 million shares of common stock in treasury at September 30, 2020, 13.0 million shares as of December 31, 2019 and 10.4 million shares as of September 30, 2019.

Debt

Debt	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Debt	Debt The outstanding amounts of debt and finance leases were as follows: (In millions) September 30, 2020 December 31, 2019 Short-term debt $1,000 million, Floating Rate Notes due 3/2020 $ — $ 999 $300 million, 5.125% Notes due 6/2020 — 300 $1,750 million, 3.2% Notes due 9/2020 — 1,748 $349 million, 4.125% Notes due 9/2020 — 351 $500 million, 2.6% Notes due 11/2020 500 496 $400 million, Floating Rate Notes due 11/2020 400 400 $250 million, 4.375% Notes due 12/2020 250 249 $1,400 million, Floating Rate Term Loan due 3/2021 1,399 — $78 million, 6.37% Notes due 6/2021 78 — $1,000 million, Floating Rate Notes due 9/2021 999 — $1,250 million, 3.4% Notes due 9/2021 1,248 — Commercial paper 1,555 944 Other, including finance leases 20 27 Total short-term debt $ 6,449 $ 5,514 Long-term debt $500 million, 3.3% Notes due 2021 $ — $ 499 $300 million, 4.5% Notes due 2021 — 298 $78 million, 6.37% Notes due 2021 — 78 $1,000 million, Floating Rate Notes due 2021 — 998 $1,250 million, 3.4% Notes due 2021 — 1,247 $1,248 million, 4.75% Notes due 2021 — 1,272 $277 million, 4% Notes due 2022 276 747 $973 million, 3.9% Notes due 2022 972 999 $500 million, 3.05% Notes due 2022 489 485 $17 million, 8.3% Notes due 2023 17 17 $63 million, 7.65% Notes due 2023 63 100 $700 million, Floating Rate Notes due 2023 698 698 $1,000 million, 3% Notes due 2023 973 966 $2,187 million, 3.75% Notes due 2023 2,180 3,088 $1,000 million, 3.5% Notes due 2024 976 970 $900 million, 3.25% Notes due 2025 896 895 $2,200 million, 4.125% Notes due 2025 2,189 2,188 $1,500 million, 4.5% Notes due 2026 1,505 1,506 $1,500 million, 3.4% Notes due 2027 1,406 1,396 $259 million, 7.875% Debentures due 2027 259 259 $600 million, 3.05% Notes due 2027 595 595 $3,800 million, 4.375% Notes due 2028 3,779 3,776 $1,500 million, 2.4% Notes due 2030 1,489 — $45 million, 8.3% Step Down Notes due 2033 45 45 $190 million, 6.15% Notes due 2036 190 190 $2,200 million, 4.8% Notes due 2038 2,180 2,178 $750 million, 3.2% Notes due 2040 742 — $121 million, 5.875% Notes due 2041 119 119 $448 million, 6.125% Notes due 2041 490 491 $317 million, 5.375% Notes due 2042 315 315 $1,500 million, 4.8% Notes due 2046 1,465 1,465 $1,000 million, 3.875% Notes due 2047 988 988 $3,000 million, 4.9% Notes due 2048 2,966 2,964 $1,250 million, 3.4% Notes due 2050 1,235 — Other, including finance leases 40 61 Total long-term debt $ 29,537 $ 31,893 Debt Issuance and Redemption. In order to decrease future interest expense and reduce future refinancing risk, the Company entered into the following transactions: • Debt issuance: On March 16, 2020, the Company issued $3.5 billion of new senior notes. The proceeds of this debt were mainly used to pay the consideration for the cash tender and redemption offer as described below. Interest on this debt is paid semi-annually. Principal Maturity Date Interest Rate Net Proceeds $1,500 million March 15, 2030 2.40% $1,491 million $750 million March 15, 2040 3.20% $743 million $1,250 million March 15, 2050 3.40% $1,237 million • Debt tender and redemption: In March and April 2020, the Company completed a tender offer and an optional redemption totaling $3.5 billion of aggregate principal amount of certain of its outstanding debt securities. The principal amount repurchased in this tender offer was $1.5 billion. Additionally, $2.0 billion of notes were repurchased via optional redemption. The Company recorded a pre-tax loss of $199 million ($151 million after-tax), consisting primarily of premium payments on the tender and optional redemption. Debt Exchange . In the fourth quarter of 2019, the Company settled an exchange of approximately $12.7 billion of Notes issued by Express Scripts Holding Company, Medco Health Solutions, Inc. and Cigna Holding Company (formerly named Cigna Corporation) for privately placed Notes issued by Cigna with the same interest rates and maturities and comparable other terms. We initiated an exchange offer to register such debt in the second quarter of 2020 and completed the exchange in July 2020 . Debt Repayment. During the first nine months of 2020, the Company repaid $6.9 billion of long-term debt, including the $3.5 billion debt tender and redemption described above. Revolving Credit Agreements. Cigna has a revolving credit and letter of credit agreement that matures in April 2023 and is diversified among 23 banks. Cigna can borrow up to $3.25 billion for general corporate purposes, with up to $500 million available for issuance of letters of credit. This revolving credit agreement also includes an option to increase the facility amount up to $500 million and an option to extend the termination date for additional one year periods, subject to consent of the banks. Additionally, Cigna has a 364-day $1.0 billion revolving credit agreement that will mature in October 2021. The agreement replaces the $1.0 billion 364-day revolving credit agreement that expired in October 2020. The agreement is diversified among 23 banks. Pursuant to this revolving credit agreement, Cigna can borrow up to $1.0 billion for general corporate purposes. The agreement includes the option to “term out” any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one year anniversary of conversion. The revolving credit agreements contain customary covenants and restrictions including a financial covenant that the Company’s leverage ratio may not exceed 60%. As of September 30, 2020, there were no outstanding balances under the revolving credit agreements. Term Loan Credit Agreement. On April 1, 2020, the Company borrowed an aggregate principal amount of $1.4 billion under a new 364-Day Term Loan Credit Agreement (the "Credit Agreement"). The Company entered into the Credit Agreement to enhance its liquidity position in light of disruption in the commercial paper market and used a portion of the net proceeds to pay down amounts outstanding under its commercial paper facility. The Credit Agreement may be prepaid at any time in whole or in part without premium or penalty. Term loans prepaid may not be re-borrowed. The Credit Agreement provides for mandatory prepayment of the term loans in an amount equal to 20% of any Net Cash Proceeds (as defined in the Credit Agreement) arising from the previously announced sale of Cigna’s U.S. Group Disability and Life insurance business to New York Life Insurance Company. Commercial Paper . The commercial paper program had approximately $1.6 billion outstanding at September 30, 2020 at an average interest rate of 0.2%. The Company was in compliance with its debt covenants as of September 30, 2020.

Insurance and Contractholder Li

Insurance and Contractholder Liabilities	9 Months Ended
	Sep. 30, 2020
Insurance Loss Reserves [Abstract]
Insurance and Contractholder Liabilities	Insurance and Contractholder Liabilities A. Account Balances – Insurance and Contractholder Liabilities As of September 30, 2020, December 31, 2019 and September 30, 2019, the Company’s insurance and contractholder liabilities were comprised of the following: September 30, 2020 December 31, 2019 September 30, 2019 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 624 $ 7,038 $ 7,662 $ 600 $ 7,139 $ 7,739 $ 7,789 Future policy benefits 597 9,505 10,102 553 9,281 9,834 9,808 Unpaid claims and claim expenses U.S. Medical 3,182 18 3,200 2,875 17 2,892 3,061 Other segments 2,521 3,714 6,235 2,529 3,474 6,003 5,857 Unearned premiums 449 379 828 453 360 813 755 Total 7,373 20,654 28,027 7,010 20,271 27,281 27,270 Insurance and contractholder liabilities classified as liabilities of business held for sale (1) (2,150) (4,441) (6,591) (2,089) (4,219) (6,308) Total insurance and contractholder liabilities $ 5,223 $ 16,213 $ 21,436 $ 4,921 $ 16,052 $ 20,973 $ 27,270 (1) Amounts classified as Liabilities of business held for sale primarily include $5.2 billion of unpaid claims, $759 million of contractholder deposit funds and $646 million of future policy benefits as of September 30, 2020 and $4.9 billion of unpaid claims, $717 million of contractholder deposit funds and $653 million of future policy benefits as of December 31, 2019. Insurance and contractholder liabilities expected to be paid within one year are classified as current. B. Unpaid Claims and Claim Expenses – U.S. Medical This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process), and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities. The total of incurred but not reported liabilities plus expected development on reported claims, including reported claims in process, was $3.0 billion at September 30, 2020 and $2.8 billion at September 30, 2019. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the nine months ended September 30 was as follows: Nine Months Ended (In millions) September 30, 2020 September 30, 2019 Beginning balance $ 2,892 $ 2,697 Less: Reinsurance and other amounts recoverable 303 264 Beginning balance, net 2,589 2,433 Incurred costs related to: Current year 18,935 18,169 Prior years (126) (159) Total incurred 18,809 18,010 Paid costs related to: Current year 16,061 15,555 Prior years 2,363 2,160 Total paid 18,424 17,715 Ending balance, net 2,974 2,728 Add: Reinsurance and other amounts recoverable 226 333 Ending balance $ 3,200 $ 3,061 Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 for additional information on reinsurance. Variances in incurred costs related to prior years’ unpaid claims and claims expenses that resulted from the differences between actual experience and the Company’s key assumptions for the nine months ended September 30 were as follows: Nine Months Ended (Dollars in millions) September 30, 2020 September 30, 2019 $ % (1) $ % (2) Actual completion factors $ 47 0.2 % $ 87 0.4 % Medical cost trend 79 0.3 72 0.3 Total favorable variance $ 126 0.5 % $ 159 0.7 % (1) Percentage of current year incurred costs as reported for the year ended December 31, 2019. (2) Percentage of current year incurred costs as reported for the year ended December 31, 2018. Incurred costs related to prior years in the table above, although adjusted through shareholders’ net income, do not directly correspond to an increase or decrease to shareholders’ net income. The primary reason for this difference is that decreases to prior year incurred costs pertaining to the portion of the liability established for moderately adverse conditions are not considered as impacting shareholders’ net income if they are offset by increases in the current year provision for moderately adverse conditions. Prior year development increased shareholders’ net income by $30 million ($38 million before-tax) for the nine months ended September 30, 2020, compared with $68 million ($86 million before-tax) for the nine months ended September 30, 2019. Favorable prior year development in both periods reflects lower than expected utilization of medical services. C. Unpaid Claims and Claim Expenses – Group Disability and Other and International Markets Liability balance details. The liability details for unpaid claims and claim expenses are as follows: (In millions) September 30, 2020 (1) September 30, 2019 Group Disability and Other Group Disability and Life $ 5,206 $ 4,887 Other Operations 162 189 Total Group Disability and Other 5,368 5,076 International Markets 867 781 Unpaid claims and claim expenses Group Disability and Other and International Markets $ 6,235 $ 5,857 (1) Includes unpaid claim amounts classified as Liabilities of business held for sale. Activity in the Company’s liabilities for unpaid claims and claim expenses, excluding Other Operations, are presented in the following table. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been fully reinsured. Nine Months Ended (In millions) September 30, 2020 (1) September 30, 2019 Beginning balance $ 5,816 $ 5,432 Less: Reinsurance 184 156 Beginning balance, net 5,632 5,276 Incurred claims related to: Current year 4,277 4,205 Prior years: Interest accretion 118 117 All other incurred (12) (59) Total incurred 4,383 4,263 Paid claims related to: Current year 2,435 2,422 Prior years 1,702 1,594 Total paid 4,137 4,016 Foreign currency 5 (26) Ending balance, net 5,883 5,497 Add: Reinsurance 190 171 Ending balance $ 6,073 $ 5,668 (1) Includes unpaid claims amounts classified as Liabilities of business held for sale. Reinsurance in the table above reflects amounts due from reinsurers related to unpaid claims liabilities. The Company’s insurance subsidiaries enter into agreements with other companies primarily to limit losses from large exposures and to permit recovery of a portion of incurred losses. See Note 10 for additional information on reinsurance.

Reinsurance

Reinsurance	9 Months Ended
	Sep. 30, 2020
Reinsurance Disclosures [Abstract]
Reinsurance	Reinsurance The Company’s insurance subsidiaries enter into agreements with other insurance companies to assume and cede reinsurance. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance is also used to limit losses from large exposures and to permit recovery of a portion of direct or assumed losses. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk. A. Reinsurance Recoverables Accounting policy. Reinsurance recoverables represent amounts due from reinsurers for both paid and unpaid claims of the Company’s insurance businesses. Most reinsurance recoverables are classified as non-current assets. The current portion of reinsurance recoverables is reported in Other current assets and consists primarily of recoverables on paid claims expected to be settled within one year. Reinsurance recoverables are presented net of allowances for uncollectible reinsurance that, effective with adopting ASU 2016-13 on January 1, 2020, consists primarily of an allowance for expected credit losses. Estimates of the allowance for expected credit losses are based on internal and external data used to develop expected loss rates over the anticipated duration of the recoverable asset that vary by external credit rating and collateral level. The Company's allowance for credit losses on reinsurance recoverables was $34 million as of September 30, 2020, of which $31 million was recorded as a cumulative effect adjustment to retained earnings at adoption. The majority of the Company’s reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. Included in the table below is $209 million of current reinsurance recoverables that are reported in Other current assets as of September 30, 2020; as of December 31, 2019 there was $222 million of current reinsurance recoverables reported in Other current assets. The Company’s reinsurance recoverables are presented in the following table by range of external credit rating and collateral level. (Dollars in millions) Fair value of collateral contractually required to meet or exceed carrying value of recoverable Collateral provisions exist that may mitigate risk of credit loss (3) No collateral Total Ongoing Operations Upper-medium grade and higher (1) $ — $ 8 $ 326 $ 334 Lower-medium grade (2) — — 63 63 Not rated 90 14 29 133 Total recoverables related to ongoing operations (3) $ 90 $ 22 $ 418 $ 530 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 3,049 — 3,049 Berkshire 318 476 — 794 Prudential Retirement Insurance and Annuity 641 — — 641 Other 237 21 17 275 Not rated — 38 4 42 Total recoverables related to acquisition, disposition or runoff activities 1,196 3,584 21 4,801 Total $ 1,286 $ 3,606 $ 439 $ 5,331 Allowance for uncollectible reinsurance (34) Reinsurance recoverables classified as assets of business held for sale (190) Total reinsurance recoverables $ 5,107 (1) Includes A- equivalent and higher current ratings certified by a nationally recognized statistical rating organization ('NRSRO') (2) Includes BBB- to BBB+ equivalent current credit ratings certified by a NRSRO (3) This includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral’s fair value. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables, as further described above. B. Effects of Reinsurance In the Company’s Consolidated Statements of Income, premiums were reported net of amounts ceded to reinsurers and medical costs and other benefit expenses were reported net of reinsurance recoveries in the following amounts: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Total ceded premiums $ 122 $ 124 $ 367 $ 380 Total reinsurance recoveries $ 117 $ 180 $ 397 $ 292 C. Effective Exit of GMDB and GMIB Business The Company entered into an agreement with Berkshire to effectively exit the GMDB and GMIB business via a reinsurance transaction in 2013. Berkshire reinsured 100% of the Company’s future claim payments in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall limit with approximately $3.2 billion remaining at September 30, 2020. GMDB is accounted for as assumed and ceded reinsurance and GMIB assets and liabilities are reported as derivatives at fair value as discussed below. GMIB assets are reported in Other current assets and Other assets, and GMIB liabilities are reported in Accrued expenses and other liabilities and Other non-current liabilities. GMDB The GMDB exposure arises under annuities written by ceding companies that guarantee the benefit received at death. The Company’s exposure arises when the guaranteed minimum death benefit exceeds the fair value of the related mutual fund investments at the time of a contractholder’s death. The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded. (Dollars in millions, excludes impact of reinsurance ceded) September 30, 2020 December 31, 2019 Account value $ 8,650 $ 9,110 Net amount at risk $ 1,694 $ 1,764 Number of contractholders (estimated) 190,000 200,000 GMIB The Company reinsured contracts with issuers of GMIB products. The Company’s exposure represents the excess of a contractually guaranteed amount over the level of variable annuity account values. Payment by the Company depends on the actual account value in the related underlying mutual funds and the level of interest rates when the contractholders elect to receive minimum income payments that can only occur within 30 days of a policy anniversary after the appropriate waiting period. The Company has purchased retrocessional coverage (“GMIB assets”) for these contracts including retrocessional coverage from Berkshire. Assumptions used in fair value measurement . GMIB assets and liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse, and annuity election rates). The Company classifies GMIB assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 because assumptions related to future annuitant behavior are largely unobservable. The only assumption expected to impact future shareholders’ net income is non-performance risk. The non-performance risk adjustment reflects a market participant’s view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the GMIB liabilities to be paid by the Company, and (b) the GMIB assets to be paid by the reinsurers, after considering collateral. The impact of non-performance risk was immaterial for the three and nine months ended September 30, 2020 and September 30, 2019. GMIB liabilities totaling $786 million as of September 30, 2020 and $688 million as of December 31, 2019 were reported in Accrued expenses and other liabilities and Other non-current liabilities. There were three reinsurers covering 100% of the GMIB exposures as of September 30, 2020 and December 31, 2019 as follows: (In millions) Line of Business Reinsurer September 30, 2020 December 31, 2019 Collateral and Other Terms at September 30, 2020 GMIB Berkshire $ 382 $ 332 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 233 202 Liberty Re (Bermuda) Ltd. 205 179 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 820 $ 713 All reinsurers are rated A- equivalent and higher by a nationally recognized statistical rating organization ('NRSRO') Amounts included in shareholders’ net income for GMIB assets and liabilities were not material for the three or nine months ended September 30, 2020 or September 30, 2019.

Investments

Investments	9 Months Ended
	Sep. 30, 2020
Investments [Abstract]
Investments	Investments Cigna’s investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 for information about the valuation of the Company’s investment portfolio. The following table summarizes the Company's investments by category and current or long-term classification. September 30, 2020 December 31, 2019 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 1,113 $ 23,560 $ 24,673 $ 928 $ 22,827 $ 23,755 Equity securities — 379 379 — 303 303 Commercial mortgage loans 13 1,966 1,979 — 1,947 1,947 Policy loans — 1,347 1,347 — 1,357 1,357 Other long-term investments — 2,698 2,698 — 2,403 2,403 Short-term investments 458 — 458 423 — 423 Total $ 1,584 $ 29,950 $ 31,534 $ 1,351 $ 28,837 $ 30,188 Investments classified as assets of business held for sale (1) (260) (7,998) (8,258) (414) (7,295) (7,709) Investments per Consolidated Balance Sheets $ 1,324 $ 21,952 $ 23,276 $ 937 $ 21,542 $ 22,479 (1) The table above includes $8.3 billion as of September 30, 2020 and $7.7 billion as of December 31, 2019 of investments associated with the U.S. Group Disability and Life business that are held for sale to New York Life. Under the terms of the definitive agreement, some of the assets currently associated with the Group Disability and Life business can be substituted for other assets. The assets that will transfer to New York Life will be primarily debt securities and to a lesser extent commercial mortgage loans and short-term investments. A. Investment Portfolio Debt Securities Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive income (loss) within Shareholders’ equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company’s run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive income (loss). When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Realized investment gains and losses. As of January 1, 2020, the Company adopted ASU 2016-13 that included certain targeted improvements to the accounting for available-for-sale debt securities. The new guidance resulted in certain policy changes related to the process used by the Company to review declines in fair value from a security’s amortized cost basis to determine whether a credit loss exists. For example, the length of time that a debt security has been impaired is no longer a criterion for this review. In addition, under this new guidance, the Company recognizes an allowance for credit loss with a corresponding charge to credit loss expense, presented in Realized investment gains and losses in the Company’s income statement. Prior to this new guidance, the Company recorded a direct write-down of the instrument’s amortized cost basis. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default, and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted through credit loss expense. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with prior practice, when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income, and interest income is recognized on a cash basis. Debt securities are classified as either Current or Long-term investments based on their contractual maturities. The amortized cost and fair value by contractual maturity periods for debt securities were as follows at September 30, 2020: (In millions) Amortized Fair Due in one year or less $ 1,133 $ 1,143 Due after one year through five years 7,403 7,789 Due after five years through ten years 9,011 10,015 Due after ten years 4,212 5,211 Mortgage and other asset-backed securities 514 515 Total $ 22,273 $ 24,673 Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties. Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below. (In millions) Amortized Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2020 Federal government and agency $ 411 $ — $ 223 $ — $ 634 State and local government 628 — 85 — 713 Foreign government 2,091 — 317 (6) 2,402 Corporate 18,629 (31) 1,890 (79) 20,409 Mortgage and other asset-backed 514 (9) 32 (22) 515 Total $ 22,273 $ (40) $ 2,547 $ (107) $ 24,673 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,147 $ (9) $ 828 $ (13) $ 2,953 December 31, 2019 Federal government and agency $ 498 $ — $ 235 $ — $ 733 State and local government 729 — 81 — 810 Foreign government 2,027 — 230 (1) 2,256 Corporate 18,149 — 1,299 (28) 19,420 Mortgage and other asset-backed 506 — 31 (1) 536 Total $ 21,909 $ — $ 1,876 $ (30) $ 23,755 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,229 $ — $ 740 $ (4) $ 2,965 (1) Net unrealized appreciation for these investments is excluded from accumulated other comprehensive income. Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include: • severity of decline; • financial health and specific prospects of the issuer; and • changes in the regulatory, economic or general market environment of the issuer’s industry or geographic region. The table below summarizes debt securities with a decline in fair value from amortized cost by investment grade and the length of time these securities have been in an unrealized loss position. These debt securities are primarily corporate securities with a decline in fair value that reflects an increase in market yields since purchase. See discussion of Realized Investment Gains and Losses below for further information on the credit loss expense recorded for the Company's investments. September 30, 2020 December 31, 2019 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 1,193 $ 1,224 $ (31) 356 $ 723 $ 729 $ (6) 267 Below investment grade $ 713 $ 774 $ (61) 536 $ 340 $ 348 $ (8) 355 More than one year Investment grade $ 107 $ 111 $ (4) 19 $ 366 $ 378 $ (12) 118 Below investment grade $ 76 $ 87 $ (11) 36 $ 84 $ 88 $ (4) 93 Total $ 2,089 $ 2,196 $ (107) 947 $ 1,513 $ 1,543 $ (30) 833 The table below presents a roll-forward of the allowance for credit losses on debt securities for the three and nine months ended September 30, 2020. Three Months Ended Nine Months Ended (Dollars in millions) 2020 2020 Balance at beginning of period $ 48 $ 0 Additions for debt securities where no credit loss has previously been recognized 2 82 Reductions for securities sold during the period (6) (15) Decrease for debt securities where credit losses have previously been recorded (4) (27) Balance September 30, $ 40 $ 40 Equity Securities Equity securities with a readily determinable fair value consist primarily of mutual funds that invest in fixed income debt securities. Equity securities without a readily determinable fair value consist of private equity investments and are carried at cost minus impairment, if any, plus or minus changes resulting from observable price changes. The amount of impairments or value changes resulting from observable price changes was not material as of September 30, 2020 and December 31, 2019. Hybrid equity securities consist of preferred stock investments that have call features. The following table provides the values of the Company's equity security investments as of September 30, 2020 and December 31, 2019. September 30, 2020 December 31, 2019 (Dollars in millions) Amortized Cost Carrying Value Amortized Cost Carrying Value Equity securities with readily determinable fair values $ 126 $ 124 $ 61 $ 64 Equity securities with no readily determinable fair value $ 203 $ 212 $ 183 $ 192 Hybrid equity securities $ 57 $ 43 $ 58 $ 47 Total $ 386 $ 379 $ 302 $ 303 Commercial Mortgage Loans Accounting policy. Commercial mortgage loans are carried at unpaid principal balances. Beginning January 1, 2020 with the adoption of ASU 2016-13, unpaid principal balances are presented net of an allowance for expected credit losses. Changes in the allowance for expected credit losses are recognized as credit loss expense and presented in Realized investment gains and losses in the Company’s income statement. Each period, the Company establishes (or adjusts) its allowance for expected credit losses for commercial mortgage loans. The allowance for expected credit losses is based on a credit risk category that is assigned to each loan at origination using key credit quality indicators, including debt service coverage and loan-to-value ratios. Credit risk categories are updated as key credit quality indicators change. An expected loss rate, assigned based on the credit risk category, is applied to each loan's unpaid principal balance to develop an aggregate allowance for expected credit losses. Prior to adoption, impaired commercial mortgage loans were written down to the lower of unpaid principal or fair value of the underlying collateral when it became probable that the Company would not collect all amounts due under its promissory note. The Company recorded an allowance of $7 million through a cumulative effect adjustment to retained earnings to reflect expected credit losses at adoption. The credit loss allowance for the Company’s commercial mortgage loan investments was $9 million as of September 30, 2020. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with our prior practice, accrued interest, reported in other current assets, is written off through a charge to net investment income; interest income on impaired loans is only recognized when a payment is received. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral. Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties. Commercial mortgage loans are classified as either current or long-term investments based on their contractual maturities. Credit quality . The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis. Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan. The following table summarizes the credit risk profile of the Company’s commercial mortgage loan portfolio based on loan-to-value and debt service coverage ratios as of September 30, 2020 and December 31, 2019: (Dollars in millions) September 30, 2020 December 31, 2019 Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Below 60% $ 861 2.20 $ 1,136 2.19 60% to 79% 985 1.93 723 1.98 80% to 100% 142 1.33 88 1.62 Allowance for credit losses (9) Total $ 1,979 2.01 60 % $ 1,947 2.09 58 % The Company’s annual in-depth review of its commercial mortgage loan investments is the primary mechanism for identifying emerging risks in the portfolio. The Company’s investment professionals completed the annual in-depth review in the second quarter of 2020 that included an analysis of each underlying property’s most recent annual financial statements, rent rolls, operating plans, budgets, a physical inspection of the property and other pertinent factors. Based on historical results, current leases, lease expirations and rental conditions in each market, the Company estimated the current year and future stabilized property income and fair value for each loan. The average loan to value increased slightly from last year and remains strong. The portfolio's average debt service coverage ratio decreased slightly at September 30, 2020 compared with December 31, 2019 but remains at a high level. The Company re-evaluates a loan’s credit quality between annual reviews if new property information is received or an event such as delinquency or a borrower’s request for restructure causes management to believe that the Company’s estimate of financial performance, fair value or the risk profile of the underlying property has been impacted. All commercial mortgage loans in the Company's portfolio are current as of September 30, 2020 and December 31, 2019. Other Long-Term Investments Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments. Other long-term investments also include investment real estate, foreign currency swaps, and statutory and other deposits. The following table provides carrying value information for these investments. Carrying value as of (In millions) September 30, 2020 December 31, 2019 Real estate investments $ 888 $ 788 Securities partnerships 1,591 1,409 Other 219 206 Total $ 2,698 $ 2,403 Short-Term Investments and Cash Equivalents Short-term investments and cash equivalents included the following types of issuers: (In millions) September 30, 2020 December 31, 2019 Corporate securities $ 2,729 $ 1,985 Federal government securities $ 1,139 $ 472 Foreign government securities $ 89 $ 65 Money market funds $ 313 $ 631 B. Realized Investment Gains and Losses Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities, and changes in valuation reserves on commercial mortgage loans. Commencing January 1, 2020, realized gains and losses also include credit loss expense resulting from the impact of changes in the allowances for credit losses on debt securities and commercial mortgage loan investments under ASU 2016-13. The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company’s separate accounts because those gains and losses generally accrue directly to separate account policyholders. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Net realized investment gains, excluding credit loss expense and asset write-downs $ 24 $ 60 $ 33 $ 96 Credit loss (expense) recoveries on invested assets 8 — (41) — Other investment asset write-downs — (9) (10) (12) Net realized investment gains (losses), before income taxes $ 32 $ 51 $ (18) $ 84 Net realized investment gains, excluding credit loss expense and asset write-downs, for the nine months ended September 30, 2020 primarily represent gains on the sales of debt securities, partially offset by mark-to-market losses on equity securities and foreign exchange derivatives. Net realized investment gains, excluding credit loss expense and asset write-downs, for the nine months ended September 30, 2019 represent gains on the sales of real estate partnerships and debt securities. Credit loss (expense) recoveries on invested assets for the nine months ended September 30, 2020 reflects credit losses incurred primarily on debt securities due to uncertainty around issuers in certain industries that are particularly impacted by the global COVID-19 pandemic. Realized gains and losses on equity securities still held at September 30, 2020 and 2019 were not material. The following table presents sales information for available-for-sale debt securities. Gross gains on sales and gross losses on sales exclude amounts required to adjust future policy benefits for the run-off settlement annuity business. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Proceeds from sales $ 380 $ 591 $ 2,003 $ 2,242 Gross gains on sales $ 15 $ 18 $ 81 $ 41 Gross losses on sales $ — $ (5) $ (21) $ (17) C. Derivative Financial Instruments The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contract holder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company’s separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders. Derivative instruments used by the Company typically include foreign currency swap contracts and foreign currency forward contracts. Foreign currency swap contracts periodically exchange cash flows between two currencies for principal and interest. Foreign currency forward contracts require the Company to purchase a foreign currency in exchange for the functional currency of its operating unit at a future date. The Company manages the credit risk of these derivative instruments by diversifying its portfolio among approved dealers of high credit quality and through routine monitoring of credit risk exposures. Certain of the Company’s over-the-counter derivative instruments require either the Company or the counterparty to post collateral or demand immediate payment depending on the amount of the net liability position of the derivative instrument and predefined financial strength or credit rating thresholds. These collateral posting requirements vary by counterparty. The Company would incur a loss if dealers completely failed to perform under derivative contracts, however collateral has been posted by dealers to cover substantially all of the fair values owed by dealers at September 30, 2020 and December 31, 2019. The fair value of collateral posted by the Company was not significant as of September 30, 2020 or December 31, 2019. The gross fair values of our derivative financial instruments are presented in Note 12. The following table summarizes the types and notional quantity of derivative instruments held by the Company. As of September 30, 2020 and December 31, 2019, the effects of these individual hedging strategies were not material to the Consolidated Financial Statements, including gains or losses reclassified from accumulated other comprehensive income into shareholders' net income, as well as amounts excluded from the assessment of hedge effectiveness. (In millions) Notional Value as of September 30, 2020 December 31, 2019 Purpose Type of Instrument Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds. Foreign currency swap contracts $ 853 $ 817 Net investment hedge : To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in Euros, Korean Won, and Taiwan Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts $ 526 $ 438 Foreign currency forward contracts $ 636 $ 406 Economic hedge: To hedge the foreign exchange-related changes in fair value of U.S. dollar-denominated investment assets to reflect the local currency for the Company’s foreign subsidiary in South Korea. The notional value of hedging instruments generally aligns with the fair value of the hedged investments. Foreign currency forward contracts $ 495 $ 410 The Company’s derivative financial instruments are presented as follows: • Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds : Swap fair values are reported in Long-term investments or Other non-current liabilities. Changes in fair values attributable to foreign exchange risk of the swap contracts and the hedged bonds are reported in Realized investment gains and losses. The portion of the swap contracts’ changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities. • Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar : The fair values of the foreign currency swap and forward contracts are reported in Other assets or Other liabilities. The changes in fair values of these instruments are reported in Other comprehensive income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are excluded from our effectiveness assessment and recognized in interest expense when coupon payments are accrued or ratably over the term of the instrument. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Cash flows relating to these contracts are reported in Investing activities. • Economic hedges for derivatives not designated as accounting hedges : Fair values of forward contracts are reported in current Investments or Accrued expenses and other liabilities. The changes in fair values are reported in Realized investment gains and losses. Cash flows relating to these contracts are reported in Investing activities.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value. Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability’s fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor. The Company’s financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset’s or a liability’s classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument’s fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3). The Company estimates fair values using prices from third parties or internal pricing methods. Fair value estimates received from third-party pricing services are based on reported trade activity and quoted market prices when available, and other market information that a market participant would use to estimate fair value. The internal pricing methods are performed by the Company’s investment professionals and generally involve using discounted cash flow analyses, incorporating current market inputs for similar financial instruments with comparable terms and credit quality as well as other qualitative factors. In instances where there is little or no market activity for the same or similar instruments, fair value is estimated using methods, models and assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. These valuation techniques involve some level of estimation and judgment that becomes significant with increasingly complex instruments or pricing models. The Company is responsible for determining fair value and for assigning the appropriate level within the fair value hierarchy based on the significance of unobservable inputs. The Company reviews methodologies, processes and controls of third-party pricing services and compares prices on a test basis to those obtained from other external pricing sources or internal estimates. The Company performs ongoing analyses of both prices received from third-party pricing services and those developed internally to determine that they represent appropriate estimates of fair value. The controls executed by the Company include evaluating changes in prices and monitoring for potentially stale valuations. The Company also performs sample testing of sales values to confirm the accuracy of prior fair value estimates. The minimal exceptions identified during these processes indicate that adjustments to prices are infrequent and do not significantly impact valuations. An annual due-diligence review of the most significant pricing service is conducted to review their processes, methodologies and controls. This review includes a walk-through of inputs for a sample of securities held across various asset types to validate the documented pricing process. A. Financial Assets and Financial Liabilities Carried at Fair Value The following table provides information as of September 30, 2020 and December 31, 2019 about the Company’s financial assets and liabilities carried at fair value. Separate account assets are also recorded at fair value on the Company’s Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to policyholders. (In millions) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs Significant Unobservable Inputs Total As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 Financial assets at fair value Debt securities Federal government and agency $ 183 $ 197 $ 451 $ 536 $ — $ — $ 634 $ 733 State and local government — — 713 810 — — 713 810 Foreign government — — 2,381 2,228 21 28 2,402 2,256 Corporate — — 19,662 19,063 747 357 20,409 19,420 Mortgage and other asset-backed — — 368 398 147 138 515 536 Total debt securities 183 197 23,575 23,035 915 523 24,673 23,755 Equity securities (1) 1 7 135 72 31 32 167 111 Short-term investments — — 458 423 — — 458 423 Derivative assets — — 104 83 — — 104 83 Real estate funds priced at NAV as a practical expedient (2) 165 184 Financial liabilities at fair value Derivative liabilities $ — $ — $ 21 $ 18 $ — $ — $ 21 $ 18 (1) Excludes certain equity securities that have no readily determinable fair value. (2) As a practical expedient, certain real estate funds are carried at fair value based on the Company’s ownership share of the equity of the investee (Net Asset Value (“NAV“)) including changes in the fair value of its underlying investments. The Company has $50 million in unfunded commitments in these funds as of September 30, 2020. Level 1 Financial Assets Inputs for instruments classified in Level 1 include unadjusted quoted prices for identical assets in active markets accessible at the measurement date. Active markets provide pricing data for trades occurring at least weekly and include exchanges and dealer markets. Assets in Level 1 include actively-traded U.S. government bonds and exchange-listed equity securities. A relatively small portion of the Company’s investment assets are classified in this category given the narrow definition of Level 1 and the Company’s investment asset strategy to maximize investment returns. Level 2 Financial Assets and Financial Liabilities Inputs for instruments classified in Level 2 include quoted prices for similar assets or liabilities in active markets, quoted prices from those willing to trade in markets that are not active or other inputs that are market observable or can be corroborated by market data for the term of the instrument. Such other inputs include market interest rates and volatilities, spreads and yield curves. An instrument is classified in Level 2 if the Company determines that unobservable inputs are insignificant. Debt and equity securities . Approximately 95% of the Company’s investments in debt and equity securities are classified in Level 2 including most public and private corporate debt and hybrid equity securities, federal agency and municipal bonds, non-government mortgage-backed securities and preferred stocks. Third-party pricing services and internal methods often use recent trades of securities with similar features and characteristics because many debt securities do not trade daily. Pricing models are used to determine these prices when recent trades are not available. These models calculate fair values by discounting future cash flows at estimated market interest rates. Such market rates are derived by calculating the appropriate spreads over comparable U.S. Treasury securities based on the credit quality, industry and structure of the asset. Typical inputs and assumptions to pricing models include, but are not limited to, a combination of benchmark yields, reported trades, issuer spreads, liquidity, benchmark securities, bids, offers, reference data and industry and economic events. For mortgage-backed securities, inputs and assumptions may also include characteristics of the issuer, collateral attributes, prepayment speeds and credit rating. Nearly all of these instruments are valued using recent trades or pricing models. Less than 1% of the fair value of investments classified in Level 2 represents foreign bonds that are valued using a single, unadjusted market-observable input derived by averaging multiple broker-dealer quotes, consistent with local market practice. Short-term investments are carried at fair value that approximates cost. The Company compares market prices for these securities to recorded amounts on a regular basis to validate that current carrying amounts approximate exit prices. The short-term nature of the investments and corroboration of the reported amounts over the holding period support their classification in Level 2. Derivative assets and liabilities classified in Level 2 represent over-the-counter instruments such as foreign currency forward and swap contracts. Fair values for these instruments are determined using market observable inputs including forward currency and interest rate curves and widely published market observable indices. Credit risk related to the counterparty and the Company is considered when estimating the fair values of these derivatives. However, the Company is largely protected by collateral arrangements with counterparties and determined that no adjustments for credit risk were required as of September 30, 2020 or December 31, 2019. The nature and use of these derivative financial instruments are described in Note 11. Level 3 Financial Assets and Financial Liabilities Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company’s best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. The Company classifies certain newly-issued, privately-placed, complex or illiquid securities in Level 3. Approximately 4% of debt and equity securities are priced using significant unobservable inputs and classified in this category. Fair values of mortgage and other asset-backed securities, as well as corporate and government debt securities, are primarily determined using pricing models that incorporate the specific characteristics of each asset and related assumptions including the investment type and structure, credit quality, industry and maturity date in comparison to current market indices, spreads and liquidity of assets with similar characteristics. Inputs and assumptions for pricing may also include characteristics of the issuer, collateral attributes and prepayment speeds for mortgage and other asset-backed securities. Recent trades in the subject security or similar securities are assessed when available, and the Company may also review published research in its evaluation, as well as the issuer’s financial statements. Quantitative Information about Unobservable Inputs The following table summarizes the fair value and significant unobservable inputs used in pricing the following debt securities that were developed directly by the Company as of September 30, 2020 and December 31, 2019. The range and weighted average basis point (“bps”) amounts for liquidity and credit spreads (adjustment to discount rates) reflect the Company’s best estimates of the unobservable adjustments a market participant would make to calculate these fair values. These liquidity and credit spreads have increased over the reported periods, resulting from continued uncertainty over the economic impacts related to COVID-19. Corporate and government debt securities. The significant unobservable input used to value the following corporate and government debt securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security. Mortgage and other asset-backed securities. The significant unobservable inputs used to value the following mortgage and other asset-backed securities are liquidity and weighting of credit spreads. An adjustment for liquidity is made as of the measurement date that considers current market conditions, issuer circumstances and complexity of the security structure when there is limited trading activity for the security. An adjustment to weight credit spreads is needed to value a more complex bond structure with multiple underlying collateral and no standard market valuation technique. The weighting of credit spreads is primarily based on the underlying collateral’s characteristics and their proportional cash flows supporting the bond obligations. Fair Value as of Unobservable Adjustment Range (Fair value in millions ) September 30, 2020 December 31, 2019 Unobservable input September 30, 2020 September 30, 2020 December 31, 2019 Debt securities Corporate and government debt securities $ 765 $ 385 Liquidity 60 - 1570 (410) bps 70 - 930 (280) bps Mortgage and other asset-backed securities 147 138 Liquidity 60 - 370 (80) bps 60 - 370 (70) bps Weighting of credit spreads 320 - 650 (460) bps 240 - 460 (330) bps Securities not priced by the Company (1) 3 — Total Level 3 debt securities $ 915 $ 523 (1) The fair values for these securities use single, unadjusted non-binding broker quotes not developed directly by the Company. Significant increases in liquidity or credit spreads would result in lower fair value measurements while decreases in these inputs would result in higher fair value measurements. The unobservable inputs are generally not interrelated and a change in the assumption used for one unobservable input is not accompanied by a change in the other unobservable input. Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value The following tables summarize the changes in financial assets and financial liabilities classified in Level 3 for the three and nine months ended September 30, 2020 and 2019. Gains and losses reported in these tables may include net changes in fair value that are attributable to both observable and unobservable inputs. Debt and Equity Securities For the Three Months Ended For the Nine Months Ended (In millions) 2020 2019 2020 2019 Balance at beginning of period $ 860 $ 431 $ 555 $ 410 Total gains (losses) included in shareholders’ net income (1) (6) 4 (7) Gains (losses) included in other comprehensive income 17 4 (42) 16 Gains (losses) required to adjust future policy benefits for settlement annuities (1) 7 1 4 3 Purchases, sales and settlements Purchases 3 10 67 53 Sales (1) — (13) — Settlements (8) (6) (15) (16) Total purchases, sales and settlements $ (6) $ 4 $ 39 $ 37 Transfers into/(out of) Level 3 Transfers into Level 3 102 80 629 113 Transfers out of Level 3 (33) — (243) (58) Total transfers into/(out of) Level 3 $ 69 $ 80 $ 386 $ 55 Balance at September 30, $ 946 $ 514 $ 946 $ 514 Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date $ — $ (6) $ (2) $ (8) Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period $ 17 N/A $ (37) N/A Total gains and losses included in Shareholders’ net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment gains (losses) and Net investment income. Gains and losses included in Other comprehensive income in the tables above are reflected in Net unrealized appreciation (depreciation) on securities in the Consolidated Statements of Comprehensive Income. Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company’s best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Transfers between Level 2 and Level 3 during 2020 and 2019 primarily reflected changes in liquidity and credit risk estimates for certain private placement issuers across several sectors. Separate Accounts The investment income and fair value gains and losses of separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company’s Consolidated Statements of Income and Cash Flows. Fair values of separate account assets at September 30, 2020 and December 31, 2019 were as follows: (In millions) Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Total September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 Guaranteed separate accounts (See Note 18) $ 208 $ 219 $ 302 $ 271 $ — $ — $ 510 $ 490 Non-guaranteed separate accounts (1) 1,541 1,450 5,508 5,522 335 263 7,384 7,235 Subtotal $ 1,749 $ 1,669 $ 5,810 $ 5,793 $ 335 $ 263 $ 7,894 $ 7,725 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 736 756 Total $ 8,630 $ 8,481 Separate account assets of business classified as held for sale (14) (16) Separate account assets per Consolidated Balance Sheets $ 8,616 $ 8,465 (1) Non-guaranteed separate accounts included $3.9 billion as of September 30, 2020 and $4.0 billion as of December 31, 2019 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of September 30, 2020 and $0.2 billion classified in Level 3 as of December 31, 2019. Separate account assets classified as Level 1 primarily include exchange-listed equity securities. Level 2 assets primarily include: • corporate and structured bonds valued using recent trades of similar securities or pricing models that discount future cash flows at estimated market interest rates as described above; and • actively-traded institutional and retail mutual fund investments. Separate account assets classified in Level 3 primarily support Cigna’s pension plans and include certain newly-issued, privately-placed, complex, or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three and nine months ended September 30, 2020 and 2019. Separate account investments in securities partnerships, real estate, and hedge funds are generally valued based on the separate account’s ownership share of the equity of the investee (NAV as a practical expedient) including changes in the fair values of its underlying investments. Substantially all of these assets support the Cigna Pension Plans. The following table provides additional information on these investments. Fair Value as of Unfunded Commitment as of September 30, 2020 Redemption Frequency Redemption Notice (In millions) September 30, 2020 December 31, 2019 Securities partnerships $ 511 $ 531 $ 283 Not applicable Not applicable Real estate funds 221 220 — Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 736 $ 756 $ 283 As of September 30, 2020, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable, and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception. B. Assets and Liabilities Measured at Fair Value under Certain Conditions Some financial assets and liabilities are not carried at fair value each reporting period, but may be measured using fair value only under certain conditions such as when investments become impaired, including investment real estate and commercial mortgage loans and certain equity securities with no readily determinable fair value. Equity securities with no readily determinable fair value are also measured at fair value when there are observable price changes from orderly transactions with the same issuer. For the nine months ended September 30, 2020 and 2019, there were immaterial gains relating to price changes for equity securities with no readily determinable fair value and no impaired investments written down to their fair values. Carrying values represented less than 1% of total investments as of both September 30, 2020 and September 30, 2019. C. Fair Value Disclosures for Financial Instruments Not Carried at Fair Value The following table includes the Company’s financial instruments not recorded at fair value that are subject to fair value disclosure requirements at September 30, 2020 and December 31, 2019. In addition to universal life products and finance leases, financial instruments that are carried in the Company’s Consolidated Financial Statements at amounts that approximate fair value are excluded from the following table. September 30, 2020 December 31, 2019 (In millions) Classification in Fair Value Hierarchy Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 2,033 $ 1,979 $ 1,989 $ 1,947 Long-term debt, including current maturities, excluding finance leases Level 2 $ 37,976 $ 32,972 $ 39,439 $ 36,375 Fair values of off-balance sheet financial instruments were not material as of September 30, 2020 and December 31, 2019.

Variable Interest Entities

Variable Interest Entities	9 Months Ended
	Sep. 30, 2020
Variable Interest Entities [Abstract]
Variable Interest Entities	Variable Interest Entities When the Company becomes involved with a variable interest entity and when there is a change in the Company’s involvement with an entity, the Company must determine if it is the primary beneficiary and must consolidate the entity. The Company is considered the primary beneficiary if it has the power to direct the entity’s most significant economic activities and has the right to receive benefits or obligation to absorb losses that could be significant to the entity. The Company evaluates the following criteria: • the structure and purpose of the entity; • the risks and rewards created by, and shared through, the entity; and • the Company’s ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity including its sponsors, equity holders, guarantors, creditors and servicers. The Company determined it was not a primary beneficiary in any material variable interest entities as of September 30, 2020 or December 31, 2019. The Company’s involvement in variable interest entities for which it is not the primary beneficiary is described below. Securities limited partnerships and real estate limited partnerships. The Company owns interests in securities limited partnerships and real estate limited partnerships that are defined as variable interest entities. These partnerships invest in the equity or mezzanine debt of privately-held companies and real estate properties. General partners unaffiliated with the Company control decisions that most significantly impact the partnership’s operations and the limited partners do not have substantive kick-out or participating rights. The Company’s maximum exposure to loss from these entities of $3.9 billion across approximately 150 limited partnerships as of September 30, 2020, included $2.0 billion reported in Long-term investments and commitments to contribute an additional $1.9 billion. The Company’s noncontrolling interest in each of these limited partnerships is generally less than 15% of the partnership ownership interests. Other asset-backed and corporate securities. In the normal course of its investing activities, the Company also makes passive investments in certain asset-backed and corporate securities that are issued by variable interest entities whose sponsors or issuers are unaffiliated with the Company. The Company receives fixed-rate cash flows from these investments and the maximum potential exposure to loss is limited to our carrying amount of $0.7 billion as of September 30, 2020 that is reported in debt securities. The Company’s combined ownership interests are insignificant relative to the total principal amounts issued by these entities. The Company is involved with various other variable interest entities with immaterial carrying values and maximum exposures to loss. The Company has not provided, and does not intend to provide, financial support to any of the variable interest entities beyond what it is contractually required to provide. The Company performs ongoing qualitative analyses of its involvement with these variable interest entities to determine if consolidation is required.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 2020
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Accumulated Other Comprehensive Income (Loss)	Accumulated Other Comprehensive Income (Loss) (“AOCI”) AOCI includes unrealized appreciation on securities and derivatives (excluding appreciation on investments supporting future policy benefit liabilities of the run-off settlement annuity business) (See Note 11), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company’s share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to net income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI were as follows: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Securities and Derivatives Beginning balance $ 1,256 $ 803 $ 975 $ 18 Appreciation on securities and derivatives 159 298 499 1,305 Tax (expense) (27) (68) (96) (284) Net appreciation on securities and derivatives 132 230 403 1,021 Reclassification adjustment for (gains) included in shareholders' net income (net realized investment (gains)) (16) (10) (3) (17) Tax benefit 4 3 1 4 Net (gains) reclassified from AOCI to net income (12) (7) (2) (13) Other comprehensive income, net of tax 120 223 401 1,008 Ending balance $ 1,376 $ 1,026 $ 1,376 $ 1,026 Translation of foreign currencies Beginning balance $ (374) $ (285) $ (275) $ (221) Translation of foreign currencies 102 (124) 7 (191) Tax (expense) benefit 7 (3) (3) (4) Net translation of foreign currencies 109 (127) 4 (195) Less: Net translation of foreign currencies attributable to noncontrolling interests (4) 1 (10) (3) Shareholders' net translation of foreign currencies 113 (128) 14 (192) Ending balance $ (261) $ (413) $ (261) $ (413) Postretirement benefits liability Beginning balance $ (1,670) $ (1,483) $ (1,641) $ (1,508) Reclassification adjustment for amortization of net losses from past experience and prior service costs (interest expense and other) 18 16 54 47 Reclassification adjustment for settlement (interest expense and other) — — — 10 Tax (expense) (4) (3) (13) (12) Net adjustments reclassified from AOCI to net income 14 13 41 45 Valuation update — (1) (73) (9) Tax benefit — — 17 1 Net change due to valuation update — (1) (56) (8) Other comprehensive (loss) income, net of tax 14 12 (15) 37 Ending balance $ (1,656) $ (1,471) $ (1,656) $ (1,471)

Organizational Efficiency Plan

Organizational Efficiency Plan	9 Months Ended
	Sep. 30, 2020
Restructuring and Related Activities [Abstract]
Organizational Efficiency Plan	Organizational Efficiency Plan The Company is continuously evaluating ways to deliver our products and services more efficiently and at a lower cost. During the fourth quarter of 2019, we committed to a plan to increase our organizational alignment and operational efficiency and reduce costs. As a result, we recognized a charge in Selling, general and administrative expenses of $207 million pre-tax ($162 million after-tax) in the fourth quarter of 2019 and an additional $31 million pre-tax ($24 million after-tax) in the first quarter 2020, primarily for severance costs related to headcount reductions. As of September 30, 2020, we expect most of the severance to be paid by the end of 2021.

Leases

Leases	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Leases	Leases Operating and finance lease right of use ("ROU") assets and lease liabilities were as follows: (In millions) September 30, 2020 December 31, 2019 Operating leases: Operating lease ROU assets $ 530 $ 536 Accrued expenses and other current liabilities $ 160 $ 166 Other non-current liabilities 461 465 Total operating lease liabilities $ 621 $ 631 Finance leases: Property and equipment, gross $ 99 $ 110 Accumulated depreciation (42) (23) Property and equipment, net $ 57 $ 87 Short-term debt $ 20 $ 27 Long-term debt 40 61 Total finance lease liabilities $ 60 $ 88
Leases	Leases Operating and finance lease right of use ("ROU") assets and lease liabilities were as follows: (In millions) September 30, 2020 December 31, 2019 Operating leases: Operating lease ROU assets $ 530 $ 536 Accrued expenses and other current liabilities $ 160 $ 166 Other non-current liabilities 461 465 Total operating lease liabilities $ 621 $ 631 Finance leases: Property and equipment, gross $ 99 $ 110 Accumulated depreciation (42) (23) Property and equipment, net $ 57 $ 87 Short-term debt $ 20 $ 27 Long-term debt 40 61 Total finance lease liabilities $ 60 $ 88

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes Income Tax Expense The 20.8% effective tax rate for the nine months ended September 30, 2020 was lower than the 22.1% rate for the same period in 2019. This decrease is primarily attributable to incremental tax benefits including the remeasurement of deferred state income taxes and the settlement of uncertain tax positions. This decrease was partially offset by return of the nondeductible health insurer tax.

Contingencies and Other Matters

Contingencies and Other Matters	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Contingencies and Other Matters	Contingencies and Other Matters The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business. A. Financial Guarantees: Retiree and Life Insurance Benefits The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of September 30, 2020, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $455 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of September 30, 2020. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy. The Company does not expect that these financial guarantees will have a material effect on the Company’s consolidated results of operations, liquidity or financial condition. B. Certain Other Guarantees The Company had indemnification obligations as of September 30, 2020 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with law or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no liabilities for these indemnification obligations as of September 30, 2020. C. Guaranty Fund Assessments The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company’s exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions. There were no material effects for existing or new guaranty fund assessments for the nine months ended September 30, 2020. D. Legal and Regulatory Matters The Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator’s filing of a complaint under court seal, and other legal matters arising, for the most part, in the ordinary course of managing a global health service business. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions. Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company’s accruals for the matters discussed below under “Litigation Matters” and “Regulatory Matters” are not material. Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if any) for these matters at this time. In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company. An adverse outcome in one or more of these matters could be material to the Company’s results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in these ongoing litigation matters or any future claims or litigation. Litigation Matters Risk Corridors and CSR Litigation with the Federal Government . As a result of a Supreme Court decision in April 2020, the Company filed suit in early May against the United States in the U.S. Court of Federal Claims seeking to recover two types of payments the Federal Government owes Cigna under the risk corridors and cost-sharing reduction (“CSR”) programs of The Patient Protection and Affordable Care Act (“ACA”). In aggregate, the complaint seeks to recover more than $315 million: $120 million in risk corridors payments and more than $195 million in CSR payments. We received $120 million in payments in September 2020, which resolved our risk corridors claim. Our claim seeking recovery for CSR payments is stayed pending resolution of a consolidated set of appeals currently before the Court of Appeals for the Federal Circuit. Cigna Litigation with Anthem . In February 2017, the Company delivered a notice to Anthem terminating the 2015 merger agreement and notifying Anthem that it must pay the Company the $1.85 billion reverse termination fee pursuant to the terms of the merger agreement. Also in February 2017, the Company filed suit against Anthem in the Delaware Court of Chancery (the “Chancery Court”) seeking declaratory judgments that the Company’s termination of the merger agreement was valid and that Anthem was not permitted to extend the termination date. The complaint also sought payment of the reverse termination fee and additional damages in an amount exceeding $13 billion, including the lost premium value to the Company’s shareholders caused by Anthem’s willful breaches of the merger agreement. Anthem countersued, alleging its own claims for damages. On February 15, 2017, the Chancery Court granted Anthem’s motion for a temporary restraining order and temporarily enjoined the Company from terminating the merger agreement. In May 2017, the Chancery Court denied Anthem’s motion for a preliminary injunction to enjoin Cigna from terminating the merger agreement but stayed its ruling pending Anthem’s determination as to whether to seek an appeal. Anthem subsequently notified Cigna and the Chancery Court that it did not intend to appeal the Chancery Court’s decision. As a result, the merger agreement was terminated. The litigation continued over the next three years. A trial was held during the first quarter of 2019, oral arguments on post-trial briefs were held on November 26, 2019, and in early 2020, supplemental post-trial briefing was completed. In August 2020, the Chancery Court i ssued an opinion finding that, although Cigna breached its contractual obligation to use reasonable best efforts to support the Anthem/Cigna merger agreement, its actions did not cause the merger to fail. The Court denied claims by both parties for damages and further denied Cigna’s claim for a reverse termination fee. The Company filed a Notice of Appeal with the Delaware Supreme Court on October 30, 2020. The Company's opening brief is due on or before December 15, 2020 with Anthem's answering brief due thirty days following the Company's brief filing. We believe in the merits of our case and intend to vigorously pursue our positions. Express Scripts Litigation with Anthem . In March 2016, Anthem filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties’ rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Anthem also requested that the court enter declaratory judgment that Express Scripts is required to provide Anthem competitive benchmark pricing, that Anthem can terminate the agreement, and that Express Scripts is required to provide Anthem with post-termination services at competitive benchmark pricing for one year following any termination by Anthem. Anthem claims it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Anthem and $150 million damages for service issues (“Anthem’s Allegations”). On April 19, 2016, in response to Anthem’s complaint, Express Scripts filed its answer denying Anthem’s Allegations in their entirety and asserting affirmative defenses and counterclaims against Anthem. The court subsequently granted Anthem’s motion to dismiss two of six counts of Express Scripts’ amended counterclaims. The current scheduling order runs through the completion of summary judgment briefing in April 2021. There is no tentative trial date. We believe in the merits of our claims and dispute Anthem’s claims, and we intend to vigorously defend ourselves and pursue our claims. Regulatory Matters Civil Investigative Demand . The U.S. Department of Justice (“DOJ”) is conducting an industry-wide investigation of Medicare Advantage organizations’ risk adjustment practices under Medicare Parts C and D including medical chart reviews and health exams. For certain other Medicare Advantage organizations, the investigation has resulted in litigation. The Company is currently responding to information requests (civil investigative demands) received from the DOJ (U.S. Attorney’s Offices for the Eastern District of Pennsylvania and the Southern District of New York ("SDNY")). Additionally, in relation to the SDNY’s pending investigation, a qui tam action that was filed by a relator in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020. The action asserts claims related to risk adjustment practices arising from certain home health assessments conducted as part of Cigna’s Medicare Advantage business. The DOJ has not intervened in the case at this time. We intend to vigorously defend ourselves against relator’s claims and will continue to cooperate with the DOJ’s investigations.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Segment Information	Segment Information See Note 1 for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy related transactions between the Evernorth and U.S. Medical segments. The Company uses “pre-tax adjusted income from operations” and “adjusted revenues” as its principal financial measures of segment operating performance because management believes they best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. Pre-tax adjusted income from operations is defined as income before taxes excluding realized investment results, amortization of acquired intangible assets, special items and, for periods prior to 2020, earnings contribution from transitioning clients Anthem Inc. and Coventry Health Care, Inc. (the “transitioning clients”). As of December 31, 2019, the transition of these clients was substantially complete; therefore, beginning in 2020, we no longer exclude results of transitioning clients from our adjusted revenues and adjusted income from operations. Income or expense amounts that are excluded from adjusted income from operations because they are not indicative of underlying performance or the responsibility of operating segment management include: • Realized investment gains (losses) including changes in market values of certain financial instruments between balance sheet dates, as well as gains and losses associated with invested asset sales. • Amortization of acquired intangible assets because these relate to costs incurred for acquisitions. • Results of transitioning clients, for periods prior to 2020, because those results were not indicative of ongoing results. • Special items, if any, that management believes are not representative of the underlying results of operations due to the nature or size of these matters. The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance. Adjusted revenues is defined as revenues excluding: 1) revenue contribution from transitioning clients for periods prior to 2020; 2) the Company’s share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting; and 3) special items, if any. The following tables present the special items recorded by the Company for the three and nine months ended September 30, 2020 and 2019. Three Months Ended (In millions) September 30, 2020 September 30, 2019 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Integration and transaction-related costs (Selling, general and administrative expenses) $ 83 $ 112 $ 88 $ 114 (Benefits) charges associated with litigation matters (Selling, general and administrative expenses) — — (23) (30) Risk corridors recovery (Selling, general and administrative expenses) $ (76) $ (101) $ — $ — Contractual adjustment for a former client (Pharmacy revenues) (89) (117) — — Total impact from special items $ (82) $ (106) $ 65 $ 84 Nine Months Ended (In millions) September 30, 2020 September 30, 2019 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Integration and transaction-related costs (Selling, general and administrative expenses) $ 256 $ 339 $ 311 $ 405 Debt extinguishment costs (Debt extinguishment costs) 151 199 — — Charge for organizational efficiency plan (Selling, general and administrative expenses) 24 31 — — (Benefits) charges associated with litigation matters (Selling, general and administrative expenses) 19 25 41 51 Risk corridors recovery (Selling, general and administrative expenses) (76) (101) — — Contractual adjustment for a former client (Pharmacy revenues) $ (155) $ (204) $ — $ — Total impact from special items $ 219 $ 289 $ 352 $ 456 Summarized segment financial information for the three and nine months ended September 30 was as follows: (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Three months ended September 30, 2020 Revenues from external customers $ 29,016 $ 9,047 $ 1,439 $ 1,156 $ — $ 40,658 Inter-segment revenues 926 478 — 6 (1,410) Net investment income 2 104 38 152 1 297 Total revenues 29,944 9,629 1,477 1,314 (1,409) 40,955 Net realized investment results from certain equity method investments — — (37) — — (37) Special item related to contractual adjustment for a former client (117) — — — — (117) Adjusted revenues $ 29,827 $ 9,629 $ 1,440 $ 1,314 $ (1,409) $ 40,801 Income (loss) before taxes $ 1,086 $ 846 $ 253 $ 97 $ (478) $ 1,804 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (5) — — (10) Net realized investment (gains) losses — 6 (48) (27) — (69) Amortization of acquired intangible assets 479 6 8 — — 493 Special items Integration and transaction-related costs — — — — 112 112 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (117) — — — — (117) Pre-tax adjusted income (loss) from operations $ 1,443 $ 757 $ 208 $ 70 $ (366) $ 2,112 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Three months ended September 30, 2019 Revenues from external customers $ 27,084 $ 8,648 $ 1,368 $ 1,107 $ — $ 38,207 Inter-segment revenues 499 376 — 7 (882) Net investment income 15 124 39 170 1 349 Total revenues 27,598 9,148 1,407 1,284 (881) 38,556 Revenue contributions from transitioning clients (2,718) — — — — (2,718) Net realized investment results from certain equity method investments — — (5) — — (5) Adjusted revenues $ 24,880 $ 9,148 $ 1,402 $ 1,284 $ (881) $ 35,833 Income (loss) before taxes $ 965 $ 1,011 $ 184 $ 159 $ (556) $ 1,763 Pre-tax adjustments to reconcile to adjusted income from operations Adjustment for transitioning clients (274) — — — — (274) (Income) attributable to noncontrolling interests — — (4) — — (4) Net realized investment (gains) losses — (43) 5 (18) — (56) Amortization of acquired intangible assets 708 15 9 2 — 734 Special items Integration and transaction-related costs — — — — 114 114 (Benefits) charges associated with litigation matters — (30) — — — (30) Pre-tax adjusted income (loss) from operations $ 1,399 $ 953 $ 194 $ 143 $ (442) $ 2,247 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Nine months ended September 30, 2020 Revenues from external customers $ 82,986 $ 26,999 $ 4,325 $ 3,506 $ — $ 117,816 Inter-segment revenues 2,785 1,448 — 17 (4,250) — Net investment income 30 279 104 458 2 873 Total revenues 85,801 28,726 4,429 3,981 (4,248) 118,689 Net realized investment results from certain equity method investments — — (87) — — (87) Special item related to contractual adjustment for a former client (204) — — — — (204) Adjusted revenues $ 85,597 $ 28,726 $ 4,342 $ 3,981 $ (4,248) $ 118,398 Income (loss) before taxes $ 2,551 $ 3,529 $ 877 $ 298 $ (1,765) $ 5,490 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (12) — (15) — — (27) Net realized investment (gains) losses — 28 (75) (22) — (69) Amortization of acquired intangible assets 1,439 23 22 3 — 1,487 Special items Integration and transaction-related costs — — — — 339 339 Debt extinguishment costs — — — — 199 199 Charge for organizational efficiency plan — — — — 31 31 (Benefits) charges associated with litigation matters — — — — 25 25 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (204) — — — — (204) Pre-tax adjusted income (loss) from operations $ 3,774 $ 3,479 $ 809 $ 279 $ (1,171) $ 7,170 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Nine months ended September 30, 2019 Revenues from external customers $ 80,618 $ 26,226 $ 4,095 $ 3,347 $ — $ 114,286 Inter-segment revenues 1,869 727 — 21 (2,617) Net investment income (loss) 47 358 117 521 (8) 1,035 Total revenues 82,534 27,311 4,212 3,889 (2,625) 115,321 Revenue contribution from transitioning clients (11,657) — — — — (11,657) Net realized investment results from certain equity method investments — — (27) — — (27) Adjusted revenues $ 70,877 $ 27,311 $ 4,185 $ 3,889 $ (2,625) $ 103,637 Income (loss) before taxes $ 3,015 $ 3,157 $ 601 $ 407 $ (1,871) $ 5,309 Pre-tax adjustments to reconcile to adjusted income from operations Adjustment for transitioning clients (1,589) — — — — (1,589) (Income) attributable to noncontrolling interests (1) — (12) — — (13) Net realized investment (gains) losses — (65) (10) (36) — (111) Amortization of acquired intangible assets 2,130 51 28 5 — 2,214 Special items Integration and transaction-related costs — — — — 405 405 (Benefits) charges associated with litigation matters — (30) — — 81 51 Pre-tax adjusted income (loss) from operations $ 3,555 $ 3,113 $ 607 $ 376 $ (1,385) $ 6,266 Revenue from external customers includes pharmacy revenues, premiums and fees and other revenues. The following table presents these revenues by product, premium and service type for the three and nine months ended September 30: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Products (Pharmacy revenues) (ASC 606) Network revenues $ 13,968 $ 12,923 $ 39,200 $ 37,954 Home delivery and specialty revenues 12,422 11,837 36,319 35,893 Other 1,412 1,227 3,945 3,607 Total pharmacy revenues 27,802 25,987 79,464 77,454 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,397 3,174 9,948 9,278 Stop loss 1,146 1,085 3,459 3,221 Other 281 260 853 779 U.S. Government Medicare Advantage 1,895 1,562 5,680 4,779 Medicare Part D 360 404 1,242 1,329 Other 1,117 1,059 3,246 3,137 Total U.S. Medical premiums 8,196 7,544 24,428 22,523 International Markets premiums 1,360 1,309 4,079 3,914 Domestic disability, life and accident premiums 1,106 1,049 3,346 3,165 Other premiums 20 33 75 107 Total premiums 10,682 9,935 31,928 29,709 Services (ASC 606) Fees 2,120 2,249 6,253 7,015 Other external revenues 54 36 171 108 Total services 2,174 2,285 6,424 7,123 Total revenues from external customers $ 40,658 $ 38,207 $ 117,816 $ 114,286 Evernorth may provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet these guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted at the end of the guarantee period. Historically, adjustments to original estimates have not been material. The performance guarantee liability was $1.0 billion as of September 30, 2020 and December 31, 2019.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The Consolidated Financial Statements include the accounts of Cigna Corporation and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”). Amounts recorded in the Consolidated Financial Statements necessarily reflect management’s estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment. These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2019 Annual Report on Form 10-K (“2019 Form 10-K”). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, competitive and other market conditions, as well as COVID-19 related impacts, call for caution in estimating full-year results based on interim results of operations.
Recent Accounting Pronouncements, Recently Adopted Accounting Guidance and Accounting Guidance Not Yet Adopted	Recent Accounting Pronouncements The Company's 2019 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted our financial statements or may impact them in the future. The following information provides updates on recently adopted or recently issued accounting pronouncements that have occurred since the Company filed its 2019 Form 10-K. Recently Adopted Accounting Guidance Accounting Standard and Adoption Date Requirements and Effects of Adopting New Guidance Measurement of Credit Losses on Financial Instruments (Accounting Standards Update (ASU) 2016-13 and related amendments) Requires: • A new approach using expected credit losses to estimate and recognize credit losses for certain financial instruments (such as mortgage loans, reinsurance recoverables and other receivables) when such instruments are first originated or acquired, and in each subsequent reporting period, compared with the incurred loss model previously followed under GAAP. At adoption, the Company recorded an allowance for estimated credit losses and subsequent changes in the allowance will be reported in current period earnings. • Changes in the criteria for impairment of available-for-sale debt securities Effects of adoption: • Adopted using a modified retrospective approach • Cumulative effect adjustment of $30 million after-tax was recorded as a reduction to retained earnings as of January 1, 2020, reflecting an additional allowance for future expected credit losses required under the new model, primarily related to reinsurance recoverables. • See additional information regarding the Company’s accounting policy for establishing the allowance for credit losses in Note 4, Accounts Receivable, Net, Note 10, Reinsurance, and Note 11, Investments. Simplifying the Test for Goodwill Impairment (ASU 2017-04) Requires: • A simplified approach to the accounting for goodwill impairment by eliminating the need to determine the fair value of individual assets and liabilities of a reporting unit to measure a goodwill impairment • The amount of goodwill impairment to equal the amount by which a reporting unit’s carrying value exceeds its fair value, limited to the total amount of goodwill of the reporting unit Effects of adoption: • Adopted on a prospective basis • There was no impact of adopting this new standard to the Company’s financial statements because our quarterly qualitative assessments did not result in a triggering event for impairment of goodwill, and the results of our annual quantitative evaluation performed in the third quarter of 2020 indicated that the estimated fair value of each of our reporting units exceeded their carrying values by significant margins. Accounting Guidance Not Yet Adopted Accounting Standard and Effective Date Requirements and Expected Effects of New Guidance Not Yet Adopted Facilitation of the Effects of Reference Rate Reform on Financial Reporting (ASU 2020-04) Optional, effective upon issuance (March 12, 2020) through December 31, 2022 Guidance: • Provides temporary optional relief to ease the potential burden of accounting for reference rate reform under existing GAAP. Amendments are elective and apply to all entities that have contracts, hedging relationships and other transactions that reference interbank offered rates, including LIBOR, expected to be discontinued by December 31, 2021. • Permits optional expedients and exceptions to simplify the accounting for contract modifications, hedging arrangements and held-to-maturity investments, when certain changes are made to a contract or instrument to facilitate reference rate reform. • An entity may elect to apply the amendments, by topic or subsection, at any point prospectively through December 31, 2022. When elected, the optional expedients must be applied consistently for all eligible contracts or transactions. Expected effects: • To date, the Company has identified minimal exposure to LIBOR and does not anticipate that LIBOR’s phase-out will have a material impact on its operations or financial results. The Financial Accounting Standards Board voted to propose the deferral of the effective date of ASU 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts
Allowance for Credit Losses	The Company's accounts receivable balances primarily include amounts due from clients, third-party payors, customers and pharmaceutical manufacturers, and are presented net of allowances. The Company's adoption of ASU 2016-13, Measurement of Credit Losses on Financial Instruments (ASU 2016-13), as of January 1, 2020 did not have a material impact on our accounts receivable credit loss allowance, as there were no substantive changes to our methodology for this class of assets. The allowance for expected credit losses for current accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due; however, when available evidence reasonably supports an assumption that counterparty credit risk over the expected payment period will differ from current and historical payment collections, a forecasting adjustment is reflected in the allowance for expected credit losses. manufacturer receivables generally results in an allowance for balances outstanding greater than 90 days. Contractual allowances for certain receivables from third-party payors are based on their contractual terms and are estimates based on the Company's best information available at the time revenue is recognized. Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.
Unpaid Claims and Claims Expenses	Unpaid Claims and Claim Expenses – U.S. MedicalThis liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process), and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.
Reinsurance	Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset.Accounting policy. Reinsurance recoverables represent amounts due from reinsurers for both paid and unpaid claims of the Company’s insurance businesses. Most reinsurance recoverables are classified as non-current assets. The current portion of reinsurance recoverables is reported in Other current assets and consists primarily of recoverables on paid claims expected to be settled within one year. Reinsurance recoverables are presented net of allowances for uncollectible reinsurance that, effective with adopting ASU 2016-13 on January 1, 2020, consists primarily of an allowance for expected credit losses. Estimates of the allowance for expected credit losses are based on internal and external data used to develop expected loss rates over the anticipated duration of the recoverable asset that vary by external credit rating and collateral level. Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral’s fair value. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables, as further described above.GMDB is accounted for as assumed and ceded reinsurance and GMIB assets and liabilities are reported as derivatives at fair value as discussed below. GMIB assets are reported in Other current assets and Other assets, and GMIB liabilities are reported in Accrued expenses and other liabilities and Other non-current liabilities. GMIB The Company reinsured contracts with issuers of GMIB products. The Company’s exposure represents the excess of a contractually guaranteed amount over the level of variable annuity account values. Payment by the Company depends on the actual account value in the related underlying mutual funds and the level of interest rates when the contractholders elect to receive minimum income payments that can only occur within 30 days of a policy anniversary after the appropriate waiting period. The Company has purchased retrocessional coverage (“GMIB assets”) for these contracts including retrocessional coverage from Berkshire. Assumptions used in fair value measurement . GMIB assets and liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse, and annuity election rates). The Company classifies GMIB assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 because assumptions related to future annuitant behavior are largely unobservable.
Contractholder Deposit Funds	The majority of the liability for unpaid claims and claim expenses is related to disability claims with long-tailed payouts that relate to a business held for sale. Interest earned on assets backing these liabilities is an integral part of pricing and reserving. Therefore, interest accreted on prior year balances is shown as a separate component of prior year incurred claims and reported in Medical costs and other benefit expenses in the income statement. This interest is calculated by applying the average discount rate used in determining the liability balance to the average liability balance over the period. The remaining prior year incurred claims amount primarily reflects updates to the Company’s liability estimates and variances between actual experience during the period relative to the assumptions and expectations reflected in determining the liability. Assumptions reflect the Company’s expectations over the life of the book of business and will vary from actual experience in any period, both favorably and unfavorably, with variation in resolution rates being the most significant driver for the long-term disability business.
Investments	Debt Securities Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive income (loss) within Shareholders’ equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company’s run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive income (loss). When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Realized investment gains and losses. As of January 1, 2020, the Company adopted ASU 2016-13 that included certain targeted improvements to the accounting for available-for-sale debt securities. The new guidance resulted in certain policy changes related to the process used by the Company to review declines in fair value from a security’s amortized cost basis to determine whether a credit loss exists. For example, the length of time that a debt security has been impaired is no longer a criterion for this review. In addition, under this new guidance, the Company recognizes an allowance for credit loss with a corresponding charge to credit loss expense, presented in Realized investment gains and losses in the Company’s income statement. Prior to this new guidance, the Company recorded a direct write-down of the instrument’s amortized cost basis. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default, and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted through credit loss expense. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with prior practice, when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income, and interest income is recognized on a cash basis. Debt securities are classified as either Current or Long-term investments based on their contractual maturities. Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include: • severity of decline; • financial health and specific prospects of the issuer; and • changes in the regulatory, economic or general market environment of the issuer’s industry or geographic region. Accounting policy. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with our prior practice, accrued interest, reported in other current assets, is written off through a charge to net investment income; interest income on impaired loans is only recognized when a payment is received. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral. Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties. Commercial mortgage loans are classified as either current or long-term investments based on their contractual maturities. Credit quality . The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis. Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan. Other Long-Term Investments Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments. Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities, and changes in valuation reserves on commercial mortgage loans. Commencing January 1, 2020, realized gains and losses also The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contract holder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company’s separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders. Derivative instruments used by the Company typically include foreign currency swap contracts and foreign currency forward contracts. Foreign currency swap contracts periodically exchange cash flows between two currencies for principal and interest. Foreign currency forward contracts require the Company to purchase a foreign currency in exchange for the functional currency of its operating unit at a future date. The Company’s derivative financial instruments are presented as follows: • Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds : Swap fair values are reported in Long-term investments or Other non-current liabilities. Changes in fair values attributable to foreign exchange risk of the swap contracts and the hedged bonds are reported in Realized investment gains and losses. The portion of the swap contracts’ changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities. • Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar : The fair values of the foreign currency swap and forward contracts are reported in Other assets or Other liabilities. The changes in fair values of these instruments are reported in Other comprehensive income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are excluded from our effectiveness assessment and recognized in interest expense when coupon payments are accrued or ratably over the term of the instrument. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Cash flows relating to these contracts are reported in Investing activities. • Economic hedges for derivatives not designated as accounting hedges : Fair values of forward contracts are reported in current Investments or Accrued expenses and other liabilities. The changes in fair values are reported in Realized investment gains and losses. Cash flows relating to these contracts are reported in Investing activities.
Fair Value Measurements	The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value. Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability’s fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor. The Company’s financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset’s or a liability’s classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument’s fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3). The Company estimates fair values using prices from third parties or internal pricing methods. Fair value estimates received from third-party pricing services are based on reported trade activity and quoted market prices when available, and other market information that a market participant would use to estimate fair value. The internal pricing methods are performed by the Company’s investment professionals and generally involve using discounted cash flow analyses, incorporating current market inputs for similar financial instruments with comparable terms and credit quality as well as other qualitative factors. In instances where there is little or no market activity for the same or similar instruments, fair value is estimated using methods, models and assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. These valuation techniques involve some level of estimation and judgment that becomes significant with increasingly complex instruments or pricing models. The Company is responsible for determining fair value and for assigning the appropriate level within the fair value hierarchy based on the significance of unobservable inputs. The Company reviews methodologies, processes and controls of third-party pricing services and compares prices on a test basis to those obtained from other external pricing sources or internal estimates. The Company performs ongoing analyses of both prices received from third-party pricing services and those developed internally to determine that they represent appropriate estimates of fair value. The controls executed by the Company include evaluating changes in prices and monitoring for potentially stale valuations. The Company also performs sample testing of sales values to confirm the accuracy of prior fair value estimates. The minimal exceptions identified during these processes indicate that adjustments to prices are infrequent and do not significantly impact valuations. An annual due-diligence review of the most significant pricing Level 1 Financial Assets Inputs for instruments classified in Level 1 include unadjusted quoted prices for identical assets in active markets accessible at the measurement date. Active markets provide pricing data for trades occurring at least weekly and include exchanges and dealer markets. Assets in Level 1 include actively-traded U.S. government bonds and exchange-listed equity securities. A relatively small portion of the Company’s investment assets are classified in this category given the narrow definition of Level 1 and the Company’s investment asset strategy to maximize investment returns. Level 2 Financial Assets and Financial Liabilities Inputs for instruments classified in Level 2 include quoted prices for similar assets or liabilities in active markets, quoted prices from those willing to trade in markets that are not active or other inputs that are market observable or can be corroborated by market data for the term of the instrument. Such other inputs include market interest rates and volatilities, spreads and yield curves. An instrument is classified in Level 2 if the Company determines that unobservable inputs are insignificant. Debt and equity securities . Approximately 95% of the Company’s investments in debt and equity securities are classified in Level 2 including most public and private corporate debt and hybrid equity securities, federal agency and municipal bonds, non-government mortgage-backed securities and preferred stocks. Third-party pricing services and internal methods often use recent trades of securities with similar features and characteristics because many debt securities do not trade daily. Pricing models are used to determine these prices when recent trades are not available. These models calculate fair values by discounting future cash flows at estimated market interest rates. Such market rates are derived by calculating the appropriate spreads over comparable U.S. Treasury securities based on the credit quality, industry and structure of the asset. Typical inputs and assumptions to pricing models include, but are not limited to, a combination of benchmark yields, reported trades, issuer spreads, liquidity, benchmark securities, bids, offers, reference data and industry and economic events. For mortgage-backed securities, inputs and assumptions may also include characteristics of the issuer, collateral attributes, prepayment speeds and credit rating. Nearly all of these instruments are valued using recent trades or pricing models. Less than 1% of the fair value of investments classified in Level 2 represents foreign bonds that are valued using a single, unadjusted market-observable input derived by averaging multiple broker-dealer quotes, consistent with local market practice. Short-term investments are carried at fair value that approximates cost. The Company compares market prices for these securities to recorded amounts on a regular basis to validate that current carrying amounts approximate exit prices. The short-term nature of the investments and corroboration of the reported amounts over the holding period support their classification in Level 2. Derivative assets and liabilities classified in Level 2 represent over-the-counter instruments such as foreign currency forward and swap contracts. Fair values for these instruments are determined using market observable inputs including forward currency and interest rate curves and widely published market observable indices. Credit risk related to the counterparty and the Company is considered when estimating the fair values of these derivatives. However, the Company is largely protected by collateral arrangements with counterparties and determined that no adjustments for credit risk were required as of September 30, 2020 or December 31, 2019. The nature and use of these derivative financial instruments are described in Note 11. Level 3 Financial Assets and Financial Liabilities Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company’s best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date. The Company classifies certain newly-issued, privately-placed, complex or illiquid securities in Level 3. Approximately 4% of debt and equity securities are priced using significant unobservable inputs and classified in this category. Corporate and government debt securities. The significant unobservable input used to value the following corporate and government debt securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security. Mortgage and other asset-backed securities. The significant unobservable inputs used to value the following mortgage and other asset-backed securities are liquidity and weighting of credit spreads. An adjustment for liquidity is made as of the measurement date that considers current market conditions, issuer circumstances and complexity of the security structure when there is limited trading activity for the security. An adjustment to weight credit spreads is needed to value a more complex bond structure with multiple underlying collateral and no standard market valuation technique. The weighting of credit spreads is primarily based on the underlying collateral’s characteristics and their proportional cash flows supporting the bond obligations. Total gains and losses included in Shareholders’ net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment gains (losses) and Net investment income. Gains and losses included in Other comprehensive income in the tables above are reflected in Net unrealized appreciation (depreciation) on securities in the Consolidated Statements of Comprehensive Income. Separate account assets classified as Level 1 primarily include exchange-listed equity securities. Level 2 assets primarily include: • corporate and structured bonds valued using recent trades of similar securities or pricing models that discount future cash flows at estimated market interest rates as described above; and • actively-traded institutional and retail mutual fund investments. Separate account assets classified in Level 3 primarily support Cigna’s pension plans and include certain newly-issued, privately-placed, complex, or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three and nine months ended September 30, 2020 and 2019.
Separate Accounts	The investment income and fair value gains and losses of separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company’s Consolidated Statements of Income and Cash Flows.
Variable Interest Entities	When the Company becomes involved with a variable interest entity and when there is a change in the Company’s involvement with an entity, the Company must determine if it is the primary beneficiary and must consolidate the entity. The Company is considered the primary beneficiary if it has the power to direct the entity’s most significant economic activities and has the right to receive benefits or obligation to absorb losses that could be significant to the entity. The Company evaluates the following criteria: • the structure and purpose of the entity; • the risks and rewards created by, and shared through, the entity; and • the Company’s ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity including its sponsors, equity holders, guarantors, creditors and servicers.
AOCI	AOCI includes unrealized appreciation on securities and derivatives (excluding appreciation on investments supporting future policy benefit liabilities of the run-off settlement annuity business) (See Note 11), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company’s share from unconsolidated entities reported on the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to net income in the same period that the related pre-tax AOCI reclassifications are recognized.
Commitment and Contingencies	For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated.
Segment Information	A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy related transactions between the Evernorth and U.S. Medical segments. The Company uses “pre-tax adjusted income from operations” and “adjusted revenues” as its principal financial measures of segment operating performance because management believes they best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. Pre-tax adjusted income from operations is defined as income before taxes excluding realized investment results, amortization of acquired intangible assets, special items and, for periods prior to 2020, earnings contribution from transitioning clients Anthem Inc. and Coventry Health Care, Inc. (the “transitioning clients”). As of December 31, 2019, the transition of these clients was substantially complete; therefore, beginning in 2020, we no longer exclude results of transitioning clients from our adjusted revenues and adjusted income from operations. Income or expense amounts that are excluded from adjusted income from operations because they are not indicative of underlying performance or the responsibility of operating segment management include: • Realized investment gains (losses) including changes in market values of certain financial instruments between balance sheet dates, as well as gains and losses associated with invested asset sales. • Amortization of acquired intangible assets because these relate to costs incurred for acquisitions. • Results of transitioning clients, for periods prior to 2020, because those results were not indicative of ongoing results. • Special items, if any, that management believes are not representative of the underlying results of operations due to the nature or size of these matters. The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance. Adjusted revenues is defined as revenues excluding: 1) revenue contribution from transitioning clients for periods prior to 2020; 2) the Company’s share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting; and 3) special items, if any.

Investments, Debt and Equity Se

Investments, Debt and Equity Securities (Policies)	9 Months Ended
	Sep. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Investments	Debt Securities Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive income (loss) within Shareholders’ equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company’s run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive income (loss). When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Realized investment gains and losses. As of January 1, 2020, the Company adopted ASU 2016-13 that included certain targeted improvements to the accounting for available-for-sale debt securities. The new guidance resulted in certain policy changes related to the process used by the Company to review declines in fair value from a security’s amortized cost basis to determine whether a credit loss exists. For example, the length of time that a debt security has been impaired is no longer a criterion for this review. In addition, under this new guidance, the Company recognizes an allowance for credit loss with a corresponding charge to credit loss expense, presented in Realized investment gains and losses in the Company’s income statement. Prior to this new guidance, the Company recorded a direct write-down of the instrument’s amortized cost basis. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default, and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted through credit loss expense. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with prior practice, when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income, and interest income is recognized on a cash basis. Debt securities are classified as either Current or Long-term investments based on their contractual maturities. Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include: • severity of decline; • financial health and specific prospects of the issuer; and • changes in the regulatory, economic or general market environment of the issuer’s industry or geographic region. Accounting policy. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. The Company elected the expedient to not measure an allowance for credit losses for accrued interest receivables. Consistent with our prior practice, accrued interest, reported in other current assets, is written off through a charge to net investment income; interest income on impaired loans is only recognized when a payment is received. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral. Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties. Commercial mortgage loans are classified as either current or long-term investments based on their contractual maturities. Credit quality . The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis. Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan. Other Long-Term Investments Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments. Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities, and changes in valuation reserves on commercial mortgage loans. Commencing January 1, 2020, realized gains and losses also The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contract holder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company’s separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders. Derivative instruments used by the Company typically include foreign currency swap contracts and foreign currency forward contracts. Foreign currency swap contracts periodically exchange cash flows between two currencies for principal and interest. Foreign currency forward contracts require the Company to purchase a foreign currency in exchange for the functional currency of its operating unit at a future date. The Company’s derivative financial instruments are presented as follows: • Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds : Swap fair values are reported in Long-term investments or Other non-current liabilities. Changes in fair values attributable to foreign exchange risk of the swap contracts and the hedged bonds are reported in Realized investment gains and losses. The portion of the swap contracts’ changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities. • Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar : The fair values of the foreign currency swap and forward contracts are reported in Other assets or Other liabilities. The changes in fair values of these instruments are reported in Other comprehensive income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are excluded from our effectiveness assessment and recognized in interest expense when coupon payments are accrued or ratably over the term of the instrument. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Cash flows relating to these contracts are reported in Investing activities. • Economic hedges for derivatives not designated as accounting hedges : Fair values of forward contracts are reported in current Investments or Accrued expenses and other liabilities. The changes in fair values are reported in Realized investment gains and losses. Cash flows relating to these contracts are reported in Investing activities.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Requirements and Expected Effects of New Guidance Adopted and Not Yet Adopted	Recently Adopted Accounting Guidance Accounting Standard and Adoption Date Requirements and Effects of Adopting New Guidance Measurement of Credit Losses on Financial Instruments (Accounting Standards Update (ASU) 2016-13 and related amendments) Requires: • A new approach using expected credit losses to estimate and recognize credit losses for certain financial instruments (such as mortgage loans, reinsurance recoverables and other receivables) when such instruments are first originated or acquired, and in each subsequent reporting period, compared with the incurred loss model previously followed under GAAP. At adoption, the Company recorded an allowance for estimated credit losses and subsequent changes in the allowance will be reported in current period earnings. • Changes in the criteria for impairment of available-for-sale debt securities Effects of adoption: • Adopted using a modified retrospective approach • Cumulative effect adjustment of $30 million after-tax was recorded as a reduction to retained earnings as of January 1, 2020, reflecting an additional allowance for future expected credit losses required under the new model, primarily related to reinsurance recoverables. • See additional information regarding the Company’s accounting policy for establishing the allowance for credit losses in Note 4, Accounts Receivable, Net, Note 10, Reinsurance, and Note 11, Investments. Simplifying the Test for Goodwill Impairment (ASU 2017-04) Requires: • A simplified approach to the accounting for goodwill impairment by eliminating the need to determine the fair value of individual assets and liabilities of a reporting unit to measure a goodwill impairment • The amount of goodwill impairment to equal the amount by which a reporting unit’s carrying value exceeds its fair value, limited to the total amount of goodwill of the reporting unit Effects of adoption: • Adopted on a prospective basis • There was no impact of adopting this new standard to the Company’s financial statements because our quarterly qualitative assessments did not result in a triggering event for impairment of goodwill, and the results of our annual quantitative evaluation performed in the third quarter of 2020 indicated that the estimated fair value of each of our reporting units exceeded their carrying values by significant margins. Accounting Guidance Not Yet Adopted Accounting Standard and Effective Date Requirements and Expected Effects of New Guidance Not Yet Adopted Facilitation of the Effects of Reference Rate Reform on Financial Reporting (ASU 2020-04) Optional, effective upon issuance (March 12, 2020) through December 31, 2022 Guidance: • Provides temporary optional relief to ease the potential burden of accounting for reference rate reform under existing GAAP. Amendments are elective and apply to all entities that have contracts, hedging relationships and other transactions that reference interbank offered rates, including LIBOR, expected to be discontinued by December 31, 2021. • Permits optional expedients and exceptions to simplify the accounting for contract modifications, hedging arrangements and held-to-maturity investments, when certain changes are made to a contract or instrument to facilitate reference rate reform. • An entity may elect to apply the amendments, by topic or subsection, at any point prospectively through December 31, 2022. When elected, the optional expedients must be applied consistently for all eligible contracts or transactions. Expected effects: • To date, the Company has identified minimal exposure to LIBOR and does not anticipate that LIBOR’s phase-out will have a material impact on its operations or financial results.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Accounts Receivable, Net	The following amounts were included within accounts receivable, net: (In millions) September 30, 2020 December 31, 2019 Noninsurance customer receivables $ 5,688 $ 5,143 Pharmaceutical manufacturers receivable 5,433 3,439 Insurance customer receivables 2,575 2,321 Other receivables 368 334 Total 14,064 11,237 Accounts receivable, net classified as assets of business held for sale (576) (521) Accounts receivable, net per Consolidated Balance Sheets $ 13,488 $ 10,716

Assets and Liabilities of Bus_2

Assets and Liabilities of Business Held for Sale (Tables)	9 Months Ended
	Sep. 30, 2020
Discontinued Operations and Disposal Groups [Abstract]
Assets and Liabilities Held for Sale	The assets and liabilities of business held for sale were as follows: (In millions) September 30, 2020 December 31, 2019 Cash and cash equivalents $ 798 $ 743 Accounts receivable, net 576 521 Investments 8,258 7,709 Other assets 390 539 Total assets of business held for sale 10,022 9,512 Insurance and contractholder liabilities 6,591 6,308 Other liabilities 604 504 Total liabilities of business held for sale $ 7,195 $ 6,812

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Computation of Basic and Diluted Earnings Per Share	Basic and diluted earnings per share were computed as follows: Three Months Ended September 30, 2020 September 30, 2019 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Dilution Diluted Basic Effect of Dilution Diluted Shareholders’ net income $ 1,388 $ 1,388 $ 1,351 $ 1,351 Shares: Weighted average 364,427 364,427 374,842 374,842 Common stock equivalents 2,763 2,763 3,479 3,479 Total shares 364,427 2,763 367,190 374,842 3,479 378,321 EPS $ 3.81 $ (0.03) $ 3.78 $ 3.60 $ (0.03) $ 3.57 Nine Months Ended September 30, 2020 September 30, 2019 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 4,323 $ 4,323 $ 4,127 $ 4,127 Shares: Weighted average 367,410 367,410 377,381 377,381 Common stock equivalents 3,421 3,421 3,710 3,710 Total shares 367,410 3,421 370,831 377,381 3,710 381,091 EPS $ 11.77 $ (0.11) $ 11.66 $ 10.94 $ (0.11) $ 10.83
Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share	The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Anti-dilutive options 4.6 3.6 4.2 3.9

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Outstanding Amounts of Debt and Finance Leases	The outstanding amounts of debt and finance leases were as follows: (In millions) September 30, 2020 December 31, 2019 Short-term debt $1,000 million, Floating Rate Notes due 3/2020 $ — $ 999 $300 million, 5.125% Notes due 6/2020 — 300 $1,750 million, 3.2% Notes due 9/2020 — 1,748 $349 million, 4.125% Notes due 9/2020 — 351 $500 million, 2.6% Notes due 11/2020 500 496 $400 million, Floating Rate Notes due 11/2020 400 400 $250 million, 4.375% Notes due 12/2020 250 249 $1,400 million, Floating Rate Term Loan due 3/2021 1,399 — $78 million, 6.37% Notes due 6/2021 78 — $1,000 million, Floating Rate Notes due 9/2021 999 — $1,250 million, 3.4% Notes due 9/2021 1,248 — Commercial paper 1,555 944 Other, including finance leases 20 27 Total short-term debt $ 6,449 $ 5,514 Long-term debt $500 million, 3.3% Notes due 2021 $ — $ 499 $300 million, 4.5% Notes due 2021 — 298 $78 million, 6.37% Notes due 2021 — 78 $1,000 million, Floating Rate Notes due 2021 — 998 $1,250 million, 3.4% Notes due 2021 — 1,247 $1,248 million, 4.75% Notes due 2021 — 1,272 $277 million, 4% Notes due 2022 276 747 $973 million, 3.9% Notes due 2022 972 999 $500 million, 3.05% Notes due 2022 489 485 $17 million, 8.3% Notes due 2023 17 17 $63 million, 7.65% Notes due 2023 63 100 $700 million, Floating Rate Notes due 2023 698 698 $1,000 million, 3% Notes due 2023 973 966 $2,187 million, 3.75% Notes due 2023 2,180 3,088 $1,000 million, 3.5% Notes due 2024 976 970 $900 million, 3.25% Notes due 2025 896 895 $2,200 million, 4.125% Notes due 2025 2,189 2,188 $1,500 million, 4.5% Notes due 2026 1,505 1,506 $1,500 million, 3.4% Notes due 2027 1,406 1,396 $259 million, 7.875% Debentures due 2027 259 259 $600 million, 3.05% Notes due 2027 595 595 $3,800 million, 4.375% Notes due 2028 3,779 3,776 $1,500 million, 2.4% Notes due 2030 1,489 — $45 million, 8.3% Step Down Notes due 2033 45 45 $190 million, 6.15% Notes due 2036 190 190 $2,200 million, 4.8% Notes due 2038 2,180 2,178 $750 million, 3.2% Notes due 2040 742 — $121 million, 5.875% Notes due 2041 119 119 $448 million, 6.125% Notes due 2041 490 491 $317 million, 5.375% Notes due 2042 315 315 $1,500 million, 4.8% Notes due 2046 1,465 1,465 $1,000 million, 3.875% Notes due 2047 988 988 $3,000 million, 4.9% Notes due 2048 2,966 2,964 $1,250 million, 3.4% Notes due 2050 1,235 — Other, including finance leases 40 61 Total long-term debt $ 29,537 $ 31,893
Summary of Debt Issuances	Principal Maturity Date Interest Rate Net Proceeds $1,500 million March 15, 2030 2.40% $1,491 million $750 million March 15, 2040 3.20% $743 million $1,250 million March 15, 2050 3.40% $1,237 million

Insurance and Contractholder _2

Insurance and Contractholder Liabilities (Tables)	9 Months Ended
	Sep. 30, 2020
Insurance Loss Reserves [Abstract]
Summary of Insurance and Contractholder Liabilities, Activity in the Unpaid Claims Liability and Liability Details for Unpaid Claims and Claim Expenses	As of September 30, 2020, December 31, 2019 and September 30, 2019, the Company’s insurance and contractholder liabilities were comprised of the following: September 30, 2020 December 31, 2019 September 30, 2019 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 624 $ 7,038 $ 7,662 $ 600 $ 7,139 $ 7,739 $ 7,789 Future policy benefits 597 9,505 10,102 553 9,281 9,834 9,808 Unpaid claims and claim expenses U.S. Medical 3,182 18 3,200 2,875 17 2,892 3,061 Other segments 2,521 3,714 6,235 2,529 3,474 6,003 5,857 Unearned premiums 449 379 828 453 360 813 755 Total 7,373 20,654 28,027 7,010 20,271 27,281 27,270 Insurance and contractholder liabilities classified as liabilities of business held for sale (1) (2,150) (4,441) (6,591) (2,089) (4,219) (6,308) Total insurance and contractholder liabilities $ 5,223 $ 16,213 $ 21,436 $ 4,921 $ 16,052 $ 20,973 $ 27,270 (1) Amounts classified as Liabilities of business held for sale primarily include $5.2 billion of unpaid claims, $759 million of contractholder deposit funds and $646 million of future policy benefits as of September 30, 2020 and $4.9 billion of unpaid claims, $717 million of contractholder deposit funds and $653 million of future policy benefits as of December 31, 2019. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the nine months ended September 30 was as follows: Nine Months Ended (In millions) September 30, 2020 September 30, 2019 Beginning balance $ 2,892 $ 2,697 Less: Reinsurance and other amounts recoverable 303 264 Beginning balance, net 2,589 2,433 Incurred costs related to: Current year 18,935 18,169 Prior years (126) (159) Total incurred 18,809 18,010 Paid costs related to: Current year 16,061 15,555 Prior years 2,363 2,160 Total paid 18,424 17,715 Ending balance, net 2,974 2,728 Add: Reinsurance and other amounts recoverable 226 333 Ending balance $ 3,200 $ 3,061 (In millions) September 30, 2020 (1) September 30, 2019 Group Disability and Other Group Disability and Life $ 5,206 $ 4,887 Other Operations 162 189 Total Group Disability and Other 5,368 5,076 International Markets 867 781 Unpaid claims and claim expenses Group Disability and Other and International Markets $ 6,235 $ 5,857 (1) Includes unpaid claim amounts classified as Liabilities of business held for sale. Activity in the Company’s liabilities for unpaid claims and claim expenses, excluding Other Operations, are presented in the following table. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been fully reinsured. Nine Months Ended (In millions) September 30, 2020 (1) September 30, 2019 Beginning balance $ 5,816 $ 5,432 Less: Reinsurance 184 156 Beginning balance, net 5,632 5,276 Incurred claims related to: Current year 4,277 4,205 Prior years: Interest accretion 118 117 All other incurred (12) (59) Total incurred 4,383 4,263 Paid claims related to: Current year 2,435 2,422 Prior years 1,702 1,594 Total paid 4,137 4,016 Foreign currency 5 (26) Ending balance, net 5,883 5,497 Add: Reinsurance 190 171 Ending balance $ 6,073 $ 5,668
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses	Variances in incurred costs related to prior years’ unpaid claims and claims expenses that resulted from the differences between actual experience and the Company’s key assumptions for the nine months ended September 30 were as follows: Nine Months Ended (Dollars in millions) September 30, 2020 September 30, 2019 $ % (1) $ % (2) Actual completion factors $ 47 0.2 % $ 87 0.4 % Medical cost trend 79 0.3 72 0.3 Total favorable variance $ 126 0.5 % $ 159 0.7 % (1) Percentage of current year incurred costs as reported for the year ended December 31, 2019. (2) Percentage of current year incurred costs as reported for the year ended December 31, 2018.

Reinsurance (Tables)

Reinsurance (Tables)	9 Months Ended
	Sep. 30, 2020
Effects of Reinsurance [Line Items]
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level	The Company’s reinsurance recoverables are presented in the following table by range of external credit rating and collateral level. (Dollars in millions) Fair value of collateral contractually required to meet or exceed carrying value of recoverable Collateral provisions exist that may mitigate risk of credit loss (3) No collateral Total Ongoing Operations Upper-medium grade and higher (1) $ — $ 8 $ 326 $ 334 Lower-medium grade (2) — — 63 63 Not rated 90 14 29 133 Total recoverables related to ongoing operations (3) $ 90 $ 22 $ 418 $ 530 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 3,049 — 3,049 Berkshire 318 476 — 794 Prudential Retirement Insurance and Annuity 641 — — 641 Other 237 21 17 275 Not rated — 38 4 42 Total recoverables related to acquisition, disposition or runoff activities 1,196 3,584 21 4,801 Total $ 1,286 $ 3,606 $ 439 $ 5,331 Allowance for uncollectible reinsurance (34) Reinsurance recoverables classified as assets of business held for sale (190) Total reinsurance recoverables $ 5,107 (1) Includes A- equivalent and higher current ratings certified by a nationally recognized statistical rating organization ('NRSRO') (2) Includes BBB- to BBB+ equivalent current credit ratings certified by a NRSRO (3) This includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level
Effects of Reinsurance	In the Company’s Consolidated Statements of Income, premiums were reported net of amounts ceded to reinsurers and medical costs and other benefit expenses were reported net of reinsurance recoveries in the following amounts: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Total ceded premiums $ 122 $ 124 $ 367 $ 380 Total reinsurance recoveries $ 117 $ 180 $ 397 $ 292
Account Value, Net Amount at Risk and the Number of Contractholders for Guarantees Assumed in the Event of Death	The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded. (Dollars in millions, excludes impact of reinsurance ceded) September 30, 2020 December 31, 2019 Account value $ 8,650 $ 9,110 Net amount at risk $ 1,694 $ 1,764 Number of contractholders (estimated) 190,000 200,000
GMIB
Effects of Reinsurance [Line Items]
Schedule of Derivative Assets at Fair Value	There were three reinsurers covering 100% of the GMIB exposures as of September 30, 2020 and December 31, 2019 as follows: (In millions) Line of Business Reinsurer September 30, 2020 December 31, 2019 Collateral and Other Terms at September 30, 2020 GMIB Berkshire $ 382 $ 332 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 233 202 Liberty Re (Bermuda) Ltd. 205 179 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 820 $ 713 All reinsurers are rated A- equivalent and higher by a nationally recognized statistical rating organization ('NRSRO')

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2020
Investments [Abstract]
Investments by Category	The following table summarizes the Company's investments by category and current or long-term classification. September 30, 2020 December 31, 2019 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 1,113 $ 23,560 $ 24,673 $ 928 $ 22,827 $ 23,755 Equity securities — 379 379 — 303 303 Commercial mortgage loans 13 1,966 1,979 — 1,947 1,947 Policy loans — 1,347 1,347 — 1,357 1,357 Other long-term investments — 2,698 2,698 — 2,403 2,403 Short-term investments 458 — 458 423 — 423 Total $ 1,584 $ 29,950 $ 31,534 $ 1,351 $ 28,837 $ 30,188 Investments classified as assets of business held for sale (1) (260) (7,998) (8,258) (414) (7,295) (7,709) Investments per Consolidated Balance Sheets $ 1,324 $ 21,952 $ 23,276 $ 937 $ 21,542 $ 22,479 (1) The table above includes $8.3 billion as of September 30, 2020 and $7.7 billion as of December 31, 2019 of investments associated with the U.S. Group Disability and Life business that are held for sale to New York Life. Under the terms of the definitive agreement, some of the assets currently associated with the Group Disability and Life business can be substituted for other assets. The assets that will transfer to New York Life will be primarily debt securities and to a lesser extent commercial mortgage loans and short-term investments.
Debt Securities by Contractual Maturity	The amortized cost and fair value by contractual maturity periods for debt securities were as follows at September 30, 2020: (In millions) Amortized Fair Due in one year or less $ 1,133 $ 1,143 Due after one year through five years 7,403 7,789 Due after five years through ten years 9,011 10,015 Due after ten years 4,212 5,211 Mortgage and other asset-backed securities 514 515 Total $ 22,273 $ 24,673
Gross Unrealized Appreciation (Depreciation) on Debt Securities	Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below. (In millions) Amortized Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2020 Federal government and agency $ 411 $ — $ 223 $ — $ 634 State and local government 628 — 85 — 713 Foreign government 2,091 — 317 (6) 2,402 Corporate 18,629 (31) 1,890 (79) 20,409 Mortgage and other asset-backed 514 (9) 32 (22) 515 Total $ 22,273 $ (40) $ 2,547 $ (107) $ 24,673 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,147 $ (9) $ 828 $ (13) $ 2,953 December 31, 2019 Federal government and agency $ 498 $ — $ 235 $ — $ 733 State and local government 729 — 81 — 810 Foreign government 2,027 — 230 (1) 2,256 Corporate 18,149 — 1,299 (28) 19,420 Mortgage and other asset-backed 506 — 31 (1) 536 Total $ 21,909 $ — $ 1,876 $ (30) $ 23,755 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,229 $ — $ 740 $ (4) $ 2,965 (1) Net unrealized appreciation for these investments is excluded from accumulated other comprehensive income.
Summary of Debt Securities with a Decline in Fair Value	The table below summarizes debt securities with a decline in fair value from amortized cost by investment grade and the length of time these securities have been in an unrealized loss position. These debt securities are primarily corporate securities with a decline in fair value that reflects an increase in market yields since purchase. See discussion of Realized Investment Gains and Losses below for further information on the credit loss expense recorded for the Company's investments. September 30, 2020 December 31, 2019 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 1,193 $ 1,224 $ (31) 356 $ 723 $ 729 $ (6) 267 Below investment grade $ 713 $ 774 $ (61) 536 $ 340 $ 348 $ (8) 355 More than one year Investment grade $ 107 $ 111 $ (4) 19 $ 366 $ 378 $ (12) 118 Below investment grade $ 76 $ 87 $ (11) 36 $ 84 $ 88 $ (4) 93 Total $ 2,089 $ 2,196 $ (107) 947 $ 1,513 $ 1,543 $ (30) 833
Roll-Forward of the Allowance for Credit Losses on Debt Securities	The table below presents a roll-forward of the allowance for credit losses on debt securities for the three and nine months ended September 30, 2020. Three Months Ended Nine Months Ended (Dollars in millions) 2020 2020 Balance at beginning of period $ 48 $ 0 Additions for debt securities where no credit loss has previously been recognized 2 82 Reductions for securities sold during the period (6) (15) Decrease for debt securities where credit losses have previously been recorded (4) (27) Balance September 30, $ 40 $ 40
Equity Security Investments	The following table provides the values of the Company's equity security investments as of September 30, 2020 and December 31, 2019. September 30, 2020 December 31, 2019 (Dollars in millions) Amortized Cost Carrying Value Amortized Cost Carrying Value Equity securities with readily determinable fair values $ 126 $ 124 $ 61 $ 64 Equity securities with no readily determinable fair value $ 203 $ 212 $ 183 $ 192 Hybrid equity securities $ 57 $ 43 $ 58 $ 47 Total $ 386 $ 379 $ 302 $ 303
Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio	The following table summarizes the credit risk profile of the Company’s commercial mortgage loan portfolio based on loan-to-value and debt service coverage ratios as of September 30, 2020 and December 31, 2019: (Dollars in millions) September 30, 2020 December 31, 2019 Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Below 60% $ 861 2.20 $ 1,136 2.19 60% to 79% 985 1.93 723 1.98 80% to 100% 142 1.33 88 1.62 Allowance for credit losses (9) Total $ 1,979 2.01 60 % $ 1,947 2.09 58 %
Carrying Value Information for Other Long-Term Investments	Other long-term investments also include investment real estate, foreign currency swaps, and statutory and other deposits. The following table provides carrying value information for these investments. Carrying value as of (In millions) September 30, 2020 December 31, 2019 Real estate investments $ 888 $ 788 Securities partnerships 1,591 1,409 Other 219 206 Total $ 2,698 $ 2,403
Short-Term Investments and Cash Equivalents	Short-term investments and cash equivalents included the following types of issuers: (In millions) September 30, 2020 December 31, 2019 Corporate securities $ 2,729 $ 1,985 Federal government securities $ 1,139 $ 472 Foreign government securities $ 89 $ 65 Money market funds $ 313 $ 631
Realized Gains and Losses on Investments	The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company’s separate accounts because those gains and losses generally accrue directly to separate account policyholders. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Net realized investment gains, excluding credit loss expense and asset write-downs $ 24 $ 60 $ 33 $ 96 Credit loss (expense) recoveries on invested assets 8 — (41) — Other investment asset write-downs — (9) (10) (12) Net realized investment gains (losses), before income taxes $ 32 $ 51 $ (18) $ 84
Sales Information for Available-for-Sale Debt Securities	The following table presents sales information for available-for-sale debt securities. Gross gains on sales and gross losses on sales exclude amounts required to adjust future policy benefits for the run-off settlement annuity business. Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Proceeds from sales $ 380 $ 591 $ 2,003 $ 2,242 Gross gains on sales $ 15 $ 18 $ 81 $ 41 Gross losses on sales $ — $ (5) $ (21) $ (17)
Summary of Derivative Instruments Held	The following table summarizes the types and notional quantity of derivative instruments held by the Company. As of September 30, 2020 and December 31, 2019, the effects of these individual hedging strategies were not material to the Consolidated Financial Statements, including gains or losses reclassified from accumulated other comprehensive income into shareholders' net income, as well as amounts excluded from the assessment of hedge effectiveness. (In millions) Notional Value as of September 30, 2020 December 31, 2019 Purpose Type of Instrument Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds. Foreign currency swap contracts $ 853 $ 817 Net investment hedge : To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in Euros, Korean Won, and Taiwan Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts $ 526 $ 438 Foreign currency forward contracts $ 636 $ 406 Economic hedge: To hedge the foreign exchange-related changes in fair value of U.S. dollar-denominated investment assets to reflect the local currency for the Company’s foreign subsidiary in South Korea. The notional value of hedging instruments generally aligns with the fair value of the hedged investments. Foreign currency forward contracts $ 495 $ 410

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Financial Assets and Financial Liabilities Carried at Fair Value	The following table provides information as of September 30, 2020 and December 31, 2019 about the Company’s financial assets and liabilities carried at fair value. Separate account assets are also recorded at fair value on the Company’s Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to policyholders. (In millions) Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs Significant Unobservable Inputs Total As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 As of September 30, 2020 As of December 31, 2019 Financial assets at fair value Debt securities Federal government and agency $ 183 $ 197 $ 451 $ 536 $ — $ — $ 634 $ 733 State and local government — — 713 810 — — 713 810 Foreign government — — 2,381 2,228 21 28 2,402 2,256 Corporate — — 19,662 19,063 747 357 20,409 19,420 Mortgage and other asset-backed — — 368 398 147 138 515 536 Total debt securities 183 197 23,575 23,035 915 523 24,673 23,755 Equity securities (1) 1 7 135 72 31 32 167 111 Short-term investments — — 458 423 — — 458 423 Derivative assets — — 104 83 — — 104 83 Real estate funds priced at NAV as a practical expedient (2) 165 184 Financial liabilities at fair value Derivative liabilities $ — $ — $ 21 $ 18 $ — $ — $ 21 $ 18 (1) Excludes certain equity securities that have no readily determinable fair value.
Fair Value and Significant Unobservable Inputs Used in Pricing Debt Securities	The following table summarizes the fair value and significant unobservable inputs used in pricing the following debt securities that were developed directly by the Company as of September 30, 2020 and December 31, 2019. The range and weighted average basis point (“bps”) amounts for liquidity and credit spreads (adjustment to discount rates) reflect the Company’s best estimates of the unobservable adjustments a market participant would make to calculate these fair values. These liquidity and credit spreads have increased over the reported periods, resulting from continued uncertainty over the economic impacts related to COVID-19. Corporate and government debt securities. The significant unobservable input used to value the following corporate and government debt securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security. Mortgage and other asset-backed securities. The significant unobservable inputs used to value the following mortgage and other asset-backed securities are liquidity and weighting of credit spreads. An adjustment for liquidity is made as of the measurement date that considers current market conditions, issuer circumstances and complexity of the security structure when there is limited trading activity for the security. An adjustment to weight credit spreads is needed to value a more complex bond structure with multiple underlying collateral and no standard market valuation technique. The weighting of credit spreads is primarily based on the underlying collateral’s characteristics and their proportional cash flows supporting the bond obligations. Fair Value as of Unobservable Adjustment Range (Fair value in millions ) September 30, 2020 December 31, 2019 Unobservable input September 30, 2020 September 30, 2020 December 31, 2019 Debt securities Corporate and government debt securities $ 765 $ 385 Liquidity 60 - 1570 (410) bps 70 - 930 (280) bps Mortgage and other asset-backed securities 147 138 Liquidity 60 - 370 (80) bps 60 - 370 (70) bps Weighting of credit spreads 320 - 650 (460) bps 240 - 460 (330) bps Securities not priced by the Company (1) 3 — Total Level 3 debt securities $ 915 $ 523 (1) The fair values for these securities use single, unadjusted non-binding broker quotes not developed directly by the Company.
Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value	The following tables summarize the changes in financial assets and financial liabilities classified in Level 3 for the three and nine months ended September 30, 2020 and 2019. Gains and losses reported in these tables may include net changes in fair value that are attributable to both observable and unobservable inputs. Debt and Equity Securities For the Three Months Ended For the Nine Months Ended (In millions) 2020 2019 2020 2019 Balance at beginning of period $ 860 $ 431 $ 555 $ 410 Total gains (losses) included in shareholders’ net income (1) (6) 4 (7) Gains (losses) included in other comprehensive income 17 4 (42) 16 Gains (losses) required to adjust future policy benefits for settlement annuities (1) 7 1 4 3 Purchases, sales and settlements Purchases 3 10 67 53 Sales (1) — (13) — Settlements (8) (6) (15) (16) Total purchases, sales and settlements $ (6) $ 4 $ 39 $ 37 Transfers into/(out of) Level 3 Transfers into Level 3 102 80 629 113 Transfers out of Level 3 (33) — (243) (58) Total transfers into/(out of) Level 3 $ 69 $ 80 $ 386 $ 55 Balance at September 30, $ 946 $ 514 $ 946 $ 514 Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date $ — $ (6) $ (2) $ (8) Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period $ 17 N/A $ (37) N/A
Fair Values of Separate Account Assets	Fair values of separate account assets at September 30, 2020 and December 31, 2019 were as follows: (In millions) Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Total September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 September 30, 2020 December 31, 2019 Guaranteed separate accounts (See Note 18) $ 208 $ 219 $ 302 $ 271 $ — $ — $ 510 $ 490 Non-guaranteed separate accounts (1) 1,541 1,450 5,508 5,522 335 263 7,384 7,235 Subtotal $ 1,749 $ 1,669 $ 5,810 $ 5,793 $ 335 $ 263 $ 7,894 $ 7,725 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 736 756 Total $ 8,630 $ 8,481 Separate account assets of business classified as held for sale (14) (16) Separate account assets per Consolidated Balance Sheets $ 8,616 $ 8,465 (1) Non-guaranteed separate accounts included $3.9 billion as of September 30, 2020 and $4.0 billion as of December 31, 2019 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of September 30, 2020 and $0.2 billion classified in Level 3 as of December 31, 2019.
Additional Information on Separate Account Assets Priced at NAV	The following table provides additional information on these investments. Fair Value as of Unfunded Commitment as of September 30, 2020 Redemption Frequency Redemption Notice (In millions) September 30, 2020 December 31, 2019 Securities partnerships $ 511 $ 531 $ 283 Not applicable Not applicable Real estate funds 221 220 — Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 736 $ 756 $ 283
Fair Value Disclosures for Financial Instruments Not Carried at Fair Value	The following table includes the Company’s financial instruments not recorded at fair value that are subject to fair value disclosure requirements at September 30, 2020 and December 31, 2019. In addition to universal life products and finance leases, financial instruments that are carried in the Company’s Consolidated Financial Statements at amounts that approximate fair value are excluded from the following table. September 30, 2020 December 31, 2019 (In millions) Classification in Fair Value Hierarchy Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 2,033 $ 1,979 $ 1,989 $ 1,947 Long-term debt, including current maturities, excluding finance leases Level 2 $ 37,976 $ 32,972 $ 39,439 $ 36,375

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2020
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]
Changes in the Components of AOCI	Changes in the components of AOCI were as follows: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Securities and Derivatives Beginning balance $ 1,256 $ 803 $ 975 $ 18 Appreciation on securities and derivatives 159 298 499 1,305 Tax (expense) (27) (68) (96) (284) Net appreciation on securities and derivatives 132 230 403 1,021 Reclassification adjustment for (gains) included in shareholders' net income (net realized investment (gains)) (16) (10) (3) (17) Tax benefit 4 3 1 4 Net (gains) reclassified from AOCI to net income (12) (7) (2) (13) Other comprehensive income, net of tax 120 223 401 1,008 Ending balance $ 1,376 $ 1,026 $ 1,376 $ 1,026 Translation of foreign currencies Beginning balance $ (374) $ (285) $ (275) $ (221) Translation of foreign currencies 102 (124) 7 (191) Tax (expense) benefit 7 (3) (3) (4) Net translation of foreign currencies 109 (127) 4 (195) Less: Net translation of foreign currencies attributable to noncontrolling interests (4) 1 (10) (3) Shareholders' net translation of foreign currencies 113 (128) 14 (192) Ending balance $ (261) $ (413) $ (261) $ (413) Postretirement benefits liability Beginning balance $ (1,670) $ (1,483) $ (1,641) $ (1,508) Reclassification adjustment for amortization of net losses from past experience and prior service costs (interest expense and other) 18 16 54 47 Reclassification adjustment for settlement (interest expense and other) — — — 10 Tax (expense) (4) (3) (13) (12) Net adjustments reclassified from AOCI to net income 14 13 41 45 Valuation update — (1) (73) (9) Tax benefit — — 17 1 Net change due to valuation update — (1) (56) (8) Other comprehensive (loss) income, net of tax 14 12 (15) 37 Ending balance $ (1,656) $ (1,471) $ (1,656) $ (1,471)

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities	Operating and finance lease right of use ("ROU") assets and lease liabilities were as follows: (In millions) September 30, 2020 December 31, 2019 Operating leases: Operating lease ROU assets $ 530 $ 536 Accrued expenses and other current liabilities $ 160 $ 166 Other non-current liabilities 461 465 Total operating lease liabilities $ 621 $ 631 Finance leases: Property and equipment, gross $ 99 $ 110 Accumulated depreciation (42) (23) Property and equipment, net $ 57 $ 87 Short-term debt $ 20 $ 27 Long-term debt 40 61 Total finance lease liabilities $ 60 $ 88

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Summary of Special Items	The following tables present the special items recorded by the Company for the three and nine months ended September 30, 2020 and 2019. Three Months Ended (In millions) September 30, 2020 September 30, 2019 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Integration and transaction-related costs (Selling, general and administrative expenses) $ 83 $ 112 $ 88 $ 114 (Benefits) charges associated with litigation matters (Selling, general and administrative expenses) — — (23) (30) Risk corridors recovery (Selling, general and administrative expenses) $ (76) $ (101) $ — $ — Contractual adjustment for a former client (Pharmacy revenues) (89) (117) — — Total impact from special items $ (82) $ (106) $ 65 $ 84 Nine Months Ended (In millions) September 30, 2020 September 30, 2019 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Integration and transaction-related costs (Selling, general and administrative expenses) $ 256 $ 339 $ 311 $ 405 Debt extinguishment costs (Debt extinguishment costs) 151 199 — — Charge for organizational efficiency plan (Selling, general and administrative expenses) 24 31 — — (Benefits) charges associated with litigation matters (Selling, general and administrative expenses) 19 25 41 51 Risk corridors recovery (Selling, general and administrative expenses) (76) (101) — — Contractual adjustment for a former client (Pharmacy revenues) $ (155) $ (204) $ — $ — Total impact from special items $ 219 $ 289 $ 352 $ 456
Summarized Segment Financial Information	Summarized segment financial information for the three and nine months ended September 30 was as follows: (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Three months ended September 30, 2020 Revenues from external customers $ 29,016 $ 9,047 $ 1,439 $ 1,156 $ — $ 40,658 Inter-segment revenues 926 478 — 6 (1,410) Net investment income 2 104 38 152 1 297 Total revenues 29,944 9,629 1,477 1,314 (1,409) 40,955 Net realized investment results from certain equity method investments — — (37) — — (37) Special item related to contractual adjustment for a former client (117) — — — — (117) Adjusted revenues $ 29,827 $ 9,629 $ 1,440 $ 1,314 $ (1,409) $ 40,801 Income (loss) before taxes $ 1,086 $ 846 $ 253 $ 97 $ (478) $ 1,804 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (5) — — (10) Net realized investment (gains) losses — 6 (48) (27) — (69) Amortization of acquired intangible assets 479 6 8 — — 493 Special items Integration and transaction-related costs — — — — 112 112 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (117) — — — — (117) Pre-tax adjusted income (loss) from operations $ 1,443 $ 757 $ 208 $ 70 $ (366) $ 2,112 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Three months ended September 30, 2019 Revenues from external customers $ 27,084 $ 8,648 $ 1,368 $ 1,107 $ — $ 38,207 Inter-segment revenues 499 376 — 7 (882) Net investment income 15 124 39 170 1 349 Total revenues 27,598 9,148 1,407 1,284 (881) 38,556 Revenue contributions from transitioning clients (2,718) — — — — (2,718) Net realized investment results from certain equity method investments — — (5) — — (5) Adjusted revenues $ 24,880 $ 9,148 $ 1,402 $ 1,284 $ (881) $ 35,833 Income (loss) before taxes $ 965 $ 1,011 $ 184 $ 159 $ (556) $ 1,763 Pre-tax adjustments to reconcile to adjusted income from operations Adjustment for transitioning clients (274) — — — — (274) (Income) attributable to noncontrolling interests — — (4) — — (4) Net realized investment (gains) losses — (43) 5 (18) — (56) Amortization of acquired intangible assets 708 15 9 2 — 734 Special items Integration and transaction-related costs — — — — 114 114 (Benefits) charges associated with litigation matters — (30) — — — (30) Pre-tax adjusted income (loss) from operations $ 1,399 $ 953 $ 194 $ 143 $ (442) $ 2,247 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Nine months ended September 30, 2020 Revenues from external customers $ 82,986 $ 26,999 $ 4,325 $ 3,506 $ — $ 117,816 Inter-segment revenues 2,785 1,448 — 17 (4,250) — Net investment income 30 279 104 458 2 873 Total revenues 85,801 28,726 4,429 3,981 (4,248) 118,689 Net realized investment results from certain equity method investments — — (87) — — (87) Special item related to contractual adjustment for a former client (204) — — — — (204) Adjusted revenues $ 85,597 $ 28,726 $ 4,342 $ 3,981 $ (4,248) $ 118,398 Income (loss) before taxes $ 2,551 $ 3,529 $ 877 $ 298 $ (1,765) $ 5,490 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (12) — (15) — — (27) Net realized investment (gains) losses — 28 (75) (22) — (69) Amortization of acquired intangible assets 1,439 23 22 3 — 1,487 Special items Integration and transaction-related costs — — — — 339 339 Debt extinguishment costs — — — — 199 199 Charge for organizational efficiency plan — — — — 31 31 (Benefits) charges associated with litigation matters — — — — 25 25 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (204) — — — — (204) Pre-tax adjusted income (loss) from operations $ 3,774 $ 3,479 $ 809 $ 279 $ (1,171) $ 7,170 (In millions) Evernorth U.S. Medical International Markets Group Disability and Other Corporate and Eliminations Total Nine months ended September 30, 2019 Revenues from external customers $ 80,618 $ 26,226 $ 4,095 $ 3,347 $ — $ 114,286 Inter-segment revenues 1,869 727 — 21 (2,617) Net investment income (loss) 47 358 117 521 (8) 1,035 Total revenues 82,534 27,311 4,212 3,889 (2,625) 115,321 Revenue contribution from transitioning clients (11,657) — — — — (11,657) Net realized investment results from certain equity method investments — — (27) — — (27) Adjusted revenues $ 70,877 $ 27,311 $ 4,185 $ 3,889 $ (2,625) $ 103,637 Income (loss) before taxes $ 3,015 $ 3,157 $ 601 $ 407 $ (1,871) $ 5,309 Pre-tax adjustments to reconcile to adjusted income from operations Adjustment for transitioning clients (1,589) — — — — (1,589) (Income) attributable to noncontrolling interests (1) — (12) — — (13) Net realized investment (gains) losses — (65) (10) (36) — (111) Amortization of acquired intangible assets 2,130 51 28 5 — 2,214 Special items Integration and transaction-related costs — — — — 405 405 (Benefits) charges associated with litigation matters — (30) — — 81 51 Pre-tax adjusted income (loss) from operations $ 3,555 $ 3,113 $ 607 $ 376 $ (1,385) $ 6,266
Revenue from External Customers	Revenue from external customers includes pharmacy revenues, premiums and fees and other revenues. The following table presents these revenues by product, premium and service type for the three and nine months ended September 30: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2020 2019 2020 2019 Products (Pharmacy revenues) (ASC 606) Network revenues $ 13,968 $ 12,923 $ 39,200 $ 37,954 Home delivery and specialty revenues 12,422 11,837 36,319 35,893 Other 1,412 1,227 3,945 3,607 Total pharmacy revenues 27,802 25,987 79,464 77,454 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,397 3,174 9,948 9,278 Stop loss 1,146 1,085 3,459 3,221 Other 281 260 853 779 U.S. Government Medicare Advantage 1,895 1,562 5,680 4,779 Medicare Part D 360 404 1,242 1,329 Other 1,117 1,059 3,246 3,137 Total U.S. Medical premiums 8,196 7,544 24,428 22,523 International Markets premiums 1,360 1,309 4,079 3,914 Domestic disability, life and accident premiums 1,106 1,049 3,346 3,165 Other premiums 20 33 75 107 Total premiums 10,682 9,935 31,928 29,709 Services (ASC 606) Fees 2,120 2,249 6,253 7,015 Other external revenues 54 36 171 108 Total services 2,174 2,285 6,424 7,123 Total revenues from external customers $ 40,658 $ 38,207 $ 117,816 $ 114,286

Description of Business (Detail

Description of Business (Details)	3 Months Ended
	Sep. 30, 2020segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments renamed	2
Number of operating segments renamed	2

COVID-19 and Related Economic_2

COVID-19 and Related Economic Impact (Details)	9 Months Ended
	Sep. 30, 2020USD ($)
COVID-19
Unusual or Infrequent Item, or Both [Line Items]
Impairments of long-lived assets

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Jun. 30, 2020	Dec. 31, 2019		Jun. 30, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Stockholders' equity	$ 48,039	$ 44,699	$ 47,371	$ 45,344		$ 43,818	$ 41,035
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member	us-gaap:AccountingStandardsUpdate201602Member
Retained Earnings
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Stockholders' equity	$ 24,440	$ 19,185	$ 23,052	20,162		$ 17,834	15,088
Adjustment upon Adoption
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Stockholders' equity				(30)	[1]		(15)
Adjustment upon Adoption | Retained Earnings
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Stockholders' equity				$ (30)	[1]		$ (15)
[1]	See Note 3 for further information about the Company's adoption of new credit loss guidance (ASU 2016-13).

Accounts Receivable, Net - Summ

Accounts Receivable, Net - Summary of Accounts Receivable, Net (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Receivables [Abstract]
Noninsurance customer receivables	$ 5,688	$ 5,143
Pharmaceutical manufacturers receivable	5,433	3,439
Insurance customer receivables	2,575	2,321
Other receivables	368	334
Total	14,064	11,237
Accounts receivable, net classified as assets of business held for sale	(576)	(521)
Accounts receivable, net per Consolidated Balance Sheets	$ 13,488	$ 10,716

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) - USD ($) $ in Millions	Sep. 30, 2020	Jan. 01, 2020	Dec. 31, 2019
Accounts, Notes, Loans and Financing Receivable [Line Items]
Allowance for receivables net current	$ 1,200		$ 778
Allowance for current expected credit losses on accounts receivable	69	$ 39
Adjustment upon Adoption
Accounts, Notes, Loans and Financing Receivable [Line Items]
Allowance for current expected credit losses on accounts receivable
COVID-19
Accounts, Notes, Loans and Financing Receivable [Line Items]
Allowance for current expected credit losses on accounts receivable	$ 11

Mergers and Acquisitions (Detai

Mergers and Acquisitions (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Business Combinations [Abstract]
Integration and transaction-related costs, pre-tax	$ 112	$ 114	$ 339	$ 405
Integration and transaction-related costs, after-tax	$ 83	$ 88	$ 256	$ 311

Assets and Liabilities of Bus_3

Assets and Liabilities of Business Held for Sale - Narrative (Details) $ in Billions	Dec. 31, 2019USD ($)
Group Disability and Life | Held-for-Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price	$ 6.3

Assets and Liabilities of Bus_4

Assets and Liabilities of Business Held for Sale - Assets and Liabilities Held for Sale (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Accounts receivable, net	$ 576	$ 521
Investments	8,300	7,700
Total assets of business held for sale	10,022	9,512
Insurance and contractholder liabilities	6,591	6,308
Total liabilities of business held for sale	7,195	6,812
Group Disability and Life | Held-for-Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash and cash equivalents	798	743
Accounts receivable, net	576	521
Investments	8,258	7,709
Other assets	390	539
Total assets of business held for sale	10,022	9,512
Insurance and contractholder liabilities	6,591	6,308
Other liabilities	604	504
Total liabilities of business held for sale	$ 7,195	$ 6,812

Earnings Per Share - Computatio

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Earnings Per Share [Abstract]
Shareholders’ net income	$ 1,388	$ 1,351	$ 4,323	$ 4,127
Shares:
Weighted average (in shares)	364,427	374,842	367,410	377,381
Common stock equivalents (in shares)	2,763	3,479	3,421	3,710
Total shares (in shares)	367,190	378,321	370,831	381,091
EPS, basic (in dollars per share)	$ 3.81	$ 3.60	$ 11.77	$ 10.94
EPS, effect of dilution (in dollars per share)	(0.03)	(0.03)	(0.11)	(0.11)
EPS, diluted (in dollars per share)	$ 3.78	$ 3.57	$ 11.66	$ 10.83

Earnings Per Share - Outstandin

Earnings Per Share - Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)	4.6	3.6	4.2	3.9

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares shares in Millions	Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019
Income Statement [Abstract]
Shares of common stock held in treasury (in shares)	26.7	13	10.4

Debt - Outstanding Amounts of D

Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Sep. 30, 2020	Dec. 31, 2019
Short-term debt
Commercial paper	$ 1,555,000,000	$ 944,000,000
Other, including finance leases	20,000,000	27,000,000
Total short-term debt	6,449,000,000	5,514,000,000
Long-term debt
Other, including finance leases	40,000,000	61,000,000
Total long-term debt	29,537,000,000	31,893,000,000
$1,000 million, Floating Rate Notes due 3/2020
Short-term debt
Current maturities	0	999,000,000
Long-term debt
Face value	1,000,000,000
$300 million, 5.125% Notes due 6/2020
Short-term debt
Current maturities	0	300,000,000
Long-term debt
Face value	$ 300,000,000
Stated interest rate	5.125%
$1,750 million, 3.2% Notes due 9/2020
Short-term debt
Current maturities	$ 0	1,748,000,000
Long-term debt
Face value	$ 1,750,000,000
Stated interest rate	3.20%
$349 million, 4.125% Notes due 9/2020
Short-term debt
Current maturities	$ 0	351,000,000
Long-term debt
Face value	$ 349,000,000
Stated interest rate	4.125%
$500 million, 2.6% Notes due 11/2020
Short-term debt
Current maturities	$ 500,000,000	496,000,000
Long-term debt
Face value	$ 500,000,000
Stated interest rate	2.60%
$400 million, Floating Rate Notes due 11/2020
Short-term debt
Current maturities	$ 400,000,000	400,000,000
Long-term debt
Face value	400,000,000
$250 million, 4.375% Notes due 12/2020
Short-term debt
Current maturities	250,000,000	249,000,000
Long-term debt
Face value	$ 250,000,000
Stated interest rate	4.375%
$1,400 million, Floating Rate Term Loan due 3/2021
Short-term debt
Current maturities	$ 1,399,000,000	0
Long-term debt
Face value	1,400,000,000
$78 million, 6.37% Notes due 6/2021
Short-term debt
Current maturities	78,000,000	0
Long-term debt
Long-term debt	0	78,000,000
Face value	$ 78,000,000
Stated interest rate	6.37%
$1,000 million, Floating Rate Notes due 2021
Short-term debt
Current maturities	$ 999,000,000	0
Long-term debt
Long-term debt	0	998,000,000
Face value	1,000,000,000
$1,250 million, 3.4% Notes due 2021
Short-term debt
Current maturities	1,248,000,000	0
Long-term debt
Long-term debt	0	1,247,000,000
Face value	$ 1,250,000,000
Stated interest rate	3.40%
$500 million, 3.3% Notes due 2021
Long-term debt
Long-term debt	$ 0	499,000,000
Face value	$ 500,000,000
Stated interest rate	3.30%
$300 million, 4.5% Notes due 2021
Long-term debt
Long-term debt	$ 0	298,000,000
Face value	$ 300,000,000
Stated interest rate	4.50%
$1,248 million, 4.75% Notes due 2021
Long-term debt
Long-term debt	$ 0	1,272,000,000
Face value	$ 1,248,000,000
Stated interest rate	4.75%
$277 million, 4% Notes due 2022
Long-term debt
Long-term debt	$ 276,000,000	747,000,000
Face value	$ 277,000,000
Stated interest rate	4.00%
$973 million, 3.9% Notes due 2022
Long-term debt
Long-term debt	$ 972,000,000	999,000,000
Face value	$ 973,000,000
Stated interest rate	3.90%
$500 million, 3.05% Notes due 2022
Long-term debt
Long-term debt	$ 489,000,000	485,000,000
Face value	$ 500,000,000
Stated interest rate	3.05%
$17 million, 8.3% Notes due 2023
Long-term debt
Long-term debt	$ 17,000,000	17,000,000
Face value	$ 17,000,000
Stated interest rate	8.30%
$63 million, 7.65% Notes due 2023
Long-term debt
Long-term debt	$ 63,000,000	100,000,000
Face value	$ 63,000,000
Stated interest rate	7.65%
$700 million, Floating Rate Notes due 2023
Long-term debt
Long-term debt	$ 698,000,000	698,000,000
Face value	700,000,000
$1,000 million, 3% Notes due 2023
Long-term debt
Long-term debt	973,000,000	966,000,000
Face value	$ 1,000,000,000
Stated interest rate	3.00%
$2,187 million, 3.75% Notes due 2023
Long-term debt
Long-term debt	$ 2,180,000,000	3,088,000,000
Face value	$ 2,187,000,000
Stated interest rate	3.75%
$1,000 million, 3.5% Notes due 2024
Long-term debt
Long-term debt	$ 976,000,000	970,000,000
Face value	$ 1,000,000,000
Stated interest rate	3.50%
$900 million, 3.25% Notes due 2025
Long-term debt
Long-term debt	$ 896,000,000	895,000,000
Face value	$ 900,000,000
Stated interest rate	3.25%
$2,200 million, 4.125% Notes due 2025
Long-term debt
Long-term debt	$ 2,189,000,000	2,188,000,000
Face value	$ 2,200,000,000
Stated interest rate	4.125%
$1,500 million, 4.5% Notes due 2026
Long-term debt
Long-term debt	$ 1,505,000,000	1,506,000,000
Face value	$ 1,500,000,000
Stated interest rate	4.50%
$1,500 million, 3.4% Notes due 2027
Long-term debt
Long-term debt	$ 1,406,000,000	1,396,000,000
Face value	$ 1,500,000,000
Stated interest rate	3.40%
$259 million, 7.875% Debentures due 2027
Long-term debt
Long-term debt	$ 259,000,000	259,000,000
Face value	$ 259,000,000
Stated interest rate	7.875%
$600 million, 3.05% Notes due 2027
Long-term debt
Long-term debt	$ 595,000,000	595,000,000
Face value	$ 600,000,000
Stated interest rate	3.05%
$3,800 million, 4.375% Notes due 2028
Long-term debt
Long-term debt	$ 3,779,000,000	3,776,000,000
Face value	$ 3,800,000,000
Stated interest rate	4.375%
$1,500 million, 2.4% Notes due 2030
Long-term debt
Long-term debt	$ 1,489,000,000	0
Face value	$ 1,500,000,000
Stated interest rate	2.40%
$45 million, 8.3% Step Down Notes due 2033
Long-term debt
Long-term debt	$ 45,000,000	45,000,000
Face value	$ 45,000,000
Stated interest rate	8.30%
$190 million, 6.15% Notes due 2036
Long-term debt
Long-term debt	$ 190,000,000	190,000,000
Face value	$ 190,000,000
Stated interest rate	6.15%
$2,200 million, 4.8% Notes due 2038
Long-term debt
Long-term debt	$ 2,180,000,000	2,178,000,000
Face value	$ 2,200,000,000
Stated interest rate	4.80%
$750 million, 3.2% Notes due 2040
Long-term debt
Long-term debt	$ 742,000,000	0
Face value	$ 750,000,000
Stated interest rate	3.20%
$121 million, 5.875% Notes due 2041
Long-term debt
Long-term debt	$ 119,000,000	119,000,000
Face value	$ 121,000,000
Stated interest rate	5.875%
$448 million, 6.125% Notes due 2041
Long-term debt
Long-term debt	$ 490,000,000	491,000,000
Face value	$ 448,000,000
Stated interest rate	6.125%
$317 million, 5.375% Notes due 2042
Long-term debt
Long-term debt	$ 315,000,000	315,000,000
Face value	$ 317,000,000
Stated interest rate	5.375%
$1,500 million, 4.8% Notes due 2046
Long-term debt
Long-term debt	$ 1,465,000,000	1,465,000,000
Face value	$ 1,500,000,000
Stated interest rate	4.80%
$1,000 million, 3.875% Notes due 2047
Long-term debt
Long-term debt	$ 988,000,000	988,000,000
Face value	$ 1,000,000,000
Stated interest rate	3.875%
$3,000 million, 4.9% Notes due 2048
Long-term debt
Long-term debt	$ 2,966,000,000	2,964,000,000
Face value	$ 3,000,000,000
Stated interest rate	4.90%
$1,250 million, 3.4% Notes due 2050
Long-term debt
Long-term debt	$ 1,235,000,000	$ 0
Face value	$ 1,250,000,000
Stated interest rate	3.40%

Debt - Narrative (Details)

Debt - Narrative (Details)	Apr. 01, 2020USD ($)	Oct. 31, 2020USD ($)bank	Apr. 30, 2020USD ($)	Sep. 30, 2020USD ($)bank	Dec. 31, 2019USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)bank	Sep. 30, 2019USD ($)	Mar. 16, 2020USD ($)
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities under tender offer and optional redemption			$ 3,500,000,000
Aggregate principal amount of outstanding debt securities repurchased under tender offer			1,500,000,000
Aggregate principal amount of outstanding debt securities repurchased under optional redemption			2,000,000,000
Loss on repurchase of debt, pre-tax			199,000,000	$ 0		$ 0	$ 199,000,000	$ 0
Loss on repurchase of debt, after-tax			$ 151,000,000
Notes issued by Express Scripts, Medco and Old Cigna exchanged for Notes issued by Cigna					$ 12,700,000,000
Repayment of long-term debt							6,897,000,000	$ 3,340,000,000
Payments for debt tender and redemption							3,500,000,000
Commercial paper				$ 1,555,000,000	$ 944,000,000		$ 1,555,000,000
Commercial Paper
Debt Instrument [Line Items]
Weighted-average interest rate				0.20%			0.20%
Revolving Credit Agreement
Debt Instrument [Line Items]
Number of participating banks | bank				23			23
Maximum borrowing capacity				$ 3,250,000,000			$ 3,250,000,000
Amount by which credit facilty amount can be increased				$ 500,000,000			$ 500,000,000
Amount by which credit facilty term length can be increased							1 year
Leverage ratio covenant				60.00%			60.00%
Outstanding balances				$ 0			$ 0
Revolving Credit Agreement | Letter of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity				500,000,000			500,000,000
364-day Revolving Credit Agreement, Maturing October 2021 | Revolving Credit Facility | Subsequent Event
Debt Instrument [Line Items]
Number of participating banks | bank		23
Maximum borrowing capacity		$ 1,000,000,000
Credit agreement term		364 days
364-day Revolving Credit Agreement, Maturing October 2020 | Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity				$ 1,000,000,000			$ 1,000,000,000
Credit agreement term							364 days
Leverage ratio covenant				60.00%			60.00%
Outstanding balances				$ 0			$ 0
364-Day Term Loan | Line of Credit
Debt Instrument [Line Items]
Aggregate principal amount	$ 1,400,000,000
Credit agreement term	364 days
Prepayment rate	20.00%
Senior Notes
Debt Instrument [Line Items]
Aggregate principal amount									$ 3,500,000,000

Debt - Summary of Debt Issuance

Debt - Summary of Debt Issuances (Details) - Senior Notes	Mar. 16, 2020USD ($)
Debt Instrument [Line Items]
Principal	$ 3,500,000,000
$1,500 Million, 2.40% Debt due March 15, 2030
Debt Instrument [Line Items]
Principal	$ 1,500,000,000
Interest rate	2.40%
Net proceeds	$ 1,491,000,000
$750 Million, 3.20% Debt due March 15, 2040
Debt Instrument [Line Items]
Principal	$ 750,000,000
Interest rate	3.20%
Net proceeds	$ 743,000,000
$1,250 Million, 3.40% Debt due March 15, 2050
Debt Instrument [Line Items]
Principal	$ 1,250,000,000
Interest rate	3.40%
Net proceeds	$ 1,237,000,000

Insurance and Contractholder _3

Insurance and Contractholder Liabilities - Summary of Insurance and Contractholder Liabilities (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019	Dec. 31, 2018
Current
Contractholder deposit funds	$ 624	$ 600
Future policy benefits	597	553
Unearned premiums, current	449	453
Total	7,373	7,010
Insurance and contractholder liabilities classified as held for sale	(2,150)	(2,089)
Total insurance and contractholder liabilities	5,223	4,921
Non-current
Contractholder deposit funds	7,038	7,139
Future policy benefits	9,505	9,281
Unearned premiums	379	360
Total	20,654	20,271
Insurance and contractholder liabilities classified as held for sale	(4,441)	(4,219)
Total insurance and contractholder liabilities	16,213	16,052
Total
Contractholder deposit funds	7,662	7,739
Future policy benefits	10,102	9,834
Unearned premiums	828	813
Total	28,027	27,281
Insurance and contractholder liabilities classified as held for sale	(6,591)	(6,308)
Contractholder deposit funds			$ 7,789
Future policy benefits			9,808
Unearned premiums			755
Total insurance and contractholder liabilities	21,436	20,973	27,270
Unpaid claims classified as liabilities of business held for sale	5,200	4,900
Contractholder deposit funds classified as liabilities of business held for sale	759	717
Future policy benefits classified as liabilities of business held for sale	646	653
U.S. Medical
Current
Unpaid claims and claim expenses	3,182	2,875
Non-current
Unpaid claims and claim expenses	18	17
Total
Unpaid claims and claim expenses	3,200	2,892
Unpaid claims and claim expenses			3,061	$ 2,697
Other segments
Current
Unpaid claims and claim expenses	2,521	2,529
Non-current
Unpaid claims and claim expenses	3,714	3,474
Total
Unpaid claims and claim expenses	$ 6,235	$ 6,003
Unpaid claims and claim expenses			$ 5,857

Insurance and Contractholder _4

Insurance and Contractholder Liabilities - Narrative (Details) - U.S. Medical - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Insurance and Contractholder Liabilities [Line Items]
Total of incurred but not reported liabilities plus expected claim development on reported claims, including reported claims in process	$ 3,000	$ 2,800
Favorable (unfavorable) impact of prior year development on shareholders' net income	30	68
Favorable (unfavorable) impact of prior year development on pre-tax income	$ 38	$ 86

Insurance and Contractholder _5

Insurance and Contractholder Liabilities - U.S. Medical - Activity (Details) - U.S. Medical - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Beginning balance	$ 2,892
Beginning balance		$ 2,697
Less: Reinsurance and other amounts recoverable	303
Less: Reinsurance and other amounts recoverable		264
Beginning balance, net	2,589
Beginning balance, net		2,433
Incurred costs related to:
Current year	18,935	18,169
Prior years	(126)	(159)
Total incurred	18,809	18,010
Paid costs related to:
Current year	16,061	15,555
Prior years	2,363	2,160
Total paid	18,424	17,715
Ending balance, net	2,974
Ending balance, net		2,728
Add: Reinsurance and other amounts recoverable	226
Add: Reinsurance and other amounts recoverable		333
Ending balance	$ 3,200
Ending balance		$ 3,061

Insurance and Contractholder _6

Insurance and Contractholder Liabilities - Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses (Details) - U.S. Medical - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 126	$ 159
Favorable (unfavorable) variance, percentage	0.50%	0.70%
Actual completion factors
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 47	$ 87
Favorable (unfavorable) variance, percentage	0.20%	0.40%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 79	$ 72
Favorable (unfavorable) variance, percentage	0.30%	0.30%

Insurance and Contractholder _7

Insurance and Contractholder Liabilities - Liability Details for Unpaid Claims and Claim Expenses (Details) - USD ($) $ in Millions	Sep. 30, 2020	Sep. 30, 2019
Group Disability and Other and International Markets
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 6,235
Unpaid claims and claim expenses		$ 5,857
Group Disability and Other
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	5,368
Unpaid claims and claim expenses		5,076
Group Disability and Life
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	5,206
Unpaid claims and claim expenses		4,887
Other Operations
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	162
Unpaid claims and claim expenses		189
International Markets
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 867
Unpaid claims and claim expenses		$ 781

Insurance and Contractholder _8

Insurance and Contractholder Liabilities - Activity in Liabilities for Unpaid Claims and Claim Expenses (Details) - Intenational Markets and Group Disability and Life - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Liability for Claims and Claims Adjustment Expense [Line Items]
Beginning balance	$ 5,816
Beginning balance		$ 5,432
Less: Reinsurance and other amounts recoverable	184
Less: Reinsurance and other amounts recoverable		156
Beginning balance, net	5,632
Beginning balance, net		5,276
Incurred claims related to:
Current year	4,277	4,205
Prior years:
Interest accretion	118	117
All other incurred	(12)	(59)
Total incurred	4,383	4,263
Paid costs related to:
Current year	2,435	2,422
Prior years	1,702	1,594
Total paid	4,137	4,016
Foreign currency	5	(26)
Ending balance, net	5,883
Ending balance, net		5,497
Add: Reinsurance and other amounts recoverable	190
Add: Reinsurance and other amounts recoverable		171
Ending balance	$ 6,073
Ending balance		$ 5,668

Reinsurance - Narrative (Detail

Reinsurance - Narrative (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)reinsurer	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)reinsurer	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)reinsurer
Effects of Reinsurance [Line Items]
Allowance for credit losses on reinsurance recoverables	$ 34		$ 34
GMIB
Effects of Reinsurance [Line Items]
Percent of future claim payments reinsured	100.00%		100.00%		100.00%
Annuitization election period			30 days
Impact of non-performance risk
GMIB liabilities	$ 786		$ 786		$ 688
Number of external reinsurers | reinsurer	3		3		3
Amounts included in shareholders net income for GMIB assets
Amounts included in shareholders net income for GMIB liabilities
Variable Annuity | Berkshire
Effects of Reinsurance [Line Items]
Percent of future claim payments reinsured	100.00%		100.00%
Remaining overall limit under reinsurance agreement	$ 3,200		$ 3,200
Other Current Assets
Effects of Reinsurance [Line Items]
Reinsurance recoverables	$ 209		$ 209		$ 222
Adjustment upon Adoption
Effects of Reinsurance [Line Items]
Allowance for credit losses on reinsurance recoverables					$ 31

Reinsurance - Reinsurance Recov

Reinsurance - Reinsurance Recoverables by Range of External Credit Rating and Collateral Level (Details) $ in Millions	Sep. 30, 2020USD ($)
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 5,331
Allowance for uncollectible reinsurance	(34)
Reinsurance recoverables classified as assets of business held for sale	(190)
Total reinsurance recoverables	5,107
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	1,286
Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,606
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	439
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables	530
Ongoing Operations | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	334
Ongoing Operations | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	63
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	133
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	90
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	90
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	22
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	8
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	14
Ongoing Operations | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	418
Ongoing Operations | No collateral | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	326
Ongoing Operations | No collateral | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	63
Ongoing Operations | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	29
Acquisition, disposition or runoff activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables	4,801
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,049
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Berkshire
Ceded Credit Risk [Line Items]
Reinsurance recoverables	794
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	641
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	275
Acquisition, disposition or runoff activities | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	42
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	1,196
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher | Berkshire
Ceded Credit Risk [Line Items]
Reinsurance recoverables	318
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	641
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	237
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,584
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,049
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher | Berkshire
Ceded Credit Risk [Line Items]
Reinsurance recoverables	476
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	21
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	38
Acquisition, disposition or runoff activities | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	21
Acquisition, disposition or runoff activities | No collateral | Upper-medium grade and higher | Lincoln National Life and Lincoln Life & Annuity of New York
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | No collateral | Upper-medium grade and higher | Berkshire
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | No collateral | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Acquisition, disposition or runoff activities | No collateral | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	17
Acquisition, disposition or runoff activities | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 4

Reinsurance - Effects of Reinsu

Reinsurance - Effects of Reinsurance (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Reinsurance Disclosures [Abstract]
Total ceded premiums	$ 122	$ 124	$ 367	$ 380
Total reinsurance recoveries	$ 117	$ 180	$ 397	$ 292

Reinsurance - Account Value, Ne

Reinsurance - Account Value, Net Amount at Risk and Contractholders for GMDB Business (Details) - Variable Annuity - GMDB contractholder in Thousands, $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2020USD ($)contractholder	Dec. 31, 2019USD ($)contractholder
Net Amount at Risk by Product and Guarantee [Line Items]
Account value	$ 8,650	$ 9,110
Net amount at risk	$ 1,694	$ 1,764
Number of contractholders (estimated) | contractholder	190	200

Reinsurance - GMIB Reinsurers (

Reinsurance - GMIB Reinsurers (Details) - GMIB - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 820	$ 713
Berkshire
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 382	332
Berkshire | Secured | GMIB Assets
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 233	202
Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 205	$ 179
Liberty Re (Bermuda) Ltd. | Secured | GMIB Assets
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%

Investments - Investments by Ca

Investments - Investments by Category (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Current
Investments including assets of business held for sale	$ 1,584	$ 1,351
Investments classified as assets of business held for sale	(260)	(414)
Investments per Consolidated Balance Sheets	1,324	937
Long-term
Investments including assets of business held for sale	29,950	28,837
Investments classified as assets of business held for sale	(7,998)	(7,295)
Investments per Consolidated Balance Sheets	21,952	21,542
Total
Investments including assets of business held for sale	31,534	30,188
Investments classified as assets of business held for sale	(8,258)	(7,709)
Investments per Consolidated Balance Sheets	23,276	22,479
Investments	8,300	7,700
Debt securities
Current
Investments including assets of business held for sale	1,113	928
Long-term
Investments including assets of business held for sale	23,560	22,827
Total
Investments including assets of business held for sale	24,673	23,755
Equity securities
Current
Investments including assets of business held for sale	0	0
Long-term
Investments including assets of business held for sale	379	303
Total
Investments including assets of business held for sale	379	303
Commercial mortgage loans
Current
Investments including assets of business held for sale	13	0
Long-term
Investments including assets of business held for sale	1,966	1,947
Total
Investments including assets of business held for sale	1,979	1,947
Policy loans
Current
Investments including assets of business held for sale	0	0
Long-term
Investments including assets of business held for sale	1,347	1,357
Total
Investments including assets of business held for sale	1,347	1,357
Other long-term investments
Current
Investments including assets of business held for sale	0	0
Long-term
Investments including assets of business held for sale	2,698	2,403
Total
Investments including assets of business held for sale	2,698	2,403
Short-term investments
Current
Investments including assets of business held for sale	458	423
Long-term
Investments including assets of business held for sale	0	0
Total
Investments including assets of business held for sale	$ 458	$ 423

Investments - Debt Securities b

Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Amortized Cost
Due in one year or less	$ 1,133
Due after one year through five years	7,403
Due after five years through ten years	9,011
Due after ten years	4,212
Mortgage and other asset-backed securities	514
Amortized Cost	22,273	$ 21,909
Fair Value
Due in one year or less	1,143
Due after one year through five years	7,789
Due after five years through ten years	10,015
Due after ten years	5,211
Mortgage and other asset-backed securities	515
Fair Value	$ 24,673

Investments - Gross Unrealized

Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 22,273	$ 21,909
Allowance for Credit Loss	(40)	0
Unrealized Appreciation	2,547	1,876
Unrealized Depreciation	(107)	(30)
Fair Value	24,673	23,755
Run-Off Settlement Annuity Business
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,147	2,229
Allowance for Credit Loss	(9)	0
Unrealized Appreciation	828	740
Unrealized Depreciation	(13)	(4)
Fair Value	2,953	2,965
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	411	498
Allowance for Credit Loss	0	0
Unrealized Appreciation	223	235
Unrealized Depreciation	0	0
Fair Value	634	733
State and local government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	628	729
Allowance for Credit Loss	0	0
Unrealized Appreciation	85	81
Unrealized Depreciation	0	0
Fair Value	713	810
Foreign government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,091	2,027
Allowance for Credit Loss	0	0
Unrealized Appreciation	317	230
Unrealized Depreciation	(6)	(1)
Fair Value	2,402	2,256
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	18,629	18,149
Allowance for Credit Loss	(31)	0
Unrealized Appreciation	1,890	1,299
Unrealized Depreciation	(79)	(28)
Fair Value	20,409	19,420
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	514	506
Allowance for Credit Loss	(9)	0
Unrealized Appreciation	32	31
Unrealized Depreciation	(22)	(1)
Fair Value	$ 515	$ 536

Investments - Summary of Debt S

Investments - Summary of Debt Securities with a Decline in Fair Value (Details) $ in Millions	Sep. 30, 2020USD ($)position	Dec. 31, 2019USD ($)position
More than one year
Total Fair Value	$ 2,089	$ 1,513
Total Amortized Cost	2,196	1,543
Total Unrealized Depreciation	$ (107)	$ (30)
Total Number of Issues | position	947	833
Investment grade
One year or less
Fair Value	$ 1,193	$ 723
Amortized Cost	1,224	729
Unrealized Depreciation	$ (31)	$ (6)
Number of Issues | position	356	267
More than one year
Fair Value	$ 107	$ 366
Amortized Cost	111	378
Unrealized Depreciation	$ (4)	$ (12)
Number of Issues | position	19	118
Below investment grade
One year or less
Fair Value	$ 713	$ 340
Amortized Cost	774	348
Unrealized Depreciation	$ (61)	$ (8)
Number of Issues | position	536	355
More than one year
Fair Value	$ 76	$ 84
Amortized Cost	87	88
Unrealized Depreciation	$ (11)	$ (4)
Number of Issues | position	36	93

Investments - Roll-Forward of t

Investments - Roll-Forward of the Allowance for Credit Losses on Debt Securities (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2020
Debt Securities, Available-for-sale, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 48	$ 0
Additions for debt securities where no credit loss has previously been recognized	2	82
Reductions for securities sold during the period	(6)	(15)
Decrease for debt securities where credit losses have previously been recorded	(4)	(27)
Ending Balance	$ 40	$ 40

Investments - Equity Security I

Investments - Equity Security Investments (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Amortized Cost
Equity securities with readily determinable fair values	$ 126	$ 61
Equity securities with no readily determinable fair value	203	183
Hybrid equity securities	57	58
Total	386	302
Carrying Value
Equity securities with readily determinable fair values	124	64
Equity securities with no readily determinable fair value	212	192
Hybrid equity securities	43	47
Total	$ 379	$ 303

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Mar. 31, 2020	Sep. 30, 2020	Sep. 30, 2019	Jun. 30, 2020	Dec. 31, 2019		Jun. 30, 2019	Dec. 31, 2018
Schedule of Investments [Line Items]
Impairments of equity securities related to value changes resulting from observable prices
Stockholders' equity		48,039	44,699	$ 47,371	$ 45,344		$ 43,818	$ 41,035
Realized gains (losses) on investments still held at the reporting date
Fair value of collateral posted
Gain (loss) recognized in the income statement
Gain (loss) recognized in other comprehensive income
Gains (losses) reclassified from other comprehensive income into shareholders' net income
Amounts excluded from assessment of hedge effectiveness
Retained Earnings
Schedule of Investments [Line Items]
Stockholders' equity		24,440	$ 19,185	$ 23,052	20,162		$ 17,834	15,088
Adjustment upon Adoption
Schedule of Investments [Line Items]
Stockholders' equity					(30)	[1]		(15)
Allowance for credit losses on financing receivables					7
Adjustment upon Adoption | Retained Earnings
Schedule of Investments [Line Items]
Stockholders' equity					(30)	[1]		$ (15)
Commercial Portfolio Segment | Real Estate Loan
Schedule of Investments [Line Items]
Allowance for credit losses on financing receivables		9
Current loans		$ 1,979			1,947
Commercial Portfolio Segment | Real Estate Loan | Adjustment upon Adoption | Retained Earnings
Schedule of Investments [Line Items]
Stockholders' equity					$ (7)
[1]	See Note 3 for further information about the Company's adoption of new credit loss guidance (ASU 2016-13).

Investments - Summary of the Cr

Investments - Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2020USD ($)	Dec. 31, 2019USD ($)
Schedule of Investments [Line Items]
Allowance for credit losses	$ (9)
Allowance for credit losses	$ 1,979	$ 1,947
Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.01	2.09
Average Loan-to-Value Ratio	60.00%	58.00%
Below 60%
Schedule of Investments [Line Items]
Carrying Value	$ 861	$ 1,136
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.20	2.19
60% to 79%
Schedule of Investments [Line Items]
Carrying Value	$ 985	$ 723
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.93	1.98
80% to 100%
Schedule of Investments [Line Items]
Carrying Value	$ 142	$ 88
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.33	1.62

Investments - Carrying Values o

Investments - Carrying Values of Other Long-Term Investments (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Schedule of Investments [Line Items]
Other long-term investments	$ 2,698	$ 2,403
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	888	788
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	1,591	1,409
Other
Schedule of Investments [Line Items]
Other long-term investments	$ 219	$ 206

Investments - Short-Term Invest

Investments - Short-Term Investments and Cash Equivalents (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Corporate securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	$ 2,729	$ 1,985
Federal government securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	1,139	472
Foreign government securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	89	65
Money market funds
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	$ 313	$ 631

Investments - Realized Gains an

Investments - Realized Gains and Losses on Investments (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Investments [Abstract]
Net realized investment gains, excluding credit loss expense and asset write-downs	$ 24	$ 60	$ 33	$ 96
Credit loss (expense) recoveries on invested assets	8	0	(41)	0
Other investment asset write-downs	0	(9)	(10)	(12)
Net realized investment gains (losses), before income taxes	$ 32	$ 51	$ (18)	$ 84

Investments - Sales Information

Investments - Sales Information for Available-for-Sale Debt Securities (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement of Financial Position [Abstract]
Proceeds from sales	$ 380	$ 591	$ 2,003	$ 2,242
Gross gains on sales	15	18	81	41
Gross losses on sales	$ 0	$ (5)	$ (21)	$ (17)

Investments - Summary of Deriva

Investments - Summary of Derivative Instruments Held (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Designated as Hedging Instrument | Fair Value Hedging | Foreign currency swap contracts
Derivative [Line Items]
Notional value	$ 853	$ 817
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency swap contracts
Derivative [Line Items]
Notional value	526	438
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency forward contracts
Derivative [Line Items]
Notional value	636	406
Not Designated as Hedging Instrument | Foreign currency forward contracts
Derivative [Line Items]
Notional value	$ 495	$ 410

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Financial assets at fair value:
Debt securities	$ 24,673	$ 23,755
Equity securities	124	64
Financial liabilities at fair value
Unfunded commitments	50
Recurring
Financial assets at fair value:
Debt securities	24,673	23,755
Equity securities	167	111
Short-term investments	458	423
Real estate funds priced at NAV as a practical expedient	165	184
Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	104	83
Financial liabilities at fair value
Derivative liabilities	21	18
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	183	197
Equity securities	1	7
Short-term investments	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	0	0
Financial liabilities at fair value
Derivative liabilities	0	0
Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	23,575	23,035
Equity securities	135	72
Short-term investments	458	423
Significant Other Observable Inputs (Level 2) | Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	104	83
Financial liabilities at fair value
Derivative liabilities	21	18
Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	915	523
Equity securities	31	32
Short-term investments	0	0
Significant Unobservable Inputs (Level 3) | Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	0	0
Financial liabilities at fair value
Derivative liabilities	0	0
Federal government and agency
Financial assets at fair value:
Debt securities	634	733
Federal government and agency | Recurring
Financial assets at fair value:
Debt securities	634	733
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	183	197
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	451	536
Federal government and agency | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	0	0
State and local government
Financial assets at fair value:
Debt securities	713	810
State and local government | Recurring
Financial assets at fair value:
Debt securities	713	810
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	0	0
State and local government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	713	810
State and local government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	0	0
Foreign government
Financial assets at fair value:
Debt securities	2,402	2,256
Foreign government | Recurring
Financial assets at fair value:
Debt securities	2,402	2,256
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	0	0
Foreign government | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	2,381	2,228
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	21	28
Corporate
Financial assets at fair value:
Debt securities	20,409	19,420
Corporate | Recurring
Financial assets at fair value:
Debt securities	20,409	19,420
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	0	0
Corporate | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	19,662	19,063
Corporate | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	747	357
Mortgage and other asset-backed
Financial assets at fair value:
Debt securities	515	536
Mortgage and other asset-backed | Recurring
Financial assets at fair value:
Debt securities	515	536
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	0	0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	368	398
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	$ 147	$ 138

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($)	3 Months Ended			9 Months Ended
	Sep. 30, 2020	Mar. 31, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percent of debt and equity securities classified in Level 2	95.00%			95.00%
Maximum percentage of investments classified in Level 2 representing foreign bonds priced using unadjusted broker quotes	1.00%			1.00%
Percent of debt and equity securities classified in Level 3	4.00%			4.00%
Realized investment losses on assets measured at fair value under certain conditions, after-tax				$ 0	$ 0
Realized investment losses on equity securities with no readily determinable fair value
Fair value of off-balance-sheet financial assets
Fair value of off-balance-sheet financial liabilities
Maximum
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Assets measured at fair value under certain conditions as a percent of total investments	1.00%		1.00%	1.00%	1.00%
Separate Account Assets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Activity, including transfers in and out of Level 3
Separate Account Assets | Recurring | Securities partnerships
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Expected liquidation period after inception				10 years
Other Derivatives | Significant Other Observable Inputs (Level 2)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Adjustment for credit risk on derivatives assets	0			$ 0		0
Adjustment for credit risk on derivatives liabilities	$ 0			$ 0		$ 0

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value and Significant Unobservable Inputs Used in Pricing Debt Securities (Details) - Recurring - Significant Unobservable Inputs (Level 3) $ in Millions	Sep. 30, 2020USD ($)	Dec. 31, 2019USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 915	$ 523
Debt securities | Securities Not Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	3	0
Corporate and government debt securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 765	$ 385
Corporate and government debt securities | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0060	0.0070
Corporate and government debt securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.1570	0.0930
Corporate and government debt securities | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0410	0.0280
Mortgage and other asset-backed securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 147	$ 138
Mortgage and other asset-backed securities | Securities Priced by the Company | Minimum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0060	0.0060
Mortgage and other asset-backed securities | Securities Priced by the Company | Minimum | Weighting of credit spreads
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0320	0.0240
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0370	0.0370
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Weighting of credit spreads
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0650	0.0460
Mortgage and other asset-backed securities | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0080	0.0070
Mortgage and other asset-backed securities | Securities Priced by the Company | Weighted Average | Weighting of credit spreads
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0460	0.0330

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Transfers into/(out of) Level 3
Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period	$ 17		$ (37)
Debt and Equity Securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance	860	$ 431	555	$ 410
Total gains (losses) included in shareholders’ net income	(1)	(6)	4	(7)
Gains (losses) included in other comprehensive income	17	4	(42)	16
Gains (losses) required to adjust future policy benefits for settlement annuities	7	1	4	3
Purchases, sales and settlements
Purchases	3	10	67	53
Sales	(1)	0	(13)	0
Settlements	(8)	(6)	(15)	(16)
Total purchases, sales and settlements	(6)	4	39	37
Transfers into/(out of) Level 3
Transfers into Level 3	102	80	629	113
Transfers out of Level 3	(33)	0	(243)	(58)
Total transfers into/(out of) Level 3	69	80	386	55
Balance	946	514	946	514
Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date	$ 0	$ (6)	$ (2)	$ (8)

Fair Value Measurements - Fai_2

Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 510	$ 490
Non-guaranteed separate accounts, including disposal groups	7,384	7,235
Subtotal	7,894	7,725
Non-guaranteed separate accounts priced at NAV as a practical expedient	736	756
Total	8,630	8,481
Separate account assets of business classified as held for sale	(14)	(16)
Separate account assets per Consolidated Balance Sheets	8,616	8,465
Pension Plan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts, including disposal groups	3,900	4,000
Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	208	219
Non-guaranteed separate accounts, including disposal groups	1,541	1,450
Subtotal	1,749	1,669
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	302	271
Non-guaranteed separate accounts, including disposal groups	5,508	5,522
Subtotal	5,810	5,793
Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	0	0
Non-guaranteed separate accounts, including disposal groups	335	263
Subtotal	335	263
Significant Unobservable Inputs (Level 3) | Pension Plan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts, including disposal groups	$ 300	$ 200

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information on Separate Account Assets Priced at NAV (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 50
Recurring
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	165	$ 184
Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	283
Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	736	756
Securities partnerships | Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	283
Securities partnerships | Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	511	531
Real estate funds | Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Real estate funds | Separate Account Assets | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Real estate funds | Separate Account Assets | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Real estate funds | Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 221	220
Hedge funds | Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Hedge funds | Separate Account Assets | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Hedge funds | Separate Account Assets | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Hedge funds | Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 4	$ 5

Fair Value Measurements - Fai_3

Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Fair Value | Significant Other Observable Inputs (Level 2)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt, including current maturities, excluding finance leases	$ 37,976	$ 39,439
Fair Value | Significant Unobservable Inputs (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	2,033	1,989
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,979	1,947
Long-term debt, including current maturities, excluding finance leases	$ 32,972	$ 36,375

Variable Interest Entities (Det

Variable Interest Entities (Details) $ in Millions	9 Months Ended
	Sep. 30, 2020USD ($)limitedPartnershipentity	Dec. 31, 2019USD ($)entity
Variable Interest Entity [Line Items]
Long-term investments	$ 21,952	$ 21,542
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Number of VIEs | entity
Variable Interest Entity, Not Primary Beneficiary | Securities Limited Partnerships and Real Estate Limited Partnerships
Variable Interest Entity [Line Items]
Maximum exposure to loss related to arrangements with variable interest entity	$ 3,900
Number of limited partnerships defined as variable interest entities | limitedPartnership	150
Long-term investments	$ 2,000
Commitments to contribute additional cash, amount	$ 1,900
Variable Interest Entity, Not Primary Beneficiary | Securities Limited Partnerships and Real Estate Limited Partnerships | Maximum
Variable Interest Entity [Line Items]
Non-controlling interest percentage	15.00%
Variable Interest Entity, Not Primary Beneficiary | Other Asset-Backed and Corporate Securities
Variable Interest Entity [Line Items]
Maximum exposure to loss related to arrangements with variable interest entity	$ 700
Carrying values	700
Variable Interest Entity, Not Primary Beneficiary | Various Other Variable Interest Entities
Variable Interest Entity [Line Items]
Maximum exposure to loss related to arrangements with variable interest entity
Carrying values

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance			$ 45,338
Other comprehensive income, net of tax	$ 243	$ 108	390	$ 850
Less: Net translation of foreign currencies attributable to noncontrolling interests	(4)	1	(10)	(3)
Shareholders other comprehensive income (loss), net of tax	247	107	400	853
Ending balance	48,032		48,032
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	1,256	803	975	18
Other comprehensive income (loss) before reclassifications, before tax	159	298	499	1,305
Other comprehensive income (loss) before reclassifications, tax	(27)	(68)	(96)	(284)
Other comprehensive income (loss) before reclassifications, after-tax	132	230	403	1,021
Reclassification adjustment, before tax	(16)	(10)	(3)	(17)
Reclassification adjustment, tax	4	3	1	4
Net amounts reclassified from AOCI to net income	(12)	(7)	(2)	(13)
Shareholders other comprehensive income (loss), net of tax	120	223	401	1,008
Ending balance	1,376	1,026	1,376	1,026
Translation of foreign currencies
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	(374)	(285)	(275)	(221)
Other comprehensive income (loss), before reclassifications, before tax, including temporary equity	102	(124)	7	(191)
Other comprehensive income (loss) before reclassifications, tax, including temporary equity	7	(3)	(3)	(4)
Other comprehensive income, net of tax	109	(127)	4	(195)
Less: Net translation of foreign currencies attributable to noncontrolling interests	(4)	1	(10)	(3)
Shareholders other comprehensive income (loss), net of tax	113	(128)	14	(192)
Ending balance	(261)	(413)	(261)	(413)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	(1,670)	(1,483)	(1,641)	(1,508)
Other comprehensive income (loss) before reclassifications, before tax	0	(1)	(73)	(9)
Other comprehensive income (loss) before reclassifications, tax	0	0	17	1
Other comprehensive income (loss) before reclassifications, after-tax	0	(1)	(56)	(8)
Reclassification adjustment, tax	(4)	(3)	(13)	(12)
Net amounts reclassified from AOCI to net income	14	13	41	45
Shareholders other comprehensive income (loss), net of tax	14	12	(15)	37
Ending balance	(1,656)	(1,471)	(1,656)	(1,471)
Reclassification adjustment for amortization of net losses from past experience and prior service costs (interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	18	16	54	47
Reclassification adjustment for settlement (interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	$ 0	$ 0	$ 0	$ 10

Organizational Efficiency Plans

Organizational Efficiency Plans (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2020	Sep. 30, 2019
Restructuring and Related Activities [Abstract]
Charge for organizational efficiency plan, pre-tax	$ 31	$ 207	$ 31	$ 0
Charge for organizational efficiency plan, after-tax	$ 24	$ 162	$ 24	$ 0

Leases (Details)

Leases (Details) - USD ($) $ in Millions	Sep. 30, 2020	Dec. 31, 2019
Operating leases:
Operating lease ROU assets	$ 530	$ 536
Accrued expenses and other current liabilities	160	166
Other non-current liabilities	461	465
Total operating lease liabilities	621	631
Finance leases:
Property and equipment, gross	99	110
Accumulated depreciation	(42)	(23)
Property and equipment, net	57	87
Short-term debt	20	27
Long-term debt	40	61
Total finance lease liabilities	$ 60	$ 88
Balance sheet location of non-current operating lease liabilities	us-gaap:OtherLiabilitiesNoncurrent	us-gaap:OtherLiabilitiesNoncurrent
Balance sheet location of non-current finance lease assets	us-gaap:PropertyPlantAndEquipmentAndFinanceLeaseRightOfUseAssetAfterAccumulatedDepreciationAndAmortization	us-gaap:PropertyPlantAndEquipmentAndFinanceLeaseRightOfUseAssetAfterAccumulatedDepreciationAndAmortization
Balance sheet location of current finance lease liabilities	us-gaap:DebtCurrent	us-gaap:DebtCurrent
Balance sheet location of non-current finance lease liabilities	us-gaap:LongTermDebtAndCapitalLeaseObligations	us-gaap:LongTermDebtAndCapitalLeaseObligations
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	ci:AccruedExpensesAndOtherLiabilities	ci:AccruedExpensesAndOtherLiabilities

Income Taxes (Details)

Income Taxes (Details)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	20.80%	22.10%

Contingencies and Other Matte_2

Contingencies and Other Matters (Details) - USD ($)	1 Months Ended		9 Months Ended
	Sep. 30, 2020	Mar. 31, 2016	Sep. 30, 2020	Apr. 30, 2020	Feb. 28, 2017
Guaranty Fund Assessments
Commitments And Contingencies [Line Items]
Provision for loss contingency
Litigation Matters and Regulatory Matters
Commitments And Contingencies [Line Items]
Reserves for litigation matters, pre-tax
CSR Litigation with the Federal Government | Pending Litigation
Commitments And Contingencies [Line Items]
Damages sought by the complaint				$ 315,000,000
Proceeds related to legal claim	120,000,000
Express Scripts Litigation with Anthem | Pending Litigation | Pricing Concessions Through Remaining Contract Term
Commitments And Contingencies [Line Items]
Damages sought by Anthem		$ 13,000,000,000
Express Scripts Litigation with Anthem | Pending Litigation | Pricing Concessions After Remaining Term of Agreement
Commitments And Contingencies [Line Items]
Damages sought by Anthem		1,800,000,000
Express Scripts Litigation with Anthem | Pending Litigation | Damages for Service Issues
Commitments And Contingencies [Line Items]
Damages sought by Anthem		$ 150,000,000
Positive Outcome of Litigation | Cigna Litigation with Anthem | Pending Litigation
Commitments And Contingencies [Line Items]
Reverse termination fee receivable					$ 1,850,000,000
Collectibility of Risk Corridor Payments | CSR Litigation with the Federal Government | Pending Litigation
Commitments And Contingencies [Line Items]
Damages sought by the complaint				120,000,000
Collectibility of CSRs | CSR Litigation with the Federal Government | Pending Litigation
Commitments And Contingencies [Line Items]
Damages sought by the complaint				$ 195,000,000
Additional Damages Including Lost Premium Value To Shareholders | Cigna Litigation with Anthem | Pending Litigation
Commitments And Contingencies [Line Items]
Damages sought by the complaint					$ 13,000,000,000
Indemnification Agreement
Commitments And Contingencies [Line Items]
Liability for guarantees	0		0
Retiree and Life Insurance Benefits | Financial Guarantee
Commitments And Contingencies [Line Items]
Maximum guarantee exposure	455,000,000		455,000,000
Assets maintained by employers (minimum)			455,000,000
Liability for guarantees	$ 0		$ 0

Segment Information - Summary o

Segment Information - Summary of Special Items (Details) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
After-tax
Integration and transaction-related costs (Selling, general and administrative expenses)	$ 83			$ 88	$ 256	$ 311
Debt extinguishment costs (Debt extinguishment costs)					151	0
Charge for organizational efficiency plan (Selling, general and administrative expenses)		$ 24	$ 162		24	0
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)	0			(23)	19	41
Risk corridors recovery (Selling, general and administrative expenses)	(76)			0	(76)	0
Contractual adjustment for a former client (Pharmacy revenues)	(89)			0	(155)	0
Total impact from special items	(82)			65	219	352
Before-tax
Integration and transaction-related costs (Selling, general and administrative expenses)	112			114	339	405
Debt extinguishment costs (Debt extinguishment costs)					199	0
Charge for organizational efficiency plan (Selling, general and administrative expenses)		$ 31	$ 207		31	0
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)	0			(30)	25	51
Risk corridors recovery (Selling, general and administrative expenses)	(101)			0	(101)	0
Contractual adjustment for a former client (Pharmacy revenues)	(117)			0	(204)	0
Total impact from special items	$ (106)			$ 84	$ 289	$ 456

Segment Information - Summarize

Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment Reporting Information [Line Items]
Revenues from customers	$ 40,658			$ 38,207	$ 117,816	$ 114,286
Net investment income	297			349	873	1,035
Total revenues	40,955			38,556	118,689	115,321
Revenue contribution from transitioning clients				(2,718)		(11,657)
Net realized investment results from certain equity method investments	(37)			(5)	(87)	(27)
Special item related to contractual adjustment for a former client	(117)				(204)
Adjusted revenues	40,801			35,833	118,398	103,637
Income before income taxes	1,804			1,763	5,490	5,309
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				(274)		(1,589)
(Income) attributable to noncontrolling interests	(10)			(4)	(27)	(13)
Net realized investments (gains) losses	(69)			(56)	(69)	(111)
Amortization of acquired intangible assets	493			734	1,487	2,214
Special items
Integration and transaction-related costs	112			114	339	405
Debt extinguishment costs					199	0
Charge for organizational efficiency plan		$ 31	$ 207		31	0
(Benefits) charges associated with litigation matters	0			(30)	25	51
Risk corridors recovery (Selling, general and administrative expenses)	(101)			0	(101)	0
Contractual adjustment for a former client	(117)			0	(204)	0
Pre-tax adjusted income (loss) from operations	2,112			2,247	7,170	6,266
Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	29,016			27,084	82,986	80,618
U.S. Medical
Segment Reporting Information [Line Items]
Revenues from customers	9,047			8,648	26,999	26,226
International Markets
Segment Reporting Information [Line Items]
Revenues from customers	1,439			1,368	4,325	4,095
Group Disability and Other
Segment Reporting Information [Line Items]
Revenues from customers	1,156			1,107	3,506	3,347
Operating Segments | Evernorth
Segment Reporting Information [Line Items]
Net investment income	2			15	30	47
Total revenues	29,944			27,598	85,801	82,534
Revenue contribution from transitioning clients				(2,718)		(11,657)
Net realized investment results from certain equity method investments	0			0	0	0
Special item related to contractual adjustment for a former client	(117)				(204)
Adjusted revenues	29,827			24,880	85,597	70,877
Income before income taxes	1,086			965	2,551	3,015
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				(274)		(1,589)
(Income) attributable to noncontrolling interests	(5)			0	(12)	(1)
Net realized investments (gains) losses	0			0	0	0
Amortization of acquired intangible assets	479			708	1,439	2,130
Special items
Integration and transaction-related costs	0			0	0	0
Debt extinguishment costs					0
Charge for organizational efficiency plan					0
(Benefits) charges associated with litigation matters				0	0	0
Risk corridors recovery (Selling, general and administrative expenses)	0				0
Contractual adjustment for a former client	(117)				(204)
Pre-tax adjusted income (loss) from operations	1,443			1,399	3,774	3,555
Operating Segments | U.S. Medical
Segment Reporting Information [Line Items]
Net investment income	104			124	279	358
Total revenues	9,629			9,148	28,726	27,311
Revenue contribution from transitioning clients				0		0
Net realized investment results from certain equity method investments	0			0	0	0
Special item related to contractual adjustment for a former client	0				0
Adjusted revenues	9,629			9,148	28,726	27,311
Income before income taxes	846			1,011	3,529	3,157
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				0		0
(Income) attributable to noncontrolling interests	0			0	0	0
Net realized investments (gains) losses	6			(43)	28	(65)
Amortization of acquired intangible assets	6			15	23	51
Special items
Integration and transaction-related costs	0			0	0	0
Debt extinguishment costs					0
Charge for organizational efficiency plan					0
(Benefits) charges associated with litigation matters				(30)	0	(30)
Risk corridors recovery (Selling, general and administrative expenses)	(101)				(101)
Contractual adjustment for a former client	0				0
Pre-tax adjusted income (loss) from operations	757			953	3,479	3,113
Operating Segments | International Markets
Segment Reporting Information [Line Items]
Net investment income	38			39	104	117
Total revenues	1,477			1,407	4,429	4,212
Revenue contribution from transitioning clients				0		0
Net realized investment results from certain equity method investments	(37)			(5)	(87)	(27)
Special item related to contractual adjustment for a former client	0				0
Adjusted revenues	1,440			1,402	4,342	4,185
Income before income taxes	253			184	877	601
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				0		0
(Income) attributable to noncontrolling interests	(5)			(4)	(15)	(12)
Net realized investments (gains) losses	(48)			5	(75)	(10)
Amortization of acquired intangible assets	8			9	22	28
Special items
Integration and transaction-related costs	0			0	0	0
Debt extinguishment costs					0
Charge for organizational efficiency plan					0
(Benefits) charges associated with litigation matters				0	0	0
Risk corridors recovery (Selling, general and administrative expenses)	0				0
Contractual adjustment for a former client	0				0
Pre-tax adjusted income (loss) from operations	208			194	809	607
Operating Segments | Group Disability and Other
Segment Reporting Information [Line Items]
Net investment income	152			170	458	521
Total revenues	1,314			1,284	3,981	3,889
Revenue contribution from transitioning clients				0		0
Net realized investment results from certain equity method investments	0			0	0	0
Special item related to contractual adjustment for a former client	0				0
Adjusted revenues	1,314			1,284	3,981	3,889
Income before income taxes	97			159	298	407
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				0		0
(Income) attributable to noncontrolling interests	0			0	0	0
Net realized investments (gains) losses	(27)			(18)	(22)	(36)
Amortization of acquired intangible assets	0			2	3	5
Special items
Integration and transaction-related costs	0			0	0	0
Debt extinguishment costs					0
Charge for organizational efficiency plan					0
(Benefits) charges associated with litigation matters				0	0	0
Risk corridors recovery (Selling, general and administrative expenses)	0				0
Contractual adjustment for a former client	0				0
Pre-tax adjusted income (loss) from operations	70			143	279	376
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net investment income	1			1	2	(8)
Total revenues	(1,409)			(881)	(4,248)	(2,625)
Revenue contribution from transitioning clients				0		0
Net realized investment results from certain equity method investments	0			0	0	0
Special item related to contractual adjustment for a former client	0				0
Adjusted revenues	(1,409)			(881)	(4,248)	(2,625)
Income before income taxes	(478)			(556)	(1,765)	(1,871)
Special items
Pre-tax adjusted income (loss) from operations	(366)			(442)	(1,171)	(1,385)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	0			0	0	0
Pre-tax adjustments to reconcile to adjusted income from operations
Adjustment for transitioning clients				0		0
(Income) attributable to noncontrolling interests	0			0	0	0
Net realized investments (gains) losses	0			0	0	0
Amortization of acquired intangible assets	0			0	0	0
Special items
Integration and transaction-related costs	112			114	339	405
Debt extinguishment costs					199
Charge for organizational efficiency plan					31
(Benefits) charges associated with litigation matters				0	25	81
Risk corridors recovery (Selling, general and administrative expenses)	0				0
Contractual adjustment for a former client	0				0
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(1,410)			(882)	(4,250)	(2,617)
Intersegment Eliminations | Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	(926)			(499)	(2,785)	(1,869)
Intersegment Eliminations | U.S. Medical
Segment Reporting Information [Line Items]
Revenues from customers	(478)			(376)	(1,448)	(727)
Intersegment Eliminations | International Markets
Segment Reporting Information [Line Items]
Revenues from customers	0			0	0	0
Intersegment Eliminations | Group Disability and Other
Segment Reporting Information [Line Items]
Revenues from customers	$ (6)			$ (7)	$ (17)	$ (21)

Segment Information - Revenue f

Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenue from External Customer [Line Items]
Premiums	$ 10,682	$ 9,935	$ 31,928	$ 29,709
Total revenues from external customers	40,658	38,207	117,816	114,286
U.S. Medical
Revenue from External Customer [Line Items]
Total revenues from external customers	9,047	8,648	26,999	26,226
International Markets
Revenue from External Customer [Line Items]
Premiums	1,360	1,309	4,079	3,914
Total revenues from external customers	1,439	1,368	4,325	4,095
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	27,802	25,987	79,464	77,454
Network revenues
Revenue from External Customer [Line Items]
Revenues	13,968	12,923	39,200	37,954
Home delivery and specialty revenues
Revenue from External Customer [Line Items]
Revenues	12,422	11,837	36,319	35,893
Other
Revenue from External Customer [Line Items]
Revenues	1,412	1,227	3,945	3,607
U.S. Medical premiums | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	8,196	7,544	24,428	22,523
Health Insurance | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	3,397	3,174	9,948	9,278
Stop loss | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	1,146	1,085	3,459	3,221
Other | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	281	260	853	779
Medicare Advantage | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	1,895	1,562	5,680	4,779
Medicare Part D | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	360	404	1,242	1,329
Other | U.S. Medical
Revenue from External Customer [Line Items]
Premiums	1,117	1,059	3,246	3,137
Domestic disability, life and accident premiums
Revenue from External Customer [Line Items]
Premiums	1,106	1,049	3,346	3,165
Other premiums
Revenue from External Customer [Line Items]
Premiums	20	33	75	107
Services
Revenue from External Customer [Line Items]
Revenues	2,174	2,285	6,424	7,123
Fees
Revenue from External Customer [Line Items]
Revenues	2,120	2,249	6,253	7,015
Other external revenues
Revenue from External Customer [Line Items]
Revenues	$ 54	$ 36	$ 171	$ 108

Segment Information - Narrative

Segment Information - Narrative (Details) - USD ($) $ in Billions	Sep. 30, 2020	Dec. 31, 2019
Performance Guarantee | Pharmacy Benefits Management Services
Loss Contingencies [Line Items]
Reserves for performance guarantees	$ 1	$ 1