Cigna (CI) 10-Q 4 Nov 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Oct. 29, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 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		331,427,775
Document Fiscal Period Focus	Q3
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		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues
Premiums	$ 10,275	$ 10,682	$ 30,812	$ 31,928
Net investment income	468	297	1,169	873
TOTAL REVENUES	44,288	40,955	128,390	118,689
Benefits and expenses
Pharmacy and other service costs	30,070	26,624	86,306	76,425
Medical costs and other benefit expenses	8,330	8,429	24,819	23,863
Selling, general and administrative expenses	3,093	3,301	9,368	10,106
Amortization of acquired intangible assets	501	493	1,499	1,487
TOTAL BENEFITS AND EXPENSES	41,994	38,847	121,992	111,881
Income (loss) from operations	2,294	2,108	6,398	6,808
Interest expense and other	(303)	(336)	(915)	(1,101)
Debt extinguishment costs	0	0	(141)	(199)
Net realized investment gains (losses)	68	32	128	(18)
Income before income taxes	2,059	1,804	5,470	5,490
TOTAL INCOME TAXES	424	406	1,188	1,143
Net income	1,635	1,398	4,282	4,347
Less: Net income attributable to noncontrolling interests	14	10	33	24
SHAREHOLDERS' NET INCOME	$ 1,621	$ 1,388	$ 4,249	$ 4,323
Shareholders’ net income per share
Basic (in dollars per share)	$ 4.84	$ 3.81	$ 12.44	$ 11.77
Diluted (in dollars per share)	$ 4.80	$ 3.78	$ 12.32	$ 11.66
Pharmacy revenues
Revenues
Revenues	$ 31,013	$ 27,802	$ 89,085	$ 79,464
Fees and other revenues
Revenues
Revenues	$ 2,532	$ 2,174	$ 7,324	$ 6,424

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 1,635	$ 1,398	$ 4,282	$ 4,347
Other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives	32	120	(119)	401
Net translation gains (losses) on foreign currencies	(125)	109	(228)	4
Postretirement benefits liability adjustment	16	14	49	(15)
Other comprehensive income (loss), net of tax	(77)	243	(298)	390
Total comprehensive income	1,558	1,641	3,984	4,737
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interest	4	4	12	12
Net income attributable to other noncontrolling interests	10	6	21	12
Other comprehensive (loss) attributable to redeemable noncontrolling interest	(1)	(4)	(6)	(10)
Total comprehensive income attributable to noncontrolling interests	13	6	27	14
SHAREHOLDERS' COMPREHENSIVE INCOME	$ 1,545	$ 1,635	$ 3,957	$ 4,723

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions		Sep. 30, 2021	Dec. 31, 2020
Assets
Cash and cash equivalents		$ 3,483	$ 10,182
Investments		1,374	1,331
Accounts receivable, net		16,250	12,191
Inventories		3,020	3,165
Other current assets		1,360	930
Total current assets		25,487	27,799
Long-term investments		23,756	23,262
Reinsurance recoverables		5,035	5,200
Deferred policy acquisition costs		3,367	3,385
Property and equipment		4,070	4,205
Goodwill		46,056	44,648
Other intangible assets		34,615	35,179
Other assets		2,715	2,687
Separate account assets		9,150	9,086
TOTAL ASSETS		154,251	155,451
Liabilities
Current insurance and contractholder liabilities		5,917	5,308
Pharmacy and other service costs payable		14,705	13,347
Accounts payable		5,659	5,478
Accrued expenses and other liabilities		7,356	8,515
Short-term debt		2,703	3,374
Total current liabilities		36,340	36,022
Non-current insurance and contractholder liabilities		16,576	16,844
Deferred tax liabilities, net		8,832	8,939
Other non-current liabilities		4,261	4,629
Long-term debt		31,609	29,545
Separate account liabilities		9,150	9,086
TOTAL LIABILITIES		106,768	105,065
Contingencies — Note 15
Redeemable noncontrolling interests		56	58
Shareholders’ equity
Common stock	[1]	4	4
Additional paid-in capital		29,077	28,975
Accumulated other comprehensive loss		(1,153)	(861)
Retained earnings		31,803	28,575
Less: Treasury stock, at cost		(12,316)	(6,372)
TOTAL SHAREHOLDERS’ EQUITY		47,415	50,321
Other noncontrolling interests		12	7
Total equity		47,427	50,328
Total liabilities and equity		$ 154,251	$ 155,451
[1]	Par value per share, $0.01; shares issued, 394 million as of September 30, 2021 and 390 million as of December 31, 2020; authorized shares, 600 million.

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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)	394,000,000	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	385		385			471				(86)
Other comprehensive income (loss)	400		400				400
Net income	4,335		4,323					4,323			12
Common dividends declared	(15)		(15)					(15)
Repurchase of common stock	(2,369)		(2,369)							(2,369)
Other transactions impacting noncontrolling interests	(11)										(11)
Balance at Sep. 30, 2020	48,039		48,032		4	28,777	(541)	24,440		(4,648)	7
Balance at Dec. 31, 2019	35
Change in Redeemable Noncontrolling Interests
Other comprehensive (loss)	(10)
Net income	12
Other transactions impacting noncontrolling interests	22
Balance at Sep. 30, 2020	$ 59
Change in Redeemable Noncontrolling Interests
Accounting Standards Update [Extensible List]	Accounting Standards Update 2016-13 [Member]
Common dividends declared (in dollars per share)	$ 0.04
Balance at Jun. 30, 2020	$ 47,371		47,366		4	28,699	(788)	23,052		(3,601)	5
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans	76		76			78				(2)
Other comprehensive income (loss)	247		247				247
Net income	1,394		1,388					1,388			6
Repurchase of common stock	(1,045)		(1,045)							(1,045)
Other transactions impacting noncontrolling interests	(4)										(4)
Balance at Sep. 30, 2020	48,039		48,032		4	28,777	(541)	24,440		(4,648)	7
Balance at Jun. 30, 2020	34
Change in Redeemable Noncontrolling Interests
Other comprehensive (loss)	(4)
Net income	4
Other transactions impacting noncontrolling interests	25
Balance at Sep. 30, 2020	59
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	417		417			507				(90)
Other comprehensive income (loss)	(292)		(292)				(292)
Net income	4,270		4,249					4,249			21
Common dividends declared	(1,021)		(1,021)					(1,021)
Repurchase of common stock	(6,254)		(6,254)			(400)				(5,854)
Other transactions impacting noncontrolling interests	(21)		(5)			(5)					(16)
Balance at Sep. 30, 2021	47,427		47,415		4	29,077	(1,153)	31,803		(12,316)	12
Balance at Dec. 31, 2020	58
Change in Redeemable Noncontrolling Interests
Other comprehensive (loss)	(6)
Net income	12
Other transactions impacting noncontrolling interests	(8)
Balance at Sep. 30, 2021	$ 56
Change in Redeemable Noncontrolling Interests
Common dividends declared (in dollars per share)	$ 3
Balance at Jun. 30, 2021	$ 48,716		48,709		4	29,403	(1,077)	30,513		(10,134)	7
Changes in Total Equity [Roll Forward]
Effect of issuing stock for employee benefit plans	75		75			76				(1)
Other comprehensive income (loss)	(76)		(76)				(76)
Net income	1,631		1,621					1,621			10
Common dividends declared	(331)		(331)					(331)
Repurchase of common stock	(2,581)		(2,581)			(400)				(2,181)
Other transactions impacting noncontrolling interests	(7)		(2)			(2)					(5)
Balance at Sep. 30, 2021	47,427		$ 47,415		$ 4	$ 29,077	$ (1,153)	$ 31,803		$ (12,316)	$ 12
Balance at Jun. 30, 2021	51
Change in Redeemable Noncontrolling Interests
Other comprehensive (loss)	(1)
Net income	4
Other transactions impacting noncontrolling interests	2
Balance at Sep. 30, 2021	$ 56
Change in Redeemable Noncontrolling Interests
Common dividends declared (in dollars per share)	$ 1

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021	Sep. 30, 2020
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 1	$ 3	$ 0.04

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Millions		9 Months Ended
		Sep. 30, 2021	Sep. 30, 2020
Cash Flows from Operating Activities
Net income		$ 4,282	$ 4,347
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		2,180	2,089
Realized investment (gains) losses, net		(128)	18
Deferred income tax (benefit)		(104)	(340)
Debt extinguishment costs		141	199
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable		(4,039)	(2,810)
Inventories		145	5
Deferred policy acquisition costs		(182)	(244)
Reinsurance recoverable and Other assets		(281)	(468)
Insurance liabilities		863	740
Pharmacy and other service costs payable		1,357	2,084
Accounts payable and Accrued expenses and other liabilities		(1,411)	(32)
Other, net		93	468
NET CASH PROVIDED BY OPERATING ACTIVITIES		2,916	6,056
Proceeds from investments sold:
Debt securities and equity securities		1,052	2,038
Investment maturities and repayments:
Debt securities and equity securities		1,265	1,097
Commercial mortgage loans		127	14
Other sales, maturities and repayments (primarily short-term and other long-term investments)		1,261	1,086
Investments purchased or originated:
Debt securities and equity securities		(2,742)	(3,317)
Commercial mortgage loans		(233)	(55)
Other (primarily short-term and other long-term investments)		(1,768)	(1,434)
Property and equipment purchases, net		(850)	(775)
Acquisitions, net of cash acquired		(1,836)	(135)
Divestiture, net of cash sold		(61)	0
Other, net		51	37
NET CASH (USED IN) INVESTING ACTIVITIES		(3,734)	(1,444)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		132	769
Withdrawals and benefit payments from contractholder deposit funds		(139)	(736)
Net change in short-term debt		1,633	592
Net proceeds on issuance of term loan		0	1,398
Payments for debt extinguishment		(136)	(212)
Repayment of long-term debt		(4,578)	(6,897)
Net proceeds on issuance of long-term debt		4,260	3,465
Repurchase of common stock		(6,321)	(2,352)
Issuance of common stock		301	239
Common stock dividend paid		(1,017)	(15)
Other, net		24	(63)
NET CASH (USED IN) FINANCING ACTIVITIES		(5,841)	(3,812)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		(46)	(7)
Net (decrease) increase in cash, cash equivalents and restricted cash		(6,705)	793
Cash, cash equivalents and restricted cash January 1,	[1]	10,245	5,411
Cash, cash equivalents and restricted cash, September 30,		3,540	6,204
Cash reclassified to assets of business held for sale		0	(798)
Cash, cash equivalents, and restricted cash December 31, per Consolidated Balance Sheets	[2]	3,540	5,406
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		1,916	1,408
Interest paid		$ 950	$ 1,112
[1]	Includes $743 million reported in Assets of business held for sale as of January 1, 2020.
[2]	Restricted cash and cash equivalents were reported in other long-term investments as of September 30, 2021, December 31, 2020 and September 30, 2020. Restricted cash and cash equivalents were reported in other long-term investments and other assets as of December 31, 2019.

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Millions	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2019
Statement of Cash Flows [Abstract]
Cash reclassified to assets of business held for sale	$ 0	$ 798	$ 743

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 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. Our subsidiaries offer a differentiated set of pharmacy, medical, dental and related products and services. 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 provides details of its reporting segments and recent changes 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 Insurance Company ("New York Life") and results of this business are reported in the U.S. Medical segment. 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. Cigna entered into a definitive agreement in October 2021 to sell its life, accident and supplemental benefits businesses in seven countries to Chubb INA Holdings, Inc. ("Chubb") for $5.75 billion cash. Subject to applicable regulatory approvals and customary closing conditions, we expect to complete the sale of our life, accident and supplemental benefits businesses in Hong Kong, Indonesia, New Zealand, South Korea, Taiwan, Thailand and our interest in a joint venture in Turkey in 2022. 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 enterprise wide project costs and intersegment eliminations for products and services sold between segments.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 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. Recent Accounting Pronouncements The Company's 2020 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted our financial statements or may impact them in the future. There have been no updates to accounting guidance not yet adopted or recently issued accounting pronouncements that have occurred since the Company filed its 2020 Form 10-K that would have a material impact to our financial statements. There were no new accounting standards adopted as of September 30, 2021 that had a material impact to our financial statements.

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2021
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net The following amounts were included within Accounts receivable, net: (In millions) September 30, 2021 December 31, 2020 Noninsurance customer receivables $ 6,797 $ 5,534 Pharmaceutical manufacturers receivable 6,526 4,676 Insurance customer receivables 2,567 1,789 Other receivables 360 192 Total $ 16,250 $ 12,191

Mergers, Acquisitions and Dives

Mergers, Acquisitions and Divestitures	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Mergers, Acquisitions and Divestitures	Mergers, Acquisitions and DivestituresAcquisition of MDLIVE On April 19, 2021, Cigna acquired 97% of MDLIVE, Inc. ("MDLIVE"), a 24/7 virtual care platform. Combined with Cigna's previously held equity investment, Cigna now owns 100% of MDLIVE. The acquisition of MDLIVE will enable Cigna's Evernorth segment to continue expanding access to virtual care and delivering a more affordable, convenient and connected care experience for consumers. The purchase price of $2.0 billion consisted of cash consideration. In accordance with GAAP, the total consideration transferred has been allocated to the tangible and intangible net assets acquired based on management's preliminary estimates of their fair values and may change as additional information becomes available over the next several months. During the three months ended September 30, 2021, the Company made immaterial measurement period adjustments to the purchase price allocation. The estimated fair values of assets acquired and liabilities assumed as of the closing date were as follows: (In millions) Goodwill $ 1,438 Acquired intangible assets 627 Tangible assets acquired net of liabilities assumed 17 Total consideration transferred 2,082 Less: Fair value to Cigna's previously held equity interest (55) Total purchase price $ 2,027 Most of the goodwill is assigned to the Evernorth segment ($1.3 billion). Goodwill is not deductible for federal income tax purposes. The acquired intangible assets primarily consist of customer relationships ($577 million) as well as internal-use software, provider networks and a trade name. The fair value of the customer relationships and the amortization period were determined using an income approach that relies heavily on projected future net cash flows including key assumptions for customer attrition, margins and discount rates. The customer relationship intangible asset is amortized over a period of 17 years in a pattern that reflects when Cigna expects to receive the benefits of the related cash flows. The results of MDLIVE have been included in the Company's Consolidated Financial Statements from the date of the acquisition. Revenues from MDLIVE and their results of operations were not material to Cigna's consolidated results of operations for the three or nine months ended September 30, 2021. The pro forma effects of this acquisition for current and prior periods were not material to our consolidated results of operations.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 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 September 30, 2021 September 30, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 1,621 $ 1,621 $ 1,388 $ 1,388 Shares: Weighted average 335,166 335,166 364,427 364,427 Common stock equivalents 2,413 2,413 2,763 2,763 Total shares 335,166 2,413 337,579 364,427 2,763 367,190 EPS $ 4.84 $ (0.04) $ 4.80 $ 3.81 $ (0.03) $ 3.78 Nine Months Ended September 30, 2021 September 30, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 4,249 $ 4,249 $ 4,323 $ 4,323 Shares: Weighted average 341,583 341,583 367,410 367,410 Common stock equivalents 3,197 3,197 3,421 3,421 Total shares 341,583 3,197 344,780 367,410 3,421 370,831 EPS $ 12.44 $ (0.12) $ 12.32 $ 11.77 $ (0.11) $ 11.66 The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Anti-dilutive options 1.5 4.6 1.5 4.2

Debt

Debt	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Debt	Debt The outstanding amounts of debt and finance leases were as follows: (In millions) September 30, 2021 December 31, 2020 Short-term debt $78 million, 6.37% Notes due 6/2021 $ — $ 78 $1,000 million, Floating Rate Notes due 9/2021 — 999 $1,250 million, 3.4% Notes due 9/2021 — 1,249 Commercial paper 2,680 1,030 Other, including finance leases 23 18 Total short-term debt $ 2,703 $ 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 494 490 $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 699 698 $1,000 million, 3% Notes due 2023 982 975 $1,187 million, 3.75% Notes due 2023 1,185 2,181 $500 million, 0.613% Notes due 2024 498 — $1,000 million, 3.5% Notes due 2024 982 977 $900 million, 3.25% Notes due 2025 897 896 $2,200 million, 4.125% Notes due 2025 2,192 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 1,419 1,410 $259 million, 7.875% Debentures due 2027 259 259 $600 million, 3.05% Notes due 2027 596 595 $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) 1,500 — $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 (1) 2,192 2,180 $750 million, 3.2% Notes due 2040 743 742 $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 2,967 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 30 36 Total long-term debt $ 31,609 $ 29,545 (1) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 9 for further information about the Company's interest rate risk management and these derivative instruments. 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 nine months ended September 30, 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: During the first nine months of 2021, the Company completed the redemption of a total of $4.5 billion in aggregate principal amount of certain of its outstanding debt securities. The Company recorded a pre-tax loss of $141 million ($110 million after-tax), consisting primarily of premium payments. 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. As of September 30, 2021, there were no outstanding balances under these revolving credit agreements. In April 2021, Cigna entered into a $3.0 billion five-year revolving credit and letter of credit agreement that matures in April 2026 and a $1.0 billion three-year revolving credit agreement that matures in April 2024, which are diversified among 23 banks and replaced the five-year revolving credit and letter of credit agreement that was scheduled to mature in April 2023. Under the current agreements, Cigna can borrow up to $3.0 billion and $1.0 billion, respectively, for general corporate purposes, with up to $500 million available under the five-year facility for issuance of letters of credit. The revolving credit agreements also include an option to extend the termination date for an additional one-year period, subject to consent of the banks. 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 replaced the prior $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-year facility, the three-year facility and the 364-day facility include an option to increase commitments in an aggregate amount of up to $1.5 billion across all three facilities. Each of the three facilities also contain customary covenants and restrictions including a financial covenant that the Company’s leverage ratio may not exceed 60%, subject to certain exceptions upon the consummation of an acquisition. Commercial Paper. Under our commercial paper program we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker dealers at any time not to exceed an aggregate amount of $5.0 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 September 30, 2021.

Insurance and Contractholder Li

Insurance and Contractholder Liabilities	9 Months Ended
	Sep. 30, 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: September 30, 2021 December 31, 2020 September 30, 2020 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 362 $ 6,717 $ 7,079 $ 350 $ 6,823 $ 7,173 $ 7,662 Future policy benefits 307 9,183 9,490 327 9,317 9,644 10,102 Unearned premiums 494 408 902 485 394 879 828 Unpaid claims and claim expenses U.S. Medical 3,825 21 3,846 3,166 18 3,184 3,200 Other segments 929 247 1,176 980 292 1,272 6,235 Total 28,027 Insurance and contractholder liabilities classified as Liabilities of business held for sale (1) (6,591) Total insurance and contractholder liabilities $ 5,917 $ 16,576 $ 22,493 $ 5,308 $ 16,844 $ 22,152 $ 21,436 (1) Amounts classified as Liabilities of business held for sale primarily include $5.2 billion of unpaid claims, $759 million of contractholder deposit funds and $646 million of future policy benefits as of September 30, 2020. 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 $3.6 billion at September 30, 2021 and $3.0 billion at September 30, 2020. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the nine months ended September 30 was as follows: Nine Months Ended (In millions) September 30, 2021 September 30, 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 22,167 18,935 Prior years (180) (126) Total incurred 21,987 18,809 Paid costs related to: Current year 18,701 16,061 Prior years 2,665 2,363 Total paid 21,366 18,424 Ending balance, net 3,581 2,974 Add: Reinsurance and other amounts recoverable 265 226 Ending balance $ 3,846 $ 3,200 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 nine months ended September 30 were as follows: Nine Months Ended (Dollars in millions) September 30, 2021 September 30, 2020 $ % (1) $ % (2) Actual completion factors $ 56 0.2 % $ 47 0.2 % Medical cost trend 124 0.5 79 0.3 Total favorable variance $ 180 0.7 % $ 126 0.5 % (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 utilization of medical services that is lower than our estimates used to establish prior year reserves. Liability balance details. The liability details for unpaid claims and claim expenses are as follows: (In millions) September 30, 2021 September 30, 2020 Other Operations Group Disability and Life $ — $ 5,206 Other Operations 267 162 Total Other Operations 267 5,368 International Markets 909 867 Unpaid claims and claim expenses Other Operations and International Markets $ 1,176 $ 6,235 Activity, net of intercompany transactions, in the unpaid claims and claim expenses for International Markets and, prior to the sale, Group Disability and Life (see Note 4 for further information) is presented in the following table. Prior to the sale, the majority of the liability related to disability claims with long tailed payouts. See Note 9C to the Consolidated Financial Statements included in our 2020 Form 10-K for additional discussion of these disability reserves that are now sold. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been fully reinsured. Nine Months Ended (In millions) September 30, 2021 September 30, 2020 (1) Beginning balance $ 963 $ 5,816 Less: Reinsurance 59 184 Beginning balance, net 904 5,632 Incurred claims related to: Current year 2,110 4,277 Prior years: Interest accretion — 118 All other incurred (38) (12) Total incurred 2,072 4,383 Paid claims related to: Current year 1,549 2,435 Prior years 532 1,702 Total paid 2,081 4,137 Foreign currency (43) 5 Ending balance, net 852 5,883 Add: Reinsurance 57 190 Ending balance $ 909 $ 6,073 (1) Includes unpaid claims amounts classified as Liabilities of business held for sale.

Reinsurance

Reinsurance	9 Months Ended
	Sep. 30, 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 $214 million of current reinsurance recoverables that are reported in Other current assets as of September 30, 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 September 30, 2021 are presented in the following table by range of external credit rating and collateral level: (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) $ — $ — $ 178 $ 178 Lower-medium grade (2) — — 63 63 Not rated 99 — 24 123 Total recoverables related to ongoing operations 99 — 265 364 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 2,942 — 2,942 Berkshire Hathaway Life Insurance Company of Nebraska 284 384 — 668 Prudential Retirement Insurance and Annuity 583 — — 583 Life Insurance Company of North America — 451 — 451 Other 223 16 17 256 Not rated — 12 3 15 Total recoverables related to acquisition, disposition or runoff activities 1,090 3,805 20 4,915 Total $ 1,189 $ 3,805 $ 285 $ 5,279 Allowance for uncollectible reinsurance (30) Total reinsurance recoverables $ 5,249 (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. In the Company’s Consolidated Statements of Income, Premiums were reported net of amounts ceded to reinsurers and Medical costs and other benefit expenses were reported net of reinsurance recoveries in the following amounts: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Total ceded premiums $ 134 $ 122 $ 418 $ 367 Total reinsurance recoveries $ 138 $ 117 $ 419 $ 397 The Company entered into an agreement with Berkshire to effectively exit the GMDB and GMIB business via a reinsurance transaction in 2013. Berkshire reinsured 100% of the Company’s future claim payments in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall limit with approximately $3.2 billion remaining at September 30, 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 for 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) September 30, 2021 December 31, 2020 Account value $ 9,552 $ 9,523 Net amount at risk $ 1,467 $ 1,570 Number of contractholders (estimated) 170,000 185,000 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 $610 million as of September 30, 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 September 30, 2021 and December 31, 2020 as follows: (In millions) Line of Business Reinsurer September 30, 2021 December 31, 2020 Collateral and Other Terms at September 30, 2021 GMIB Berkshire $ 298 $ 353 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 179 215 Liberty Re (Bermuda) Ltd. 160 190 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 637 $ 758 All reinsurers are rated A- equivalent and higher by an NRSRO.

Investments

Investments	9 Months Ended
	Sep. 30, 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: September 30, 2021 December 31, 2020 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 895 $ 16,962 $ 17,857 $ 959 $ 17,172 $ 18,131 Equity securities — 551 551 — 501 501 Commercial mortgage loans 40 1,485 1,525 13 1,406 1,419 Policy loans — 1,329 1,329 — 1,351 1,351 Other long-term investments — 3,429 3,429 — 2,832 2,832 Short-term investments 439 — 439 359 — 359 Total $ 1,374 $ 23,756 $ 25,130 $ 1,331 $ 23,262 $ 24,593 The amortized cost and fair value by contractual maturity periods for debt securities were as follows at September 30, 2021: (In millions) Amortized Fair Due in one year or less $ 914 $ 920 Due after one year through five years 5,316 5,543 Due after five years through ten years 5,799 6,161 Due after ten years 3,975 4,759 Mortgage and other asset-backed securities 457 474 Total $ 16,461 $ 17,857 Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties. Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below: (In millions) Amortized Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2021 Federal government and agency $ 277 $ — $ 105 $ — $ 382 State and local government 153 — 16 — 169 Foreign government 2,317 — 235 (33) 2,519 Corporate 13,257 (11) 1,136 (69) 14,313 Mortgage and other asset-backed 457 — 21 (4) 474 Total $ 16,461 $ (11) $ 1,513 $ (106) $ 17,857 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,282 $ (3) $ 721 $ (9) $ 2,991 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. Our allowance for credit losses on debt securities was not material as of September 30, 2021 and December 31, 2020. September 30, 2021 December 31, 2020 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 2,583 $ 2,660 $ (77) 799 $ 1,026 $ 1,045 $ (19) 300 Below investment grade 558 571 (13) 695 381 405 (24) 232 More than one year Investment grade 115 123 (8) 67 18 18 — 6 Below investment grade 201 209 (8) 45 90 100 (10) 33 Total $ 3,457 $ 3,563 $ (106) 1,606 $ 1,515 $ 1,568 $ (53) 571 Equity Securities The following table provides the values of the Company's equity security investments as of September 30, 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 September 30, 2021 or December 31, 2020. September 30, 2021 December 31, 2020 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 203 $ 180 $ 180 $ 202 Equity securities with no readily determinable fair value 227 332 225 255 Hybrid equity securities 57 39 58 44 Total $ 487 $ 551 $ 463 $ 501 Loan-to-value and debt service coverage ratio are the two most significant contributors to the credit quality ratings that the Company uses to evaluate and monitor credit risk in its commercial mortgage loan portfolio. The following table summarizes the credit risk profile of the Company’s commercial mortgage loan portfolio as of September 30, 2021 and December 31, 2020: (Dollars in millions) September 30, 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% $ 563 2.18 $ 533 2.28 60% to 79% 839 1.84 751 2.08 80% to 100% 129 1.47 141 1.33 Allowance for credit losses (6) (6) Total $ 1,525 1.93 61 % $ 1,419 2.08 61 % All commercial mortgage loans in the Company's portfolio are current as of September 30, 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 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) September 30, 2021 December 31, 2020 Real estate investments $ 1,161 $ 951 Securities partnerships 2,098 1,737 Other 170 144 Total $ 3,429 $ 2,832 The gross fair values of our derivative financial instruments are presented in Note 10. As of September 30, 2021 and December 31, 2020, the effects of derivative financial instruments used in 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, amounts excluded from the assessment of hedge effectiveness and fair values of assets posted or held as collateral supporting these fair values. The following table summarizes the types and notional quantity of derivative instruments held by the Company: Notional Value as of (In millions) September 30, 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 $ 1,070 $ 925 Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR. Interest rate swap contracts $ 750 $ — 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 $ 697 $ 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 $ 671 $ 538 Economic hedge: To hedge against the foreign exchange depreciation of certain foreign subsidiary earnings denominated in South Korean Won. The notional value of hedging instruments aligns with the U.S. dollar equivalent of hedged foreign-denominated earnings. Average rate option contracts $ 120 $ — The Company implemented two new hedging strategies during the second quarter of 2021 that are described in the above table and are accounted for as follows: • Fair value hedges of the interest rate exposure on the Company’s long-term debt: Using fair value hedge accounting, the fair values of the swap contracts are reported in Other assets or Other liabilities. The critical terms of these swaps match those of the long-term debt being hedged. As a result, the carrying value of the hedged debt is adjusted to reflect changes in its fair value driven by the Secured Overnight Financing Rate ("SOFR"). The effects of those adjustments on interest expense are offset by the effects of corresponding changes in the swaps' fair value. The net impact from the hedge reported in Interest expense and other reflects interest expense on the hedged debt at the variable interest rate. Cash flows relating to these contracts are reported in Operating activities. • Economic hedge against the depreciation of foreign subsidiary earnings due to changes in the quarterly average exchange rate: Fair values of average rate option contracts are reported in Other assets. Because hedge accounting is not applied, changes in fair value are reported currently in earnings in Fees and other revenues. Cash flows relating to these contracts are reported in Operating activities. As there have been no other changes to the types of derivative financial instruments the Company uses, refer to the Company’s 2020 Form 10-K for further discussion on 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 September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Net realized investment gains (losses), excluding credit loss expense and asset write-downs $ 44 $ 24 $ 114 $ 33 Credit loss (expense) recoveries 24 8 14 (41) Other investment asset write-downs — — — (10) Net realized investment gains (losses), before income taxes $ 68 $ 32 $ 128 $ (18) Net realized investment gains, excluding credit loss expense and asset write-downs for the nine months ended September 30, 2021 was primarily driven by mark-to-market gains on equity securities and gains on the sales of real estate partnerships, partially offset by mark-to-market losses on derivatives. This activity for the nine months ended September 30, 2020 primarily represent gains on sales of debt securities, partially offset by mark-to-market losses on equity securities and derivatives. 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 September 30, 2021 and 2020 were not material.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 10 – 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 following table provides information as of September 30, 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 September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 Financial assets at fair value Debt securities Federal government and agency $ 141 $ 207 $ 241 $ 249 $ — $ — $ 382 $ 456 State and local government — — 169 167 — — 169 167 Foreign government — — 2,505 2,498 14 13 2,519 2,511 Corporate — — 13,600 13,878 713 684 14,313 14,562 Mortgage and other asset-backed — — 333 309 141 126 474 435 Total debt securities 141 207 16,848 17,101 868 823 17,857 18,131 Equity securities (1) 23 50 165 165 31 31 219 246 Short-term investments — — 439 325 — — 439 325 Derivative assets (2) — — 126 72 — — 126 72 Financial liabilities at fair value Derivative liabilities $ — $ — $ 49 $ 108 $ — $ — $ 49 $ 108 (1) Excludes certain equity securities that have no readily determinable fair value. (2) Derivative assets above include an immaterial amount as of September 30, 2021 and $34 million as of December 31, 2020 that are presented in the Short-term investments category disclosed in Note 9. See Note 9 for more information on our Derivative Financial Instruments. 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. Quantitative Information about Unobservable Inputs The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed 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. The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities as of September 30, 2021 and December 31, 2020. The range and weighted average basis point (“bps”) amounts for liquidity reflect the Company’s best estimates of the unobservable adjustments a market participant would make to calculate these fair values. Fair Value as of Unobservable Adjustment Range (Weighted Average by Quantity) as of (Fair value in millions ) September 30, 2021 December 31, 2020 Unobservable input September 30, 2021 September 30, 2021 December 31, 2020 Debt securities Corporate and government debt securities $ 727 $ 696 Liquidity 60 - 2300 (460) bps 60 - 1370 (470) bps Mortgage and other asset-backed securities 141 126 Liquidity 60 - 390 (90) bps 60 - 380 (80) bps Securities not priced by the Company (1) — 1 Total Level 3 debt securities $ 868 $ 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 table summarizes the changes in financial assets and financial liabilities classified in Level 3 for the three and nine months ended September 30, 2021 and 2020. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs. For the Three Months Ended For the Nine Months Ended (In millions) 2021 2020 2021 2020 Debt and Equity Securities Beginning balance $ 854 $ 860 $ 854 $ 555 Total gains (losses) included in shareholders’ net income 3 (1) (8) 4 Gains (losses) included in other comprehensive income 2 17 (7) (42) Gains (losses) required to adjust future policy benefits for settlement annuities (1) 1 7 (6) 4 Purchases, sales and settlements Purchases 37 3 108 67 Sales (36) (1) (36) (13) Settlements (1) (8) (26) (15) Total purchases, sales and settlements — (6) 46 39 Transfers into/(out of) Level 3 Transfers into Level 3 58 102 181 629 Transfers out of Level 3 (19) (33) (161) (243) Total transfers into/(out of) Level 3 39 69 20 386 Ending balance $ 899 $ 946 $ 899 $ 946 Total gains (losses) included in Shareholders’ net income attributable to instruments held at the reporting date $ (3) $ — $ (3) $ (2) Change in unrealized gains or losses included in Other comprehensive income for assets held at the end of the reporting period $ 2 $ 17 $ (8) $ (37) (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 judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2021 and 2020 primarily reflected changes in liquidity 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 unobservable inputs 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 September 30, 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 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 Guaranteed separate accounts (See Note 15) $ 223 $ 226 $ 290 $ 297 $ — $ — $ 513 $ 523 Non-guaranteed separate accounts (1) 1,982 1,925 5,463 5,600 345 355 7,790 7,880 Subtotal $ 2,205 $ 2,151 $ 5,753 $ 5,897 $ 345 $ 355 8,303 8,403 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 847 683 Separate account assets per Consolidated Balance Sheets $ 9,150 $ 9,086 (1) Non-guaranteed separate accounts included $4.4 billion as of September 30, 2021 and $4.2 billion as of December 31, 2020 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of September 30, 2021 and December 31, 2020. Separate account assets classified in Level 3 primarily support Cigna’s pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the three and nine months ended September 30, 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 September 30, 2021 Redemption Frequency Redemption Notice (In millions) September 30, 2021 December 31, 2020 Securities partnerships $ 534 $ 463 $ 253 Not applicable Not applicable Real estate funds 309 215 — Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 847 $ 683 $ 253 As of September 30, 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. Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value. For the nine months ended September 30, 2021 and 2020, no impairments were recognized requiring these assets to be measured at fair value. Realized investment gains and losses from these observable price changes for the nine months ended September 30, 2021 and September 30, 2020 were not material. The following table includes the Company’s financial instruments not recorded at fair value that are subject to fair value disclosure requirements at September 30, 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 September 30, 2021 December 31, 2020 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,563 $ 1,525 $ 1,456 $ 1,419 Long-term debt, including current maturities, excluding finance leases Level 2 $ 35,794 $ 31,579 $ 37,676 $ 31,835

Variable Interest Entities

Variable Interest Entities	9 Months Ended
	Sep. 30, 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 September 30, 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 the Company's 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)	9 Months Ended
	Sep. 30, 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 Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI were as follows: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Securities and Derivatives Beginning balance $ 749 $ 1,256 $ 900 $ 975 Appreciation (depreciation) on securities and derivatives 59 159 (113) 499 Tax (expense) benefit (16) (27) 9 (96) Net appreciation (depreciation) on securities and derivatives 43 132 (104) 403 Reclassification adjustment for (gains) losses included in Shareholders' net income (Net realized investment (gains) losses) (14) (16) (20) (3) Reclassification adjustment for tax expense included in Shareholders’ net income 3 4 5 1 Net (gains) losses reclassified from AOCI to Shareholders' net income (11) (12) (15) (2) Other comprehensive income (loss), net of tax 32 120 (119) 401 Ending balance $ 781 $ 1,376 $ 781 $ 1,376 Translation of foreign currencies Beginning balance $ (113) $ (374) $ (15) $ (275) Translation of foreign currencies (118) 102 (216) 7 Tax (expense) benefit (7) 7 (12) (3) Other comprehensive income (loss), net of tax (125) 109 (228) 4 Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests (1) (4) (6) (10) Shareholders' other comprehensive income (loss), net of tax (124) 113 (222) 14 Ending balance $ (237) $ (261) $ (237) $ (261) Postretirement benefits liability Beginning balance $ (1,713) $ (1,670) $ (1,746) $ (1,641) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 21 18 60 54 Reclassification adjustment for settlement (Interest expense and other) — — 4 — Reclassification adjustment for tax (benefit) included in Shareholders’ net income (5) (4) (15) (13) Net adjustments reclassified from AOCI to Shareholders' net income 16 14 49 41 Valuation update — — — (73) Tax benefit — — — 17 Net change due to valuation update — — — (56) Other comprehensive income (loss), net of tax 16 14 49 (15) Ending balance $ (1,697) $ (1,656) $ (1,697) $ (1,656)

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	Leases Operating and finance lease Right-of-Use (“ROU”) assets and lease liabilities were as follows: (In millions) September 30, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 519 $ 552 Accrued expenses and other liabilities $ 145 $ 152 Other non-current liabilities 460 491 Total operating lease liabilities $ 605 $ 643 Finance leases: Property and equipment, gross $ 96 $ 98 Accumulated depreciation (45) (46) Property and equipment, net $ 51 $ 52 Short-term debt $ 23 $ 18 Long-term debt 30 36 Total finance lease liabilities $ 53 $ 54
Leases	Leases Operating and finance lease Right-of-Use (“ROU”) assets and lease liabilities were as follows: (In millions) September 30, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 519 $ 552 Accrued expenses and other liabilities $ 145 $ 152 Other non-current liabilities 460 491 Total operating lease liabilities $ 605 $ 643 Finance leases: Property and equipment, gross $ 96 $ 98 Accumulated depreciation (45) (46) Property and equipment, net $ 51 $ 52 Short-term debt $ 23 $ 18 Long-term debt 30 36 Total finance lease liabilities $ 53 $ 54

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesIncome Tax ExpenseThe 21.7% effective tax rate for the nine months ended September 30, 2021 was higher than the 20.8% 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 due to changes in statutory rates and adjustments in apportionment factors, partially offset by the elimination of the nondeductible health insurance industry tax in 2021

Contingencies and Other Matters

Contingencies and Other Matters	9 Months Ended
	Sep. 30, 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 the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of September 30, 2021, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $440 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of September 30, 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 September 30, 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 September 30, 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 charges or credits resulting from existing or new guaranty fund assessments for the nine months ended September 30, 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 remains pending. 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. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Anthem’s completed filing of its Response to Express Scripts’ Motion for Summary Judgment on October 16, 2021. Express Scripts’ Reply in Support of its Motion for Summary Judgment is due November 19, 2021. There is no tentative trial date. 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. On September 29, 2021, the qui tam

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 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 results, 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. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results. The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance. The Company defines adjusted revenues 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. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. 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 and nine months ended September 30, 2021 and 2020: Three Months Ended Nine Months Ended (In millions) September 30, 2021 September 30, 2020 September 30, 2021 September 30, 2020 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax After-tax Before-tax After-tax Before-tax Debt extinguishment costs $ — $ — $ — $ — $ 110 $ 141 $ 151 $ 199 Integration and transaction-related (benefits) costs (35) 13 83 112 1 58 256 339 (Benefits) charges associated with litigation matters — — — — (21) (27) 19 25 Charge for organizational efficiency plan — — — — — — 24 31 Risk corridors recovery — — (76) (101) — — (76) (101) Contractual adjustment for a former client — — (89) (117) — — (155) (204) Total impact from special items $ (35) $ 13 $ (82) $ (106) $ 90 $ 172 $ 219 $ 289 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended September 30, 2021 Revenues from external customers $ 32,668 $ 9,588 $ 1,500 $ 63 $ 1 $ 43,820 Inter-segment revenues 942 587 — — (1,529) Net investment income 4 322 66 77 (1) 468 Total revenues 33,614 10,497 1,566 140 (1,529) 44,288 Net realized investment results from certain equity method investments — — 22 — — 22 Adjusted revenues $ 33,614 $ 10,497 $ 1,588 $ 140 $ (1,529) $ 44,310 Income (loss) before taxes $ 1,074 $ 1,075 $ 199 $ 32 $ (321) $ 2,059 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (10) — (6) — — (16) Net realized investment (gains) losses — (93) 46 1 — (46) Amortization of acquired intangible assets 484 6 11 — — 501 Special items Integration and transaction-related (benefits) costs — — — — 13 13 Pre-tax adjusted income (loss) from operations $ 1,548 $ 988 $ 250 $ 33 $ (308) $ 2,511 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended September 30, 2020 Revenues from external customers $ 29,016 $ 9,047 $ 1,439 $ 1,156 $ — $ 40,658 Inter-segment revenues 926 478 — 6 (1,410) Net investment income 2 104 38 152 1 297 Total revenues 29,944 9,629 1,477 1,314 (1,409) 40,955 Net realized investment results from certain equity method investments — — (37) — — (37) Special item related to contractual adjustment for a former client (117) — — — — (117) Adjusted revenues $ 29,827 $ 9,629 $ 1,440 $ 1,314 $ (1,409) $ 40,801 Income (loss) before taxes $ 1,086 $ 846 $ 253 $ 97 $ (478) $ 1,804 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (5) — — (10) Net realized investment (gains) losses — 6 (48) (27) — (69) Amortization of acquired intangible assets 479 6 8 — — 493 Special items Integration and transaction-related (benefits) costs — — — — 112 112 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (117) — — — — (117) Pre-tax adjusted income (loss) from operations $ 1,443 $ 757 $ 208 $ 70 $ (366) $ 2,112 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Nine months ended September 30, 2021 Revenues from external customers $ 93,640 $ 28,879 $ 4,526 $ 175 $ 1 $ 127,221 Inter-segment revenues 3,174 1,692 — — (4,866) Net investment income 12 744 180 233 — 1,169 Total revenues 96,826 31,315 4,706 408 (4,865) 128,390 Net realized investment results from certain equity method investments — — 12 — — 12 Adjusted revenues $ 96,826 $ 31,315 $ 4,718 $ 408 $ (4,865) $ 128,402 Income (loss) before taxes $ 2,752 $ 3,144 $ 685 $ 67 $ (1,178) $ 5,470 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (21) — (18) — — (39) Net realized investment (gains) losses (1) 4 (172) 49 3 — (116) Amortization of acquired intangible assets 1,449 20 30 — — 1,499 Special items Debt extinguishment costs — — — — 141 141 Integration and transaction-related (benefits) costs — — — — 58 58 (Benefits) charges associated with litigation matters — — — — (27) (27) Pre-tax adjusted income (loss) from operations $ 4,184 $ 2,992 $ 746 $ 70 $ (1,006) $ 6,986 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Nine months ended September 30, 2020 Revenues from external customers $ 82,986 $ 26,999 $ 4,325 $ 3,506 $ — $ 117,816 Inter-segment revenues 2,785 1,448 — 17 (4,250) Net investment income 30 279 104 458 2 873 Total revenues 85,801 28,726 4,429 3,981 (4,248) 118,689 Net realized investment results from certain equity method investments — — (87) — — (87) Special item related to contractual adjustment for a former client (204) — — — — (204) Adjusted revenues $ 85,597 $ 28,726 $ 4,342 $ 3,981 $ (4,248) $ 118,398 Income (loss) before taxes $ 2,551 $ 3,529 $ 877 $ 298 $ (1,765) $ 5,490 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (12) — (15) — — (27) Net realized investment (gains) losses (1) — 28 (75) (22) — (69) Amortization of acquired intangible assets 1,439 23 22 3 — 1,487 Special items Debt extinguishment costs — — — — 199 199 Integration and transaction-related (benefits) costs — — — — 339 339 (Benefits) charges associated with litigation matters — — — — 25 25 Charge for organizational efficiency plan — — — — 31 31 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (204) — — — — (204) Pre-tax adjusted income (loss) from operations $ 3,774 $ 3,479 $ 809 $ 279 $ (1,171) $ 7,170 (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 and nine months ended September 30: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Products (Pharmacy revenues) (ASC 606) Network revenues $ 15,797 $ 13,968 $ 45,390 $ 39,200 Home delivery and specialty revenues 13,515 12,422 38,987 36,319 Other 1,701 1,412 4,708 3,945 Total pharmacy revenues 31,013 27,802 89,085 79,464 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,591 3,397 10,692 9,948 Stop loss 1,225 1,146 3,613 3,459 Other 320 281 938 853 U.S. Government Medicare Advantage 2,079 1,895 6,287 5,680 Medicare Part D 315 360 1,175 1,242 Other 1,241 1,117 3,606 3,246 Total U.S. Medical premiums 8,771 8,196 26,311 24,428 International Markets premiums 1,446 1,360 4,338 4,079 Domestic disability, life and accident premiums — 1,106 — 3,346 Other premiums 58 20 163 75 Total premiums 10,275 10,682 30,812 31,928 Services (ASC 606) Fees 2,513 2,120 7,185 6,253 Other external revenues 19 54 139 171 Total services 2,532 2,174 7,324 6,424 Total revenues from external customers $ 43,820 $ 40,658 $ 127,221 $ 117,816

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 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.
Business Combinations	In accordance with GAAP, the total consideration transferred has been allocated to the tangible and intangible net assets acquired based on management's preliminary estimates of their fair values and may change as additional information becomes available over the next several months.The fair value of the customer relationships and the amortization period were determined using an income approach that relies heavily on projected future net cash flows including key assumptions for customer attrition, margins and discount rates.
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.
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.
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 contractholder 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 and to hedge the interest rate risk of its long-term debt. 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. • Fair value hedges of the interest rate exposure on the Company’s long-term debt: Using fair value hedge accounting, the fair values of the swap contracts are reported in Other assets or Other liabilities. The critical terms of these swaps match those of the long-term debt being hedged. As a result, the carrying value of the hedged debt is adjusted to reflect changes in its fair value driven by the Secured Overnight Financing Rate ("SOFR"). The effects of those adjustments on interest expense are offset by the effects of corresponding changes in the swaps' fair value. The net impact from the hedge reported in Interest expense and other reflects interest expense on the hedged debt at the variable interest rate. Cash flows relating to these contracts are reported in Operating activities. • Economic hedge against the depreciation of foreign subsidiary earnings due to changes in the quarterly average exchange rate: Fair values of average rate option contracts are reported in Other assets. Because hedge accounting is not applied, changes in fair value are reported currently in earnings in Fees and other revenues. Cash flows relating to these contracts are reported in Operating activities. As there have been no other changes to the types of derivative financial instruments the Company uses, refer to the Company’s 2020 Form 10-K for further discussion on our accounting policy.
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). 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. 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 Accounts	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.
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 Shareholders' 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 results, 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. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results. The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2021
Receivables [Abstract]
Accounts Receivable, Net	The following amounts were included within Accounts receivable, net: (In millions) September 30, 2021 December 31, 2020 Noninsurance customer receivables $ 6,797 $ 5,534 Pharmaceutical manufacturers receivable 6,526 4,676 Insurance customer receivables 2,567 1,789 Other receivables 360 192 Total $ 16,250 $ 12,191

Mergers, Acquisitions and Dispo

Mergers, Acquisitions and Dispositions (Tables)	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Merger consideration and fair values of assets acquired and liabilities assumed	During the three months ended September 30, 2021, the Company made immaterial measurement period adjustments to the purchase price allocation. The estimated fair values of assets acquired and liabilities assumed as of the closing date were as follows: (In millions) Goodwill $ 1,438 Acquired intangible assets 627 Tangible assets acquired net of liabilities assumed 17 Total consideration transferred 2,082 Less: Fair value to Cigna's previously held equity interest (55) Total purchase price $ 2,027

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 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 September 30, 2021 September 30, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 1,621 $ 1,621 $ 1,388 $ 1,388 Shares: Weighted average 335,166 335,166 364,427 364,427 Common stock equivalents 2,413 2,413 2,763 2,763 Total shares 335,166 2,413 337,579 364,427 2,763 367,190 EPS $ 4.84 $ (0.04) $ 4.80 $ 3.81 $ (0.03) $ 3.78 Nine Months Ended September 30, 2021 September 30, 2020 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders’ net income $ 4,249 $ 4,249 $ 4,323 $ 4,323 Shares: Weighted average 341,583 341,583 367,410 367,410 Common stock equivalents 3,197 3,197 3,421 3,421 Total shares 341,583 3,197 344,780 367,410 3,421 370,831 EPS $ 12.44 $ (0.12) $ 12.32 $ 11.77 $ (0.11) $ 11.66
Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share	The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Anti-dilutive options 1.5 4.6 1.5 4.2

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Outstanding Amounts of Debt and Finance Leases	The outstanding amounts of debt and finance leases were as follows: (In millions) September 30, 2021 December 31, 2020 Short-term debt $78 million, 6.37% Notes due 6/2021 $ — $ 78 $1,000 million, Floating Rate Notes due 9/2021 — 999 $1,250 million, 3.4% Notes due 9/2021 — 1,249 Commercial paper 2,680 1,030 Other, including finance leases 23 18 Total short-term debt $ 2,703 $ 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 494 490 $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 699 698 $1,000 million, 3% Notes due 2023 982 975 $1,187 million, 3.75% Notes due 2023 1,185 2,181 $500 million, 0.613% Notes due 2024 498 — $1,000 million, 3.5% Notes due 2024 982 977 $900 million, 3.25% Notes due 2025 897 896 $2,200 million, 4.125% Notes due 2025 2,192 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 1,419 1,410 $259 million, 7.875% Debentures due 2027 259 259 $600 million, 3.05% Notes due 2027 596 595 $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) 1,500 — $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 (1) 2,192 2,180 $750 million, 3.2% Notes due 2040 743 742 $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 2,967 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 30 36 Total long-term debt $ 31,609 $ 29,545 (1) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 9 for further information about the Company's interest rate risk management and these derivative instruments.
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)	9 Months Ended
	Sep. 30, 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: September 30, 2021 December 31, 2020 September 30, 2020 (In millions) Current Non-current Total Current Non-current Total Total Contractholder deposit funds $ 362 $ 6,717 $ 7,079 $ 350 $ 6,823 $ 7,173 $ 7,662 Future policy benefits 307 9,183 9,490 327 9,317 9,644 10,102 Unearned premiums 494 408 902 485 394 879 828 Unpaid claims and claim expenses U.S. Medical 3,825 21 3,846 3,166 18 3,184 3,200 Other segments 929 247 1,176 980 292 1,272 6,235 Total 28,027 Insurance and contractholder liabilities classified as Liabilities of business held for sale (1) (6,591) Total insurance and contractholder liabilities $ 5,917 $ 16,576 $ 22,493 $ 5,308 $ 16,844 $ 22,152 $ 21,436 (1) Amounts classified as Liabilities of business held for sale primarily include $5.2 billion of unpaid claims, $759 million of contractholder deposit funds and $646 million of future policy benefits as of September 30, 2020. Activity, net of intercompany transactions, in the unpaid claims liability for the U.S. Medical segment for the nine months ended September 30 was as follows: Nine Months Ended (In millions) September 30, 2021 September 30, 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 22,167 18,935 Prior years (180) (126) Total incurred 21,987 18,809 Paid costs related to: Current year 18,701 16,061 Prior years 2,665 2,363 Total paid 21,366 18,424 Ending balance, net 3,581 2,974 Add: Reinsurance and other amounts recoverable 265 226 Ending balance $ 3,846 $ 3,200 Liability balance details. The liability details for unpaid claims and claim expenses are as follows: (In millions) September 30, 2021 September 30, 2020 Other Operations Group Disability and Life $ — $ 5,206 Other Operations 267 162 Total Other Operations 267 5,368 International Markets 909 867 Unpaid claims and claim expenses Other Operations and International Markets $ 1,176 $ 6,235 Activity, net of intercompany transactions, in the unpaid claims and claim expenses for International Markets and, prior to the sale, Group Disability and Life (see Note 4 for further information) is presented in the following table. Prior to the sale, the majority of the liability related to disability claims with long tailed payouts. See Note 9C to the Consolidated Financial Statements included in our 2020 Form 10-K for additional discussion of these disability reserves that are now sold. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been fully reinsured. Nine Months Ended (In millions) September 30, 2021 September 30, 2020 (1) Beginning balance $ 963 $ 5,816 Less: Reinsurance 59 184 Beginning balance, net 904 5,632 Incurred claims related to: Current year 2,110 4,277 Prior years: Interest accretion — 118 All other incurred (38) (12) Total incurred 2,072 4,383 Paid claims related to: Current year 1,549 2,435 Prior years 532 1,702 Total paid 2,081 4,137 Foreign currency (43) 5 Ending balance, net 852 5,883 Add: Reinsurance 57 190 Ending balance $ 909 $ 6,073
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 nine months ended September 30 were as follows: Nine Months Ended (Dollars in millions) September 30, 2021 September 30, 2020 $ % (1) $ % (2) Actual completion factors $ 56 0.2 % $ 47 0.2 % Medical cost trend 124 0.5 79 0.3 Total favorable variance $ 180 0.7 % $ 126 0.5 % (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)	9 Months Ended
	Sep. 30, 2021
Reinsurance Disclosures [Abstract]
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level	The Company’s reinsurance recoverables as of September 30, 2021 are presented in the following table by range of external credit rating and collateral level: (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) $ — $ — $ 178 $ 178 Lower-medium grade (2) — — 63 63 Not rated 99 — 24 123 Total recoverables related to ongoing operations 99 — 265 364 Acquisition, disposition or runoff activities Upper-medium grade and higher (1) Lincoln National Life and Lincoln Life & Annuity of New York — 2,942 — 2,942 Berkshire Hathaway Life Insurance Company of Nebraska 284 384 — 668 Prudential Retirement Insurance and Annuity 583 — — 583 Life Insurance Company of North America — 451 — 451 Other 223 16 17 256 Not rated — 12 3 15 Total recoverables related to acquisition, disposition or runoff activities 1,090 3,805 20 4,915 Total $ 1,189 $ 3,805 $ 285 $ 5,279 Allowance for uncollectible reinsurance (30) Total reinsurance recoverables $ 5,249 (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 September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Total ceded premiums $ 134 $ 122 $ 418 $ 367 Total reinsurance recoveries $ 138 $ 117 $ 419 $ 397
Account Value, Net Amount at Risk and the Number of Contractholders for Guarantees Assumed in the Event of Death	The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded. (Dollars in millions, excludes impact of reinsurance ceded) September 30, 2021 December 31, 2020 Account value $ 9,552 $ 9,523 Net amount at risk $ 1,467 $ 1,570 Number of contractholders (estimated) 170,000 185,000
Schedule of Derivative Assets at Fair Value	GMIB liabilities totaling $610 million as of September 30, 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 September 30, 2021 and December 31, 2020 as follows: (In millions) Line of Business Reinsurer September 30, 2021 December 31, 2020 Collateral and Other Terms at September 30, 2021 GMIB Berkshire $ 298 $ 353 100% were secured by assets in a trust. Sun Life Assurance Company of Canada 179 215 Liberty Re (Bermuda) Ltd. 160 190 100% were secured by assets in a trust. Total GMIB recoverables reported in Other current assets and Other assets $ 637 $ 758 All reinsurers are rated A- equivalent and higher by an NRSRO.

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2021
Investments [Abstract]
Investments by category and current or long-term classification	The following table summarizes the Company's investments by category and current or long-term classification: September 30, 2021 December 31, 2020 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 895 $ 16,962 $ 17,857 $ 959 $ 17,172 $ 18,131 Equity securities — 551 551 — 501 501 Commercial mortgage loans 40 1,485 1,525 13 1,406 1,419 Policy loans — 1,329 1,329 — 1,351 1,351 Other long-term investments — 3,429 3,429 — 2,832 2,832 Short-term investments 439 — 439 359 — 359 Total $ 1,374 $ 23,756 $ 25,130 $ 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 September 30, 2021: (In millions) Amortized Fair Due in one year or less $ 914 $ 920 Due after one year through five years 5,316 5,543 Due after five years through ten years 5,799 6,161 Due after ten years 3,975 4,759 Mortgage and other asset-backed securities 457 474 Total $ 16,461 $ 17,857
Gross Unrealized Appreciation (Depreciation) on Debt Securities	Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below: (In millions) Amortized Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2021 Federal government and agency $ 277 $ — $ 105 $ — $ 382 State and local government 153 — 16 — 169 Foreign government 2,317 — 235 (33) 2,519 Corporate 13,257 (11) 1,136 (69) 14,313 Mortgage and other asset-backed 457 — 21 (4) 474 Total $ 16,461 $ (11) $ 1,513 $ (106) $ 17,857 Investments supporting liabilities of the Company’s run-off settlement annuity business (included in total above) (1) $ 2,282 $ (3) $ 721 $ (9) $ 2,991 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. Our allowance for credit losses on debt securities was not material as of September 30, 2021 and December 31, 2020. September 30, 2021 December 31, 2020 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 2,583 $ 2,660 $ (77) 799 $ 1,026 $ 1,045 $ (19) 300 Below investment grade 558 571 (13) 695 381 405 (24) 232 More than one year Investment grade 115 123 (8) 67 18 18 — 6 Below investment grade 201 209 (8) 45 90 100 (10) 33 Total $ 3,457 $ 3,563 $ (106) 1,606 $ 1,515 $ 1,568 $ (53) 571
Equity Security Investments	The following table provides the values of the Company's equity security investments as of September 30, 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 September 30, 2021 or December 31, 2020. September 30, 2021 December 31, 2020 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 203 $ 180 $ 180 $ 202 Equity securities with no readily determinable fair value 227 332 225 255 Hybrid equity securities 57 39 58 44 Total $ 487 $ 551 $ 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 as of September 30, 2021 and December 31, 2020: (Dollars in millions) September 30, 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% $ 563 2.18 $ 533 2.28 60% to 79% 839 1.84 751 2.08 80% to 100% 129 1.47 141 1.33 Allowance for credit losses (6) (6) Total $ 1,525 1.93 61 % $ 1,419 2.08 61 %
Carrying Value Information for Other Long-Term Investments	The following table provides the carrying value information for these investments: Carrying value as of (In millions) September 30, 2021 December 31, 2020 Real estate investments $ 1,161 $ 951 Securities partnerships 2,098 1,737 Other 170 144 Total $ 3,429 $ 2,832
Summary of Derivative Instruments Held	As of September 30, 2021 and December 31, 2020, the effects of derivative financial instruments used in 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, amounts excluded from the assessment of hedge effectiveness and fair values of assets posted or held as collateral supporting these fair values. The following table summarizes the types and notional quantity of derivative instruments held by the Company: Notional Value as of (In millions) September 30, 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 $ 1,070 $ 925 Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR. Interest rate swap contracts $ 750 $ — 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 $ 697 $ 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 $ 671 $ 538 Economic hedge: To hedge against the foreign exchange depreciation of certain foreign subsidiary earnings denominated in South Korean Won. The notional value of hedging instruments aligns with the U.S. dollar equivalent of hedged foreign-denominated earnings. Average rate option contracts $ 120 $ —
Realized Gains and Losses on Investments	The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company’s separate accounts because those gains and losses generally accrue directly to separate account policyholders: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Net realized investment gains (losses), excluding credit loss expense and asset write-downs $ 44 $ 24 $ 114 $ 33 Credit loss (expense) recoveries 24 8 14 (41) Other investment asset write-downs — — — (10) Net realized investment gains (losses), before income taxes $ 68 $ 32 $ 128 $ (18)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Financial Assets and Financial Liabilities Carried at Fair Value	The following table provides information as of September 30, 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 September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 As of September 30, 2021 As of December 31, 2020 Financial assets at fair value Debt securities Federal government and agency $ 141 $ 207 $ 241 $ 249 $ — $ — $ 382 $ 456 State and local government — — 169 167 — — 169 167 Foreign government — — 2,505 2,498 14 13 2,519 2,511 Corporate — — 13,600 13,878 713 684 14,313 14,562 Mortgage and other asset-backed — — 333 309 141 126 474 435 Total debt securities 141 207 16,848 17,101 868 823 17,857 18,131 Equity securities (1) 23 50 165 165 31 31 219 246 Short-term investments — — 439 325 — — 439 325 Derivative assets (2) — — 126 72 — — 126 72 Financial liabilities at fair value Derivative liabilities $ — $ — $ 49 $ 108 $ — $ — $ 49 $ 108 (1) Excludes certain equity securities that have no readily determinable fair value. (2) Derivative assets above include an immaterial amount as of September 30, 2021 and $34 million as of December 31, 2020 that are presented in the Short-term investments category 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 that were developed directly by the Company and used in pricing these debt securities as of September 30, 2021 and December 31, 2020. The range and weighted average basis point (“bps”) amounts for liquidity reflect the Company’s best estimates of the unobservable adjustments a market participant would make to calculate these fair values. Fair Value as of Unobservable Adjustment Range (Weighted Average by Quantity) as of (Fair value in millions ) September 30, 2021 December 31, 2020 Unobservable input September 30, 2021 September 30, 2021 December 31, 2020 Debt securities Corporate and government debt securities $ 727 $ 696 Liquidity 60 - 2300 (460) bps 60 - 1370 (470) bps Mortgage and other asset-backed securities 141 126 Liquidity 60 - 390 (90) bps 60 - 380 (80) bps Securities not priced by the Company (1) — 1 Total Level 3 debt securities $ 868 $ 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 table summarizes the changes in financial assets and financial liabilities classified in Level 3 for the three and nine months ended September 30, 2021 and 2020. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs. For the Three Months Ended For the Nine Months Ended (In millions) 2021 2020 2021 2020 Debt and Equity Securities Beginning balance $ 854 $ 860 $ 854 $ 555 Total gains (losses) included in shareholders’ net income 3 (1) (8) 4 Gains (losses) included in other comprehensive income 2 17 (7) (42) Gains (losses) required to adjust future policy benefits for settlement annuities (1) 1 7 (6) 4 Purchases, sales and settlements Purchases 37 3 108 67 Sales (36) (1) (36) (13) Settlements (1) (8) (26) (15) Total purchases, sales and settlements — (6) 46 39 Transfers into/(out of) Level 3 Transfers into Level 3 58 102 181 629 Transfers out of Level 3 (19) (33) (161) (243) Total transfers into/(out of) Level 3 39 69 20 386 Ending balance $ 899 $ 946 $ 899 $ 946 Total gains (losses) included in Shareholders’ net income attributable to instruments held at the reporting date $ (3) $ — $ (3) $ (2) Change in unrealized gains or losses included in Other comprehensive income for assets held at the end of the reporting period $ 2 $ 17 $ (8) $ (37) (1) Amounts do not accrue to shareholders.
Fair Values of Separate Account Assets	Fair values of Separate account assets at September 30, 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 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 September 30, 2021 December 31, 2020 Guaranteed separate accounts (See Note 15) $ 223 $ 226 $ 290 $ 297 $ — $ — $ 513 $ 523 Non-guaranteed separate accounts (1) 1,982 1,925 5,463 5,600 345 355 7,790 7,880 Subtotal $ 2,205 $ 2,151 $ 5,753 $ 5,897 $ 345 $ 355 8,303 8,403 Non-guaranteed separate accounts priced at NAV as a practical expedient (1) 847 683 Separate account assets per Consolidated Balance Sheets $ 9,150 $ 9,086 (1) Non-guaranteed separate accounts included $4.4 billion as of September 30, 2021 and $4.2 billion as of December 31, 2020 in assets supporting the Company’s pension plans, including $0.3 billion classified in Level 3 as of September 30, 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 September 30, 2021 Redemption Frequency Redemption Notice (In millions) September 30, 2021 December 31, 2020 Securities partnerships $ 534 $ 463 $ 253 Not applicable Not applicable Real estate funds 309 215 — Quarterly 30 - 90 days Hedge funds 4 5 — Up to annually, varying by fund 30 - 90 days Total $ 847 $ 683 $ 253
Fair Value Disclosures for Financial Instruments Not Carried at Fair Value	The following table includes the Company’s financial instruments not recorded at fair value that are subject to fair value disclosure requirements at September 30, 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 September 30, 2021 December 31, 2020 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,563 $ 1,525 $ 1,456 $ 1,419 Long-term debt, including current maturities, excluding finance leases Level 2 $ 35,794 $ 31,579 $ 37,676 $ 31,835

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 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 September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Securities and Derivatives Beginning balance $ 749 $ 1,256 $ 900 $ 975 Appreciation (depreciation) on securities and derivatives 59 159 (113) 499 Tax (expense) benefit (16) (27) 9 (96) Net appreciation (depreciation) on securities and derivatives 43 132 (104) 403 Reclassification adjustment for (gains) losses included in Shareholders' net income (Net realized investment (gains) losses) (14) (16) (20) (3) Reclassification adjustment for tax expense included in Shareholders’ net income 3 4 5 1 Net (gains) losses reclassified from AOCI to Shareholders' net income (11) (12) (15) (2) Other comprehensive income (loss), net of tax 32 120 (119) 401 Ending balance $ 781 $ 1,376 $ 781 $ 1,376 Translation of foreign currencies Beginning balance $ (113) $ (374) $ (15) $ (275) Translation of foreign currencies (118) 102 (216) 7 Tax (expense) benefit (7) 7 (12) (3) Other comprehensive income (loss), net of tax (125) 109 (228) 4 Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests (1) (4) (6) (10) Shareholders' other comprehensive income (loss), net of tax (124) 113 (222) 14 Ending balance $ (237) $ (261) $ (237) $ (261) Postretirement benefits liability Beginning balance $ (1,713) $ (1,670) $ (1,746) $ (1,641) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 21 18 60 54 Reclassification adjustment for settlement (Interest expense and other) — — 4 — Reclassification adjustment for tax (benefit) included in Shareholders’ net income (5) (4) (15) (13) Net adjustments reclassified from AOCI to Shareholders' net income 16 14 49 41 Valuation update — — — (73) Tax benefit — — — 17 Net change due to valuation update — — — (56) Other comprehensive income (loss), net of tax 16 14 49 (15) Ending balance $ (1,697) $ (1,656) $ (1,697) $ (1,656)

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 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) September 30, 2021 December 31, 2020 Operating leases: Operating lease ROU assets $ 519 $ 552 Accrued expenses and other liabilities $ 145 $ 152 Other non-current liabilities 460 491 Total operating lease liabilities $ 605 $ 643 Finance leases: Property and equipment, gross $ 96 $ 98 Accumulated depreciation (45) (46) Property and equipment, net $ 51 $ 52 Short-term debt $ 23 $ 18 Long-term debt 30 36 Total finance lease liabilities $ 53 $ 54

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
Summary of Special Items	The following tables present the special items recorded by the Company for the three and nine months ended September 30, 2021 and 2020: Three Months Ended Nine Months Ended (In millions) September 30, 2021 September 30, 2020 September 30, 2021 September 30, 2020 Description of Special Item Charges (Benefits) and Financial Statement Line Item(s) After-tax Before-tax After-tax Before-tax After-tax Before-tax After-tax Before-tax Debt extinguishment costs $ — $ — $ — $ — $ 110 $ 141 $ 151 $ 199 Integration and transaction-related (benefits) costs (35) 13 83 112 1 58 256 339 (Benefits) charges associated with litigation matters — — — — (21) (27) 19 25 Charge for organizational efficiency plan — — — — — — 24 31 Risk corridors recovery — — (76) (101) — — (76) (101) Contractual adjustment for a former client — — (89) (117) — — (155) (204) Total impact from special items $ (35) $ 13 $ (82) $ (106) $ 90 $ 172 $ 219 $ 289
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 September 30, 2021 Revenues from external customers $ 32,668 $ 9,588 $ 1,500 $ 63 $ 1 $ 43,820 Inter-segment revenues 942 587 — — (1,529) Net investment income 4 322 66 77 (1) 468 Total revenues 33,614 10,497 1,566 140 (1,529) 44,288 Net realized investment results from certain equity method investments — — 22 — — 22 Adjusted revenues $ 33,614 $ 10,497 $ 1,588 $ 140 $ (1,529) $ 44,310 Income (loss) before taxes $ 1,074 $ 1,075 $ 199 $ 32 $ (321) $ 2,059 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (10) — (6) — — (16) Net realized investment (gains) losses — (93) 46 1 — (46) Amortization of acquired intangible assets 484 6 11 — — 501 Special items Integration and transaction-related (benefits) costs — — — — 13 13 Pre-tax adjusted income (loss) from operations $ 1,548 $ 988 $ 250 $ 33 $ (308) $ 2,511 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Three months ended September 30, 2020 Revenues from external customers $ 29,016 $ 9,047 $ 1,439 $ 1,156 $ — $ 40,658 Inter-segment revenues 926 478 — 6 (1,410) Net investment income 2 104 38 152 1 297 Total revenues 29,944 9,629 1,477 1,314 (1,409) 40,955 Net realized investment results from certain equity method investments — — (37) — — (37) Special item related to contractual adjustment for a former client (117) — — — — (117) Adjusted revenues $ 29,827 $ 9,629 $ 1,440 $ 1,314 $ (1,409) $ 40,801 Income (loss) before taxes $ 1,086 $ 846 $ 253 $ 97 $ (478) $ 1,804 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (5) — (5) — — (10) Net realized investment (gains) losses — 6 (48) (27) — (69) Amortization of acquired intangible assets 479 6 8 — — 493 Special items Integration and transaction-related (benefits) costs — — — — 112 112 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (117) — — — — (117) Pre-tax adjusted income (loss) from operations $ 1,443 $ 757 $ 208 $ 70 $ (366) $ 2,112 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Nine months ended September 30, 2021 Revenues from external customers $ 93,640 $ 28,879 $ 4,526 $ 175 $ 1 $ 127,221 Inter-segment revenues 3,174 1,692 — — (4,866) Net investment income 12 744 180 233 — 1,169 Total revenues 96,826 31,315 4,706 408 (4,865) 128,390 Net realized investment results from certain equity method investments — — 12 — — 12 Adjusted revenues $ 96,826 $ 31,315 $ 4,718 $ 408 $ (4,865) $ 128,402 Income (loss) before taxes $ 2,752 $ 3,144 $ 685 $ 67 $ (1,178) $ 5,470 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (21) — (18) — — (39) Net realized investment (gains) losses (1) 4 (172) 49 3 — (116) Amortization of acquired intangible assets 1,449 20 30 — — 1,499 Special items Debt extinguishment costs — — — — 141 141 Integration and transaction-related (benefits) costs — — — — 58 58 (Benefits) charges associated with litigation matters — — — — (27) (27) Pre-tax adjusted income (loss) from operations $ 4,184 $ 2,992 $ 746 $ 70 $ (1,006) $ 6,986 (In millions) Evernorth U.S. Medical International Markets Other Operations Corporate and Eliminations Total Nine months ended September 30, 2020 Revenues from external customers $ 82,986 $ 26,999 $ 4,325 $ 3,506 $ — $ 117,816 Inter-segment revenues 2,785 1,448 — 17 (4,250) Net investment income 30 279 104 458 2 873 Total revenues 85,801 28,726 4,429 3,981 (4,248) 118,689 Net realized investment results from certain equity method investments — — (87) — — (87) Special item related to contractual adjustment for a former client (204) — — — — (204) Adjusted revenues $ 85,597 $ 28,726 $ 4,342 $ 3,981 $ (4,248) $ 118,398 Income (loss) before taxes $ 2,551 $ 3,529 $ 877 $ 298 $ (1,765) $ 5,490 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (12) — (15) — — (27) Net realized investment (gains) losses (1) — 28 (75) (22) — (69) Amortization of acquired intangible assets 1,439 23 22 3 — 1,487 Special items Debt extinguishment costs — — — — 199 199 Integration and transaction-related (benefits) costs — — — — 339 339 (Benefits) charges associated with litigation matters — — — — 25 25 Charge for organizational efficiency plan — — — — 31 31 Risk corridors recovery — (101) — — — (101) Contractual adjustment for a former client (204) — — — — (204) Pre-tax adjusted income (loss) from operations $ 3,774 $ 3,479 $ 809 $ 279 $ (1,171) $ 7,170
Revenue from External Customers	Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type for the three and nine months ended September 30: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2021 2020 2021 2020 Products (Pharmacy revenues) (ASC 606) Network revenues $ 15,797 $ 13,968 $ 45,390 $ 39,200 Home delivery and specialty revenues 13,515 12,422 38,987 36,319 Other 1,701 1,412 4,708 3,945 Total pharmacy revenues 31,013 27,802 89,085 79,464 Insurance premiums (ASC 944) U.S. Medical premiums U.S. Commercial Health Insurance 3,591 3,397 10,692 9,948 Stop loss 1,225 1,146 3,613 3,459 Other 320 281 938 853 U.S. Government Medicare Advantage 2,079 1,895 6,287 5,680 Medicare Part D 315 360 1,175 1,242 Other 1,241 1,117 3,606 3,246 Total U.S. Medical premiums 8,771 8,196 26,311 24,428 International Markets premiums 1,446 1,360 4,338 4,079 Domestic disability, life and accident premiums — 1,106 — 3,346 Other premiums 58 20 163 75 Total premiums 10,275 10,682 30,812 31,928 Services (ASC 606) Fees 2,513 2,120 7,185 6,253 Other external revenues 19 54 139 171 Total services 2,532 2,174 7,324 6,424 Total revenues from external customers $ 43,820 $ 40,658 $ 127,221 $ 117,816

Description of Business (Detail

Description of Business (Details) $ in Millions	Oct. 31, 2021USD ($)
International life, accident and supplemental benefits businesses | Held-for-Sale | Subsequent Event
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price	$ 5,750

Accounts Receivable, Net - Summ

Accounts Receivable, Net - Summary of Accounts Receivable, Net (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Receivables [Abstract]
Noninsurance customer receivables	$ 6,797	$ 5,534
Pharmaceutical manufacturers receivable	6,526	4,676
Insurance customer receivables	2,567	1,789
Other receivables	360	192
Total	$ 16,250	$ 12,191

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Receivables [Abstract]
Allowance for receivables net current	$ 1,500	$ 1,200
Allowance for current expected credit losses on accounts receivable	$ 57	$ 65

Mergers, Acquisitions and Div_2

Mergers, Acquisitions and Divestitures - Narrative (Details) - USD ($) $ in Millions	Apr. 19, 2021	Dec. 31, 2020	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Business Acquisition [Line Items]
Goodwill		$ 44,648	$ 46,056		$ 46,056
Acquired intangible assets		35,179	34,615		34,615
Integration and transaction-related costs, pre-tax			13	$ 112	58	$ 339
Integration and transaction-related costs, after-tax			$ (35)	$ 83	$ 1	$ 256
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.
Business Acquisition [Line Items]
Ownership interest acquired	97.00%
Ownership interest after acquisition	100.00%
Total purchase price	$ 2,027
Goodwill	1,438
MDLIVE, Inc. | Customer relationships
Business Acquisition [Line Items]
Acquired intangible assets	577
Amortization period					17 years
MDLIVE, Inc. | Evernorth
Business Acquisition [Line Items]
Goodwill	$ 1,300

Mergers, Acquisitions and Dis_2

Mergers, Acquisitions and Dispositions - Purchase Price Allocation (Details) - USD ($) $ in Millions	Sep. 30, 2021	Apr. 19, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill	$ 46,056		$ 44,648
MDLIVE, Inc.
Business Acquisition [Line Items]
Goodwill		$ 1,438
Acquired intangible assets		627
Tangible assets acquired net of liabilities assumed		17
Total consideration transferred		$ 2,082

Mergers, Acquisitions and Dis_3

Mergers, Acquisitions and Dispositions - Merger Consideration (Details) - MDLIVE, Inc. $ in Millions	Apr. 19, 2021USD ($)
Business Acquisition [Line Items]
Total consideration transferred	$ 2,082
Less: Fair value to Cigna's previously held equity interest	(55)
Total purchase price	$ 2,027

Earnings Per Share - Computatio

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Shareholders’ net income	$ 1,621	$ 1,388	$ 4,249	$ 4,323
Shares:
Weighted average (in shares)	335,166	364,427	341,583	367,410
Common stock equivalents (in shares)	2,413	2,763	3,197	3,421
Total shares (in shares)	337,579	367,190	344,780	370,831
EPS, basic (in dollars per share)	$ 4.84	$ 3.81	$ 12.44	$ 11.77
EPS, effect of dilution (in dollars per share)	(0.04)	(0.03)	(0.12)	(0.11)
EPS, diluted (in dollars per share)	$ 4.80	$ 3.78	$ 12.32	$ 11.66

Earnings Per Share - Outstandin

Earnings Per Share - Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options (in shares)	1.5	4.6	1.5	4.2

Earnings Per Share - Shares of

Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares shares in Millions	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020
Earnings Per Share [Abstract]
Shares of common stock held in treasury (in shares)	62.6	35.5	26.7

Earnings Per Share - Accelerate

Earnings Per Share - Accelerated Stock Repurchase Agreements (Details) - USD ($) shares in Millions, $ in Millions	Aug. 23, 2021	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accelerated Share Repurchases [Line Items]
Accelerated stock repurchase, amount authorized	$ 2,000
Accelerated stock repurchase, amount remitted	$ 2,000
Stock repurchased (in shares)	7.7
Stock repurchased		$ 2,581	$ 1,045	$ 6,254	$ 2,369
Treasury Stock
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 1,600	2,181	$ 1,045	5,854	$ 2,369
Additional Paid-in Capital
Accelerated Share Repurchases [Line Items]
Stock repurchased	$ 400	$ 400		$ 400

Debt - Outstanding Amounts of D

Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Sep. 30, 2021	Dec. 31, 2020
Short-term debt
Commercial paper	$ 2,680,000,000	$ 1,030,000,000
Other, including finance leases	23,000,000	18,000,000
Total short-term debt	2,703,000,000	3,374,000,000
Long-term debt
Other, including finance leases	30,000,000	36,000,000
Total long-term debt	31,609,000,000	29,545,000,000
$78 million, 6.37% Notes due 6/2021
Short-term debt
Current maturities	0	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
Long-term debt
Long-term debt	0	$ 276,000,000
Gross value		$ 277,000,000
Stated interest rate		4.00%
Notes Due 2022, 3.9% Interest
Long-term debt
Long-term debt	0	$ 972,000,000
Gross value		$ 973,000,000
Stated interest rate		3.90%
$500 million, 3.05% Notes due 2022
Long-term debt
Long-term debt	494,000,000	$ 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	$ 699,000,000	698,000,000
Gross value	700,000,000
$1,000 million, 3% Notes due 2023
Long-term debt
Long-term debt	982,000,000	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	$ 1,185,000,000	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	$ 982,000,000	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	$ 897,000,000	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	$ 2,192,000,000	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	$ 1,419,000,000	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	$ 596,000,000	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 (1)
Long-term debt
Long-term debt	$ 1,500,000,000	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 (1)
Long-term debt
Long-term debt	$ 2,192,000,000	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	$ 743,000,000	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	$ 2,967,000,000	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 - Summary of Debt Issuance

Debt - Summary of Debt Issuances (Details) - USD ($)	Mar. 03, 2021	Sep. 30, 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 (1)
Debt Instrument [Line Items]
Interest rate		2.375%
$1,500 million, 2.375% Notes due 2031 (1) | 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

Debt - Narrative (Details)

Debt - Narrative (Details)	1 Months Ended	3 Months Ended		9 Months Ended
	Apr. 30, 2021USD ($)bank	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Mar. 03, 2021USD ($)
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities redeemed		$ 4,500,000,000		$ 4,500,000,000
Loss on repurchase of debt, pre-tax		0	$ 0	141,000,000	$ 199,000,000
Loss on repurchase of debt, after-tax				110,000,000
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity		5,000,000,000		$ 5,000,000,000
Five-year Revolving Credit Agreement, Maturing April 2023
Debt Instrument [Line Items]
Credit agreement term				5 years
364-day Revolving Credit Agreement, Maturing October 2021
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Credit agreement term	364 days
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
Debt Instrument [Line Items]
Aggregate amount of options to increase commitments	$ 1,500,000,000
Outstanding balances		$ 0		$ 0
Five-year Revolving Credit Agreement, Maturing April 2026
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 3,000,000,000
Number of participating banks | bank	23
Amount by which credit facility 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
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
Three-year Revolving Credit Agreement, Maturing April 2024
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Number of participating banks | bank	23
Amount by which credit facility term length can be increased	1 year
Credit agreement term	3 years
Leverage ratio covenant	60.00%
364-day Revolving Credit Agreement, Maturing April 2022
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

Insurance and Contractholder _3

Insurance and Contractholder Liabilities - Summary of Insurance and Contractholder Liabilities (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2019
Current
Contractholder deposit funds	$ 362	$ 350
Future policy benefits	307	327
Unearned premiums	494	485
Total insurance and contractholder liabilities	5,917	5,308
Non-current
Contractholder deposit funds	6,717	6,823
Future policy benefits	9,183	9,317
Unearned premiums	408	394
Total insurance and contractholder liabilities	16,576	16,844
Total
Contractholder deposit funds	7,079	7,173
Future policy benefits	9,490	9,644
Unearned premiums	902	879
Contractholder deposit funds			$ 7,662
Future policy benefits			10,102
Unearned premiums			828
Total			28,027
Insurance and contractholder liabilities classified as held for sale			(6,591)
Total insurance and contractholder liabilities	22,493	22,152	21,436
Unpaid claims classified as liabilities of business held for sale			5,200
Contractholder deposit funds classified as liabilities of business held for sale			759
Future policy benefits classified as liabilities of business held for sale			646
Integrated Medical
Current
Unpaid claims and claim expenses	3,825	3,166
Non-current
Unpaid claims and claim expenses	21	18
Total
Unpaid claims and claim expenses	3,846	3,184
Unpaid claims and claim expenses			3,200	$ 2,892
Other segments
Current
Unpaid claims and claim expenses	929	980
Non-current
Unpaid claims and claim expenses	247	292
Total
Unpaid claims and claim expenses	$ 1,176	$ 1,272
Unpaid claims and claim expenses			$ 6,235

Insurance and Contractholder _4

Insurance and Contractholder Liabilities - Narrative (Details) - USD ($) $ in Billions	Sep. 30, 2021	Sep. 30, 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	$ 3.6	$ 3

Insurance and Contractholder _5

Insurance and Contractholder Liabilities - U.S. Medical - Activity (Details) - Integrated Medical - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 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	22,167	18,935
Prior years	(180)	(126)
Total incurred	21,987	18,809
Paid costs related to:
Current year	18,701	16,061
Prior years	2,665	2,363
Total paid	21,366	18,424
Ending balance, net	3,581
Ending balance, net, including disposal groups		2,974
Add: Reinsurance and other amounts recoverable	265
Add: Reinsurance and other amounts recoverable, including disposal groups		226
Ending balance	$ 3,846
Ending balance, including disposal groups		$ 3,200

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	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 180	$ 126
Favorable (unfavorable) variance, percentage	0.70%	0.50%
Actual completion factors
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 56	$ 47
Favorable (unfavorable) variance, percentage	0.20%	0.20%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 124	$ 79
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	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020
Group Disability And Other And International Markets [Member]
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 1,176
Unpaid claims and claim expenses			$ 6,235
Total Other Operations
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	267
Unpaid claims and claim expenses			5,368
Group Disability and Life
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	0
Unpaid claims and claim expenses			5,206
Other Operations
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	267
Unpaid claims and claim expenses			162
International Markets
Liability for Claims and Claims Adjustment Expense [Line Items]
Unpaid claims and claim expenses	$ 909	$ 963
Unpaid claims and claim expenses			$ 867

Insurance and Contractholder _8

Insurance and Contractholder Liabilities - Activity in Liabilities for Unpaid Claims and Claim Expenses (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 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		4,277
Prior years:
Interest accretion		118
All other incurred		(12)
Total incurred		4,383
Paid costs related to:
Current year		2,435
Prior years		1,702
Total paid		4,137
Foreign currency		5
Ending balance, net, including disposal groups		5,883
Add: Reinsurance and other amounts recoverable, including disposal groups		190
Ending balance, including disposal groups		6,073
International Markets
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	2,110
Prior years:
Interest accretion	0
All other incurred	(38)
Total incurred	2,072
Paid costs related to:
Current year	1,549
Prior years	532
Total paid	2,081
Foreign currency	(43)
Ending balance, net	852
Add: Reinsurance and other amounts recoverable	57
Ending balance, including disposal groups		$ 867
Ending balance	$ 909

Reinsurance - Narrative (Detail

Reinsurance - Narrative (Details) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)reinsurer	Dec. 31, 2020USD ($)reinsurer
GMIB
Effects of Reinsurance [Line Items]
Percent of future claim payments reinsured	100.00%	100.00%
Annuitization election period	30 days
Number of external reinsurers | reinsurer	3	3
GMIB | Other Contract [Member]
Effects of Reinsurance [Line Items]
GMIB liabilities	$ 610	$ 729
Variable Annuity | Berkshire Hathaway Life Insurance Company of Nebraska
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	$ 214	$ 217

Reinsurance - Reinsurance Recov

Reinsurance - Reinsurance Recoverables by Range of External Credit Rating and Collateral Level (Details) $ in Millions	Sep. 30, 2021USD ($)
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 5,279
Allowance for uncollectible reinsurance	(30)
Total reinsurance recoverables	5,249
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	1,189
Collateral provisions exist that may mitigate risk of credit loss
Ceded Credit Risk [Line Items]
Reinsurance recoverables	3,805
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	285
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables	364
Ongoing Operations | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	178
Ongoing Operations | Lower-medium grade
Ceded Credit Risk [Line Items]
Reinsurance recoverables	63
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	123
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Ceded Credit Risk [Line Items]
Reinsurance recoverables	99
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	99
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	265
Ongoing Operations | No collateral | Upper-medium grade and higher
Ceded Credit Risk [Line Items]
Reinsurance recoverables	178
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	24
Acquisition, disposition or runoff activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables	4,915
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	2,942
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Berkshire Hathaway Life Insurance Company of Nebraska
Ceded Credit Risk [Line Items]
Reinsurance recoverables	668
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Prudential Retirement Insurance and Annuity
Ceded Credit Risk [Line Items]
Reinsurance recoverables	583
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Life Insurance Company of North America
Ceded Credit Risk [Line Items]
Reinsurance recoverables	451
Acquisition, disposition or runoff activities | Upper-medium grade and higher | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables	256
Acquisition, disposition or runoff activities | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	15
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	1,090
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 Hathaway Life Insurance Company of Nebraska
Ceded Credit Risk [Line Items]
Reinsurance recoverables	284
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	583
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	223
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	3,805
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	2,942
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Upper-medium grade and higher | Berkshire Hathaway Life Insurance Company of Nebraska
Ceded Credit Risk [Line Items]
Reinsurance recoverables	384
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	451
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	16
Acquisition, disposition or runoff activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	12
Acquisition, disposition or runoff activities | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables	20
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 Hathaway Life Insurance Company of Nebraska
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	17
Acquisition, disposition or runoff activities | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables	$ 3

Reinsurance - Effects of Reinsu

Reinsurance - Effects of Reinsurance 10-Q (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Reinsurance Disclosures [Abstract]
Total ceded premiums	$ 134	$ 122	$ 418	$ 367
Total reinsurance recoveries	$ 138	$ 117	$ 419	$ 397

Reinsurance - Account Value, Ne

Reinsurance - Account Value, Net Amount at Risk and Contractholders for GMDB Business (Details) - Variable Annuity - GMDB contractholder in Thousands, $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2021USD ($)contractholder	Dec. 31, 2019contractholder	Dec. 31, 2020USD ($)
Net Amount at Risk by Product and Guarantee [Line Items]
Account value	$ 9,552		$ 9,523
Net amount at risk	$ 1,467		$ 1,570
Number of contractholders (estimated) | contractholder	170	185

Reinsurance - GMIB Reinsurers (

Reinsurance - GMIB Reinsurers (Details) - GMIB - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Berkshire | Secured | GMIB Assets | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
Liberty Re (Bermuda) Ltd. | Secured | GMIB Assets | Collateralization risk
Ceded Credit Risk [Line Items]
Concentration percentage	100.00%
Other Contract [Member]
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 637	$ 758
Other Contract [Member] | Berkshire
Ceded Credit Risk [Line Items]
GMIB recoverables	298	353
Other Contract [Member] | Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
GMIB recoverables	179	215
Other Contract [Member] | Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
GMIB recoverables	$ 160	$ 190

Investments - Investments by Ca

Investments - Investments by Category (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Schedule of Investments [Line Items]
Current	$ 1,374	$ 1,331
Long-term	23,756	23,262
Total	25,130	24,593
Debt securities
Schedule of Investments [Line Items]
Current	895	959
Long-term	16,962	17,172
Total	17,857	18,131
Equity securities
Schedule of Investments [Line Items]
Current	0	0
Long-term	551	501
Total	551	501
Commercial mortgage loans
Schedule of Investments [Line Items]
Current	40	13
Long-term	1,485	1,406
Total	1,525	1,419
Policy loans
Schedule of Investments [Line Items]
Current	0	0
Long-term	1,329	1,351
Total	1,329	1,351
Other long-term investments
Schedule of Investments [Line Items]
Current	0	0
Long-term	3,429	2,832
Total	3,429	2,832
Short-term investments
Schedule of Investments [Line Items]
Current	439	359
Long-term	0	0
Total	$ 439	$ 359

Investments - Debt Securities b

Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Amortized Cost
Due in one year or less	$ 914
Due after one year through five years	5,316
Due after five years through ten years	5,799
Due after ten years	3,975
Mortgage and other asset-backed securities	457
Total	16,461
Fair Value
Due in one year or less	920
Due after one year through five years	5,543
Due after five years through ten years	6,161
Due after ten years	4,759
Mortgage and other asset-backed securities	474
Total	$ 17,857	$ 18,131

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($)	6 Months Ended	9 Months Ended
	Jun. 30, 2021	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Schedule of Investments [Line Items]
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

Investments - Gross Unrealized

Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 16,461	$ 16,220
Allowance for Credit Loss	(11)	(26)
Unrealized Appreciation	1,513	1,990
Unrealized Depreciation	(106)	(53)
Fair Value	17,857	18,131
Run-Off Settlement Annuity Business
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,282	2,282
Allowance for Credit Loss	(3)	(5)
Unrealized Appreciation	721	838
Unrealized Depreciation	(9)	(3)
Fair Value	2,991	3,112
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	277	334
Allowance for Credit Loss	0	0
Unrealized Appreciation	105	122
Unrealized Depreciation	0	0
Fair Value	382	456
State and local government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	153	150
Allowance for Credit Loss	0	0
Unrealized Appreciation	16	17
Unrealized Depreciation	0	0
Fair Value	169	167
Foreign government
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,317	2,201
Allowance for Credit Loss	0	0
Unrealized Appreciation	235	318
Unrealized Depreciation	(33)	(8)
Fair Value	2,519	2,511
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	13,257	13,108
Allowance for Credit Loss	(11)	(19)
Unrealized Appreciation	1,136	1,506
Unrealized Depreciation	(69)	(33)
Fair Value	14,313	14,562
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	457	427
Allowance for Credit Loss	0	(7)
Unrealized Appreciation	21	27
Unrealized Depreciation	(4)	(12)
Fair Value	$ 474	$ 435

Investments - Summary of Debt S

Investments - Summary of Debt Securities with a Decline in Fair Value (Details) $ in Millions	Sep. 30, 2021USD ($)position	Dec. 31, 2020USD ($)position
More than one year
Fair Value	$ 3,457	$ 1,515
Amortized Cost	3,563	1,568
Unrealized Depreciation	$ (106)	$ (53)
Number of Issues | position	1,606	571
Investment grade
One year or less
Fair Value	$ 2,583	$ 1,026
Amortized Cost	2,660	1,045
Unrealized Depreciation	$ (77)	$ (19)
Number of Issues | position	799	300
More than one year
Fair Value	$ 115	$ 18
Amortized Cost	123	18
Unrealized Depreciation	$ (8)	$ 0
Number of Issues | position	67	6
Below investment grade
One year or less
Fair Value	$ 558	$ 381
Amortized Cost	571	405
Unrealized Depreciation	$ (13)	$ (24)
Number of Issues | position	695	232
More than one year
Fair Value	$ 201	$ 90
Amortized Cost	209	100
Unrealized Depreciation	$ (8)	$ (10)
Number of Issues | position	45	33

Investments - Equity Security I

Investments - Equity Security Investments (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Cost
Equity securities with readily determinable fair values	$ 203	$ 180
Equity securities with no readily determinable fair value	227	225
Hybrid equity securities	57	58
Total	487	463
Carrying Value
Equity securities with readily determinable fair values	180	202
Equity securities with no readily determinable fair value	332	255
Hybrid equity securities	39	44
Total	$ 551	$ 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	9 Months Ended	12 Months Ended
	Sep. 30, 2021USD ($)	Dec. 31, 2020USD ($)
Schedule of Investments [Line Items]
Allowance for credit losses	$ (6)	$ (6)
Total	$ 1,525	$ 1,419
Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.93	2.08
Average Loan-to-Value Ratio	61.00%	61.00%
Below 60%
Schedule of Investments [Line Items]
Carrying Value	$ 563	$ 533
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	2.18	2.28
60% to 79%
Schedule of Investments [Line Items]
Carrying Value	$ 839	$ 751
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.84	2.08
80% to 100%
Schedule of Investments [Line Items]
Carrying Value	$ 129	$ 141
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio	1.47	1.33

Investments - Carrying Values o

Investments - Carrying Values of Other Long-Term Investments (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Schedule of Investments [Line Items]
Other long-term investments	$ 3,429	$ 2,832
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	1,161	951
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	2,098	1,737
Other
Schedule of Investments [Line Items]
Other long-term investments	$ 170	$ 144

Investments - Summary of Deriva

Investments - Summary of Derivative Instruments Held (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Designated as Hedging Instrument | Fair Value Hedging | Foreign currency swap contracts
Derivative [Line Items]
Notional Value	$ 1,070	$ 925
Designated as Hedging Instrument | Fair Value Hedging | Interest rate swap contracts
Derivative [Line Items]
Notional Value	750	0
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	697	636
Not Designated as Hedging Instrument, Economic Hedge | Foreign currency forward contracts
Derivative [Line Items]
Notional Value	671	538
Not Designated as Hedging Instrument, Economic Hedge | Average rate option contracts
Derivative [Line Items]
Notional Value	$ 120	$ 0

Investments - Realized Gains an

Investments - Realized Gains and Losses on Investments (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Investments [Abstract]
Net realized investment gains (losses), excluding credit loss expense and asset write-downs	$ 44	$ 24	$ 114	$ 33
Credit loss (expense) recoveries	24	8	14	(41)
Other investment asset write-downs	0	0	0	(10)
Net realized investment gains (losses), before income taxes	$ 68	$ 32	$ 128	$ (18)

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Financial Liabilities Carried at Fair Value (Details) - Recurring - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Financial assets at fair value:
Debt Securities	$ 17,857	$ 18,131
Equity securities	219	246
Short-term investments	439	325
Forwards, swaps and options
Financial assets at fair value:
Derivative assets	126	72
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	49	108
Forwards, swaps and options | Short-term investments
Financial assets at fair value:
Derivative assets		34
Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	141	207
Equity securities	23	50
Short-term investments	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) | Forwards, swaps and options
Financial assets at fair value:
Derivative assets	0	0
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	0	0
Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	16,848	17,101
Equity securities	165	165
Short-term investments	439	325
Significant Other Observable Inputs (Level 2) | Forwards, swaps and options
Financial assets at fair value:
Derivative assets	126	72
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	49	108
Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	868	823
Equity securities	31	31
Short-term investments	0	0
Significant Unobservable Inputs (Level 3) | Forwards, swaps and options
Financial assets at fair value:
Derivative assets	0	0
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	0	0
Federal government and agency
Financial assets at fair value:
Debt Securities	382	456
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	141	207
Federal government and agency | Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	241	249
Federal government and agency | Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	0	0
State and local government
Financial assets at fair value:
Debt Securities	169	167
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	0	0
State and local government | Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	169	167
State and local government | Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	0	0
Foreign government
Financial assets at fair value:
Debt Securities	2,519	2,511
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	0	0
Foreign government | Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	2,505	2,498
Foreign government | Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	14	13
Corporate
Financial assets at fair value:
Debt Securities	14,313	14,562
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	0	0
Corporate | Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	13,600	13,878
Corporate | Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	713	684
Mortgage and other asset-backed
Financial assets at fair value:
Debt Securities	474	435
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1)
Financial assets at fair value:
Debt Securities	0	0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2)
Financial assets at fair value:
Debt Securities	333	309
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3)
Financial assets at fair value:
Debt Securities	$ 141	$ 126

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - Separate Account Assets - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
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
Recurring | Securities partnerships
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Expected liquidation period after inception			10 years

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value and Significant Unobservable Inputs Used in Pricing Debt Securities (Details) - Recurring - Significant Unobservable Inputs (Level 3) $ in Millions	Sep. 30, 2021USD ($)	Dec. 31, 2020USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 868	$ 823
Debt securities | Securities Not Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	0	1
Corporate and government debt securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 727	$ 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	0.2300	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	0.0460	0.0470
Mortgage and other asset-backed securities | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value	$ 141	$ 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 | Maximum | Liquidity
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Unobservable Adjustment	0.0390	0.0380
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

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 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	$ 2	$ 17	$ (8)	$ (37)
Debt and Equity Securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance	854		854
Balance		860		555
Total gains (losses) included in shareholders’ net income	3	(1)	(8)	4
Gains (losses) included in other comprehensive income	2	17	(7)	(42)
Gains (losses) required to adjust future policy benefits for settlement annuities	1	7	(6)	4
Purchases, sales and settlements
Purchases	37	3	108	67
Sales	(36)	(1)	(36)	(13)
Settlements	(1)	(8)	(26)	(15)
Total purchases, sales and settlements	0	(6)	46	39
Transfers into/(out of) Level 3
Transfers into Level 3	58	102	181	629
Transfers out of Level 3	(19)	(33)	(161)	(243)
Total transfers into/(out of) Level 3	39	69	20	386
Balance	899		899
Balance		946		946
Total gains (losses) included in Shareholders’ net income attributable to instruments held at the reporting date	$ (3)	$ 0	$ (3)	$ (2)

Fair Value Measurements - Fai_2

Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 513	$ 523
Non-guaranteed separate accounts	7,790	7,880
Subtotal	8,303	8,403
Non-guaranteed separate accounts priced at NAV as a practical expedient	847	683
Separate account assets per Consolidated Balance Sheets	9,150	9,086
Pension Plan
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	4,400	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	223	226
Non-guaranteed separate accounts	1,982	1,925
Subtotal	2,205	2,151
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	290	297
Non-guaranteed separate accounts	5,463	5,600
Subtotal	5,753	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	345	355
Subtotal	345	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) - Separate Account Assets - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 253
Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	847	$ 683
Securities partnerships
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	253
Securities partnerships | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	534	463
Real estate funds
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Real estate funds | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Real estate funds | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Real estate funds | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 309	215
Hedge funds
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 0
Hedge funds | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Hedge funds | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Hedge funds | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 4	$ 5

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
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

Fair Value Measurements - Fai_3

Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($) $ in Millions	Sep. 30, 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	$ 35,794	$ 37,676
Fair Value | Significant Unobservable Inputs (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,563	1,456
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Commercial mortgage loans	1,525	1,419
Long-term debt, including current maturities, excluding finance leases	$ 31,579	$ 31,835

Variable Interest Entities (Det

Variable Interest Entities (Details) - entity	Sep. 30, 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		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 48,716	$ 47,371	$ 50,328	$ 45,344
Other comprehensive income (loss), net of tax	(77)	243	(298)	390
Less: Net translation gain (loss) on foreign currencies attributable to noncontrolling interests	(1)	(4)	(6)	(10)
Shareholders other comprehensive income (loss), net of tax	(76)	247	(292)	400
Balance	47,427	48,039	47,427	48,039
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	749	1,256	900	975
Other comprehensive income (loss) before reclassifications, before tax	59	159	(113)	499
Other comprehensive income (loss) before reclassifications, tax	(16)	(27)	9	(96)
Other comprehensive income (loss) before reclassifications, after-tax	43	132	(104)	403
Reclassification adjustment, tax	3	4	5	1
Net amounts reclassified from AOCI to net income	(11)	(12)	(15)	(2)
Shareholders other comprehensive income (loss), net of tax	32	120	(119)	401
Balance	781	1,376	781	1,376
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	(14)	(16)	(20)	(3)
Translation of foreign currencies
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) before reclassifications, before tax, including temporary equity	(118)	102	(216)	7
Other comprehensive income (loss) before reclassifications, tax, including temporary equity	(7)	7	(12)	(3)
Other comprehensive income (loss), net of tax	(125)	109	(228)	4
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	(1)	(4)	(6)	(10)
Translation of foreign currencies attributable to parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(113)	(374)	(15)	(275)
Shareholders other comprehensive income (loss), net of tax	(124)	113	(222)	14
Balance	(237)	(261)	(237)	(261)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(1,713)	(1,670)	(1,746)	(1,641)
Other comprehensive income (loss) before reclassifications, before tax	0	0	0	(73)
Other comprehensive income (loss) before reclassifications, tax	0	0	0	17
Other comprehensive income (loss) before reclassifications, after-tax	0	0	0	(56)
Reclassification adjustment, tax	(5)	(4)	(15)	(13)
Net amounts reclassified from AOCI to net income	16	14	49	41
Shareholders other comprehensive income (loss), net of tax	16	14	49	(15)
Balance	(1,697)	(1,656)	(1,697)	(1,656)
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	21	18	60	54
Reclassification adjustment for settlement (Interest expense and other)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	$ 0	$ 0	$ 4	$ 0

Leases - Operating and Finance

Leases - Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities (Details) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Operating leases:
Operating lease ROU assets	$ 519	$ 552
Accrued expenses and other liabilities	145	152
Other non-current liabilities	460	491
Total operating lease liabilities	605	643
Finance leases:
Property and equipment, gross	96	98
Accumulated depreciation	(45)	(46)
Property and equipment, net	51	52
Short-term debt	23	18
Long-term debt	30	36
Total finance lease liabilities	$ 53	$ 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)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	21.70%	20.80%

Contingencies and Other Matte_2

Contingencies and Other Matters (Details)	Apr. 19, 2016claim	Sep. 30, 2020USD ($)	Mar. 31, 2016USD ($)	Sep. 30, 2021USD ($)	May 31, 2020USD ($)
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
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 | Settled 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
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				440,000,000
Assets maintained by employers (minimum)				440,000,000
Liability for guarantees				$ 0

Segment Information - Summary o

Segment Information - Summary of Special Items (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
After-tax
Debt extinguishment costs	$ 0	$ 0	$ 110	$ 151
Integration and transaction-related (benefits) costs (Selling, general and administrative expenses)	(35)	83	1	256
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)	0	0	(21)	19
Charge for organizational efficiency plan (Selling, general and administrative expenses)	0	0	0	24
Risk corridors recovery (Selling, general and administrative expenses)	0	(76)	0	(76)
Contractual adjustment for a former client (Pharmacy revenues)	0	(89)	0	(155)
Total impact from special items	(35)	(82)	90	219
Before-tax
Debt extinguishment costs	0	0	141	199
Integration and transaction-related (benefits) costs (Selling, general and administrative expenses)	13	112	58	339
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)	0	0	(27)	25
Charge for organizational efficiency plan (Selling, general and administrative expenses)	0	0	0	31
Risk corridors recovery (Selling, general and administrative expenses)	0	(101)	0	(101)
Contractual adjustment for a former client (Pharmacy revenues)	0	(117)	0	(204)
Total impact from special items	$ 13	$ (106)	$ 172	$ 289

Segment Information - Summarize

Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Segment Reporting Information [Line Items]
Revenues from customers	$ 43,820	$ 40,658	$ 127,221	$ 117,816
Net investment income	468	297	1,169	873
TOTAL REVENUES	44,288	40,955	128,390	118,689
Net realized investment results from certain equity method investments	22	(37)	12	(87)
Special item related to contractual adjustment for a former client		(117)		(204)
Adjusted revenues	44,310	40,801	128,402	118,398
Income before income taxes	2,059	1,804	5,470	5,490
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(16)	(10)	(39)	(27)
Net realized investment (gains) losses	(46)	(69)	(116)	(69)
Amortization of acquired intangible assets	501	493	1,499	1,487
Special items
Debt extinguishment costs	0	0	141	199
Integration and transaction-related (benefits) costs	13	112	58	339
(Benefits) charges associated with litigation matters	0	0	(27)	25
Charge for organizational efficiency plan	0	0	0	31
Risk corridors recovery	0	(101)	0	(101)
Contractual adjustment for a former client	0	(117)	0	(204)
Pre-tax adjusted income (loss) from operations	2,511	2,112	6,986	7,170
Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	32,668	29,016	93,640	82,986
Integrated Medical
Segment Reporting Information [Line Items]
Revenues from customers	9,588	9,047	28,879	26,999
International Markets
Segment Reporting Information [Line Items]
Revenues from customers	1,500	1,439	4,526	4,325
Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	63	1,156	175	3,506
Operating Segments | Evernorth
Segment Reporting Information [Line Items]
Net investment income	4	2	12	30
TOTAL REVENUES	33,614	29,944	96,826	85,801
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to contractual adjustment for a former client		(117)		(204)
Adjusted revenues	33,614	29,827	96,826	85,597
Income before income taxes	1,074	1,086	2,752	2,551
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(10)	(5)	(21)	(12)
Net realized investment (gains) losses	0	0	4	0
Amortization of acquired intangible assets	484	479	1,449	1,439
Special items
Debt extinguishment costs			0	0
Integration and transaction-related (benefits) costs	0	0	0	0
(Benefits) charges associated with litigation matters			0	0
Charge for organizational efficiency plan				0
Risk corridors recovery		0		0
Contractual adjustment for a former client		(117)		(204)
Pre-tax adjusted income (loss) from operations	1,548	1,443	4,184	3,774
Operating Segments | Integrated Medical
Segment Reporting Information [Line Items]
Net investment income	322	104	744	279
TOTAL REVENUES	10,497	9,629	31,315	28,726
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to contractual adjustment for a former client		0		0
Adjusted revenues	10,497	9,629	31,315	28,726
Income before income taxes	1,075	846	3,144	3,529
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0	0	0
Net realized investment (gains) losses	(93)	6	(172)	28
Amortization of acquired intangible assets	6	6	20	23
Special items
Debt extinguishment costs			0	0
Integration and transaction-related (benefits) costs	0	0	0	0
(Benefits) charges associated with litigation matters			0	0
Charge for organizational efficiency plan				0
Risk corridors recovery		(101)		(101)
Contractual adjustment for a former client		0		0
Pre-tax adjusted income (loss) from operations	988	757	2,992	3,479
Operating Segments | International Markets
Segment Reporting Information [Line Items]
Net investment income	66	38	180	104
TOTAL REVENUES	1,566	1,477	4,706	4,429
Net realized investment results from certain equity method investments	22	(37)	12	(87)
Special item related to contractual adjustment for a former client		0		0
Adjusted revenues	1,588	1,440	4,718	4,342
Income before income taxes	199	253	685	877
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	(6)	(5)	(18)	(15)
Net realized investment (gains) losses	46	(48)	49	(75)
Amortization of acquired intangible assets	11	8	30	22
Special items
Debt extinguishment costs			0	0
Integration and transaction-related (benefits) costs	0	0	0	0
(Benefits) charges associated with litigation matters			0	0
Charge for organizational efficiency plan				0
Risk corridors recovery		0		0
Contractual adjustment for a former client		0		0
Pre-tax adjusted income (loss) from operations	250	208	746	809
Operating Segments | Other Operations
Segment Reporting Information [Line Items]
Net investment income	77	152	233	458
TOTAL REVENUES	140	1,314	408	3,981
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to contractual adjustment for a former client		0		0
Adjusted revenues	140	1,314	408	3,981
Income before income taxes	32	97	67	298
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0	0	0
Net realized investment (gains) losses	1	(27)	3	(22)
Amortization of acquired intangible assets	0	0	0	3
Special items
Debt extinguishment costs			0	0
Integration and transaction-related (benefits) costs	0	0	0	0
(Benefits) charges associated with litigation matters			0	0
Charge for organizational efficiency plan				0
Risk corridors recovery		0		0
Contractual adjustment for a former client		0		0
Pre-tax adjusted income (loss) from operations	33	70	70	279
Corporate and Eliminations
Segment Reporting Information [Line Items]
Net investment income	(1)	1	0	2
TOTAL REVENUES	(1,529)	(1,409)	(4,865)	(4,248)
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to contractual adjustment for a former client		0		0
Adjusted revenues	(1,529)	(1,409)	(4,865)	(4,248)
Income before income taxes	(321)	(478)	(1,178)	(1,765)
Special items
Pre-tax adjusted income (loss) from operations	(308)	(366)	(1,006)	(1,171)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	1	0	1	0
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests	0	0	0	0
Net realized investment (gains) losses	0	0	0	0
Amortization of acquired intangible assets	0	0	0	0
Special items
Debt extinguishment costs			141	199
Integration and transaction-related (benefits) costs	13	112	58	339
(Benefits) charges associated with litigation matters			(27)	25
Charge for organizational efficiency plan				31
Risk corridors recovery		0		0
Contractual adjustment for a former client		0		0
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(1,529)	(1,410)	(4,866)	(4,250)
Intersegment Eliminations | Evernorth
Segment Reporting Information [Line Items]
Revenues from customers	(942)	(926)	(3,174)	(2,785)
Intersegment Eliminations | Integrated Medical
Segment Reporting Information [Line Items]
Revenues from customers	(587)	(478)	(1,692)	(1,448)
Intersegment Eliminations | International Markets
Segment Reporting Information [Line Items]
Revenues from customers	0	0	0	0
Intersegment Eliminations | Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	$ 0	$ (6)	$ 0	$ (17)

Segment Information - Revenue f

Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue from External Customer [Line Items]
Premiums	$ 10,275	$ 10,682	$ 30,812	$ 31,928
Total revenues from external customers	43,820	40,658	127,221	117,816
Integrated Medical
Revenue from External Customer [Line Items]
Total revenues from external customers	9,588	9,047	28,879	26,999
International Markets
Revenue from External Customer [Line Items]
Premiums	1,446	1,360	4,338	4,079
Total revenues from external customers	1,500	1,439	4,526	4,325
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenues	31,013	27,802	89,085	79,464
Network revenues
Revenue from External Customer [Line Items]
Revenues	15,797	13,968	45,390	39,200
Home delivery and specialty revenues
Revenue from External Customer [Line Items]
Revenues	13,515	12,422	38,987	36,319
Other
Revenue from External Customer [Line Items]
Revenues	1,701	1,412	4,708	3,945
U.S. Medical premiums | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	8,771	8,196	26,311	24,428
Health Insurance | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	3,591	3,397	10,692	9,948
Stop loss | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	1,225	1,146	3,613	3,459
Other | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	320	281	938	853
Medicare Advantage | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	2,079	1,895	6,287	5,680
Medicare Part D | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	315	360	1,175	1,242
Other | Integrated Medical
Revenue from External Customer [Line Items]
Premiums	1,241	1,117	3,606	3,246
Domestic disability, life and accident premiums
Revenue from External Customer [Line Items]
Premiums	0	1,106	0	3,346
Other premiums
Revenue from External Customer [Line Items]
Premiums	58	20	163	75
Total services
Revenue from External Customer [Line Items]
Revenues	2,532	2,174	7,324	6,424
Fees
Revenue from External Customer [Line Items]
Revenues	2,513	2,120	7,185	6,253
Other external revenues
Revenue from External Customer [Line Items]
Revenues	$ 19	$ 54	$ 139	$ 171

Segment Information - 10-Q Narr

Segment Information - 10-Q Narrative (Details) - USD ($) $ in Billions	Sep. 30, 2021	Dec. 31, 2020
Pharmacy Benefits Management Services | Performance Guarantee
Loss Contingencies [Line Items]
Performance guarantee liability	$ 1	$ 1.1