Cigna (CI) 10-Q 7 May 21 2021 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2021	Apr. 30, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
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		343,145,549
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2021
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Entity Central Index Key	0001739940

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues
Premiums	$ 10,214	$ 10,840
Net investment income	391	353
TOTAL REVENUES	40,971	38,469
Benefits and expenses
Pharmacy and other service costs	27,235	24,190
Medical costs and other benefit expenses	8,005	8,322
Selling, general and administrative expenses	3,279	3,398
Amortization of acquired intangible assets	495	498
TOTAL BENEFITS AND EXPENSES	39,014	36,408
Income (loss) from operations	1,957	2,061
Interest expense and other	(314)	(391)
Debt extinguishment costs	(131)	(185)
Net realized investment gains (losses)	1	(88)
Income before income taxes	1,513	1,397
TOTAL INCOME TAXES	342	208
Net income	1,171	1,189
Less: Net income attributable to noncontrolling interests	10	8
SHAREHOLDERS' NET INCOME	$ 1,161	$ 1,181
Shareholders’ net income per share
Basic (in dollars per share)	$ 3.33	$ 3.19
Diluted (in dollars per share)	$ 3.30	$ 3.15
Pharmacy revenues
Revenues
Revenues	$ 28,025	$ 25,098
Fees and other revenues
Revenues
Revenues	$ 2,341	$ 2,178

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 1,171	$ 1,189
Other comprehensive loss, net of tax
Net unrealized appreciation (depreciation) on securities and derivatives	(273)	(428)
Net translation gains (losses) on foreign currencies	(119)	(175)
Postretirement benefits liability adjustment	18	13
Other comprehensive loss, net of tax	(374)	(590)
Total comprehensive income	797	599
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interest	5	4
Net income attributable to other noncontrolling interests	5	4
Other comprehensive (loss) attributable to redeemable noncontrolling interest	(4)	(4)
Total comprehensive income attributable to noncontrolling interests	6	4
SHAREHOLDERS' COMPREHENSIVE INCOME	$ 791	$ 595

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions		Mar. 31, 2021	Dec. 31, 2020
Assets
Cash and cash equivalents		$ 6,505	$ 10,182
Investments		1,477	1,331
Accounts receivable, net		13,588	12,191
Inventories		2,919	3,165
Other current assets		1,065	930
Total current assets		25,554	27,799
Long-term investments		22,821	23,262
Reinsurance recoverables		5,175	5,200
Deferred policy acquisition costs		3,351	3,385
Property and equipment		4,114	4,205
Goodwill		44,635	44,648
Other intangible assets		34,792	35,179
Other assets		2,551	2,687
Separate account assets		9,088	9,086
TOTAL ASSETS		152,081	155,451
Liabilities
Current insurance and contractholder liabilities		5,743	5,308
Pharmacy and other service costs payable		13,762	13,347
Accounts payable		5,640	5,478
Accrued expenses and other liabilities		7,921	8,515
Short-term debt		404	3,374
Total current liabilities		33,470	36,022
Non-current insurance and contractholder liabilities		16,424	16,844
Deferred tax liabilities, net		8,832	8,939
Other non-current liabilities		4,485	4,629
Long-term debt		31,568	29,545
Separate account liabilities		9,088	9,086
TOTAL LIABILITIES		103,867	105,065
Contingencies — Note 15
Redeemable noncontrolling interests		59	58
Shareholders’ equity
Common stock	[1]	4	4
Additional paid-in capital		29,254	28,975
Accumulated other comprehensive loss		(1,231)	(861)
Retained earnings		29,389	28,575
Less: treasury stock, at cost		(9,267)	(6,372)
TOTAL SHAREHOLDERS’ EQUITY		48,149	50,321
Other noncontrolling interests		6	7
Total equity		48,155	50,328
Total liabilities and equity		$ 152,081	$ 155,451
[1]	Par value per share, $0.01; shares issued, 393 million as of March 31, 2021 and 390 million as of December 31, 2020; authorized shares, 600 million.

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	393,000,000	390,000,000
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, 2019	$ 45,344	$ (30)	$ 45,338	$ (30)	$ 4	$ 28,306	$ (941)	$ 20,162	$ (30)	$ (2,193)	$ 6
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans	170		170			248				(78)
Other comprehensive loss	(586)		(586)				(586)
Net income	1,185		1,181					1,181			4
Common dividends declared	(15)		(15)					(15)
Repurchase of common stock	(979)		(979)							(979)
Other transactions impacting noncontrolling interests	(3)										(3)
Balance at Mar. 31, 2020	45,086		45,079		4	28,554	(1,527)	21,298		(3,250)	7
Balance at Dec. 31, 2019	35
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	(4)
Net income	4
Other transactions impacting noncontrolling interests	0
Balance at Mar. 31, 2020	$ 35
Change in Redeemable Noncontrolling Interests
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member
Balance at Dec. 31, 2020	$ 50,328		50,321		4	28,975	(861)	28,575		(6,372)	7
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans	192		192			279				(87)
Other comprehensive loss	(370)		(370)				(370)
Net income	1,166		1,161					1,161			5
Common dividends declared	(347)		(347)					(347)
Repurchase of common stock	(2,808)		(2,808)							(2,808)
Other transactions impacting noncontrolling interests	(6)										(6)
Balance at Mar. 31, 2021	48,155		$ 48,149		$ 4	$ 29,254	$ (1,231)	$ 29,389		$ (9,267)	$ 6
Balance at Dec. 31, 2020	58
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	(4)
Net income	5
Other transactions impacting noncontrolling interests	0
Balance at Mar. 31, 2021	$ 59

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 1	$ 0.04

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Millions		3 Months Ended
		Mar. 31, 2021	Mar. 31, 2020
Cash Flows from Operating Activities
Net income		$ 1,171	$ 1,189
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		715	693
Realized investment (gains) losses, net		(1)	88
Deferred income tax (benefit)		(35)	(161)
Debt extinguishment costs		131	185
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable		(1,420)	(1,056)
Inventories		247	96
Deferred policy acquisition costs		(60)	(138)
Reinsurance recoverable and Other assets		40	(210)
Insurance liabilities		443	341
Pharmacy and other service costs payable		415	408
Accounts payable and Accrued expenses and other liabilities		(637)	308
Other, net		84	144
NET CASH PROVIDED BY OPERATING ACTIVITIES		1,093	1,887
Proceeds from investments sold:
Debt securities and equity securities		378	756
Investment maturities and repayments:
Debt securities and equity securities		328	408
Commercial mortgage loans		72	5
Other sales, maturities and repayments (primarily short-term and other long-term investments)		364	346
Investments purchased or originated:
Debt securities and equity securities		(980)	(1,174)
Other (primarily short-term and other long-term investments)		(637)	(380)
Property and equipment purchases, net		(242)	(267)
Other, net		0	37
NET CASH (USED IN) INVESTING ACTIVITIES		(717)	(269)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		47	267
Withdrawals and benefit payments from contractholder deposit funds		(35)	(255)
Net change in short-term debt		(1,030)	(180)
Payments for debt extinguishment		(126)	(192)
Repayment of long-term debt		(4,199)	(4,209)
Net proceeds on issuance of long-term debt		4,262	3,470
Repurchase of common stock		(2,794)	(956)
Issuance of common stock		204	153
Common stock dividend paid		(345)	0
Other, net		(35)	84
NET CASH (USED IN) FINANCING ACTIVITIES		(4,051)	(1,818)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		(26)	(37)
Net (decrease) in cash, cash equivalents and restricted cash		(3,701)	(237)
Cash, cash equivalents and restricted cash January 1,	[1]	10,245	5,411
Cash, cash equivalents and restricted cash, March 31,		6,544	5,174
Cash reclassified to assets of business held for sale		0	(597)
Cash, cash equivalents, and restricted cash December 31, per Consolidated Balance Sheets	[2]	6,544	4,577
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		122	81
Interest paid		$ 331	$ 395
[1]	Includes $743 million reported in Assets of business held for sale as of January 1, 2020. See table below for Cash, cash equivalents and restricted cash reconciliation.
[2]	See table below for Cash, cash equivalents and restricted cash reconciliation as of March 31, 2021 and 2020.

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Millions		Mar. 31, 2021	Mar. 31, 2020
Statement of Cash Flows [Abstract]
Cash reclassified to assets of business held for sale		$ 0	$ 597
Cash and cash equivalents		6,505	4,452
Restricted cash and cash equivalents, included in other long-term investments		39	125
Total cash, cash equivalents and restricted cash and cash equivalents	[1]	$ 6,544	$ 4,577
[1]	See table below for Cash, cash equivalents and restricted cash reconciliation as of March 31, 2021 and 2020.

Description of Business

Description of Business	3 Months Ended
	Mar. 31, 2021
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 by making health care simple, affordable and predictable. We offer a differentiated set of pharmacy, medical, dental and related products and services 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 segments detailed below: In connection with the sale of the U.S. Group Disability and Life business on December 31, 2020, the remainder of our operations previously referred to as "Group Disability and Other" in our 2020 Form 10-K is now referred to as "Other Operations". There were no changes to the underlying business included in this category. Our business that offers group voluntary products and services was not sold to New York Life and results of this business are reported in the U.S. Medical segment. In connection with the launch of Evernorth in the third quarter of 2020, two reporting segments were renamed. Health Services was renamed as Evernorth and Integrated Medical was renamed U.S. Medical. In addition, two of our operating segments were renamed: Commercial and Government were renamed 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 capabilities, as well as those from partners across the health care system in pharmacy solutions, benefits management solutions, care solutions and intelligence solutions, which are provided to health plans, employers, government organizations and health care providers. U.S. Medical includes U.S. Commercial and U.S. Government businesses that provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental, vision, health advocacy programs and other products and services for insured and administrative services only ("ASO") clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors, 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 for globally mobile employees of multinational organizations. The remainder of our business operations are reported in Other Operations, consisting of the following: • Group Disability and Life . Prior to the sale of the U.S. Group Disability and Life business on December 31, 2020, this segment provided group long-term and short-term disability, group life, accident, voluntary and specialty insurance products and related services. • 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 net interest expense (defined as interest on corporate debt less net investment income on investments not supporting segment and other operations), certain litigation matters, expense associated with our frozen pension plans, charitable contributions, severance, certain overhead and project costs and intersegment eliminations for products and services sold between segments.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
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.

Accounts Receivable, Net

Accounts Receivable, Net	3 Months Ended
	Mar. 31, 2021
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net The following amounts were included within Accounts receivable, net: (In millions) March 31, 2021 December 31, 2020 Noninsurance customer receivables $ 6,249 $ 5,534 Pharmaceutical manufacturers receivable 4,978 4,676 Insurance customer receivables 2,172 1,789 Other receivables 189 192 Total $ 13,588 $ 12,191

Mergers, Acquisitions and Dives

Mergers, Acquisitions and Divestitures	3 Months Ended
	Mar. 31, 2021
Business Combinations [Abstract]
Mergers, Acquisitions and Divestitures	Mergers, Acquisitions and DivestituresAcquisition of MDLIVEIn April 2021, Cigna's Evernorth segment completed the 100% acquisition of MDLIVE, Inc. ("MDLIVE"), a 24/7 virtual care platform. The acquisition of MDLIVE will enable Evernorth to continue expanding access to virtual care and delivering a more affordable, convenient and connected care experience for consumers. The Company will complete the purchase price allocation in the second quarter of 2021. Divestiture of U.S. Group Disability and Life businessOn December 31, 2020, Cigna completed the sale of its U.S. Group Disability and Life business to New York Life Insurance Company for cash proceeds of $6.2 billion. The Company recognized a gain of $4.2 billion pre-tax ($3.2 billion after-tax), which includes recognition of previously unrealized capital gains on investments sold.Integration and Transaction-related CostsIn the first three months of 2021, the Company incurred costs related to the acquisition of MDLIVE, the terminated merger with Anthem, Inc. (“Anthem”), the sale of the U.S. Group Disability and Life business and other transactions. In the first three months of 2020, the Company incurred costs related to the acquisition and integration of Express Scripts Holding Company ("Express Scripts"), the terminated merger with Anthem, the sale of the U.S. Group Disability and Life insurance business and other transactions. These costs were $29 million pre-tax ($22 million after-tax) for the three months ended March 31, 2021, compared with $97 million pre-tax ($74 million after-tax) for the three months ended March 31, 2020, and consisted primarily of certain projects related to the Company’s systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs.

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share (“EPS”) Basic and diluted earnings per share were computed as follows: Three Months Ended March 31, 2021 March 31, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 1,161 $ 1,161 $ 1,181 $ 1,181 Shares: Weighted average 348,248 348,248 370,440 370,440 Common stock equivalents 3,728 3,728 4,199 4,199 Total shares 348,248 3,728 351,976 370,440 4,199 374,639 EPS $ 3.33 $ (0.03) $ 3.30 $ 3.19 $ (0.04) $ 3.15 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 March 31, (In millions) 2021 2020 Anti-dilutive options 1.5 4.1

Debt

Debt	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Debt	Debt The outstanding amounts of debt and finance leases were as follows: (In millions) March 31, 2021 December 31, 2020 Short-term debt $78 million, 6.37% Notes due 6/2021 78 78 $1,000 million, Floating Rate Notes due 9/2021 — 999 $1,250 million, 3.4% Notes due 9/2021 — 1,249 $181 million, 3.9% Notes due 2/2022 181 — $120 million, 4% Notes due 2/2022 120 — Commercial paper 5 1,030 Other, including finance leases 20 18 Total short-term debt $ 404 $ 3,374 Long-term debt $277 million, 4% Notes due 2022 — 276 $973 million, 3.9% Notes due 2022 — 972 $500 million, 3.05% Notes due 2022 491 490 $17 million, 8.3% Notes due 2023 17 17 $63 million, 7.65% Notes due 2023 63 63 $700 million, Floating Rate Notes due 2023 698 698 $1,000 million, 3% Notes due 2023 978 975 $1,187 million, 3.75% Notes due 2023 1,184 2,181 $500 million, 0.613% Notes due 2024 498 — $1,000 million, 3.5% Notes due 2024 979 977 $900 million, 3.25% Notes due 2025 896 896 $2,200 million, 4.125% Notes due 2025 2,191 2,191 $1,500 million, 4.5% Notes due 2026 1,504 1,505 $800 million, 1.25% Notes due 2026 796 — $1,500 million, 3.4% Notes due 2027 1,413 1,410 $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 3,781 3,780 $1,500 million, 2.4% Notes due 2030 1,490 1,489 $1,500 million, 2.375% Notes due 2031 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 2,180 $750 million, 3.2% Notes due 2040 742 742 $121 million, 5.875% Notes due 2041 119 119 $448 million, 6.125% Notes due 2041 490 490 $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 2,966 $1,250 million, 3.4% Notes due 2050 1,235 1,235 $1,500 million , 3.4% Notes due 2051 1,476 — Other, including finance leases 35 36 Total long-term debt $ 31,568 $ 29,545 Debt Issuance and Redemption. In order to decrease future interest expense, mitigate future refinancing risk and raise proceeds for general corporate purposes, the Company entered into the following transactions during the three months ended March 31, 2021: • Debt issuance: On March 3, 2021, the Company issued $4.3 billion of new senior notes. The proceeds of this issuance were mainly used to redeem outstanding debt securities. The remaining proceeds are available for general corporate purposes. Interest on this debt is paid semi-annually. Principal Maturity Date Interest Rate Net Proceeds $500 million March 15, 2024 0.613% $499 million $800 million March 15, 2026 1.250% $797 million $1,500 million March 15, 2031 2.375% $1,492 million $1,500 million March 15, 2051 3.400% $1,479 million • Debt redemption: In the first quarter of 2021, the Company completed the redemption of a total of $4.2 billion in aggregate principal amount of certain of its outstanding debt securities. The Company recorded a pre-tax loss of $131 million ($101 million after-tax), consisting primarily of premium payments. An additional $301 million of outstanding debt securities due February 2022 were redeemed on April 2, 2021. The effect of a pre-tax loss from this April redemption is not expected to be material to results of operations for the second quarter of 2021. Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including for the purpose of providing liquidity support if necessary under our commercial paper program discussed below. For the first quarter of 2021, Cigna had a $3.25 billion revolving credit and letter of credit agreement maturing in April 2023 that was diversified among 23 banks. Under the facility $3.25 billion was available for general corporate purposes and up to $500 million was available for issuance of letters of credit. The facility included options to extend the termination date for additional one-year periods and increase the facility by $500 million, subject to the consent of the banks. Additionally, for the first quarter of 2021, Cigna had a $1.0 billion 364-day revolving credit agreement maturing in October 2021 that was diversified among 23 banks. Under this agreement, Cigna could borrow up to $1.0 billion for general corporate purposes. The agreement included the option to “term out” any revolving loans that were outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion. The revolving credit agreements contained customary covenants and restrictions, including a financial covenant that Cigna’s leverage ratio may not exceed 60%. As of March 31, 2021, there were no outstanding balances under these revolving credit agreements. In April 2021, Cigna entered into a $3.0 billion five three five five Additionally, in April 2021, Cigna entered into a $1.0 billion 364-day revolving credit agreement that will mature in April 2022 and is diversified among 23 banks. This agreement replaces the $1.0 billion 364-day revolving credit agreement that was scheduled to expire in October 2021. 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. Each of the five three Commercial Paper. Under our commercial paper program we may issue short-term, unsecured commercial paper notes privately placed on a discount basis through certain broker dealers at any time not to exceed $4.25 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. The Company was in compliance with its debt covenants as of March 31, 2021.

Insurance and Contractholder Li

Insurance and Contractholder Liabilities	3 Months Ended
	Mar. 31, 2021
Insurance Loss Reserves [Abstract]
Insurance and Contractholder Liabilities	Insurance and Contractholder Liabilities A. Account Balances – Insurance and Contractholder Liabilities The Company’s insurance and contractholder liabilities were comprised of the following: March 31, 2021 December 31, 2020 March 31, 2020 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 355 $ 6,806 $ 7,161 $ 350 $ 6,823 $ 7,173 $ 7,699 Future policy benefits 361 8,945 9,306 327 9,317 9,644 9,651 Unearned premiums 561 389 950 485 394 879 840 Unpaid claims and claim expenses U.S. Medical 3,528 21 3,549 3,166 18 3,184 3,000 Other segments 938 263 1,201 980 292 1,272 6,119 Total 27,309 Insurance and contractholder liabilities classified as liabilities of business held for sale (1) (6,441) Total insurance and contractholder liabilities $ 5,743 $ 16,424 $ 22,167 $ 5,308 $ 16,844 $ 22,152 $ 20,868 (1) Amounts classified as Liabilities of business held for sale primarily include $5.1 billion of unpaid claims, $726 million of contractholder deposit funds and $640 million of future policy benefits as of March 31, 2020. Insurance and contractholder liabilities expected to be paid within one year are classified as current. The total of incurred but not reported liabilities plus expected development on reported claims, including reported claims in process, was $3.3 billion at March 31, 2021 and $2.7 billion at March 31, 2020. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the three months ended March 31 was as follows: Three Months Ended (In millions) March 31, 2021 March 31, 2020 Beginning balance $ 3,184 $ 2,892 Less: Reinsurance and other amounts recoverable 224 303 Beginning balance, net 2,960 2,589 Incurred costs related to: Current year 7,285 6,661 Prior years (185) (152) Total incurred 7,100 6,509 Paid costs related to: Current year 4,423 4,271 Prior years 2,317 2,027 Total paid 6,740 6,298 Ending balance, net 3,320 2,800 Add: Reinsurance and other amounts recoverable 229 200 Ending balance $ 3,549 $ 3,000 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 8 for additional information on reinsurance. Variances in incurred costs related to prior years’ unpaid claims and claim expenses that resulted from the differences between actual experience and the Company’s key assumptions for the three months ended March 31 were as follows: Three Months Ended (Dollars in millions) March 31, 2021 March 31, 2020 $ % (1) $ % (2) Actual completion factors $ 68 0.2 % $ 63 0.3 % Medical cost trend 117 0.5 89 0.3 Total favorable variance $ 185 0.7 % $ 152 0.6 % (1) Percentage of current year incurred costs as reported for the year ended December 31, 2020. (2) Percentage of current year incurred costs as reported for the year ended December 31, 2019. Favorable prior year development in both years reflects lower than expected utilization of medical services. Liability balance details. The liability details for unpaid claims and claim expenses are as follows: (In millions) March 31, 2021 March 31, 2020 Other Operations Group Disability and Life $ — $ 5,084 Other Operations 281 209 Total Other Operations 281 5,293 International Markets 920 826 Unpaid claims and claim expenses Other Operations and International Markets $ 1,201 $ 6,119 Activity in the Company’s liabilities for unpaid claims and claim expenses for International Markets and, prior to the sale, Group Disability and Life, is 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. Three Months Ended (In millions) March 31, 2021 March 31, 2020 (1) Beginning balance $ 963 $ 5,816 Less: Reinsurance 59 184 Beginning balance, net 904 5,632 Incurred claims related to: Current year 724 1,473 Prior years: Interest accretion — 42 All other incurred (48) 46 Total incurred 676 1,561 Paid claims related to: Current year 326 490 Prior years 372 946 Total paid 698 1,436 Foreign currency (20) (25) Ending balance, net 862 5,732 Add: Reinsurance 58 178 Ending balance $ 920 $ 5,910 (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 8 for additional information on reinsurance.

Reinsurance

Reinsurance	3 Months Ended
	Mar. 31, 2021
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 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 are $216 million of current reinsurance recoverables that are reported in Other current assets as of March 31, 2021; as of December 31, 2020 there was $217 million of current reinsurance recoverables reported in Other current assets. The Company’s reinsurance recoverables as of March 31, 2021 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) $ — $ — $ 173 $ 173 Lower-medium grade (2) — — 63 63 Not rated 92 — 34 126 Total recoverables related to ongoing operations 92 — 270 362 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 3,022 — 3,022 Berkshire 301 399 — 700 Prudential Retirement Insurance and Annuity 607 — — 607 Life Insurance Company of North America — 449 — 449 Other 230 17 18 265 Not rated — 13 4 17 Total recoverables related to acquisition, disposition or runoff activities 1,138 3,900 22 5,060 Total $ 1,230 $ 3,900 $ 292 $ 5,422 Allowance for uncollectible reinsurance (31) Total reinsurance recoverables $ 5,391 (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 an NRSRO (3) 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. 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 March 31, (In millions) 2021 2020 Total ceded premiums $ 149 $ 128 Total reinsurance recoveries $ 148 $ 178 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 March 31, 2021. 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. Assumptions used in fair value measurement these assets and liabilities are discussed in Note 10 of the Company's 2020 Form 10-K. 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) March 31, 2021 December 31, 2020 Account value $ 9,518 $ 9,523 Net amount at risk $ 1,518 $ 1,570 Number of contractholders (estimated) 180,000 185,000 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. GMIB liabilities totaling $595 million as of March 31, 2021 and $729 million as of December 31, 2020 are classified as Level 3 because fair value inputs are largely unobservable. There were three reinsurers covering 100% of the GMIB exposures as of March 31, 2021 and December 31, 2020 as follows: (In millions) Line of Business Reinsurer March 31, 2021 December 31, 2020 Collateral and Other Terms at March 31, 2021 GMIB Berkshire $ 288 $ 353 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 173 215 Liberty Re (Bermuda) Ltd. 155 190 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 616 $ 758 All reinsurers are rated A- equivalent and higher by an NRSRO.

Investments

Investments	3 Months Ended
	Mar. 31, 2021
Investments [Abstract]
Investments	InvestmentsCigna’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 10 for information about the valuation of the Company’s investment portfolio. Further information about our accounting policies for investment assets can be found in Note 11 of the Company's 2020 Form 10-K. The following table summarizes the Company's investments by category and current or long-term classification. March 31, 2021 December 31, 2020 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 906 $ 16,743 $ 17,649 $ 959 $ 17,172 $ 18,131 Equity securities — 550 550 — 501 501 Commercial mortgage loans 60 1,287 1,347 13 1,406 1,419 Policy loans — 1,344 1,344 — 1,351 1,351 Other long-term investments — 2,897 2,897 — 2,832 2,832 Short-term investments 511 — 511 359 — 359 Total $ 1,477 $ 22,821 $ 24,298 $ 1,331 $ 23,262 $ 24,593 The amortized cost and fair value by contractual maturity periods for debt securities were as follows at March 31, 2021: (In millions) Amortized Fair Due in one year or less $ 930 $ 938 Due after one year through five years 5,394 5,635 Due after five years through ten years 5,769 6,110 Due after ten years 3,869 4,507 Mortgage and other asset-backed securities 461 459 Total $ 16,423 $ 17,649 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 March 31, 2021 Federal government and agency $ 298 $ — $ 99 $ (3) $ 394 State and local government 149 — 14 (1) 162 Foreign government 2,206 — 237 (23) 2,420 Corporate 13,309 (24) 1,037 (108) 14,214 Mortgage and other asset-backed 461 (11) 20 (11) 459 Total $ 16,423 $ (35) $ 1,407 $ (146) $ 17,649 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,355 $ (4) $ 590 $ (18) $ 2,923 December 31, 2020 Federal government and agency $ 334 $ — $ 122 $ — $ 456 State and local government 150 — 17 — 167 Foreign government 2,201 — 318 (8) 2,511 Corporate 13,108 (19) 1,506 (33) 14,562 Mortgage and other asset-backed 427 (7) 27 (12) 435 Total $ 16,220 $ (26) $ 1,990 $ (53) $ 18,131 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,282 $ (5) $ 838 $ (3) $ 3,112 (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 for which an allowance for credit losses has not been recorded, 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. March 31, 2021 December 31, 2020 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 2,225 $ 2,333 $ (108) 815 $ 1,026 $ 1,045 $ (19) 300 Below investment grade $ 463 $ 485 $ (22) 567 $ 381 $ 405 $ (24) 232 More than one year Investment grade $ 66 $ 70 $ (4) 15 $ 18 $ 18 $ — 6 Below investment grade $ 179 $ 191 $ (12) 51 $ 90 $ 100 $ (10) 33 Total $ 2,933 $ 3,079 $ (146) 1,448 $ 1,515 $ 1,568 $ (53) 571 The table below presents a roll-forward of the allowance for credit losses on debt securities for the three months ended March 31: Three Months Ended Three Months Ended (In millions) 2021 2020 Beginning balance $ 26 $ — Additions for debt securities where no credit loss has previously been recognized 11 55 Reductions for securities sold during the period — — Decrease for debt securities where credit losses have previously been recorded (2) — Ending balance $ 35 $ 55 Equity Securities The following table provides the values of the Company's equity security investments as of March 31, 2021 and December 31, 2020. The amount of impairments or value changes resulting from observable price changes on equity securities still held was not material to the financial statements as of March 31, 2021 or December 31, 2020. March 31, 2021 December 31, 2020 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 192 $ 211 $ 180 $ 202 Equity securities with no readily determinable fair value $ 231 $ 298 $ 225 $ 255 Hybrid equity securities $ 58 $ 41 $ 58 $ 44 Total $ 481 $ 550 $ 463 $ 501 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 March 31, 2021 and December 31, 2020. (Dollars in millions) March 31, 2021 December 31, 2020 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% $ 513 2.25 $ 533 2.28 60% to 79% 699 2.11 751 2.08 80% to 100% 141 1.33 141 1.33 Allowance for credit losses (6) (6) Total $ 1,347 2.08 61 % $ 1,419 2.08 61 % 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 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 March 31, 2021 and December 31, 2020. 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 carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits, healthcare related investment partnerships and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments. Carrying value as of (In millions) March 31, 2021 December 31, 2020 Real estate investments $ 999 $ 951 Securities partnerships 1,712 1,683 Other 186 198 Total $ 2,897 $ 2,832 Short-Term Investments and Cash Equivalents Short-term investments and cash equivalents included the following types of issuers. The decrease in Money market funds is primarily due to the deployment of proceeds received on December 31, 2020 from the U.S. Group Disability and Life business divestiture for Corporate purposes. (In millions) March 31, 2021 December 31, 2020 Corporate securities $ 2,953 $ 2,669 Federal government securities $ 113 $ 158 Foreign government securities $ 42 $ 90 Money market funds $ 960 $ 5,134 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 8. 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 may incur a loss if dealers failed to perform under derivative contracts, however collateral has been posted by dealers to cover substantially all of the net fair values owed at March 31, 2021 and December 31, 2020. The fair value of collateral posted by the Company was not significant as of March 31, 2021 or December 31, 2020. The gross fair values of our derivative financial instruments are presented in Note 10. The following table summarizes the types and notional quantity of derivative instruments held by the Company. As of March 31, 2021 and December 31, 2020, 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. Notional Value as of (In millions) March 31, 2021 December 31, 2020 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 $ 956 $ 925 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 $ 526 Foreign currency forward contracts $ 706 $ 636 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 $ 630 $ 538 As there has been no material change in the types of derivative financial instruments the Company uses, refer to the Company’s 2020 Form 10-K for a discussion of our accounting policy. 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 March 31, (In millions) 2021 2020 Net realized investment gains (losses), excluding credit loss expense and asset write-downs $ 10 $ (24) Credit loss (expense) on invested assets (9) (55) Other investment asset write-downs — (9) Net realized investment gains (losses), before income taxes $ 1 $ (88) Net realized investment gains, excluding credit loss expense and asset write-downs for the three months ended March 31, 2021 was primarily driven by mark-to-market gains on equity securities, partially offset by mark-to-market losses on derivatives. This activity for the three months ended March 31, 2020 was primarily driven by mark-to-market losses on equity securities and derivatives, partially offset by gains on sales of debt securities. Credit loss (expense) recoveries on invested assets reflect credit losses incurred on debt securities primarily relating to issuers in certain industries that have been impacted by the global COVID-19 pandemic. Realized gains and losses on equity securities still held at March 31, 2021 and 2020 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 March 31, (In millions) 2021 2020 Proceeds from sales $ 377 $ 743 Gross gains on sales $ 9 $ 39 Gross losses on sales $ (3) $ (7)

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2021
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 March 31, 2021 and December 31, 2020 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 Significant Other Observable Inputs Significant Unobservable Inputs Total As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 Financial assets at fair value Debt securities Federal government and agency $ 164 $ 207 $ 230 $ 249 $ — $ — $ 394 $ 456 State and local government — — 162 167 — — 162 167 Foreign government — — 2,407 2,498 13 13 2,420 2,511 Corporate — — 13,504 13,878 710 684 14,214 14,562 Mortgage and other asset-backed — — 310 309 149 126 459 435 Total debt securities 164 207 16,613 17,101 872 823 17,649 18,131 Equity securities (1) 56 50 165 165 31 31 252 246 Short-term investments — — 505 325 — — 505 325 Derivative assets (3) — — 62 72 — — 62 72 Real estate funds priced at NAV as a practical expedient (2) 146 156 Financial liabilities at fair value Derivative liabilities $ — $ — $ 74 $ 108 $ — $ — $ 74 $ 108 (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 $46 million in unfunded commitments in these funds as of March 31, 2021. (3) Derivative assets above include $6 million that are presented in the Short-term investments category that is disclosed in Note 9. See Note 9 for more information on our Derivative Financial Instruments. 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 94% 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 March 31, 2021 or December 31, 2020. The nature and use of these derivative financial instruments are described in Note 9. 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 5% 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 March 31, 2021 and December 31, 2020. 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. 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 (Weighted Average by Quantity) as of (Fair value in millions ) March 31, 2021 December 31, 2020 Unobservable input March 31, 2021 March 31, 2021 December 31, 2020 Debt securities Corporate and government debt securities $ 722 $ 696 Liquidity 60 - 1560 (480) bps 60 - 1370 (470) bps Mortgage and other asset-backed securities 149 126 Liquidity 60 - 380 (90) bps 60 - 380 (80) bps Weighting of credit spreads 250 - 660 (450) bps 300 - 670 (480) bps Securities not priced by the Company (1) 1 1 Total Level 3 debt securities $ 872 $ 823 (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 months ended March 31, 2021 and 2020. Gains and losses reported in these tables may include net changes in fair value that are attributable to both observable and unobservable inputs. For the Three Months Ended (In millions) 2021 2020 Debt and Equity Securities Beginning balance $ 854 $ 555 Total gains (losses) included in shareholders’ net income (10) (12) Gains (losses) included in other comprehensive income (16) (71) Gains (losses) required to adjust future policy benefits for settlement annuities (1) (8) (10) Purchases, sales and settlements Purchases 29 62 Sales — (12) Settlements (16) (2) Total purchases, sales and settlements $ 13 $ 48 Transfers into/(out of) Level 3 Transfers into Level 3 86 348 Transfers out of Level 3 (16) (92) Total transfers into/(out of) Level 3 $ 70 $ 256 Ending balance $ 903 $ 766 Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date $ (11) $ (18) Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period $ (16) $ (66) (1) Amounts do not accrue to shareholders. . 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 and derivatives 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. Market activity typically decreases during periods of economic uncertainty, and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgement that must be applied to the pricing of certain instruments increases, and is typically observed through the widening of liquidity and credit spreads. Transfers between Level 2 and Level 3 during 2021 and 2020 primarily reflected changes in liquidity and credit risk estimates for certain private placement issuers across several sectors. Transfers into and out of Level 3 were higher in 2020 due to significant fluctuations in liquidity and credit spreads experienced as a result of the uncertainty over the economic impacts related to COVID-19. See discussion under Quantitative Information about Unobservable Inputs above for more information. 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 March 31, 2021 and December 31, 2020 were as follows: (In millions) Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Total March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 Guaranteed separate accounts (See Note 15) $ 222 $ 226 $ 282 $ 297 $ — $ — $ 504 $ 523 Non-guaranteed separate accounts (1) 2,071 1,925 5,417 5,600 378 355 7,866 7,880 Subtotal $ 2,293 $ 2,151 $ 5,699 $ 5,897 $ 378 $ 355 8,370 8,403 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 718 683 Separate account assets per Consolidated Balance Sheets $ 9,088 $ 9,086 (1) Non-guaranteed separate accounts included $4.2 billion as of March 31, 2021 and December 31, 2020 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of March 31, 2021 and December 31, 2020. 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 months ended March 31, 2021 or 2020. 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 March 31, 2021 Redemption Frequency Redemption Notice (In millions) March 31, 2021 December 31, 2020 Securities partnerships $ 463 $ 463 $ 274 Not applicable Not applicable Real estate funds 251 215 45 Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 718 $ 683 $ 319 As of March 31, 2021, 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. For the three months ended March 31, 2021 and 2020, there were no such impairments. 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. Realized investment gains and losses from these observable price changes for the three months ended March 31, 2021 and March 31, 2020 were not material. Carrying values represented less than 1% of total investments as of both March 31, 2021 and March 31, 2020. 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 March 31, 2021 and December 31, 2020. 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. Classification in Fair Value Hierarchy March 31, 2021 December 31, 2020 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,373 $ 1,347 $ 1,456 $ 1,419 Long-term debt, including current maturities, excluding finance leases Level 2 $ 35,649 $ 31,912 $ 37,676 $ 31,835

Variable Interest Entities

Variable Interest Entities	3 Months Ended
	Mar. 31, 2021
Variable Interest Entities [Abstract]
Variable Interest Entities	Variable Interest EntitiesWe perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined it was not a primary beneficiary in any material variable interest entity as of March 31, 2021 or December 31, 2020. The Company’s involvement with variable interest entities for which it is not the primary beneficiary has not changed materially from December 31, 2020. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 13 in our 2020 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	3 Months Ended
	Mar. 31, 2021
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 9), 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 March 31, (In millions) 2021 2020 Securities and Derivatives Beginning balance $ 900 $ 975 Appreciation (depreciation) on securities and derivatives (342) (580) Tax (expense) benefit 65 127 Net appreciation (depreciation) on securities and derivatives (277) (453) Reclassification adjustment for (gains) losses included in shareholders' net income (net realized investment (gains) losses) 5 32 Reclassification adjustment for tax expense (benefit) included in shareholders’ net income (1) (7) Net (gains) losses reclassified from AOCI to net income 4 25 Other comprehensive (loss), net of tax (273) (428) Ending balance $ 627 $ 547 Translation of foreign currencies Beginning balance $ (15) $ (275) Translation of foreign currencies (114) (160) Tax (expense) benefit (5) (15) Net translation of foreign currencies (119) (175) Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests (4) (4) Shareholders' other comprehensive (loss), net of tax (115) (171) Ending balance $ (130) $ (446) Postretirement benefits liability Beginning balance $ (1,746) $ (1,641) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (interest expense and other) 20 18 Reclassification adjustment for settlement (interest expense and other) 3 — Reclassification adjustment for tax expense (benefit) included in shareholders’ net income (5) (5) Net adjustments reclassified from AOCI to net income 18 13 Other comprehensive income, net of tax 18 13 Ending balance $ (1,728) $ (1,628)

Leases

Leases	3 Months Ended
	Mar. 31, 2021
Leases [Abstract]
Leases	Leases Operating and finance lease Right-of-Use (“ROU”) assets and lease liabilities were as follows: (In millions) March 31, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 534 $ 552 Accrued expenses and other liabilities $ 152 $ 152 Other non-current liabilities 480 491 Total operating lease liabilities $ 632 $ 643 Finance leases: Property and equipment, gross $ 103 $ 98 Accumulated depreciation (51) (46) Property and equipment, net $ 52 $ 52 Short-term debt $ 20 $ 18 Long-term debt 35 36 Total finance lease liabilities $ 55 $ 54
Leases	Leases Operating and finance lease Right-of-Use (“ROU”) assets and lease liabilities were as follows: (In millions) March 31, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 534 $ 552 Accrued expenses and other liabilities $ 152 $ 152 Other non-current liabilities 480 491 Total operating lease liabilities $ 632 $ 643 Finance leases: Property and equipment, gross $ 103 $ 98 Accumulated depreciation (51) (46) Property and equipment, net $ 52 $ 52 Short-term debt $ 20 $ 18 Long-term debt 35 36 Total finance lease liabilities $ 55 $ 54

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesIncome Tax ExpenseThe 22.6% effective tax rate for the three months ended March 31, 2021 was higher than the 14.9% rate for the same period in 2020. This increase is primarily attributable to the absence of favorable items which reduced the rate in 2020, including settlements of uncertain tax positions and the remeasurement of deferred state income taxes; partially offset by the elimination of the nondeductible health insurer tax in 2021

Contingencies and Other Matters

Contingencies and Other Matters	3 Months Ended
	Mar. 31, 2021
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 Prudential Retirement Insurance and Annuity, the buyer of the retirement benefits business (see Note 8 for further information) has the right to redirect the management of the related assets to provide for benefit payments. As of March 31, 2021, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $445 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 March 31, 2021. 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 March 31, 2021 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 March 31, 2021. 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 three months ended March 31, 2021. 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 2020 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. In aggregate, the complaint sought 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 until either the Federal Circuit’s judgments in the CSR appeals become final and non-appealable or the Supreme Court resolves any petition for writ of certiorari. Cigna Litigation with Anthem . In February 2017, the Company filed suit against Anthem, Inc. in the Delaware Court of Chancery (the “Chancery Court”) seeking, among other relief, payment of the $1.85 billion reverse termination fee under the parties’ 2015 merger agreement and damages. Anthem countersued, alleging its own claims for damages. A trial was held during the first quarter of 2019. In August 2020, the Chancery Court issued an opinion finding that, although Cigna breached its contractual obligation to use reasonable best efforts to support the Anthem/Cigna merger, 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 the reverse termination fee. The Company filed a Notice of Appeal with the Delaware Supreme Court on October 30, 2020, and sought reversal of the portion of the Chancery Court’s decision denying Cigna the reverse termination fee. Briefing on the appeal was completed on January 29, 2021 and oral arguments were held on April 14, 2021. On May 3, 2021, the Delaware Supreme Court issued an order affirming the decision of the Chancery Court. 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 October 2021. There is no tentative trial date. Regulatory Matters Civil Investigative Demand . The U.S. Department of Justice (“DOJ”) is conducting industry-wide investigations of Medicare Advantage organizations’ risk adjustment practices under Medicare Parts C and D including medical chart reviews and health exams. For certain Medicare Advantage organizations, those investigations have resulted in litigation. The Company has received information requests (civil investigative demands) from the DOJ (U.S. Attorney’s Offices for the Eastern District of Pennsylvania and the Southern District of New York ("SDNY")). We are continuing to cooperate with the DOJ and have responded and continue to respond to its requests. Additionally, in relation to the SDNY’s 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 health exams conducted as part of Cigna’s Medicare Advantage business. The DOJ has not intervened in the case at this time.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2021
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. We define pre-tax adjusted income from operations as income before taxes excluding net realized investment gains and losses, amortization of acquired intangible assets and special items. Cigna’s share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting are also excluded. Income or expense amounts 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. Cigna's share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting are also excluded. • Amortization of acquired intangible assets because these relate to costs incurred for acquisitions. • 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. The term adjusted revenues is defined as total revenues excluding the following adjustments: special items and Cigna's share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business. The following tables present the special items recorded by the Company for the three months ended March 31, 2021 and 2020. Three Months Ended (In millions) March 31, 2021 March 31, 2020 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Debt extinguishment costs $ 101 $ 131 $ 140 $ 185 Integration and transaction-related costs (Selling, general and administrative expenses) 22 29 74 97 Charges associated with litigation matters (Selling, general and administrative expenses) (21) (27) 19 25 Charge for organizational efficiency plan (Selling, general and administrative expenses) — — 24 31 Contractual adjustment for a former client (Pharmacy revenues) — — (66) (87) Total impact from special items $ 102 $ 133 $ 191 $ 251 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended March 31, 2021 Revenues from external customers $ 29,419 $ 9,602 $ 1,499 $ 60 $ — $ 40,580 Inter-segment revenues 1,198 510 — — (1,708) Net investment income 3 250 59 79 — 391 Total revenues $ 30,620 $ 10,362 $ 1,558 $ 139 $ (1,708) $ 40,971 Net realized investment results from certain equity method investments — — 14 — — 14 Adjusted revenues $ 30,620 $ 10,362 $ 1,572 $ 139 $ (1,708) $ 40,985 Income (loss) before taxes $ 749 $ 1,009 $ 226 $ 16 $ (487) $ 1,513 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (7) — — (12) Net realized investment (gains) losses (1) 2 (30) 33 8 — 13 Amortization of acquired intangible assets 477 8 10 — — 495 Special items Debt extinguishment costs — — — — 131 131 Integration and transaction-related costs — — — — 29 29 Charges associated with litigation matters — — — — (27) (27) Pre-tax adjusted income (loss) from operations $ 1,223 $ 987 $ 262 $ 24 $ (354) $ 2,142 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended March 31, 2020 Revenues from external customers $ 26,256 $ 9,268 $ 1,420 $ 1,172 $ — $ 38,116 Inter-segment revenues 974 466 — 5 (1,445) Net investment income 25 126 40 162 — 353 Total revenues $ 27,255 $ 9,860 $ 1,460 $ 1,339 $ (1,445) $ 38,469 Net realized investment results from certain equity method investments — — 10 — — 10 Special item related to contractual adjustment for a former client (87) — — — — (87) Adjusted revenues $ 27,168 $ 9,860 $ 1,470 $ 1,339 $ (1,445) $ 38,392 Income (loss) before taxes $ 694 $ 1,140 $ 234 $ 72 $ (743) $ 1,397 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (4) — (5) — — (9) Net realized investment (gains) losses (1) — 48 46 4 — 98 Amortization of acquired intangible assets 479 11 7 1 — 498 Special items Debt extinguishment costs — — — — 185 185 Integration and transaction-related costs — — — — 97 97 Charges associated with litigation matters — — — — 25 25 Charge for organizational efficiency plan — — — — 31 31 Contractual adjustment for a former client (87) — — — — (87) Pre-tax adjusted income (loss) from operations $ 1,082 $ 1,199 $ 282 $ 77 $ (405) $ 2,235 (1) Includes 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. 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 months ended March 31: Three Months Ended March 31, (In millions) 2021 2020 Products (Pharmacy revenues) (ASC 606) Network revenues $ 14,179 $ 12,142 Home delivery and specialty revenues 12,458 11,714 Other 1,388 1,242 Total pharmacy revenues $ 28,025 $ 25,098 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,523 3,461 Stop loss 1,194 1,161 Other 310 289 U.S. Government Medicare Advantage 2,092 1,881 Medicare Part D 450 462 Other 1,138 1,066 Total U.S. Medical premiums 8,707 8,320 International Markets premiums 1,450 1,375 Domestic disability, life and accident premiums — 1,116 Other premiums 57 29 Total premiums 10,214 10,840 Services (ASC 606) Fees 2,327 2,154 Other external revenues 14 24 Total services 2,341 2,178 Total revenues from external customers $ 40,580 $ 38,116

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
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.
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. See Note 8 for additional information on reinsuranceThe 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. 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.
Investments	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. 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 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 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.
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 8. 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.
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 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 94% 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 March 31, 2021 or December 31, 2020. The nature and use of these derivative financial instruments are described in Note 9. 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 5% 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. 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 and derivatives 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 Accounts	Separate AccountsThe 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.
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 9), 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	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.
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. We define pre-tax adjusted income from operations as income before taxes excluding net realized investment gains and losses, amortization of acquired intangible assets and special items. Cigna’s share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting are also excluded. Income or expense amounts 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. Cigna's share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting are also excluded. • Amortization of acquired intangible assets because these relate to costs incurred for acquisitions. • 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. The term adjusted revenues is defined as total revenues excluding the following adjustments: special items and Cigna's share of certain realized investment results of its joint ventures reported in the International Markets segment using the equity method of accounting. We exclude these items from this measure because management believes they are not indicative of past or future underlying performance of the business.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	3 Months Ended
	Mar. 31, 2021
Receivables [Abstract]
Accounts Receivable, Net	The following amounts were included within Accounts receivable, net: (In millions) March 31, 2021 December 31, 2020 Noninsurance customer receivables $ 6,249 $ 5,534 Pharmaceutical manufacturers receivable 4,978 4,676 Insurance customer receivables 2,172 1,789 Other receivables 189 192 Total $ 13,588 $ 12,191

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2021
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 March 31, 2021 March 31, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 1,161 $ 1,161 $ 1,181 $ 1,181 Shares: Weighted average 348,248 348,248 370,440 370,440 Common stock equivalents 3,728 3,728 4,199 4,199 Total shares 348,248 3,728 351,976 370,440 4,199 374,639 EPS $ 3.33 $ (0.03) $ 3.30 $ 3.19 $ (0.04) $ 3.15
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 March 31, (In millions) 2021 2020 Anti-dilutive options 1.5 4.1

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Outstanding Amounts of Debt and Finance Leases	The outstanding amounts of debt and finance leases were as follows: (In millions) March 31, 2021 December 31, 2020 Short-term debt $78 million, 6.37% Notes due 6/2021 78 78 $1,000 million, Floating Rate Notes due 9/2021 — 999 $1,250 million, 3.4% Notes due 9/2021 — 1,249 $181 million, 3.9% Notes due 2/2022 181 — $120 million, 4% Notes due 2/2022 120 — Commercial paper 5 1,030 Other, including finance leases 20 18 Total short-term debt $ 404 $ 3,374 Long-term debt $277 million, 4% Notes due 2022 — 276 $973 million, 3.9% Notes due 2022 — 972 $500 million, 3.05% Notes due 2022 491 490 $17 million, 8.3% Notes due 2023 17 17 $63 million, 7.65% Notes due 2023 63 63 $700 million, Floating Rate Notes due 2023 698 698 $1,000 million, 3% Notes due 2023 978 975 $1,187 million, 3.75% Notes due 2023 1,184 2,181 $500 million, 0.613% Notes due 2024 498 — $1,000 million, 3.5% Notes due 2024 979 977 $900 million, 3.25% Notes due 2025 896 896 $2,200 million, 4.125% Notes due 2025 2,191 2,191 $1,500 million, 4.5% Notes due 2026 1,504 1,505 $800 million, 1.25% Notes due 2026 796 — $1,500 million, 3.4% Notes due 2027 1,413 1,410 $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 3,781 3,780 $1,500 million, 2.4% Notes due 2030 1,490 1,489 $1,500 million, 2.375% Notes due 2031 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 2,180 $750 million, 3.2% Notes due 2040 742 742 $121 million, 5.875% Notes due 2041 119 119 $448 million, 6.125% Notes due 2041 490 490 $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 2,966 $1,250 million, 3.4% Notes due 2050 1,235 1,235 $1,500 million , 3.4% Notes due 2051 1,476 — Other, including finance leases 35 36 Total long-term debt $ 31,568 $ 29,545
Summary of Debt Issuances	The proceeds of this issuance were mainly used to redeem outstanding debt securities. The remaining proceeds are available for general corporate purposes. Interest on this debt is paid semi-annually. Principal Maturity Date Interest Rate Net Proceeds $500 million March 15, 2024 0.613% $499 million $800 million March 15, 2026 1.250% $797 million $1,500 million March 15, 2031 2.375% $1,492 million $1,500 million March 15, 2051 3.400% $1,479 million

Insurance and Contractholder _2

Insurance and Contractholder Liabilities (Tables)	3 Months Ended
	Mar. 31, 2021
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	The Company’s insurance and contractholder liabilities were comprised of the following: March 31, 2021 December 31, 2020 March 31, 2020 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 355 $ 6,806 $ 7,161 $ 350 $ 6,823 $ 7,173 $ 7,699 Future policy benefits 361 8,945 9,306 327 9,317 9,644 9,651 Unearned premiums 561 389 950 485 394 879 840 Unpaid claims and claim expenses U.S. Medical 3,528 21 3,549 3,166 18 3,184 3,000 Other segments 938 263 1,201 980 292 1,272 6,119 Total 27,309 Insurance and contractholder liabilities classified as liabilities of business held for sale (1) (6,441) Total insurance and contractholder liabilities $ 5,743 $ 16,424 $ 22,167 $ 5,308 $ 16,844 $ 22,152 $ 20,868 (1) Amounts classified as Liabilities of business held for sale primarily include $5.1 billion of unpaid claims, $726 million of contractholder deposit funds and $640 million of future policy benefits as of March 31, 2020. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the three months ended March 31 was as follows: Three Months Ended (In millions) March 31, 2021 March 31, 2020 Beginning balance $ 3,184 $ 2,892 Less: Reinsurance and other amounts recoverable 224 303 Beginning balance, net 2,960 2,589 Incurred costs related to: Current year 7,285 6,661 Prior years (185) (152) Total incurred 7,100 6,509 Paid costs related to: Current year 4,423 4,271 Prior years 2,317 2,027 Total paid 6,740 6,298 Ending balance, net 3,320 2,800 Add: Reinsurance and other amounts recoverable 229 200 Ending balance $ 3,549 $ 3,000 Liability balance details. The liability details for unpaid claims and claim expenses are as follows: (In millions) March 31, 2021 March 31, 2020 Other Operations Group Disability and Life $ — $ 5,084 Other Operations 281 209 Total Other Operations 281 5,293 International Markets 920 826 Unpaid claims and claim expenses Other Operations and International Markets $ 1,201 $ 6,119 Activity in the Company’s liabilities for unpaid claims and claim expenses for International Markets and, prior to the sale, Group Disability and Life, is 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. Three Months Ended (In millions) March 31, 2021 March 31, 2020 (1) Beginning balance $ 963 $ 5,816 Less: Reinsurance 59 184 Beginning balance, net 904 5,632 Incurred claims related to: Current year 724 1,473 Prior years: Interest accretion — 42 All other incurred (48) 46 Total incurred 676 1,561 Paid claims related to: Current year 326 490 Prior years 372 946 Total paid 698 1,436 Foreign currency (20) (25) Ending balance, net 862 5,732 Add: Reinsurance 58 178 Ending balance $ 920 $ 5,910
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses	Variances in incurred costs related to prior years’ unpaid claims and claim expenses that resulted from the differences between actual experience and the Company’s key assumptions for the three months ended March 31 were as follows: Three Months Ended (Dollars in millions) March 31, 2021 March 31, 2020 $ % (1) $ % (2) Actual completion factors $ 68 0.2 % $ 63 0.3 % Medical cost trend 117 0.5 89 0.3 Total favorable variance $ 185 0.7 % $ 152 0.6 % (1) Percentage of current year incurred costs as reported for the year ended December 31, 2020. (2) Percentage of current year incurred costs as reported for the year ended December 31, 2019.

Reinsurance (Tables)

Reinsurance (Tables)	3 Months Ended
	Mar. 31, 2021
Reinsurance Disclosures [Abstract]
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level	The Company’s reinsurance recoverables as of March 31, 2021 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) $ — $ — $ 173 $ 173 Lower-medium grade (2) — — 63 63 Not rated 92 — 34 126 Total recoverables related to ongoing operations 92 — 270 362 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 3,022 — 3,022 Berkshire 301 399 — 700 Prudential Retirement Insurance and Annuity 607 — — 607 Life Insurance Company of North America — 449 — 449 Other 230 17 18 265 Not rated — 13 4 17 Total recoverables related to acquisition, disposition or runoff activities 1,138 3,900 22 5,060 Total $ 1,230 $ 3,900 $ 292 $ 5,422 Allowance for uncollectible reinsurance (31) Total reinsurance recoverables $ 5,391 (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 an NRSRO (3) 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 March 31, (In millions) 2021 2020 Total ceded premiums $ 149 $ 128 Total reinsurance recoveries $ 148 $ 178
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) March 31, 2021 December 31, 2020 Account value $ 9,518 $ 9,523 Net amount at risk $ 1,518 $ 1,570 Number of contractholders (estimated) 180,000 185,000
Schedule of Derivative Assets at Fair Value	GMIB liabilities totaling $595 million as of March 31, 2021 and $729 million as of December 31, 2020 are classified as Level 3 because fair value inputs are largely unobservable. There were three reinsurers covering 100% of the GMIB exposures as of March 31, 2021 and December 31, 2020 as follows: (In millions) Line of Business Reinsurer March 31, 2021 December 31, 2020 Collateral and Other Terms at March 31, 2021 GMIB Berkshire $ 288 $ 353 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 173 215 Liberty Re (Bermuda) Ltd. 155 190 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 616 $ 758 All reinsurers are rated A- equivalent and higher by an NRSRO.

Investments (Tables)

Investments (Tables)	3 Months Ended
	Mar. 31, 2021
Investments [Abstract]
Investments by Category	The following table summarizes the Company's investments by category and current or long-term classification. March 31, 2021 December 31, 2020 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 906 $ 16,743 $ 17,649 $ 959 $ 17,172 $ 18,131 Equity securities — 550 550 — 501 501 Commercial mortgage loans 60 1,287 1,347 13 1,406 1,419 Policy loans — 1,344 1,344 — 1,351 1,351 Other long-term investments — 2,897 2,897 — 2,832 2,832 Short-term investments 511 — 511 359 — 359 Total $ 1,477 $ 22,821 $ 24,298 $ 1,331 $ 23,262 $ 24,593
Debt Securities by Contractual Maturity	The amortized cost and fair value by contractual maturity periods for debt securities were as follows at March 31, 2021: (In millions) Amortized Fair Due in one year or less $ 930 $ 938 Due after one year through five years 5,394 5,635 Due after five years through ten years 5,769 6,110 Due after ten years 3,869 4,507 Mortgage and other asset-backed securities 461 459 Total $ 16,423 $ 17,649
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 March 31, 2021 Federal government and agency $ 298 $ — $ 99 $ (3) $ 394 State and local government 149 — 14 (1) 162 Foreign government 2,206 — 237 (23) 2,420 Corporate 13,309 (24) 1,037 (108) 14,214 Mortgage and other asset-backed 461 (11) 20 (11) 459 Total $ 16,423 $ (35) $ 1,407 $ (146) $ 17,649 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,355 $ (4) $ 590 $ (18) $ 2,923 December 31, 2020 Federal government and agency $ 334 $ — $ 122 $ — $ 456 State and local government 150 — 17 — 167 Foreign government 2,201 — 318 (8) 2,511 Corporate 13,108 (19) 1,506 (33) 14,562 Mortgage and other asset-backed 427 (7) 27 (12) 435 Total $ 16,220 $ (26) $ 1,990 $ (53) $ 18,131 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,282 $ (5) $ 838 $ (3) $ 3,112 (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 for which an allowance for credit losses has not been recorded, 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. March 31, 2021 December 31, 2020 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 2,225 $ 2,333 $ (108) 815 $ 1,026 $ 1,045 $ (19) 300 Below investment grade $ 463 $ 485 $ (22) 567 $ 381 $ 405 $ (24) 232 More than one year Investment grade $ 66 $ 70 $ (4) 15 $ 18 $ 18 $ — 6 Below investment grade $ 179 $ 191 $ (12) 51 $ 90 $ 100 $ (10) 33 Total $ 2,933 $ 3,079 $ (146) 1,448 $ 1,515 $ 1,568 $ (53) 571
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 months ended March 31: Three Months Ended Three Months Ended (In millions) 2021 2020 Beginning balance $ 26 $ — Additions for debt securities where no credit loss has previously been recognized 11 55 Reductions for securities sold during the period — — Decrease for debt securities where credit losses have previously been recorded (2) — Ending balance $ 35 $ 55
Equity Security Investments	The following table provides the values of the Company's equity security investments as of March 31, 2021 and December 31, 2020. The amount of impairments or value changes resulting from observable price changes on equity securities still held was not material to the financial statements as of March 31, 2021 or December 31, 2020. March 31, 2021 December 31, 2020 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 192 $ 211 $ 180 $ 202 Equity securities with no readily determinable fair value $ 231 $ 298 $ 225 $ 255 Hybrid equity securities $ 58 $ 41 $ 58 $ 44 Total $ 481 $ 550 $ 463 $ 501
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 March 31, 2021 and December 31, 2020. (Dollars in millions) March 31, 2021 December 31, 2020 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% $ 513 2.25 $ 533 2.28 60% to 79% 699 2.11 751 2.08 80% to 100% 141 1.33 141 1.33 Allowance for credit losses (6) (6) Total $ 1,347 2.08 61 % $ 1,419 2.08 61 %
Carrying Value Information for Other Long-Term Investments	Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Additionally, statutory and other restricted deposits, healthcare related investment partnerships and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments. Carrying value as of (In millions) March 31, 2021 December 31, 2020 Real estate investments $ 999 $ 951 Securities partnerships 1,712 1,683 Other 186 198 Total $ 2,897 $ 2,832
Short-Term Investments and Cash Equivalents	Short-term investments and cash equivalents included the following types of issuers. The decrease in Money market funds is primarily due to the deployment of proceeds received on December 31, 2020 from the U.S. Group Disability and Life business divestiture for Corporate purposes. (In millions) March 31, 2021 December 31, 2020 Corporate securities $ 2,953 $ 2,669 Federal government securities $ 113 $ 158 Foreign government securities $ 42 $ 90 Money market funds $ 960 $ 5,134
Summary of Derivative Instruments Held	The following table summarizes the types and notional quantity of derivative instruments held by the Company. As of March 31, 2021 and December 31, 2020, 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. Notional Value as of (In millions) March 31, 2021 December 31, 2020 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 $ 956 $ 925 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 $ 526 Foreign currency forward contracts $ 706 $ 636 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 $ 630 $ 538
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 March 31, (In millions) 2021 2020 Net realized investment gains (losses), excluding credit loss expense and asset write-downs $ 10 $ (24) Credit loss (expense) on invested assets (9) (55) Other investment asset write-downs — (9) Net realized investment gains (losses), before income taxes $ 1 $ (88)
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 March 31, (In millions) 2021 2020 Proceeds from sales $ 377 $ 743 Gross gains on sales $ 9 $ 39 Gross losses on sales $ (3) $ (7)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Financial Assets and Financial Liabilities Carried at Fair Value	The following table provides information as of March 31, 2021 and December 31, 2020 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 Significant Other Observable Inputs Significant Unobservable Inputs Total As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 As of March 31, 2021 As of December 31, 2020 Financial assets at fair value Debt securities Federal government and agency $ 164 $ 207 $ 230 $ 249 $ — $ — $ 394 $ 456 State and local government — — 162 167 — — 162 167 Foreign government — — 2,407 2,498 13 13 2,420 2,511 Corporate — — 13,504 13,878 710 684 14,214 14,562 Mortgage and other asset-backed — — 310 309 149 126 459 435 Total debt securities 164 207 16,613 17,101 872 823 17,649 18,131 Equity securities (1) 56 50 165 165 31 31 252 246 Short-term investments — — 505 325 — — 505 325 Derivative assets (3) — — 62 72 — — 62 72 Real estate funds priced at NAV as a practical expedient (2) 146 156 Financial liabilities at fair value Derivative liabilities $ — $ — $ 74 $ 108 $ — $ — $ 74 $ 108 (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 $46 million in unfunded commitments in these funds as of March 31, 2021. (3) Derivative assets above include $6 million that are presented in the Short-term investments category that is disclosed in Note 9. See Note 9 for more information on our Derivative Financial Instruments.
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 March 31, 2021 and December 31, 2020. 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. 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 (Weighted Average by Quantity) as of (Fair value in millions ) March 31, 2021 December 31, 2020 Unobservable input March 31, 2021 March 31, 2021 December 31, 2020 Debt securities Corporate and government debt securities $ 722 $ 696 Liquidity 60 - 1560 (480) bps 60 - 1370 (470) bps Mortgage and other asset-backed securities 149 126 Liquidity 60 - 380 (90) bps 60 - 380 (80) bps Weighting of credit spreads 250 - 660 (450) bps 300 - 670 (480) bps Securities not priced by the Company (1) 1 1 Total Level 3 debt securities $ 872 $ 823 (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 months ended March 31, 2021 and 2020. Gains and losses reported in these tables may include net changes in fair value that are attributable to both observable and unobservable inputs. For the Three Months Ended (In millions) 2021 2020 Debt and Equity Securities Beginning balance $ 854 $ 555 Total gains (losses) included in shareholders’ net income (10) (12) Gains (losses) included in other comprehensive income (16) (71) Gains (losses) required to adjust future policy benefits for settlement annuities (1) (8) (10) Purchases, sales and settlements Purchases 29 62 Sales — (12) Settlements (16) (2) Total purchases, sales and settlements $ 13 $ 48 Transfers into/(out of) Level 3 Transfers into Level 3 86 348 Transfers out of Level 3 (16) (92) Total transfers into/(out of) Level 3 $ 70 $ 256 Ending balance $ 903 $ 766 Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date $ (11) $ (18) Change in unrealized gains or losses included in other comprehensive income for assets held at the end of the reporting period $ (16) $ (66) (1) Amounts do not accrue to shareholders.
Fair Values of Separate Account Assets	Fair values of separate account assets at March 31, 2021 and December 31, 2020 were as follows: (In millions) Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Total March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 March 31, 2021 December 31, 2020 Guaranteed separate accounts (See Note 15) $ 222 $ 226 $ 282 $ 297 $ — $ — $ 504 $ 523 Non-guaranteed separate accounts (1) 2,071 1,925 5,417 5,600 378 355 7,866 7,880 Subtotal $ 2,293 $ 2,151 $ 5,699 $ 5,897 $ 378 $ 355 8,370 8,403 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 718 683 Separate account assets per Consolidated Balance Sheets $ 9,088 $ 9,086 (1) Non-guaranteed separate accounts included $4.2 billion as of March 31, 2021 and December 31, 2020 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of March 31, 2021 and December 31, 2020.
Additional Information on Separate Account Assets Priced at NAV	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 March 31, 2021 Redemption Frequency Redemption Notice (In millions) March 31, 2021 December 31, 2020 Securities partnerships $ 463 $ 463 $ 274 Not applicable Not applicable Real estate funds 251 215 45 Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 718 $ 683 $ 319
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 March 31, 2021 and December 31, 2020. 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. Classification in Fair Value Hierarchy March 31, 2021 December 31, 2020 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,373 $ 1,347 $ 1,456 $ 1,419 Long-term debt, including current maturities, excluding finance leases Level 2 $ 35,649 $ 31,912 $ 37,676 $ 31,835

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	3 Months Ended
	Mar. 31, 2021
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 March 31, (In millions) 2021 2020 Securities and Derivatives Beginning balance $ 900 $ 975 Appreciation (depreciation) on securities and derivatives (342) (580) Tax (expense) benefit 65 127 Net appreciation (depreciation) on securities and derivatives (277) (453) Reclassification adjustment for (gains) losses included in shareholders' net income (net realized investment (gains) losses) 5 32 Reclassification adjustment for tax expense (benefit) included in shareholders’ net income (1) (7) Net (gains) losses reclassified from AOCI to net income 4 25 Other comprehensive (loss), net of tax (273) (428) Ending balance $ 627 $ 547 Translation of foreign currencies Beginning balance $ (15) $ (275) Translation of foreign currencies (114) (160) Tax (expense) benefit (5) (15) Net translation of foreign currencies (119) (175) Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests (4) (4) Shareholders' other comprehensive (loss), net of tax (115) (171) Ending balance $ (130) $ (446) Postretirement benefits liability Beginning balance $ (1,746) $ (1,641) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (interest expense and other) 20 18 Reclassification adjustment for settlement (interest expense and other) 3 — Reclassification adjustment for tax expense (benefit) included in shareholders’ net income (5) (5) Net adjustments reclassified from AOCI to net income 18 13 Other comprehensive income, net of tax 18 13 Ending balance $ (1,728) $ (1,628)

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2021
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) March 31, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 534 $ 552 Accrued expenses and other liabilities $ 152 $ 152 Other non-current liabilities 480 491 Total operating lease liabilities $ 632 $ 643 Finance leases: Property and equipment, gross $ 103 $ 98 Accumulated depreciation (51) (46) Property and equipment, net $ 52 $ 52 Short-term debt $ 20 $ 18 Long-term debt 35 36 Total finance lease liabilities $ 55 $ 54

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Summary of Special Items	The following tables present the special items recorded by the Company for the three months ended March 31, 2021 and 2020. Three Months Ended (In millions) March 31, 2021 March 31, 2020 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax Debt extinguishment costs $ 101 $ 131 $ 140 $ 185 Integration and transaction-related costs (Selling, general and administrative expenses) 22 29 74 97 Charges associated with litigation matters (Selling, general and administrative expenses) (21) (27) 19 25 Charge for organizational efficiency plan (Selling, general and administrative expenses) — — 24 31 Contractual adjustment for a former client (Pharmacy revenues) — — (66) (87) Total impact from special items $ 102 $ 133 $ 191 $ 251
Summarized Segment Financial Information	Summarized segment financial information was as follows: (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended March 31, 2021 Revenues from external customers $ 29,419 $ 9,602 $ 1,499 $ 60 $ — $ 40,580 Inter-segment revenues 1,198 510 — — (1,708) Net investment income 3 250 59 79 — 391 Total revenues $ 30,620 $ 10,362 $ 1,558 $ 139 $ (1,708) $ 40,971 Net realized investment results from certain equity method investments — — 14 — — 14 Adjusted revenues $ 30,620 $ 10,362 $ 1,572 $ 139 $ (1,708) $ 40,985 Income (loss) before taxes $ 749 $ 1,009 $ 226 $ 16 $ (487) $ 1,513 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (7) — — (12) Net realized investment (gains) losses (1) 2 (30) 33 8 — 13 Amortization of acquired intangible assets 477 8 10 — — 495 Special items Debt extinguishment costs — — — — 131 131 Integration and transaction-related costs — — — — 29 29 Charges associated with litigation matters — — — — (27) (27) Pre-tax adjusted income (loss) from operations $ 1,223 $ 987 $ 262 $ 24 $ (354) $ 2,142 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended March 31, 2020 Revenues from external customers $ 26,256 $ 9,268 $ 1,420 $ 1,172 $ — $ 38,116 Inter-segment revenues 974 466 — 5 (1,445) Net investment income 25 126 40 162 — 353 Total revenues $ 27,255 $ 9,860 $ 1,460 $ 1,339 $ (1,445) $ 38,469 Net realized investment results from certain equity method investments — — 10 — — 10 Special item related to contractual adjustment for a former client (87) — — — — (87) Adjusted revenues $ 27,168 $ 9,860 $ 1,470 $ 1,339 $ (1,445) $ 38,392 Income (loss) before taxes $ 694 $ 1,140 $ 234 $ 72 $ (743) $ 1,397 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (4) — (5) — — (9) Net realized investment (gains) losses (1) — 48 46 4 — 98 Amortization of acquired intangible assets 479 11 7 1 — 498 Special items Debt extinguishment costs — — — — 185 185 Integration and transaction-related costs — — — — 97 97 Charges associated with litigation matters — — — — 25 25 Charge for organizational efficiency plan — — — — 31 31 Contractual adjustment for a former client (87) — — — — (87) Pre-tax adjusted income (loss) from operations $ 1,082 $ 1,199 $ 282 $ 77 $ (405) $ 2,235
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 months ended March 31: Three Months Ended March 31, (In millions) 2021 2020 Products (Pharmacy revenues) (ASC 606) Network revenues $ 14,179 $ 12,142 Home delivery and specialty revenues 12,458 11,714 Other 1,388 1,242 Total pharmacy revenues $ 28,025 $ 25,098 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,523 3,461 Stop loss 1,194 1,161 Other 310 289 U.S. Government Medicare Advantage 2,092 1,881 Medicare Part D 450 462 Other 1,138 1,066 Total U.S. Medical premiums 8,707 8,320 International Markets premiums 1,450 1,375 Domestic disability, life and accident premiums — 1,116 Other premiums 57 29 Total premiums 10,214 10,840 Services (ASC 606) Fees 2,327 2,154 Other external revenues 14 24 Total services 2,341 2,178 Total revenues from external customers $ 40,580 $ 38,116

Accounts Receivable, Net - Summ

Accounts Receivable, Net - Summary of Accounts Receivable, Net (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Receivables [Abstract]
Noninsurance customer receivables	$ 6,249	$ 5,534
Pharmaceutical manufacturers receivable	4,978	4,676
Insurance customer receivables	2,172	1,789
Other receivables	189	192
Total	$ 13,588	$ 12,191

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Receivables [Abstract]
Allowance for receivables net current	$ 1,300	$ 1,200
Allowance for current expected credit losses on accounts receivable	$ 70	$ 65

Mergers, Acquisitions and Div_2

Mergers, Acquisitions and Divestitures - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2020	Mar. 31, 2021	Mar. 31, 2020	Apr. 30, 2021
Business Acquisition [Line Items]
Integration and transaction-related costs, pre-tax		$ 29	$ 97
Integration and transaction-related costs, after-tax		$ 22	$ 74
U.S Group Disability and Life Insurance | Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash proceeds from sale of business	$ 6,200
Gain (loss) on sale of business, pre-tax	4,200
Gain (loss) on sale of business, after-tax	$ 3,200
MDLIVE, Inc. | Subsequent Event
Business Acquisition [Line Items]
Ownership interest acquired				100.00%

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
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Shareholders’ net income	$ 1,161	$ 1,181
Shares:
Weighted average (in shares)	348,248	370,440
Common stock equivalents (in shares)	3,728	4,199
Total shares (in shares)	351,976	374,639
EPS, basic (in dollars per share)	$ 3.33	$ 3.19
EPS, effect of dilution (in dollars per share)	(0.03)	(0.04)
EPS, diluted (in dollars per share)	$ 3.30	$ 3.15

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
	Mar. 31, 2021	Mar. 31, 2020
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)	1.5	4.1

Earnings Per Share - Shares of

Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares shares in Millions	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Earnings Per Share [Abstract]
Shares of common stock held in treasury (in shares)	48.7	35.5	18.8

Debt - Outstanding Amounts of D

Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Mar. 31, 2021	Dec. 31, 2020
Short-term debt
Commercial paper	$ 5,000,000	$ 1,030,000,000
Other, including finance leases	20,000,000	18,000,000
Total short-term debt	404,000,000	3,374,000,000
Long-term debt
Other, including finance leases	35,000,000	36,000,000
Total long-term debt	31,568,000,000	29,545,000,000
$78 million, 6.37% Notes due 6/2021
Short-term debt
Current maturities	78,000,000	78,000,000
Long-term debt
Gross value	$ 78,000,000
Stated interest rate	6.37%
$1,000 million, Floating Rate Notes due 9/2021
Short-term debt
Current maturities	$ 0	999,000,000
Long-term debt
Gross value		1,000,000,000
$1,250 million, 3.4% Notes due 9/2021
Short-term debt
Current maturities	$ 0	1,249,000,000
Long-term debt
Gross value		1,250,000,000
Stated interest rate	3.40%
Notes due 2022 4% Interest
Short-term debt
Current maturities	$ 120,000,000	0
Long-term debt
Long-term debt	0	276,000,000
Gross value	$ 120,000,000	277,000,000
Stated interest rate	4.00%
Notes Due 2022, 3.9% Interest
Short-term debt
Current maturities	$ 181,000,000	0
Long-term debt
Long-term debt	0	972,000,000
Gross value	$ 181,000,000	973,000,000
Stated interest rate	3.90%
$500 million, 3.05% Notes due 2022
Long-term debt
Long-term debt	$ 491,000,000	490,000,000
Gross 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
Gross 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	63,000,000
Gross 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
Gross value	700,000,000
$1,000 million, 3% Notes due 2023
Long-term debt
Long-term debt	978,000,000	975,000,000
Gross value	$ 1,000,000,000
Stated interest rate	3.00%
$1,187 million, 3.75% Notes due 2023
Long-term debt
Long-term debt	$ 1,184,000,000	2,181,000,000
Gross value	$ 1,187,000,000
Stated interest rate	3.75%
$500 million, 0.613% Notes due 2024
Long-term debt
Long-term debt	$ 498,000,000	0
Gross value	$ 500,000,000
Stated interest rate	0.613%
$1,000 million, 3.5% Notes due 2024
Long-term debt
Long-term debt	$ 979,000,000	977,000,000
Gross 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	896,000,000
Gross value	$ 900,000,000
Stated interest rate	3.25%
$2,200 million, 4.125% Notes due 2025
Long-term debt
Long-term debt	$ 2,191,000,000	2,191,000,000
Gross value	$ 2,200,000,000
Stated interest rate	4.125%
$1,500 million, 4.5% Notes due 2026
Long-term debt
Long-term debt	$ 1,504,000,000	1,505,000,000
Gross value	$ 1,500,000,000
Stated interest rate	4.50%
$800 million, 1.25% Notes due 2026
Long-term debt
Long-term debt	$ 796,000,000	0
Gross value	$ 800,000,000
Stated interest rate	1.25%
$1,500 million, 3.4% Notes due 2027
Long-term debt
Long-term debt	$ 1,413,000,000	1,410,000,000
Gross 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
Gross 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
Gross value	$ 600,000,000
Stated interest rate	3.05%
$3,800 million, 4.375% Notes due 2028
Long-term debt
Long-term debt	$ 3,781,000,000	3,780,000,000
Gross value	$ 3,800,000,000
Stated interest rate	4.375%
$1,500 million, 2.4% Notes due 2030
Long-term debt
Long-term debt	$ 1,490,000,000	1,489,000,000
Gross value	$ 1,500,000,000
Stated interest rate	2.40%
$1,500 million, 2.375% Notes due 2031
Long-term debt
Long-term debt	$ 1,489,000,000	0
Gross value	$ 1,500,000,000
Stated interest rate	2.375%
$45 million, 8.3% Step Down Notes due 2033
Long-term debt
Long-term debt	$ 45,000,000	45,000,000
Gross 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
Gross 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	2,180,000,000
Gross 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	742,000,000
Gross 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
Gross 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	490,000,000
Gross 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
Gross 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
Gross 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
Gross 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	2,966,000,000
Gross 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	1,235,000,000
Gross value	$ 1,250,000,000
Stated interest rate	3.40%
$1,500 million , 3.4% Notes due 2051
Long-term debt
Long-term debt	$ 1,476,000,000	$ 0
Gross value	$ 1,500,000,000
Stated interest rate	3.40%

Debt - Narrative (Details)

Debt - Narrative (Details)	1 Months Ended	3 Months Ended
	Apr. 30, 2021USD ($)bank	Mar. 31, 2021USD ($)bank	Mar. 31, 2020USD ($)	Apr. 02, 2021USD ($)	Mar. 03, 2021USD ($)
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities redeemed		$ 4,200,000,000
Loss on repurchase of debt, pre-tax		131,000,000	$ 185,000,000
Loss on repurchase of debt, after-tax		101,000,000
Subsequent Event
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities redeemed				$ 301,000,000
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity		4,250,000,000
Five-year Revolving Credit Agreement, Maturing April 2023
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 3,250,000,000
Number of participating banks | bank		23
Amount by which credit facilty amount can be increased		$ 500,000,000
Amount by which credit facilty term length can be increased		1 year
Credit agreement term		5 years
Term of borrowing after exercising the "term out" option		1 year
Leverage ratio covenant		60.00%
Outstanding balances		$ 0
Five-year Revolving Credit Agreement, Maturing April 2023 | Letter of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		500,000,000
364-day Revolving Credit Agreement, Maturing October 2021
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 1,000,000,000
Number of participating banks | bank		23
Credit agreement term		364 days
Leverage ratio covenant		60.00%
Outstanding balances		$ 0
Revolving Credit and Letter of Credit Facility Maturing April 2026, Revolving Credit and Letter of Credit Facility Maturing April 2024, and 364 Day Revolving Credit Agreement Maturing April 2022 | Subsequent Event
Debt Instrument [Line Items]
Aggregate amount of options to increase commitments	$ 1,500,000,000
Five-year Revolving Credit Agreement, Maturing April 2026 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 3,000,000,000
Number of participating banks | bank	23
Amount by which credit facilty term length can be increased	1 year
Credit agreement term	5 years
Leverage ratio covenant	60.00%
Five-year Revolving Credit Agreement, Maturing April 2026 | Letter of Credit | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
Three-year Revolving Credit Agreement, Maturing April 2024 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Number of participating banks | bank	23
Amount by which credit facilty term length can be increased	1 year
Credit agreement term	3 years
Leverage ratio covenant	60.00%
Three-year Revolving Credit Agreement, Maturing April 2024 | Letter of Credit | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
364-day Revolving Credit Agreement, Maturing April 2022 | Subsequent Event
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Number of participating banks | bank	23
Credit agreement term	364 days
Term of borrowing after exercising the "term out" option	1 year
Leverage ratio covenant	60.00%
Senior Notes
Debt Instrument [Line Items]
Aggregate principal amount					$ 4,300,000,000

Debt - Summary of Debt Issuance

Debt - Summary of Debt Issuances (Details) - USD ($)	Mar. 03, 2021	Mar. 31, 2021
Senior Notes
Debt Instrument [Line Items]
Principal	$ 4,300,000,000
$500 million, 0.613% Notes due 2024
Debt Instrument [Line Items]
Interest rate		0.613%
$500 million, 0.613% Notes due 2024 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 500,000,000
Interest rate	0.613%
Net proceeds	$ 499,000,000
$800 million, 1.25% Notes due 2026
Debt Instrument [Line Items]
Interest rate		1.25%
$800 million, 1.25% Notes due 2026 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 800,000,000
Interest rate	1.25%
Net proceeds	$ 797,000,000
$1,500 million, 2.375% Notes due 2031
Debt Instrument [Line Items]
Interest rate		2.375%
$1,500 million, 2.375% Notes due 2031 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,500,000,000
Interest rate	2.375%
Net proceeds	$ 1,492,000,000
$1,500 million , 3.4% Notes due 2051
Debt Instrument [Line Items]
Interest rate		3.40%
$1,500 million , 3.4% Notes due 2051 | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,500,000,000
Interest rate	3.40%
Net proceeds	$ 1,479,000,000

Insurance and Contractholder _3

Insurance and Contractholder Liabilities - Summary of Insurance and Contractholder Liabilities (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Current
Contractholder deposit funds	$ 355	$ 350
Future policy benefits	361	327
Unearned premiums	561	485
Total insurance and contractholder liabilities	5,743	5,308
Non-current
Contractholder deposit funds	6,806	6,823
Future policy benefits	8,945	9,317
Unearned premiums	389	394
Total insurance and contractholder liabilities	16,424	16,844
Total
Contractholder deposit funds	7,161	7,173
Future policy benefits	9,306	9,644
Unearned premiums	950	879
Contractholder deposit funds			$ 7,699
Future policy benefits			9,651
Unearned premiums			840
Total			27,309
Insurance and contractholder liabilities classified as held for sale			(6,441)
Total insurance and contractholder liabilities	22,167	22,152	20,868
Unpaid claims classified as liabilities of business held for sale			5,100
Contractholder deposit funds classified as liabilities of business held for sale			726
Future policy benefits classified as liabilities of business held for sale			640
Integrated Medical
Current
Unpaid claims and claim expenses	3,528	3,166
Non-current
Unpaid claims and claim expenses	21	18
Total
Unpaid claims and claim expenses	3,549	3,184
Unpaid claims and claim expenses			3,000	$ 2,892
Other segments
Current
Unpaid claims and claim expenses	938	980
Non-current
Unpaid claims and claim expenses	263	292
Total
Unpaid claims and claim expenses	$ 1,201	$ 1,272
Unpaid claims and claim expenses			$ 6,119

Insurance and Contractholder _4

Insurance and Contractholder Liabilities - Narrative (Details) - USD ($) $ in Billions	Mar. 31, 2021	Mar. 31, 2020
Integrated Medical
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	$ 3.3	$ 2.7

Insurance and Contractholder _5

Insurance and Contractholder Liabilities - U.S. Medical - Activity (Details) - Integrated Medical - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Beginning balance	$ 3,184
Beginning balance, including disposal groups		$ 2,892
Less: Reinsurance and other amounts recoverable	224
Less: Reinsurance and other amounts recoverable, including disposal groups		303
Beginning balance, net	2,960
Beginning balance, net, including disposal groups		2,589
Incurred costs related to:
Current year	7,285	6,661
Prior years	(185)	(152)
Total incurred	7,100	6,509
Paid costs related to:
Current year	4,423	4,271
Prior years	2,317	2,027
Total paid	6,740	6,298
Ending balance, net	3,320
Ending balance, net, including disposal groups		2,800
Add: Reinsurance and other amounts recoverable	229
Add: Reinsurance and other amounts recoverable, including disposal groups		200
Ending balance	$ 3,549
Ending balance, including disposal groups		$ 3,000

Insurance and Contractholder _6

Insurance and Contractholder Liabilities - Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses (Details) - Integrated Medical - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 185	$ 152
Favorable (unfavorable) variance, percentage	0.70%	0.60%
Actual completion factors
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 68	$ 63
Favorable (unfavorable) variance, percentage	0.20%	0.30%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 117	$ 89
Favorable (unfavorable) variance, percentage	0.50%	0.30%

Insurance and Contractholder _7

Insurance and Contractholder Liabilities - Liability Details for Unpaid Claims and Claim Expenses (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Group Disability And Other And International Markets [Member]
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 1,201
Unpaid claims and claim expenses			$ 6,119
Total Other Operations
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	281
Unpaid claims and claim expenses			5,293
Group Disability and Life
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	0
Unpaid claims and claim expenses			5,084
Other Operations
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	281
Unpaid claims and claim expenses			209
International Markets [Member]
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 920	$ 963
Unpaid claims and claim expenses			$ 826

Insurance and Contractholder _8

Insurance and Contractholder Liabilities - Activity in Liabilities for Unpaid Claims and Claim Expenses (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Intenational Markets and Group Disability and Life
Liability for Claims and Claims Adjustment Expense [Line Items]
Beginning balance, including disposal groups		$ 5,816
Less: Reinsurance and other amounts recoverable, including disposal groups		184
Beginning balance, net, including disposal groups		5,632
Incurred claims related to:
Current year		1,473
Prior years:
Interest accretion		42
All other incurred		46
Total incurred		1,561
Paid costs related to:
Current year		490
Prior years		946
Total paid		1,436
Foreign currency		(25)
Ending balance, net, including disposal groups		5,732
Add: Reinsurance and other amounts recoverable, including disposal groups		178
Ending balance, including disposal groups		5,910
International Markets [Member]
Liability for Claims and Claims Adjustment Expense [Line Items]
Beginning balance	$ 963
Less: Reinsurance and other amounts recoverable	59
Beginning balance, net	904
Incurred claims related to:
Current year	724
Prior years:
Interest accretion	0
All other incurred	(48)
Total incurred	676
Paid costs related to:
Current year	326
Prior years	372
Total paid	698
Foreign currency	(20)
Ending balance, net	862
Add: Reinsurance and other amounts recoverable	58
Ending balance, including disposal groups		$ 826
Ending balance	$ 920

Reinsurance - Narrative (Detail

Reinsurance - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2021USD ($)reinsurer	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)reinsurer
GMIB
Effects of Reinsurance [Line Items]
Percent of future claim payments reinsured	100.00%		100.00%
Annuitization election period	30 days
GMIB liabilities	$ 595		$ 729
Number of external reinsurers | reinsurer	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%
Remaining overall limit under reinsurance agreement	$ 3,200
Other Current Assets
Effects of Reinsurance [Line Items]
Reinsurance recoverables	$ 216		$ 217

Reinsurance - Reinsurance Recov

Reinsurance - Reinsurance Recoverables by Range of External Credit Rating and Collateral Level (Details) $ in Millions	Mar. 31, 2021USD ($)
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 5,422
Allowance for uncollectible reinsurance	(31)
Total reinsurance recoverables	5,391
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	1,230
Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,900
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	292
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables	362
Ongoing Operations | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	173
Ongoing Operations | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	63
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	126
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	92
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	92
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	0
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	0
Ongoing Operations | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	270
Ongoing Operations | No collateral | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	173
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	34
Acquisition, disposition or runoff activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables	5,060
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	3,022
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Berkshire
Ceded Credit Risk [Line Items]
Reinsurance recoverables	700
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	607
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables	449
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	265
Acquisition, disposition or runoff activities | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	17
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	1,138
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	301
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	607
Acquisition, disposition or runoff activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Upper-medium grade and higher | Life Insurance Company of North America
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 | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	230
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	3,900
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	3,022
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	399
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 | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables	449
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	17
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	13
Acquisition, disposition or runoff activities | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	22
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 | Life Insurance Company of North America
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	18
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 10-Q (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Reinsurance Disclosures [Abstract]
Total ceded premiums	$ 149	$ 128
Total reinsurance recoveries	$ 148	$ 178

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	3 Months Ended	12 Months Ended
	Mar. 31, 2021USD ($)contractholder	Dec. 31, 2019contractholder	Dec. 31, 2020USD ($)
Net Amount at Risk by Product and Guarantee [Line Items]
Account value	$ 9,518		$ 9,523
Net amount at risk	$ 1,518		$ 1,570
Number of contractholders (estimated) | contractholder	180	185

Reinsurance - GMIB Reinsurers (

Reinsurance - GMIB Reinsurers (Details) - GMIB - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 616	$ 758
Berkshire
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 288	353
Berkshire | Secured | GMIB Assets | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 173	215
Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 155	$ 190
Liberty Re (Bermuda) Ltd. | Secured | GMIB Assets | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%

Investments - Investments by Ca

Investments - Investments by Category (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Schedule of Investments [Line Items]
Current	$ 1,477	$ 1,331
Long-term	22,821	23,262
Total	24,298	24,593
Debt securities
Schedule of Investments [Line Items]
Current	906	959
Long-term	16,743	17,172
Total	17,649	18,131
Equity securities
Schedule of Investments [Line Items]
Current	0	0
Long-term	550	501
Total	550	501
Commercial mortgage loans
Schedule of Investments [Line Items]
Current	60	13
Long-term	1,287	1,406
Total	1,347	1,419
Policy loans
Schedule of Investments [Line Items]
Current	0	0
Long-term	1,344	1,351
Total	1,344	1,351
Other long-term investments
Schedule of Investments [Line Items]
Current	0	0
Long-term	2,897	2,832
Total	2,897	2,832
Short-term investments
Schedule of Investments [Line Items]
Current	511	359
Long-term	0	0
Total	$ 511	$ 359

Investments - Debt Securities b

Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Amortized Cost
Due in one year or less	$ 930
Due after one year through five years	5,394
Due after five years through ten years	5,769
Due after ten years	3,869
Mortgage and other asset-backed securities	461
Total	16,423	$ 16,220
Fair Value
Due in one year or less	938
Due after one year through five years	5,635
Due after five years through ten years	6,110
Due after ten years	4,507
Mortgage and other asset-backed securities	459
Total	$ 17,649	$ 18,131

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020	Dec. 31, 2019
Schedule of Investments [Line Items]
Stockholders' equity	$ 48,155	$ 45,086	$ 50,328	$ 45,344
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
Amount of impairments or value changes resulting from observable price changes on equity securities with no readily available fair value still held
Retained Earnings
Schedule of Investments [Line Items]
Stockholders' equity	29,389	$ 21,298	28,575	20,162
Adjustment upon Adoption
Schedule of Investments [Line Items]
Stockholders' equity				(30)
Adjustment upon Adoption | Retained Earnings
Schedule of Investments [Line Items]
Stockholders' equity				$ (30)
Commercial Portfolio Segment | Real Estate Loan
Schedule of Investments [Line Items]
Allowance for credit losses on financing receivables	$ 6		$ 6

Investments - Gross Unrealized

Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 16,423	$ 16,220
Allowance for Credit Loss	(35)	(26)	$ (55)	$ 0
Unrealized Appreciation	1,407	1,990
Unrealized Depreciation	(146)	(53)
Fair Value	17,649	18,131
Run-Off Settlement Annuity Business
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,355	2,282
Allowance for Credit Loss	(4)	(5)
Unrealized Appreciation	590	838
Unrealized Depreciation	(18)	(3)
Fair Value	2,923	3,112
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	298	334
Allowance for Credit Loss	0	0
Unrealized Appreciation	99	122
Unrealized Depreciation	(3)	0
Fair Value	394	456
State and local government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	149	150
Allowance for Credit Loss	0	0
Unrealized Appreciation	14	17
Unrealized Depreciation	(1)	0
Fair Value	162	167
Foreign government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,206	2,201
Allowance for Credit Loss	0	0
Unrealized Appreciation	237	318
Unrealized Depreciation	(23)	(8)
Fair Value	2,420	2,511
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	13,309	13,108
Allowance for Credit Loss	(24)	(19)
Unrealized Appreciation	1,037	1,506
Unrealized Depreciation	(108)	(33)
Fair Value	14,214	14,562
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	461	427
Allowance for Credit Loss	(11)	(7)
Unrealized Appreciation	20	27
Unrealized Depreciation	(11)	(12)
Fair Value	$ 459	$ 435

Investments - Summary of Debt S

Investments - Summary of Debt Securities with a Decline in Fair Value (Details) $ in Millions	Mar. 31, 2021USD ($)position	Dec. 31, 2020USD ($)position
More than one year
Fair Value	$ 2,933	$ 1,515
Amortized Cost	3,079	1,568
Unrealized Depreciation	$ (146)	$ (53)
Number of Issues | position	1,448	571
Investment grade | Debt securities
One year or less
Fair Value	$ 2,225	$ 1,026
Amortized Cost	2,333	1,045
Unrealized Depreciation	$ (108)	$ (19)
Number of Issues | position	815	300
More than one year
Fair Value	$ 66	$ 18
Amortized Cost	70	18
Unrealized Depreciation	$ (4)	$ 0
Number of Issues | position	15	6
Below investment grade | Debt securities
One year or less
Fair Value	$ 463	$ 381
Amortized Cost	485	405
Unrealized Depreciation	$ (22)	$ (24)
Number of Issues | position	567	232
More than one year
Fair Value	$ 179	$ 90
Amortized Cost	191	100
Unrealized Depreciation	$ (12)	$ (10)
Number of Issues | position	51	33

Investments - Roll-Forward of t

Investments - Roll-Forward of the Allowance for Credit Losses on Debt Securities (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Debt Securities, Available-for-sale, Allowance for Credit Loss [Roll Forward]
Beginning balance	$ 26	$ 0
Additions for debt securities where no credit loss has previously been recognized	11	55
Reductions for securities sold during the period	0	0
Decrease for debt securities where credit losses have previously been recorded	(2)	0
Ending Balance	$ 35	$ 55

Investments - Equity Security I

Investments - Equity Security Investments (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Cost
Equity securities with readily determinable fair values	$ 192	$ 180
Equity securities with no readily determinable fair value	231	225
Hybrid equity securities	58	58
Total	481	463
Carrying Value
Equity securities with readily determinable fair values	211	202
Equity securities with no readily determinable fair value	298	255
Hybrid equity securities	41	44
Total	$ 550	$ 501

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	3 Months Ended	12 Months Ended
	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)
Schedule of Investments [Line Items]
Allowance for credit losses	$ (6)	$ (6)
Total	$ 1,347	$ 1,419
Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.08	2.08
Average Loan-to-Value Ratio	61.00%	61.00%
Below 60%
Schedule of Investments [Line Items]
Carrying Value	$ 513	$ 533
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.25	2.28
60% to 79%
Schedule of Investments [Line Items]
Carrying Value	$ 699	$ 751
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.11	2.08
80% to 100%
Schedule of Investments [Line Items]
Carrying Value	$ 141	$ 141
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.33	1.33

Investments - Carrying Values o

Investments - Carrying Values of Other Long-Term Investments (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Schedule of Investments [Line Items]
Other long-term investments	$ 2,897	$ 2,832
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	999	951
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	1,712	1,683
Other
Schedule of Investments [Line Items]
Other long-term investments	$ 186	$ 198

Investments - Short-Term Invest

Investments - Short-Term Investments and Cash Equivalents (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Corporate securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	$ 2,953	$ 2,669
Federal government securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	113	158
Foreign government securities
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	42	90
Money market funds
Short Term Investments And Cash Equivalents [Line Items]
Short-term investments and cash equivalents	$ 960	$ 5,134

Investments - Summary of Deriva

Investments - Summary of Derivative Instruments Held (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Designated as Hedging Instrument | Fair Value Hedging | Foreign currency swap contracts
Derivative [Line Items]
Notional Value	$ 956	$ 925
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency swap contracts
Derivative [Line Items]
Notional Value	526	526
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency forward contracts
Derivative [Line Items]
Notional Value	706	636
Not Designated as Hedging Instrument | Foreign currency forward contracts
Derivative [Line Items]
Notional Value	$ 630	$ 538

Investments - Components of Net

Investments - Components of Net Investment Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Net Investment Income [Line Items]
Net investment income	$ 391	$ 353

Investments - Realized Gains an

Investments - Realized Gains and Losses on Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Investments [Abstract]
Net realized investment gains (losses), excluding credit loss expense and asset write-downs	$ 10	$ (24)
Credit loss (expense) on invested assets	(9)	(55)
Other investment asset write-downs	0	(9)
Net realized investment gains (losses), before income taxes	$ 1	$ (88)

Investments - Sales Information

Investments - Sales Information for Available-for-Sale Debt Securities (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement of Financial Position [Abstract]
Proceeds from sales	$ 377	$ 743
Gross gains on sales	9	39
Gross losses on sales	$ (3)	$ (7)

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Financial assets at fair value:
Debt securities	$ 17,649	$ 18,131
Equity securities	211	202
Financial liabilities at fair value
Unfunded commitments	46
Recurring
Financial assets at fair value:
Debt securities	17,649	18,131
Equity securities	252	246
Short-term investments	505	325
Real estate funds priced at NAV as a practical expedient	146	156
Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	62	72
Financial liabilities at fair value
Derivative liabilities	74	108
Recurring | Other Derivatives | Short-term investments
Financial assets at fair value:
Derivative assets	6
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	164	207
Equity securities	56	50
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	16,613	17,101
Equity securities	165	165
Short-term investments	505	325
Significant Other Observable Inputs (Level 2) | Recurring | Other Derivatives
Financial assets at fair value:
Derivative assets	62	72
Financial liabilities at fair value
Derivative liabilities	74	108
Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	872	823
Equity securities	31	31
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	394	456
Federal government and agency | Recurring
Financial assets at fair value:
Debt securities	394	456
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Debt securities	164	207
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt securities	230	249
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	162	167
State and local government | Recurring
Financial assets at fair value:
Debt securities	162	167
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	162	167
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	2,420	2,511
Foreign government | Recurring
Financial assets at fair value:
Debt securities	2,420	2,511
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	2,407	2,498
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	13	13
Corporate
Financial assets at fair value:
Debt securities	14,214	14,562
Corporate | Recurring
Financial assets at fair value:
Debt securities	14,214	14,562
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	13,504	13,878
Corporate | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	710	684
Mortgage and other asset-backed
Financial assets at fair value:
Debt securities	459	435
Mortgage and other asset-backed | Recurring
Financial assets at fair value:
Debt securities	459	435
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	310	309
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt securities	$ 149	$ 126

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percent of debt and equity securities classified in Level 2	94.00%
Maximum percentage of investments classified in Level 2 representing foreign bonds priced using unadjusted broker quotes	1.00%
Percent of debt and equity securities classified in Level 3	5.00%
Realized investment losses on assets measured at fair value under certain conditions, after-tax	$ 0	$ 0
Realized investment gains on equity securities with no readily determinable fair value
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%
Separate Account Assets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Separate accounts assets classified in Level 3, period increase (decrease), , including transfers in and out of Level 3
Separate accounts assets classified in Level 3, including disposal groups, period increase (decrease), 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
Adjustment for credit risk on derivatives liabilities	$ 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	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 872	$ 823
Debt securities | Securities Not Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	1	1
Corporate and government debt securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 722	$ 696
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	0.0060
Corporate and government debt securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.1560	0.1370
Corporate and government debt securities | Securities Priced by the Company | Weighted Average | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0480	0.0470
Mortgage and other asset-backed securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 149	$ 126
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	0.0250	0.0300
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0380	0.0380
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	0.0660	0.0670
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	0.0090	0.0080
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	0.0450	0.0480

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
	Mar. 31, 2021	Mar. 31, 2020
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	$ (16)	$ (66)
Debt and Equity Securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance	854
Balance		555
Total gains (losses) included in shareholders’ net income	(10)	(12)
Gains (losses) included in other comprehensive income	(16)	(71)
Gains (losses) required to adjust future policy benefits for settlement annuities	(8)	(10)
Purchases, sales and settlements
Purchases	29	62
Sales	0	(12)
Settlements	(16)	(2)
Total purchases, sales and settlements	13	48
Transfers into/(out of) Level 3
Transfers into Level 3	86	348
Transfers out of Level 3	(16)	(92)
Total transfers into/(out of) Level 3	70	256
Balance	903
Balance		766
Total gains (losses) included in shareholders’ net income attributable to instruments held at the reporting date	$ (11)	$ (18)

Fair Value Measurements - Fai_2

Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 504	$ 523
Non-guaranteed separate accounts	7,866	7,880
Subtotal	8,370	8,403
Non-guaranteed separate accounts priced at NAV as a practical expedient	718	683
Separate account assets per Consolidated Balance Sheets	9,088	9,086
Pension Plan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	4,200	4,200
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	222	226
Non-guaranteed separate accounts	2,071	1,925
Subtotal	2,293	2,151
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	282	297
Non-guaranteed separate accounts	5,417	5,600
Subtotal	5,699	5,897
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	378	355
Subtotal	378	355
Significant Unobservable Inputs (Level 3) | Pension Plan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	$ 300	$ 300

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information on Separate Account Assets Priced at NAV (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 46
Recurring
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	146	$ 156
Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	319
Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	718	683
Securities partnerships | Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	274
Securities partnerships | Separate Account Assets | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	463	463
Real estate funds | Separate Account Assets
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 45
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	$ 251	215
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	Mar. 31, 2021	Dec. 31, 2020
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	$ 35,649	$ 37,676
Fair Value | Significant Unobservable Inputs (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,373	1,456
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,347	1,419
Long-term debt, including current maturities, excluding finance leases	$ 31,912	$ 31,835

Variable Interest Entities (Det

Variable Interest Entities (Details) - entity	Mar. 31, 2021	Dec. 31, 2020
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Number of VIEs

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 50,328	$ 45,344
Other comprehensive loss, net of tax	(374)	(590)
Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests	(4)	(4)
Shareholders other comprehensive income (loss), net of tax	(370)	(586)
Balance	48,155	45,086
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	900	975
Other comprehensive income (loss) before reclassifications, before tax	(342)	(580)
Other comprehensive income (loss) before reclassifications, tax	65	127
Other comprehensive income (loss) before reclassifications, after-tax	(277)	(453)
Reclassification adjustment, tax	(1)	(7)
Net amounts reclassified from AOCI to net income	4	25
Shareholders other comprehensive income (loss), net of tax	(273)	(428)
Balance	627	547
Reclassification adjustment for (gains) losses included in shareholders' net income (net realized investment (gains) losses)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	5	32
Translation of foreign currencies
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax, including temporary equity	(114)	(160)
Other comprehensive income (loss) before reclassifications, tax, including temporary equity	(5)	(15)
Other comprehensive income (loss) before reclassifications, after-tax, including temporary equity	(119)	(175)
Translation of foreign currencies attributable to noncontrolling interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests	(4)	(4)
Translation of foreign currencies attributable to parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(15)	(275)
Shareholders other comprehensive income (loss), net of tax	(115)	(171)
Balance	(130)	(446)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(1,746)	(1,641)
Reclassification adjustment, tax	(5)	(5)
Net amounts reclassified from AOCI to net income	18	13
Shareholders other comprehensive income (loss), net of tax	18	13
Balance	(1,728)	(1,628)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	20	18
Reclassification adjustment for settlement (interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	$ 3	$ 0

Leases - Operating and Finance

Leases - Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities (Details) - USD ($) $ in Millions	Mar. 31, 2021	Dec. 31, 2020
Operating leases:
Operating lease ROU assets	$ 534	$ 552
Accrued expenses and other liabilities	152	152
Other non-current liabilities	480	491
Total operating lease liabilities	632	643
Finance leases:
Property and equipment, gross	103	98
Accumulated depreciation	(51)	(46)
Property and equipment, net	52	52
Short-term debt	20	18
Long-term debt	35	36
Total finance lease liabilities	$ 55	$ 54
Balance sheet location of current operating lease liabilities	Accrued expenses and other liabilities	Accrued expenses and other liabilities
Balance sheet location of non-current operating lease liabilities	Other non-current liabilities	Other non-current liabilities
Balance sheet location of non-current finance lease assets	Property and equipment	Property and equipment
Balance sheet location of current finance lease liabilities	Short-term debt	Short-term debt
Balance sheet location of non-current finance lease liabilities	Long-term debt	Long-term debt

Income Taxes - 10-Q Narrative (

Income Taxes - 10-Q Narrative (Details)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	22.60%	14.90%

Contingencies and Other Matte_2

Contingencies and Other Matters (Details)	Apr. 19, 2016claim	Sep. 30, 2020USD ($)	Mar. 31, 2016USD ($)	Mar. 31, 2021USD ($)	Apr. 30, 2020USD ($)	Feb. 28, 2017USD ($)
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
Express Scripts Litigation with Anthem | Pending Litigation
Commitments And Contingencies [Line Items]
Number of counts dismissed | claim	2
Number of counts | claim	6
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
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
Proceeds related to legal claim		$ 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
Positive Outcome of Litigation | Cigna Litigation with Anthem | Pending Litigation
Commitments And Contingencies [Line Items]
Reverse termination fee receivable						$ 1,850,000,000
Certain other guarantees, indemnification obligations in connection with acquisition and disposition transactions
Commitments And Contingencies [Line Items]
Liability for guarantees				0
Retiree and Life Insurance Benefits | Financial Guarantees
Commitments And Contingencies [Line Items]
Maximum guarantee exposure				445,000,000
Assets maintained by employers (minimum)				445,000,000
Liability for guarantees				$ 0

Segment Information - Summary o

Segment Information - Summary of Special Items (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
After-tax
Debt extinguishment costs	$ 101	$ 140
Integration and transaction-related costs (Selling, general and administrative expenses)	22	74
Charges associated with litigation matters (Selling, general and administrative expenses)	(21)	19
Charge for organizational efficiency plan (Selling, general and administrative expenses)	0	24
Contractual adjustment for a former client (Pharmacy revenues)	0	(66)
Total impact from special items	102	191
Before-tax
Debt extinguishment costs	131	185
Integration and transaction-related costs (Selling, general and administrative expenses)	29	97
Charges associated with litigation matters (Selling, general and administrative expenses)	(27)	25
Charge for organizational efficiency plan (Selling, general and administrative expenses)	0	31
Contractual adjustment for a former client (Pharmacy revenues)	0	(87)
Total impact from special items	$ 133	$ 251

Segment Information - Summarize

Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Segment Reporting Information [Line Items]
Revenues from customers	$ 40,580	$ 38,116
Net investment income	391	353
TOTAL REVENUES	40,971	38,469
Net realized investment results from certain equity method investments	14	10
Special item related to contractual adjustment for a former client		(87)
Adjusted revenues	40,985	38,392
Depreciation and amortization	715	693
Income before income taxes	1,513	1,397
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(12)	(9)
Net realized investment (gains) losses	13	98
Amortization of acquired intangible assets	495	498
Special items
Debt extinguishment costs	131	185
Integration and transaction-related costs	29	97
Charges associated with litigation matters	(27)	25
Charge for organizational efficiency plan	0	31
Contractual adjustment for a former client	0	(87)
Pre-tax adjusted income (loss) from operations	2,142	2,235
Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	29,419	26,256
Integrated Medical
Segment Reporting Information [Line Items]
Revenues from customers	9,602	9,268
International Markets [Member]
Segment Reporting Information [Line Items]
Revenues from customers	1,499	1,420
Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	60	1,172
Operating Segments | Evernorth
Segment Reporting Information [Line Items]
Net investment income	3	25
TOTAL REVENUES	30,620	27,255
Net realized investment results from certain equity method investments	0	0
Special item related to contractual adjustment for a former client		(87)
Adjusted revenues	30,620	27,168
Income before income taxes	749	694
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(5)	(4)
Net realized investment (gains) losses	2	0
Amortization of acquired intangible assets	477	479
Special items
Debt extinguishment costs	0	0
Integration and transaction-related costs	0	0
Charges associated with litigation matters	0	0
Charge for organizational efficiency plan		0
Contractual adjustment for a former client		(87)
Pre-tax adjusted income (loss) from operations	1,223	1,082
Operating Segments | Integrated Medical
Segment Reporting Information [Line Items]
Net investment income	250	126
TOTAL REVENUES	10,362	9,860
Net realized investment results from certain equity method investments	0	0
Special item related to contractual adjustment for a former client		0
Adjusted revenues	10,362	9,860
Income before income taxes	1,009	1,140
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0
Net realized investment (gains) losses	(30)	48
Amortization of acquired intangible assets	8	11
Special items
Debt extinguishment costs	0	0
Integration and transaction-related costs	0	0
Charges associated with litigation matters	0	0
Charge for organizational efficiency plan		0
Contractual adjustment for a former client		0
Pre-tax adjusted income (loss) from operations	987	1,199
Operating Segments | International Markets [Member]
Segment Reporting Information [Line Items]
Net investment income	59	40
TOTAL REVENUES	1,558	1,460
Net realized investment results from certain equity method investments	14	10
Special item related to contractual adjustment for a former client		0
Adjusted revenues	1,572	1,470
Income before income taxes	226	234
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(7)	(5)
Net realized investment (gains) losses	33	46
Amortization of acquired intangible assets	10	7
Special items
Debt extinguishment costs	0	0
Integration and transaction-related costs	0	0
Charges associated with litigation matters	0	0
Charge for organizational efficiency plan		0
Contractual adjustment for a former client		0
Pre-tax adjusted income (loss) from operations	262	282
Operating Segments | Other Operations
Segment Reporting Information [Line Items]
Net investment income	79	162
TOTAL REVENUES	139	1,339
Net realized investment results from certain equity method investments	0	0
Special item related to contractual adjustment for a former client		0
Adjusted revenues	139	1,339
Income before income taxes	16	72
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0
Net realized investment (gains) losses	8	4
Amortization of acquired intangible assets	0	1
Special items
Debt extinguishment costs	0	0
Integration and transaction-related costs	0	0
Charges associated with litigation matters	0	0
Charge for organizational efficiency plan		0
Contractual adjustment for a former client		0
Pre-tax adjusted income (loss) from operations	24	77
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net investment income	0	0
TOTAL REVENUES	(1,708)	(1,445)
Net realized investment results from certain equity method investments	0	0
Special item related to contractual adjustment for a former client		0
Adjusted revenues	(1,708)	(1,445)
Income before income taxes	(487)	(743)
Special items
Pre-tax adjusted income (loss) from operations	(354)	(405)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	0	0
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0
Net realized investment (gains) losses	0	0
Amortization of acquired intangible assets	0	0
Special items
Debt extinguishment costs	131	185
Integration and transaction-related costs	29	97
Charges associated with litigation matters	(27)	25
Charge for organizational efficiency plan		31
Contractual adjustment for a former client		0
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(1,708)	(1,445)
Intersegment Eliminations | Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	(1,198)	(974)
Intersegment Eliminations | Integrated Medical
Segment Reporting Information [Line Items]
Revenues from customers	(510)	(466)
Intersegment Eliminations | International Markets [Member]
Segment Reporting Information [Line Items]
Revenues from customers	0	0
Intersegment Eliminations | Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	$ 0	$ (5)

Segment Information - Revenue f

Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenue from External Customer [Line Items]
Premiums	$ 10,214	$ 10,840
Total revenues from external customers	40,580	38,116
Integrated Medical
Revenue from External Customer [Line Items]
Total revenues from external customers	9,602	9,268
International Markets [Member]
Revenue from External Customer [Line Items]
Premiums	1,450	1,375
Total revenues from external customers	1,499	1,420
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	28,025	25,098
Network revenues
Revenue from External Customer [Line Items]
Revenues	14,179	12,142
Home delivery and specialty revenues
Revenue from External Customer [Line Items]
Revenues	12,458	11,714
Other
Revenue from External Customer [Line Items]
Revenues	1,388	1,242
U.S. Medical premiums | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	8,707	8,320
Health Insurance | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	3,523	3,461
Stop loss | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	1,194	1,161
Other | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	310	289
Medicare Advantage | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	2,092	1,881
Medicare Part D | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	450	462
Other | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	1,138	1,066
Domestic disability, life and accident premiums
Revenue from External Customer [Line Items]
Premiums	0	1,116
Other premiums
Revenue from External Customer [Line Items]
Premiums	57	29
Total services
Revenue from External Customer [Line Items]
Revenues	2,341	2,178
Fees
Revenue from External Customer [Line Items]
Revenues	2,327	2,154
Other external revenues
Revenue from External Customer [Line Items]
Revenues	$ 14	$ 24

Segment Information - 10-Q Narr

Segment Information - 10-Q Narrative (Details) - USD ($) $ in Billions	Mar. 31, 2021	Dec. 31, 2020
Pharmacy Benefits Management Services | Performance Guarantee
Loss Contingencies [Line Items]
Performance guarantee liability	$ 1.3	$ 1.1