CVS HEALTH CORP, 10-K filed on 2/12/2025
Annual Report
v3.25.0.1
Cover Page - USD ($)
12 Months Ended
Dec. 31, 2024
Feb. 05, 2025
Jun. 30, 2024
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2024    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-01011    
Entity Registrant Name CVS HEALTH CORPORATION    
Entity Incorporation, State or Country Code DE    
Entity Tax Identification Number 05-0494040    
Entity Address, Address Line One One CVS Drive,    
Entity Address, City or Town Woonsocket,    
Entity Address, State or Province RI    
Entity Address, Postal Zip Code 02895    
City Area Code (401)    
Local Phone Number 765-1500    
Title of 12(b) Security Common Stock, par value $0.01 per share    
Trading Symbol CVS    
Security Exchange Name NYSE    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
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    
ICFR Auditor Attestation Flag true    
Document Financial Statement Error Correction [Flag] false    
Entity Shell Company false    
Entity Public Float     $ 74,072,103,405
Entity Common Stock, Shares Outstanding   1,260,795,063  
Documents Incorporated by Reference
The following materials are incorporated by reference into this Form 10-K:
Information contained in the definitive proxy statement for CVS Health Corporation’s 2025 Annual Meeting of Stockholders, to be filed with the Securities and Exchange Commission within 120 days after the end of the fiscal year ended December 31, 2024 (the “Proxy Statement”), is incorporated by reference in Parts III and IV to the extent described therein.
   
Entity Central Index Key 0000064803    
Document Fiscal Year Focus 2024    
Document Fiscal Period Focus FY    
Amendment Flag false    
v3.25.0.1
Audit Information
12 Months Ended
Dec. 31, 2024
Auditor Information [Abstract]  
Auditor Name Ernst & Young LLP
Auditor Location Boston, Massachusetts
Auditor Firm ID 42
v3.25.0.1
Consolidated Statements of Operations - USD ($)
shares in Millions, $ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Revenues:      
Premiums $ 122,896 $ 99,192 $ 85,330
Net investment income 2,153 1,153 838
Total revenues 372,809 357,776 322,467
Operating costs:      
Cost of products sold 206,287 217,098 196,892
Health care costs 115,121 86,247 71,073
Operating expenses 41,606 39,832 38,212
Restructuring charges 1,179 507 0
Opioid litigation charges 100 0 5,803
Loss on assets held for sale 0 349 2,533
Total operating costs 364,293 344,033 314,513
Operating income 8,516 13,743 7,954
Interest expense 2,958 2,658 2,287
Gain on early extinguishment of debt (491) 0 0
Other income (99) (88) (169)
Income before income tax provision 6,148 11,173 5,836
Income tax provision 1,562 2,805 1,509
Net income 4,586 8,368 4,327
Net (income) loss attributable to noncontrolling interests 28 (24) (16)
Net income attributable to CVS Health $ 4,614 $ 8,344 $ 4,311
Net income per share attributable to CVS Health:      
Basic (in dollars per share) $ 3.67 $ 6.49 $ 3.29
Diluted (in dollars per share) $ 3.66 $ 6.47 $ 3.26
Weighted average shares outstanding:      
Basic (in shares) 1,259 1,285 1,312
Diluted (in shares) 1,262 1,290 1,323
Cost, Product and Service [Extensible List] Products Products Products
Products      
Revenues:      
Revenues $ 231,521 $ 245,138 $ 226,616
Services      
Revenues:      
Revenues $ 16,239 $ 12,293 $ 9,683
v3.25.0.1
Consolidated Statements of Comprehensive Income - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Statement of Comprehensive Income [Abstract]      
Net income $ 4,586 $ 8,368 $ 4,327
Other comprehensive income (loss), net of tax:      
Net unrealized investment gains (losses) 30 1,090 (2,317)
Change in discount rate on long-duration insurance reserves 113 (67) 870
Foreign currency translation adjustments (4) 0 0
Net cash flow hedges (15) 5 17
Pension and other postretirement benefits 53 (61) (168)
Other comprehensive income (loss) 177 967 (1,598)
Comprehensive income 4,763 9,335 2,729
Comprehensive (income) loss attributable to noncontrolling interests 28 (24) (16)
Comprehensive income attributable to CVS Health $ 4,791 $ 9,311 $ 2,713
v3.25.0.1
Consolidated Balance Sheets - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Assets:    
Cash and cash equivalents $ 8,586 $ 8,196
Investments 2,407 3,259
Accounts receivable, net 36,469 35,227
Inventories 18,107 18,025
Other current assets 3,076 3,151
Total current assets 68,645 67,858
Long-term investments 28,934 23,019
Property and equipment, net 12,993 13,183
Operating lease right-of-use assets 15,944 17,252
Goodwill 91,272 91,272
Intangible assets, net 27,323 29,234
Separate accounts assets 3,311 3,250
Other assets 4,793 4,660
Total assets 253,215 249,728
Liabilities:    
Accounts payable 15,892 14,897
Pharmacy claims and discounts payable 24,166 22,874
Health care costs payable 15,064 12,049
Accrued expenses and other current liabilities 20,810 23,515
Other insurance liabilities 1,183 1,141
Current portion of operating lease liabilities 1,751 1,741
Short-term debt 2,119 200
Current portion of long-term debt 3,624 2,772
Total current liabilities 84,609 79,189
Long-term operating lease liabilities 14,899 16,034
Long-term debt 60,527 58,638
Deferred income taxes 3,806 4,311
Separate accounts liabilities 3,311 3,250
Other long-term insurance liabilities 4,902 5,459
Other long-term liabilities 5,431 6,211
Total liabilities 177,485 173,092
Commitments and contingencies (Note 18)
Shareholders’ equity:    
Preferred stock, par value $0.01: 0.1 shares authorized; none issued or outstanding 0 0
Common stock, par value $0.01: 3,200 shares authorized; 1,778 shares issued and 1,260 shares outstanding at December 31, 2024 and 1,768 shares issued and 1,288 shares outstanding at December 31, 2023 and capital surplus 49,661 48,992
Treasury stock, at cost: 518 and 480 shares at December 31, 2024 and 2023 (36,818) (33,838)
Retained earnings 62,837 61,604
Accumulated other comprehensive loss (120) (297)
Total CVS Health shareholders’ equity 75,560 76,461
Noncontrolling interests 170 175
Total shareholders’ equity 75,730 76,636
Total liabilities and shareholders’ equity $ 253,215 $ 249,728
v3.25.0.1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2024
Dec. 31, 2023
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.01 $ 0.01
Preferred stock, shares authorized (in shares) 100,000 100,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 3,200,000,000 3,200,000,000
Common stock, shares issued (in shares) 1,778,000,000 1,768,000,000
Common stock, shares outstanding (in shares) 1,260,000,000 1,288,000,000
Treasury stock (in shares) 518,000,000 480,000,000
v3.25.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash flows from operating activities:      
Cash receipts from customers $ 357,995 $ 345,464 $ 313,662
Cash paid for inventory, prescriptions dispensed and health services rendered (197,726) (208,848) (189,766)
Insurance benefits paid (109,464) (84,097) (69,728)
Cash paid to other suppliers and employees (38,821) (34,735) (32,662)
Interest and investment income received 1,735 1,584 1,026
Interest paid (2,909) (2,418) (2,239)
Income taxes paid (1,703) (3,524) (4,116)
Net cash provided by operating activities 9,107 13,426 16,177
Cash flows from investing activities:      
Proceeds from sales and maturities of investments 10,353 7,729 6,729
Purchases of investments (15,191) (9,043) (7,746)
Purchases of property and equipment (2,781) (3,031) (2,727)
Acquisitions (net of cash and restricted cash acquired) (95) (16,612) (139)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,854 in 2022) 0 0 (1,249)
Other 101 68 85
Net cash used in investing activities (7,613) (20,889) (5,047)
Cash flows from financing activities:      
Commercial paper borrowings (repayments), net 1,919 200 0
Proceeds from issuance of short-term loan 0 5,000 0
Repayment of short-term loan 0 (5,000) 0
Proceeds from issuance of long-term debt 7,913 10,898 0
Repayments of long-term debt (4,773) (3,166) (4,211)
Repurchase of common stock (3,023) (2,012) (3,500)
Dividends paid (3,373) (3,132) (2,907)
Proceeds from exercise of stock options 361 277 551
Payments for taxes related to net share settlement of equity awards (185) (181) (370)
Other 26 (201) (79)
Net cash provided by (used in) financing activities (1,135) 2,683 (10,516)
Net increase (decrease) in cash, cash equivalents and restricted cash 359 (4,780) 614
Cash, cash equivalents and restricted cash at the beginning of the period 8,525 13,305 12,691
Cash, cash equivalents and restricted cash at the end of the period 8,884 8,525 13,305
Reconciliation of net income to net cash provided by operating activities:      
Net income 4,586 8,368 4,327
Adjustments required to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 4,597 4,366 4,224
Loss on assets held for sale 0 349 2,533
Stock-based compensation 540 588 447
Restructuring charges (impairment of long-lived assets) 840 152 0
Gain on sale of subsidiaries 0 0 (475)
Gain on early extinguishment of debt (491) 0 0
Deferred income taxes (572) (676) (2,029)
Other items (502) 264 332
Change in operating assets and liabilities, net of effects from acquisitions:      
Accounts receivable, net (1,301) (6,260) (2,971)
Inventories (102) 1,233 (1,435)
Other assets (38) (510) (491)
Accounts payable and pharmacy claims and discounts payable 2,335 3,618 4,260
Health care costs payable and other insurance liabilities 2,757 394 992
Other liabilities (3,542) 1,540 6,463
Net cash provided by operating activities $ 9,107 $ 13,426 $ 16,177
v3.25.0.1
Consolidated Statements of Cash Flows (Parenthetical)
$ in Millions
12 Months Ended
Dec. 31, 2022
USD ($)
Statement of Cash Flows [Abstract]  
Cash and restricted cash sold $ 2,854
v3.25.0.1
Consolidated Statements of Shareholders' Equity - USD ($)
shares in Millions, $ in Millions
Total
Total CVS Health Shareholders’ Equity
Common Shares
Treasury Shares
Common Stock and Capital Surplus
[2]
Retained Earnings
Accumulated Other Comprehensive Income (Loss)
Noncontrolling Interests
Shares outstanding, beginning of year balance (in shares) at Dec. 31, 2021     1,744          
Treasury shares outstanding, beginning of year balance (in shares) at Dec. 31, 2021 [1]       (422)        
Beginning of year balance at Dec. 31, 2021 $ 74,841 $ 74,535   $ (28,173) [1] $ 47,377 $ 54,997 $ 334 $ 306
Stockholders' Equity [Roll Forward]                
Net income 4,327 4,311       4,311   16
Other comprehensive income (loss) (1,598) (1,598)         (1,598)  
Stock option activity, stock awards and other (in shares)     14          
Stock option activity, stock awards and other 816 816     816      
Purchase of treasury shares, net of ESPP issuances (in shares) [1]       (36)        
Purchase of treasury shares, net of ESPP issuances (3,685) (3,685)   $ (3,685) [1]        
Common stock dividends ($2.20 per share) (2,910) (2,910)       (2,910)    
Other increases (decreases) in noncontrolling interests (22)             (22)
Shares outstanding, end of year balance (in shares) at Dec. 31, 2022     1,758          
Treasury shares outstanding, end of year balance (in shares) at Dec. 31, 2022 [1]       (458)        
End of year balance at Dec. 31, 2022 71,769 71,469   $ (31,858) [1] 48,193 56,398 (1,264) 300
Stockholders' Equity [Roll Forward]                
Net income 8,368 8,344       8,344   24
Other comprehensive income (loss) 967 967         967  
Stock option activity, stock awards and other (in shares)     10          
Stock option activity, stock awards and other 795 795     795      
Purchase of treasury shares, net of ESPP issuances (in shares) [1]       (22)        
Purchase of treasury shares, net of ESPP issuances (1,992) (1,992)   $ (1,980) [1] (12)      
Common stock dividends ($2.20 per share) (3,138) (3,138)       (3,138)    
Acquisition of noncontrolling interests 66             66
Other increases (decreases) in noncontrolling interests $ (199) 16     16     (215)
Shares outstanding, end of year balance (in shares) at Dec. 31, 2023     1,768          
Treasury shares outstanding, end of year balance (in shares) at Dec. 31, 2023 (480)     (480) [1]        
End of year balance at Dec. 31, 2023 $ 76,636 76,461   $ (33,838) [1] 48,992 61,604 (297) 175
Stockholders' Equity [Roll Forward]                
Net income 4,586 4,614       4,614   (28)
Other comprehensive income (loss) 177 177         177  
Stock option activity, stock awards and other (in shares)     10          
Stock option activity, stock awards and other 700 700     700      
Purchase of treasury shares, net of ESPP issuances (in shares) [1]       (38)        
Purchase of treasury shares, net of ESPP issuances (3,002) (3,002)   $ (2,980) [1] (22)      
Common stock dividends ($2.20 per share) (3,381) (3,381)       (3,381)    
Other increases (decreases) in noncontrolling interests $ 14 (9)     (9)     23
Shares outstanding, end of year balance (in shares) at Dec. 31, 2024     1,778          
Treasury shares outstanding, end of year balance (in shares) at Dec. 31, 2024 (518)     (518) [1]        
End of year balance at Dec. 31, 2024 $ 75,730 $ 75,560   $ (36,818) [1] $ 49,661 $ 62,837 $ (120) $ 170
[1] Treasury shares include 1 million shares held in trust for each of the years ended December 31, 2024, 2023 and 2022. Treasury stock includes $29 million related to shares held in trust for each of the years ended December 31, 2024, 2023 and 2022. See Note 1 ‘‘Significant Accounting Policies’’ for additional information.
[2] Common stock and capital surplus includes the par value of common stock of $18 million as of December 31, 2024, 2023 and 2022.
v3.25.0.1
Consolidated Statements of Shareholders' Equity (Parentheticals) - USD ($)
shares in Millions, $ in Millions
3 Months Ended 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Statement of Stockholders' Equity [Abstract]            
Dividends declared per share (in dollars per share) $ 0.665 $ 0.605 $ 0.55 $ 2.66 $ 2.42 $ 2.20
Treasury shares held in trust (in shares) 1 1 1 1 1 1
Treasury shares held in trust $ 29 $ 29 $ 29 $ 29 $ 29 $ 29
Common stock $ 18 $ 18 $ 18 $ 18 $ 18 $ 18
v3.25.0.1
Significant Accounting Policies
12 Months Ended
Dec. 31, 2024
Accounting Policies [Abstract]  
Significant Accounting Policies Significant Accounting Policies
Description of Business 

CVS Health Corporation, together with its subsidiaries (collectively, “CVS Health” or the “Company”), is a leading health solutions company building a world of health around every consumer it serves and connecting care so that it works for people wherever they are. As of December 31, 2024, the Company had more than 9,000 retail locations, more than 1,000 walk-in and primary medical clinics, a leading pharmacy benefits manager with approximately 90 million plan members and expanding specialty pharmacy solutions, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 36 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company is creating new sources of value through its integrated model allowing it to expand into personalized, technology driven care delivery and health services, increasing access to quality care, delivering better health outcomes and lowering overall health care costs.

The Company has four reportable segments: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other, which are described below.

Health Care Benefits Segment
The Health Care Benefits segment operates as one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs and Medicaid health care management services. The Health Care Benefits segment’s primary customers, its members, primarily access the segment’s products and services through employer groups, government-sponsored plans or individually. The Health Care Benefits segment also serves customers who purchase products and services that are ancillary to its health insurance products. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.” The Company sold Insured plans directly to individual consumers through the individual public health insurance exchanges (“Public Exchanges”) in 17 states as of December 31, 2024.

Health Services Segment
The Health Services segment provides a full range of pharmacy benefit management (“PBM”) solutions, delivers health care services in its medical clinics, virtually, and in the home, and offers provider enablement solutions. PBM solutions include plan design offerings and administration, formulary management, retail pharmacy network management services, and specialty and mail order pharmacy services. In addition, the Company provides clinical services, disease management services, medical spend management and pharmacy and/or other administrative services for providers and federal 340B drug pricing program covered entities (“Covered Entities”). The Company operates a group purchasing organization that negotiates pricing for the purchase of pharmaceuticals and rebates with pharmaceutical manufacturers on behalf of its participants and provides various administrative, management and reporting services to pharmaceutical manufacturers. During 2023, the Company completed the acquisition of two key health care delivery assets – Signify Health, Inc. (“Signify Health”), a leader in health risk assessments, value-based care and provider enablement services, and Oak Street Health, Inc. (“Oak Street Health”), a leading multi-payor operator of value-based primary care centers serving Medicare eligible patients. The Company also launched CordavisTM, a wholly owned subsidiary that works directly with pharmaceutical manufacturers to commercialize and/or co-produce high quality biosimilar products. The Health Services segment’s clients and customers are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, the U.S. Centers for Medicare & Medicaid Services (“CMS”), plans offered on public and private health insurance exchanges and other sponsors of health benefit plans throughout the U.S., patients who receive care in the Health Services segment’s medical clinics, virtually or in the home, as well as Covered Entities.

Pharmacy & Consumer Wellness Segment
The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy
consulting and ancillary services to long-term care facilities and other care settings, and provides pharmacy fulfillment services to support the Health Services segment’s specialty and mail order pharmacy offerings. As of December 31, 2024, the Pharmacy & Consumer Wellness segment operated more than 9,000 retail locations, as well as online retail pharmacy websites, LTC pharmacies and on-site pharmacies, retail specialty pharmacy stores, compounding pharmacies and branches for infusion and enteral nutrition services.

Corporate/Other Segment
The Company presents the remainder of its financial results in the Corporate/Other segment, which primarily consists of:

Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources and finance departments, information technology, digital, data and analytics, as well as acquisition-related transaction and integration costs; and
Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.

Basis of Presentation

The accompanying consolidated financial statements of CVS Health and its subsidiaries have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). The consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.

Reclassifications

Certain prior year amounts have been reclassified to conform with the current year presentation.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.

Cash and Cash Equivalents

Cash and cash equivalents consist of cash and temporary investments with maturities of three months or less when purchased. The Company invests in short-term money market funds, commercial paper and time deposits, as well as other debt securities that are classified as cash equivalents within the accompanying consolidated balance sheets, as these funds are highly liquid and readily convertible to known amounts of cash.

Restricted Cash

Restricted cash included in other current assets on the consolidated balance sheets primarily represents funds held on behalf of members and funds held in escrow in connection with agreements with accountable care organizations. Restricted cash included in other assets on the consolidated balance sheets represents amounts held in a trust in one of the Company’s captive insurance companies to satisfy collateral requirements associated with the assignment of certain insurance policies. All restricted cash is invested in demand deposits, time deposits and money market funds.

The following is a reconciliation of cash and cash equivalents on the consolidated balance sheets to total cash, cash equivalents and restricted cash on the consolidated statements of cash flows as of December 31, 2024, 2023 and 2022:
In millions202420232022
Cash and cash equivalents$8,586 $8,196 $12,945 
Restricted cash (included in other current assets)95 90 144 
Restricted cash (included in other assets)203 239 216 
Total cash, cash equivalents and restricted cash in the consolidated statements of cash flows$8,884 $8,525 $13,305 
Investments

Debt Securities
Debt securities consist primarily of U.S. Treasury and agency securities, mortgage-backed securities, corporate and foreign bonds and other debt securities. Debt securities are classified as either current or long-term investments based on their contractual maturities unless the Company intends to sell an investment within the next twelve months, in which case it is classified as current on the consolidated balance sheets. Debt securities are classified as available for sale and are carried at fair value. See Note 5 ‘‘Fair Value’’ for additional information on how the Company estimates the fair value of these investments.

If a debt security is in an unrealized loss position and the Company has the intent to sell the security, or it is more likely than not that the Company will have to sell the security before recovery of its amortized cost basis, the amortized cost basis of the security is written down to its fair value and the difference is recognized in net income. If a debt security is in an unrealized loss position and the Company does not have the intent to sell and it is more likely than not that the Company will not have to sell such security before recovery of its amortized cost basis, the Company bifurcates the impairment into credit-related and non-credit related (yield-related) components. In evaluating whether a credit related loss exists, the Company considers a variety of factors including: the extent to which the fair value is less than the amortized cost basis; adverse conditions specifically related to the issuer of a security, an industry or geographic area; the payment structure of the security; the failure of the issuer of the security to make scheduled interest or principal payments; and any changes to the rating of the security by a rating agency. The amount of the credit-related component is recorded as an allowance for credit losses and recognized in net income, and the amount of the non-credit related component is included in other comprehensive income (loss). Interest is not accrued on debt securities when management believes the collection of interest is unlikely.

The credit-related component is determined by comparing the present value of cash flows expected to be collected from the security, considering all reasonably available information relevant to the collectability of the security, with the amortized cost basis of the security. If the present value of cash flows expected to be collected is less than the amortized cost basis of the security, the Company records an allowance for credit losses, which is limited by the amount that the fair value is less than amortized cost basis.

For mortgage-backed and other asset-backed securities, the Company recognizes income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The Company’s investment in the security is adjusted to the amount that would have existed had the new effective yield been applied since the acquisition of the security, with adjustments recognized in net income.

Equity Securities
Equity securities with readily available fair values are measured at fair value with changes in fair value recognized in net income.

Mortgage Loans
Mortgage loan investments on the consolidated balance sheets are valued at the unpaid principal balance, net of an allowance for credit losses. Mortgage loans with a maturity date or a committed prepayment date within twelve months are classified as current on the consolidated balance sheets. The Company assesses whether its loans share similar risk characteristics and, if so, groups such loans in a risk pool when measuring expected credit losses. The Company considers the following characteristics when evaluating whether its loans share similar risk characteristics: loan-to-value ratios, property type (e.g., office, retail, apartment, industrial), geographic location, vacancy rates and property condition.

Credit loss reserves are determined using a loss rate method that multiplies the unpaid principal balance of each loan within a risk pool group by an estimated loss rate percentage. The loss rate percentage considers both the expected loan loss severity and the probability of loan default. For periods where the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions (e.g., gross domestic product, employment), the Company adjusts its expected loss rates to reflect these forecasted economic conditions. For periods beyond which the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions, the Company reverts to historical loss rates in determining expected credit losses.

Interest income on a potential problem loan (i.e., high probability of default) or restructured loan is accrued to the extent it is deemed to be collectible and the loan continues to perform under its original or restructured terms. Interest income on problem loans (i.e., more than 60 days delinquent, in bankruptcy or in process of foreclosure) is recognized on a cash basis. Cash payments on loans in the process of foreclosure are treated as a return of principal.
Other Investments
Other investments consist primarily of the following:

Private equity and hedge fund limited partnerships, which are accounted for using the equity method of accounting. Under this method, the carrying value of the investment is based on the value of the Company’s equity ownership of the underlying investment funds provided by the general partner or manager of the investments, the financial statements of which generally are audited. As a result of the timing of the receipt of the valuation information provided by the fund managers, these investments are generally reported on up to a three month lag. The Company reviews investments for impairment at least quarterly and monitors their performance throughout the year through discussions with the administrators, managers and/or general partners. If the Company becomes aware of an impairment of a limited partnership’s investments through its review or prior to receiving the limited partnership’s financial statements at the financial statement date, an impairment will be recognized by recording a reduction in the carrying value of the limited partnership with a corresponding charge to net investment income.
Investment real estate, which is carried on the consolidated balance sheets at depreciated cost, including capital additions, net of write-downs for other-than-temporary declines in fair value. Depreciation is calculated using the straight-line method based on the estimated useful life of each asset. If any real estate investment is considered held-for-sale, it is carried at the lower of its carrying value or fair value less estimated selling costs. The Company generally estimates fair value using net operating income and applying a capitalization rate in conjunction with comparable sales information. At the time of the sale, the difference between the sales price and the carrying value is recorded as a realized capital gain or loss.
Privately-placed equity securities, which are carried on the consolidated balance sheets using the measurement alternative, at cost less impairments, plus or minus subsequent adjustments for observable price changes. Additionally, as a member of the Federal Home Loan Bank of Boston (“FHLBB”), a subsidiary of the Company is required to purchase and hold shares of the FHLBB. These shares are restricted and carried at cost.

Net Investment Income
Net investment income on the Company’s investments is recorded when earned and is reflected in the Company’s net income (other than net investment income on assets supporting experience-rated products). Experience-rated products are products in the large case pensions business where the contract holder, not the Company, assumes investment and other risks, subject to, among other things, minimum guarantees provided by the Company. The effect of investment performance on experience-rated products is allocated to contract holders’ accounts daily, based on the underlying investment experience and, therefore, does not impact the Company’s net income (as long as the contract’s minimum guarantees are not triggered). Net investment income on assets supporting large case pensions’ experience-rated products is included in net investment income in the consolidated statements of operations and is credited to contract holders’ accounts through a charge to benefit costs. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.

Realized capital gains and losses on investments (other than realized capital gains and losses on investments supporting experience-rated products) are included as a component of net investment income in the consolidated statements of operations. Realized capital gains and losses are determined on a specific identification basis. Purchases and sales of debt and equity securities and alternative investments are reflected on the trade date. Purchases and sales of mortgage loans and investment real estate are reflected on the closing date.

Realized capital gains and losses on investments supporting large case pensions’ experience-rated products are not included in realized capital gains and losses in the consolidated statements of operations and instead are credited directly to contract holders’ accounts. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.

Unrealized capital gains and losses on investments (other than unrealized capital gains and losses on investments supporting experience-rated products) are reflected in shareholders’ equity, net of tax, as a component of accumulated other comprehensive income (loss). Unrealized capital gains and losses on investments supporting large case pensions’ experience-rated products are credited directly to contract holders’ accounts. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.

Derivative Financial Instruments

The Company uses derivative financial instruments in order to manage interest rate and foreign exchange risk and credit exposure. The Company’s use of these derivatives is generally limited to hedging risk and has principally consisted of using interest rate swaps, treasury rate locks, forward contracts, futures contracts, warrants, put options and credit default swaps.
Accounts Receivable

Accounts receivable are stated net of allowances for credit losses, customer credit allowances, contractual allowances and estimated terminations. Accounts receivable, net was composed of the following at December 31, 2024 and 2023:
In millions20242023
Trade receivables$9,881 $11,908 
Vendor and manufacturer receivables13,891 15,711 
Premium receivables4,731 3,714 
Other receivables7,966 3,894 
   Total accounts receivable, net
$36,469 $35,227 

The Company’s allowance for credit losses was $407 million and $343 million as of December 31, 2024 and 2023, respectively. When developing an estimate of the Company’s expected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days.

Inventories

Inventories are valued at the lower of cost or net realizable value using the weighted average cost method. Physical inventory counts are taken on a regular basis in each retail store and pharmacy, and a continuous cycle count process is the primary procedure used to validate the inventory balances on hand in each distribution center and mail facility to ensure that the amounts reflected in the consolidated financial statements are properly stated. During the interim period between physical inventory counts, the Company accrues for anticipated physical inventory losses on a location-by-location basis based on historical results and current physical inventory trends.

Reinsurance Recoverables
The Company utilizes reinsurance agreements primarily to: (a) reduce required capital and (b) facilitate the acquisition or disposition of certain insurance contracts. Ceded reinsurance agreements permit the Company to recover a portion of its losses from reinsurers, although they do not discharge the Company’s primary liability as the direct insurer of the risks reinsured. Failure of reinsurers to indemnify the Company could result in losses; however, the Company does not expect charges for unrecoverable reinsurance to have a material effect on its consolidated operating results or financial condition. The Company evaluates the financial condition of its reinsurers and monitors concentrations of credit risk arising from similar geographic regions, activities or economic characteristics of its reinsurers. At December 31, 2024, the Company’s reinsurance recoverables consisted primarily of amounts due from third parties that are rated consistent with companies that are considered to have the ability to meet their obligations. Reinsurance recoverables are recorded as other current assets or other assets on the consolidated balance sheets.

Health Care Contract Acquisition Costs

Insurance products included in the Health Care Benefits segment are cancellable by either the customer or the member monthly upon written notice. Acquisition costs related to prepaid health care and health indemnity contracts are generally expensed as incurred. For certain long-duration insurance contracts, acquisition costs directly related to the successful acquisition of a new or renewal insurance contract, including commissions, are deferred and are recorded as other current assets or other assets on the consolidated balance sheets. Contracts are grouped by product and issue year into cohorts consistent with the grouping used in estimating the associated liability and are amortized on a constant level basis based on the remaining in-force policies over the estimated term of the contracts to approximate straight-line amortization. Changes to the Company’s assumptions, including assumptions related to persistency, are reflected at the cohort level at the time of change and are recognized prospectively over the estimated terms of the contract. The amortization of deferred acquisition costs is recorded in operating expenses in the consolidated statements of operations.
The following is a roll forward of deferred acquisition costs for the years ended December 31, 2024 and 2023:
In millions20242023
Deferred acquisition costs, beginning of the period$1,502 $1,219 
Capitalizations544 548 
Amortization expense(299)(265)
Deferred acquisition costs, end of the period$1,747 $1,502 

Property and Equipment

Property and equipment is reported at historical cost, net of accumulated depreciation. Property, equipment and improvements to leased premises are depreciated using the straight-line method over the estimated useful lives of the assets, or when applicable, the term of the lease, whichever is shorter. Estimated useful lives generally range from 1 to 40 years for buildings, building improvements and leasehold improvements and 3 to 10 years for fixtures, equipment and internally developed software. Repair and maintenance costs are charged directly to expense as incurred. Major renewals or replacements that substantially extend the useful life of an asset are capitalized and depreciated. Application development stage costs for significant internally developed software projects are capitalized and depreciated.

Property and equipment consisted of the following at December 31, 2024 and 2023:
In millions20242023
Land$1,847 $1,958 
Building and improvements4,632 4,571 
Fixtures and equipment11,716 11,024 
Leasehold improvements6,725 6,511 
Software11,520 9,818 
Total property and equipment36,440 33,882 
Accumulated depreciation and amortization(23,447)(20,699)
Property and equipment, net
$12,993 $13,183 

Depreciation expense (which includes the amortization of property and equipment under finance or capital leases) totaled $2.6 billion, $2.5 billion and $2.4 billion for the years ended December 31, 2024, 2023 and 2022, respectively. See Note 7 ‘‘Leases’’ for additional information about the Company’s finance leases.

Right-of-Use Assets and Lease Liabilities

The Company determines if an arrangement contains a lease at the inception of a contract. Right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Right-of-use assets and lease liabilities are recognized at the commencement date of the lease, renewal date of the lease or significant remodeling of the lease space based on the present value of the remaining future minimum lease payments. As the interest rate implicit in the Company’s leases is not readily determinable, the Company utilizes its incremental borrowing rate, determined by class of underlying asset, to discount the lease payments. The operating lease right-of-use assets also include lease payments made before commencement and are reduced by lease incentives.

The Company’s real estate leases typically contain options that permit renewals for additional periods of up to five years each. For real estate leases, the options to extend are not considered reasonably certain at lease commencement because the Company reevaluates each lease on a regular basis to consider the economic and strategic incentives of exercising the renewal options and regularly opens or closes stores to align with its operating strategy. Generally, the renewal option periods are not included within the lease term and the associated payments are not included in the measurement of the right-of-use asset and lease liability. Similarly, renewal options are not included in the lease term for non-real estate leases because they are not considered reasonably certain of being exercised at lease commencement. Leases with an initial term of 12 months or less are not recorded on the balance sheets, and lease expense is recognized on a straight-line basis over the term of the short-term lease.

For real estate leases, the Company accounts for lease components and nonlease components as a single lease component. Certain real estate leases require additional payments based on sales volume, as well as reimbursement for real estate taxes, common area maintenance and insurance, which are expensed as incurred as variable lease costs. Other real estate leases
contain one fixed lease payment that includes real estate taxes, common area maintenance and insurance. These fixed payments are considered part of the lease payment and included in the right-of-use assets and lease liabilities.

See Note 7 ‘‘Leases’’ for additional information about right-of-use assets and lease liabilities.

Goodwill

The Company accounts for business combinations using the acquisition method of accounting, which requires the excess cost of an acquisition over the fair value of net assets acquired and identifiable intangible assets to be recorded as goodwill. Goodwill is not amortized, but is subject to impairment reviews annually, or more frequently, if necessary, as further described in “Recoverability of Long-Lived Assets” below. See Note 6 ‘‘Goodwill and Other Intangibles’’ for additional information about goodwill.

Intangible Assets

The Company’s identifiable intangible assets consist primarily of trademarks, trade names, customer contracts/relationships, covenants not to compete, technology and provider networks. These intangible assets arise primarily from the determination of their respective fair market values at the date of acquisition. Amounts assigned to identifiable intangible assets, and their related useful lives, are derived from established valuation techniques and management estimates.

The Company’s definite-lived intangible assets are amortized over their estimated useful lives based upon the pattern of future cash flows attributable to the asset. Definite-lived intangible assets are amortized using the straight-line method. Indefinite-lived intangible assets are not amortized but are tested for impairment annually, or more frequently, if necessary, as further described in “Recoverability of Long-Lived Assets” below.

See Note 6 ‘‘Goodwill and Other Intangibles’’ for additional information about intangible assets.

Recoverability of Long-Lived Assets

The Company evaluates the recoverability of long-lived assets, excluding goodwill and indefinite-lived intangible assets, which are tested for impairment using separate tests described below, whenever events or changes in circumstances indicate that the carrying value of such asset may not be recoverable. The Company groups and evaluates these long-lived assets for impairment at the lowest level at which individual cash flows can be identified. If indicators of impairment are present, the Company first compares the carrying amount of the asset group to the estimated future cash flows associated with the asset group (undiscounted). If the estimated future cash flows used in the analysis are less than the carrying amount of the asset group, an impairment loss calculation is prepared. The impairment loss calculation compares the carrying amount of the asset group to the asset group’s estimated future cash flows (discounted). If required, an impairment loss is recorded for the portion of the asset group’s carrying value that exceeds the asset group’s estimated future cash flows (discounted).

During the year ended December 31, 2024, in connection with its enterprise-wide restructuring plan described in Note 3 ‘‘Restructuring’’, the Company recorded a store impairment charge of $607 million, consisting of a write down of $483 million related to operating and financing lease right-of-use assets and $124 million related to property and equipment. In addition, in connection with its enterprise-wide restructuring plan the Company recorded $269 million of other asset impairments and related charges associated with the discontinuation of certain non-core long-lived assets recorded as reductions to property and equipment, net and operating lease right-of-use assets. During the year ended December 31, 2023, in connection with its 2023 restructuring program, the Company recorded $152 million of asset impairment charges in connection with the termination of certain transformation initiatives.

See Note 3 ‘‘Restructuring’’ for additional information about the Company’s restructuring plan.

During the years ended December 31, 2024, 2023, and 2022, the Company recorded office real estate optimization charges of $30 million, $46 million, and $117 million, respectively, primarily related to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the planned reduction of corporate office real estate space in response to its ongoing flexible work arrangement.

See Note 7 ‘‘Leases’’ for additional information about the right-of-use asset charges.
When evaluating goodwill for potential impairment, the Company compares the fair value of its reporting units to their respective carrying amounts. The Company estimates the fair value of its reporting units using a combination of a discounted cash flow method and a market multiple method. If the carrying amount of a reporting unit exceeds its estimated fair value, an impairment loss is recognized in an amount equal to that excess.

During the fourth quarter of 2024, the Company performed its required annual impairment test of goodwill and concluded there were no goodwill impairments as of the testing date. During the third quarter of 2024, the Company performed an interim goodwill impairment test of the Government reporting unit after determining there were indicators that the Government reporting unit’s goodwill may be impaired. The results of the interim impairment test showed that the fair value of the Government reporting unit exceeded its carrying value, therefore there was no impairment of goodwill as of the interim testing date.

During the fourth quarter of 2023 and the third quarter of 2022, the Company performed its required annual impairment test of goodwill and concluded there were no goodwill impairments as of the testing date or during the years ended December 31, 2023 and 2022.

Indefinite-lived intangible assets are tested for impairment by comparing the estimated fair value of the asset to its carrying value. The Company estimates the fair value of its indefinite-lived trademarks using the relief from royalty method under the income approach. If the carrying value of the asset exceeds its estimated fair value, an impairment loss is recognized, and the asset is written down to its estimated fair value. There were no impairment losses recognized on indefinite-lived intangible assets in any of the years ended December 31, 2024, 2023 or 2022.

Separate Accounts

Separate Accounts assets and liabilities related to large case pensions products represent funds maintained to meet specific objectives of contract holders who bear the investment risk. These assets and liabilities are carried at fair value. Net investment income (including net realized capital gains and losses) accrue directly to such contract holders. The assets of each account are legally segregated and are not subject to claims arising from the Company’s other businesses. Deposits, withdrawals and net investment income (including net realized and net unrealized capital gains and losses) on Separate Accounts assets are not reflected in the consolidated statements of operations or cash flows. Management fees charged to contract holders are included in services revenue and recognized over the period earned.

Health Care Costs Payable

Health care costs payable within the Health Care Benefits segment consist principally of unpaid fee-for-service medical, dental and pharmacy claims, capitation costs, other amounts due to providers pursuant to risk-sharing arrangements related to the Health Care Benefits segment’s Insured Commercial, Medicare and Medicaid products and accruals for state assessments. Unpaid health care claims include an estimate of payments the Company will make for (i) services rendered to the Company’s Insured members but not yet reported to the Company and (ii) claims which have been reported to the Company but not yet paid, each as of the financial statement date (collectively, “IBNR”). Health care costs payable also include an estimate of the cost of services that will continue to be rendered after the financial statement date if the Company is obligated to pay for such services in accordance with contractual or regulatory requirements. Such estimates are developed using actuarial principles and assumptions which consider, among other things, historical and projected claim submission and processing patterns, assumed and historical medical cost trends, historical utilization of medical services, claim inventory levels, changes in Insured membership and product mix, seasonality and other relevant factors. The Company reflects changes in these estimates in benefit costs in the Company’s consolidated operating results in the period they are determined. Capitation costs represent contractual monthly fees paid to participating physicians and other medical providers for providing medical care, regardless of the volume of medical services provided to the Insured member. Amounts due under risk-sharing arrangements are based on the terms of the underlying contracts with the providers and consider claims experience under the contracts through the financial statement date. Within the Health Services segment, health care costs payable includes estimates of the Company’s obligations for medical care services that have been rendered by third parties on behalf of consumers for which the Company is contractually obligated to pay, but for which claims have either not yet been received, processed or paid.

The Company develops its estimate of IBNR using actuarial principles and assumptions that consider numerous factors. Of those factors, the Company considers the analysis of historical and projected claim payment patterns (including claims submission and processing patterns) and the assumed health care cost trend rate (the year-over-year change in per member per month health care costs) to be the most critical assumptions. In developing its IBNR estimate, the Company consistently applies
these actuarial principles and assumptions each period, with consideration to the variability of related factors. There have been no significant changes to the methodologies or assumptions used to develop the Company’s estimate of IBNR in 2024.

The Company analyzes historical claim payment patterns by comparing claim incurred dates (i.e., the date services were provided) to claim payment dates to estimate “completion factors.” The Company uses completion factors predominantly to estimate the ultimate cost of claims incurred more than three months before the financial statement date. The Company estimates completion factors by aggregating claim data based on the month of service and month of claim payment and estimating the percentage of claims incurred for a given month that are complete by each month thereafter. For any given month, substantially all claims are paid within six months of the date of service, but it can take up to 48 months or longer after the date of service before all of the claims are completely resolved and paid. These historically-derived completion factors are then applied to claims paid through the financial statement date to estimate the ultimate claim cost for a given month’s incurred claim activity. The difference between the estimated ultimate claim cost and the claims paid through the financial statement date represents the Company’s estimate of claims remaining to be paid as of the financial statement date and is included in the Company’s health care costs payable. The completion factors the Company uses reflect judgments and possible adjustments based on data such as claim inventory levels, claim submission and processing patterns and, to a lesser extent, other factors such as changes in health care cost trend rates, changes in Insured membership and changes in product mix. If claims are submitted or processed on a faster (slower) pace than prior periods, the actual claims may be more (less) complete than originally estimated using the Company’s completion factors, which may result in reserves that are higher (lower) than the ultimate cost of claims.

Because claims incurred within three months before the financial statement date are less mature, the Company uses a combination of historically-derived completion factors and the assumed health care cost trend rate to estimate the ultimate cost of claims incurred for these months. The Company applies its actuarial judgment and places a greater emphasis on the assumed health care cost trend rate for the most recent claim incurred dates as these months may be influenced by seasonal patterns and changes in membership and product mix.

The Company’s health care cost trend rate is affected by changes in per member utilization of medical services as well as changes in the unit cost of such services. Many factors influence the health care cost trend rate, including the Company’s ability to manage benefit costs through product design, negotiation of favorable provider contracts and medical management programs, as well as the mix of the Company’s business. The health status of the Company’s Insured members, aging of the population and other demographic characteristics, advances in medical technology and other factors continue to contribute to rising per member utilization and unit costs. Changes in health care practices, inflation, new technologies, increases in the cost of prescription drugs (including specialty pharmacy drugs), direct-to-consumer marketing by pharmaceutical companies, clusters of high-cost cases, claim intensity, changes in the regulatory environment, health care provider or member fraud and numerous other factors also contribute to the cost of health care and the Company’s health care cost trend rate.

For each reporting period, the Company uses an extensive degree of judgment in the process of estimating its health care costs payable. As a result, considerable variability and uncertainty is inherent in such estimates, particularly with respect to claims with claim incurred dates of three months or less before the financial statement date; and the adequacy of such estimates is highly sensitive to changes in assumed completion factors and the assumed health care cost trend rates. For each reporting period the Company recognizes the actuarial best estimate of health care costs payable considering the potential volatility in assumed completion factors and health care cost trend rates, as well as other factors. The Company believes its estimate of health care costs payable is reasonable and adequate to cover its obligations at December 31, 2024; however, actual claim payments may differ from the Company’s estimates. A worsening (or improvement) of the Company’s health care cost trend rates or changes in completion factors from those that the Company assumed in estimating health care costs payable at December 31, 2024 would cause these estimates to change in the near term, and such a change could be material.

Each quarter, the Company re-examines previously established health care costs payable estimates based on actual claim payments for prior periods and other changes in facts and circumstances. Given the extensive degree of judgment in this estimate, it is possible that the Company’s estimates of health care costs payable could develop either favorably (that is, its actual health care costs for the period were less than estimated) or unfavorably. The changes in the Company’s estimate of health care costs payable may relate to a prior quarter, prior year or earlier periods. For a roll forward of the Company’s health care costs payable, see Note 8 ‘‘Health Care Costs Payable.’’ The Company’s reserving practice is to consistently recognize the actuarial best estimate of its ultimate liability for health care costs payable.
Other Insurance Liabilities

Unpaid Claims
Unpaid claims consist primarily of reserves associated with certain short-duration group disability and term life insurance contracts, including an estimate for IBNR as of the financial statement date. Reserves associated with certain short-duration group disability and term life insurance contracts are based upon the Company’s estimate of the present value of future benefits, which is based on assumed investment yields and assumptions regarding mortality, morbidity and recoveries from the U.S. Social Security Administration. The Company develops its estimate of IBNR using actuarial principles and assumptions which consider, among other things, contractual requirements, claim incidence rates, claim recovery rates, seasonality and other relevant factors. The Company discounts certain claim liabilities related to group long-term disability and life insurance waiver of premium contracts. The discount rates generally reflect the Company’s expected investment returns for the investments supporting all incurral years of these liabilities. The discount rates for retrospectively-rated contracts are set at contractually specified levels. The Company’s estimates of unpaid claims are subject to change due to changes in the underlying experience of the insurance contracts, changes in investment yields or other factors, and these changes are recorded in current and future benefits in the consolidated statements of operations in the period they are determined. The Company estimates its reserve for claims IBNR for life products largely based on completion factors. The completion factors used are based on the Company’s historical experience and reflect judgments and possible adjustments based on data such as claim inventory levels, claim payment patterns, changes in business volume and other factors. If claims are submitted or processed on a faster (slower) pace than historical periods, the actual claims may be more (less) complete than originally estimated using completion factors, which may result in reserves that are higher (lower) than required to cover future life benefit payments. There have been no significant changes to the methodologies or assumptions used to develop the Company’s estimate of unpaid claims IBNR in 2024. As of December 31, 2024, unpaid claims balances of $280 million and $713 million were recorded in other insurance liabilities and other long-term insurance liabilities, respectively. As of December 31, 2023, unpaid claims balances of $285 million and $834 million were recorded in other insurance liabilities and other long-term insurance liabilities, respectively.

Substantially all life and disability insurance liabilities have been fully ceded to unrelated third parties through indemnity reinsurance agreements; however, the Company remains directly obligated to the policyholders.

Future Policy Benefits
Future policy benefits consist primarily of reserves for products for which the Company no longer solicits or accepts new customers, including limited payment pension and annuity contracts and long-term care insurance contracts. Contracts are grouped into cohorts by contract type and issue year. The liability for future policy benefits is adjusted for differences between actual and expected experience.

Reserves for limited payment pension and annuity contracts represent the Company’s estimate of the present value of future benefits to be paid to or on behalf of policyholders and are computed using actuarial principles that consider, among other things, assumptions reflecting anticipated mortality and retirement experience. On an annual basis, or more frequently if necessary, the Company reviews mortality assumptions against both industry standards and its experience.

Reserves for long-term care insurance contracts represent the Company’s estimate of the present value of future benefits and settlement costs to be paid to or on behalf of policyholders less the present value of future net premiums. The Company’s estimate of the present value of future benefits under such contracts is based upon mortality, morbidity, lapse and interest rate assumptions. On an annual basis, or more frequently if necessary, the Company reviews its mortality, morbidity and lapse assumptions against its experience. Annually, or each time the assumptions are changed, the net premium ratio used to calculate the future policy benefit liability is updated to reflect actual experience, as well as the impact of any change in assumptions on the Company’s future cash flows.

The Company discounts its future policy benefit liability using a curve of spot rates derived from Single A rated fixed income instruments. At each reporting date, the Company will measure its liability for future policy benefits using both the current spot rate curve and the locked-in discount rate at each cohort’s inception. Any difference between the measured liabilities is recorded in other comprehensive income (loss).

As of December 31, 2024, future policy benefits balances of $371 million and $4.2 billion were recorded in other insurance liabilities and other long-term insurance liabilities, respectively. As of December 31, 2023, future policy benefits balances of $393 million and $4.6 billion were recorded in other insurance liabilities and other long-term insurance liabilities, respectively.
Premium Deficiency Reserves

The Company evaluates its short-duration insurance contracts to determine if it is probable that a loss will be incurred. For purposes of determining premium deficiency losses, contracts are grouped consistent with the Company’s method of acquiring, servicing and measuring the profitability of such contracts. For each contract grouping, a premium deficiency reserve is recognized when it is probable that expected future incurred claims, including costs to maintain the contract grouping exceed anticipated future premiums and reinsurance recoveries. Anticipated investment income is not considered in the calculation of premium deficiency reserves. A premium deficiency is first recognized by charging any unamortized acquisition costs to operating expenses, and to the extent the premium deficiency is greater than the unamortized acquisition costs, a premium deficiency reserve liability is established and reflected in health care costs payable on the consolidated balance sheets. Losses recognized as a premium deficiency reserve result in a beneficial effect in subsequent periods as subsequent costs under these contracts are then charged to this previously established liability.

During the third quarter of 2024, the Company determined it had a premium deficiency in its Medicare product line related to the 2024 coverage year and, accordingly, recorded a premium deficiency reserve of $766 million. The premium deficiency reserve consisted of a $383 million write-off of unamortized acquisition costs, which was recorded in operating expenses, and $383 million recorded in health care costs which was subsequently utilized in the fourth quarter of 2024. The Company did not have any premium deficiency reserves related to its Medicare product line as of December 31, 2024.

Additionally, during the third quarter of 2024, the Company established a premium deficiency reserve of $270 million related to its individual exchange product line for the 2024 coverage year. The premium deficiency reserve consisted of an $11 million write-off of unamortized acquisition costs, which was recorded in operating expenses, and $259 million recorded in health care costs which was subsequently utilized in the fourth quarter of 2024. The Company did not have any premium deficiency reserves related to its individual exchange product line as of December 31, 2024.

The Company did not have any premium deficiency reserves as of December 31, 2024 or 2023.

Self-Insurance Liabilities

The Company is self-insured for certain losses related to general liability, workers’ compensation and auto liability. The Company obtains third party insurance coverage to limit exposure from these claims. The Company is also self-insured for certain losses related to health and medical liabilities. The Company’s self-insurance accruals, which include reported claims and claims incurred but not reported, are calculated using standard insurance industry actuarial assumptions and the Company’s historical claims experience. As of both December 31, 2024 and 2023, self-insurance liabilities totaled $1.1 billion and were recorded in accrued expenses and other current liabilities, as well as other long-term liabilities on the consolidated balance sheets.

Foreign Currency Translation and Transactions

For non-U.S. dollar functional currency locations, (i) assets and liabilities are translated at end-of-period exchange rates, (ii) revenues and expenses are translated at average exchange rates in effect during the period and (iii) equity is translated at historical exchange rates. The resulting cumulative translation adjustments are included as a component of accumulated other comprehensive loss.

For U.S. dollar functional currency locations, foreign currency assets and liabilities are remeasured into U.S. dollars at end-of-period exchange rates, except for nonmonetary balance sheet accounts which are remeasured at historical exchange rates. Revenues and expenses are remeasured at average exchange rates in effect during each period, except for those expenses related to the nonmonetary balance sheet amounts which are remeasured at historical exchange rates. Gains or losses from foreign currency remeasurement are included in net income.

Gains and losses from foreign currency transactions and the effects of foreign currency remeasurements were not material in the years ended December 31, 2024, 2023 or 2022.

Revenue Recognition

Health Care Benefits Segment
Health Care Benefits revenue is principally derived from insurance premiums and fees billed to customers. Revenue is recognized based on customer billings, which, in the Company’s Commercial business, reflect contracted rates per member and
the number of covered members recorded in the Company’s records at the time the billings are prepared. Billings are generally sent monthly for coverage during the following month. Revenue related to the Company’s Government business is collected monthly from the U.S. federal government and various government agencies based on fixed payment rates and member eligibility.

The Company’s billings may be subsequently adjusted to reflect enrollment changes due to member terminations or other factors. These adjustments are known as retroactivity adjustments. In each period, the Company estimates the amount of future retroactivity and adjusts the recorded revenue accordingly. As information regarding actual retroactivity amounts becomes known, the Company refines its estimates and records any required adjustments to revenues in the period in which they arise.

Premium Revenue
Premiums are recognized as revenue in the month in which the enrollee is entitled to receive health care services. Premiums are reported net of an allowance for estimated terminations and uncollectible amounts. Additionally, premium revenue subject to the minimum medical loss ratio (“MLR”) rebate requirements of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (as amended, collectively, the “ACA”) is recorded net of the estimated minimum MLR rebates for the current calendar year. Premiums related to unexpired contractual coverage periods (unearned premiums) are reported as other insurance liabilities on the consolidated balance sheets and recognized as revenue when earned.

Some of the Company’s contracts allow for premiums to be adjusted to reflect actual experience or the relative health status of Insured members. Such adjustments are reasonably estimable at the outset of the contract, and adjustments to those estimates are made based on actual experience of the customer emerging under the contract and the terms of the underlying contract.

The ACA established a permanent risk adjustment program to transfer funds from qualified individual and small group insurance plans with below average risk scores to plans with above average risk scores. Based on the risk of the Company’s qualified plan members relative to the average risk of members of other qualified plans in comparable markets, as defined by the ACA, the Company estimates its ultimate risk adjustment receivable (recorded in accounts receivable) or payable (recorded in accrued expenses and other current liabilities) for the current calendar year and reflects the pro-rata year-to-date impact as an adjustment to premium revenue.

Services Revenue
Services revenue relates to contracts that can include various combinations of services or series of services which generally are capable of being distinct and accounted for as separate performance obligations. The Health Care Benefits segment’s services revenue primarily consists of ASC fees received in exchange for performing certain claim processing and member services for ASC members. ASC fee revenue is recognized over the period the service is provided. Some of the Company’s administrative services contracts include guarantees with respect to certain functions, such as customer service response time, claim processing accuracy and claim processing turnaround time, as well as certain guarantees that a plan sponsor’s benefit claim experience will fall within a certain range. With any of these guarantees, the Company is financially at risk if the conditions of the arrangements are not met, although the maximum amount at risk typically is limited to a percentage of the fees otherwise payable to the Company by the customer involved. Each period the Company estimates its obligations under the terms of these guarantees and records its estimate as an offset to services revenues.

Accounting for Medicare Part D
Revenues include insurance premiums earned by the Company’s PDPs, which are determined based on the PDP’s annual bid and related contractual arrangements with CMS. The insurance premiums include a beneficiary premium, which is the responsibility of the PDP member, and can be subsidized by CMS in the case of low-income members, and a direct premium paid by CMS. Premiums collected in advance are initially recorded within other insurance liabilities and are then recognized ratably as revenue over the period in which members are entitled to receive benefits.

Revenues also include a risk-sharing feature of the Medicare Part D program design referred to as the risk corridor. The Company estimates variable consideration in the form of amounts payable to, or receivable from, CMS under the risk corridor, and adjusts revenue based on calculations of additional subsidies to be received from or owed to CMS at the end of the reporting year.

In addition to Medicare Part D premiums, the Company receives additional payments each month from CMS related to catastrophic reinsurance, low-income cost-sharing subsidies and coverage gap benefits. If the subsidies received differ from the amounts earned from actual prescriptions transferred, the difference is recorded in either accounts receivable, net or accrued expenses.
Health Services Segment

Pharmacy Services
The Health Services segment sells prescription drugs directly through its specialty and mail order pharmacy offerings and indirectly through the Company’s retail pharmacy network. The Company’s pharmacy benefit arrangements are accounted for in a manner consistent with a master supply arrangement as there are no contractual minimum volumes and each prescription is considered a separate purchasing decision and distinct performance obligation transferred at a point in time. PBM services performed in connection with each prescription claim are considered part of a single performance obligation which culminates in the fulfillment of prescription drugs.

The Company recognizes revenue using the gross method at the contract price negotiated with its clients when the Company has concluded it controls the prescription drug before it is transferred to the client plan members. The Company controls prescriptions fulfilled indirectly through its retail pharmacy network because it has separate contractual arrangements with those pharmacies, has discretion in setting the price for the transaction and assumes primary responsibility for fulfilling the promise to provide prescription drugs to its client plan members while also performing the related PBM services.

Revenues include (i) the portion of the price the client pays directly to the Company, net of any discounts earned on brand name drugs or other discounts and refunds paid back to the client (see “Drug Discounts” and “Guarantees” below), (ii) the price paid to the Company by client plan members for mail order prescriptions and the price paid to retail network pharmacies by client plan members for retail prescriptions (“retail co-payments”), and (iii) claims based administrative fees for retail pharmacy network contracts. Sales taxes are not included in revenues.

The Company recognizes revenue when control of the prescription drugs is transferred to customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those prescription drugs. The Company has established the following revenue recognition policies for the Health Services segment:

Revenues generated from prescription drugs sold by third party pharmacies in the Company’s retail pharmacy network and associated administrative fees are recognized at the Company’s point-of-sale, which is when the claim is adjudicated by the Company’s online claims processing system and the Company has transferred control of the prescription drug and completed all of its performance obligations.
Revenues generated from prescription drugs sold by specialty and mail order pharmacies are recognized when the prescription drug is delivered to the client plan member. At the time of delivery, the Company has performed substantially all of its performance obligations under its client contracts and does not experience a significant level of returns or reshipments.

For contracts under which the Company acts as an agent or does not control the prescription drugs prior to transfer to the client plan member, revenue is recognized using the net method.

Drug Discounts
The Company records revenue net of manufacturers’ rebates earned by its clients based on their plan members’ utilization of brand-name formulary drugs. The Company estimates these rebates at period-end based on actual and estimated claims data and its estimates of the manufacturers’ rebates earned by its clients. The estimates are based on the best available data at period-end and recent history for the various factors that can affect the amount of rebates due to the client. The Company adjusts its rebates payable to clients to the actual amounts paid when these rebates are paid or as significant events occur. Any cumulative effect of these adjustments is recorded against revenues at the time it is identified. Adjustments generally result from contract changes with clients or manufacturers that have retroactive rebate adjustments, differences between the estimated and actual product mix subject to rebates, or whether the brand name drug was included in the applicable formulary. The effect of adjustments between estimated and actual manufacturers’ rebate amounts has not been material to the Company’s operating results or financial condition.

Guarantees
The Company also adjusts revenues for refunds owed to clients resulting from pricing guarantees and performance against defined service and performance metrics. The inputs to these estimates are not subject to a high degree of subjectivity or volatility. The effect of adjustments between estimated and actual pricing and performance refund amounts has not been material to the Company’s operating results or financial condition.
Walk-In Medical Clinics
For services provided by the Company’s walk-in medical clinics, revenue recognition occurs for completed services provided to patients, with adjustments taken for third party payor contractual obligations and patient direct bill historical collection rates.

Primary Care Capitated Revenue
Capitated revenue related to the Company’s primary care operations consists primarily of capitated fees for medical services it provides under capitated or capitation arrangements directly made with various Medicare Advantage managed care payors or CMS. Under the risk contracts, the Company receives from the third-party payor a fixed payment per patient per month for a defined patient population, and the Company is then responsible for providing, managing and paying for healthcare services for that patient population, including those not provided by the Company. The Company recognizes revenue using the gross method as the Company is the principal in arranging, providing and controlling the managed healthcare services provided to the defined patient population. The Company considers all contracts with customers (enrolled patients) as a single performance obligation to stand ready to provide healthcare services. This performance obligation is satisfied over time as the Company stands ready to fulfill its obligation to enrolled patients.

In-Home Health Evaluations (“IHEs”)
Revenue generated from IHEs relates to the assessments performed either within the patient’s home, virtually or at a healthcare provider facility as well as certain in-home clinical evaluations performed by the Company’s mobile network of providers. Revenue is recognized when the IHEs are submitted to customers on a daily basis. Submission to the customer occurs after the IHEs are completed and coded, a process which may take one to several days after completion of the evaluation. The pricing for the IHEs is generally based on a fixed transaction fee, which is directly linked to the usage of the service by the customer during a distinct service period. Customers are invoiced for evaluations performed each month and remit payment accordingly. Each IHE represents a single performance obligation for which revenue is recognized at a point in time when control is transferred to the customer upon submission of the completed and coded evaluation.

Pharmacy & Consumer Wellness Segment

Retail Pharmacy
The Company’s retail drugstores recognize revenue at the time the customer takes possession of the merchandise. For pharmacy sales, each prescription claim is its own arrangement with the customer and is a performance obligation, separate and distinct from other prescription claims under other retail network arrangements. Revenues are adjusted for refunds owed to third party payers resulting from pricing guarantees and performance against defined value-based service and performance metrics. The inputs to these estimates are not subject to a high degree of subjectivity or volatility. The effect of adjustments between estimated and actual pricing and performance refund amounts has not been material to the Company’s operating results or financial condition.

Revenue from Company gift cards purchased by customers is deferred as a contract liability until goods or services are transferred. Any amounts not expected to be redeemed by customers (i.e., breakage) are recognized based on historical redemption patterns.

Customer returns are not material to the Company’s operating results or financial condition. Sales taxes are not included in revenues.

Loyalty and Other Programs
The Company’s customer loyalty program, ExtraCare®, consists of two components, ExtraSavingsTM and ExtraBucks® Rewards. ExtraSavings are coupons that are recorded as a reduction of revenue when redeemed as the Company concluded that they do not represent a promise to the customer to deliver additional goods or services at the time of issuance because they are not tied to a specific transaction or spending level.

ExtraBucks Rewards are accumulated by customers based on their historical spending levels. Thus, the Company has determined that there is an additional performance obligation to those customers at the time of the initial transaction. The Company allocates the transaction price to the initial transaction and the ExtraBucks Rewards transaction based upon the relative standalone selling price, which considers historical redemption patterns for the rewards. Revenue allocated to ExtraBucks Rewards is recognized as those rewards are redeemed. At the end of each period, unredeemed ExtraBucks Rewards are reflected as a contract liability.

The Company also offers a subscription-based membership program, ExtraCare PlusTM, under which members are entitled to a suite of benefits delivered over the course of the subscription period, as well as a promotional reward that can be redeemed for
future goods and services. Subscriptions are paid for on a monthly or annual basis at the time of or in advance of the Company delivering the goods and services. Revenue from these arrangements is recognized as the performance obligations are satisfied.

Long-term Care
Revenue is recognized when control of the promised goods or services is transferred to customers in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those goods or services. Each prescription claim represents a separate performance obligation of the Company, separate and distinct from other prescription claims under customer arrangements. A significant portion of long-term care revenue from sales of pharmaceutical and medical products is reimbursed by the federal Medicare Part D program and, to a lesser extent, state Medicaid programs. The Company monitors its revenues and receivables from these reimbursement sources, as well as long-term care facilities and other third-party insurance payors, and reduces revenue at the revenue recognition date to properly account for the variable consideration due to anticipated differences between billed and reimbursed amounts. Accordingly, the total revenues and receivables reported in the Company’s consolidated financial statements are recorded at the amount expected to be ultimately received from these payors.

Patient co-payments associated with Medicare Part D, certain state Medicaid programs, Medicare Part B and certain third-party payors typically are not collected at the time products are delivered or services are rendered, but are billed to the individuals as part of normal billing procedures and subject to normal accounts receivable collections procedures.
Disaggregation of Revenue
The following table disaggregates the Company’s revenue by major source in each segment for the years ended December 31, 2024, 2023 and 2022:
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
2024
Major goods/services lines:
Pharmacy$— $162,527 $100,687 $— $(52,942)$210,272 
Front Store— — 21,522 — — 21,522 
Premiums122,849 — — 47 — 122,896 
Net investment income
1,473 285 — 395 — 2,153 
Other6,343 10,793 2,291 (3,470)15,966 
Total$130,665 $173,605 $124,500 $451 $(56,412)$372,809 
Health Services distribution channel:
Pharmacy network (1)
$91,650 
Mail & specialty (2)
70,877 
Net investment income
285 
Other10,793 
Total$173,605 
2023
Major goods/services lines:
Pharmacy$— $180,710 $92,111 $— $(49,369)$223,452 
Front Store— — 22,458 — — 22,458 
Premiums99,144 — — 48 — 99,192 
Net investment income (loss)765 (1)(5)394 — 1,153 
Other5,737 6,134 2,199 (2,558)11,521 
Total$105,646 $186,843 $116,763 $451 $(51,927)$357,776 
Health Services distribution channel:
Pharmacy network (1)
$112,718 
Mail & specialty (2)
67,992 
Net investment income (loss)
(1)
Other6,134 
Total$186,843 
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
2022
Major goods/services lines:
Pharmacy$— $166,793 $83,480 $— $(45,154)$205,119 
Front Store— — 22,780 — — 22,780 
Premiums85,274 — — 56 — 85,330 
Net investment income (loss)
476 — (44)406 — 838 
Other5,600 2,783 2,380 68 (2,431)8,400 
Total$91,350 $169,576 $108,596 $530 $(47,585)$322,467 
Health Services distribution channel:
Pharmacy network (1)
$102,968 
Mail & specialty (2)
63,825 
Other2,783 
Total$169,576 
_____________________________________________
(1)Health Services pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, as well as activity associated with Maintenance Choice®, which permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS pharmacy retail store for the same price as mail order.
(2)Health Services mail & specialty is defined as specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as mail order and specialty claims fulfilled by the Pharmacy & Consumer Wellness segment.

Contract Balances
Contract liabilities primarily represent the Company’s obligation to transfer additional goods or services to a customer for which the Company has received consideration, and include ExtraBucks Rewards and unredeemed Company gift cards. The consideration received remains a contract liability until goods or services have been provided to the customer. In addition, the Company recognizes breakage on Company gift cards based on historical redemption patterns.

The following table provides information about receivables and contract liabilities from contracts with customers as of December 31, 2024 and 2023:
In millions20242023
Trade receivables (included in accounts receivable, net)$9,881 $11,908 
Contract liabilities (included in accrued expenses and other current liabilities)
144 149 

Cost of Products Sold

The Company accounts for cost of products sold as follows:

Health Services Segment
Cost of products sold includes: (i) the cost of prescription drugs sold during the reporting period directly through the Company’s specialty and mail order pharmacies and indirectly through the Company’s retail pharmacy network, (ii) the cost of care provided within the Company’s primary care centers, (iii) direct operating costs associated with generating revenues related to services provided, including fees paid to clinicians for performing IHEs, (iv) administrative service fees paid to the Pharmacy & Consumer Wellness segment for specialty and mail order pharmacy fulfillment services and (v) shipping and handling costs.

The cost of prescription drugs sold component of cost of products sold includes: (i) the cost of the prescription drugs purchased from manufacturers or distributors and shipped to members in clients’ benefit plans from the Company’s mail order pharmacies, net of any volume-related or other discounts (see “Vendor Allowances and Purchase Discounts” below) and (ii) the cost of prescription drugs sold (including retail co-payments) through the Company’s retail pharmacy network under contracts where the Company is the principal, net of any volume-related or other discounts.
The cost of care provided within the Company’s costs of products sold includes the costs incurred to operate the primary care centers and care model. These costs consist of care team and patient support employee-related costs, occupancy costs, patient transportation, medical supplies, insurance, fees paid to specialists and other operating costs.

Pharmacy & Consumer Wellness Segment
Cost of products sold includes: the cost of merchandise sold during the reporting period, including the costs of prescription drugs sold through its retail pharmacies, net of any volume-related or other discounts, the related purchasing costs, warehousing and delivery costs (including depreciation and amortization), the operating costs of the Company’s specialty and mail order pharmacy fulfillment operations and inventory losses.

Vendor Allowances and Purchase Discounts

The Company accounts for vendor allowances and purchase discounts as follows:

Health Services Segment
The Health Services segment receives purchase discounts on pharmaceutical products purchased. Contractual arrangements with vendors, including manufacturers, wholesalers and retail pharmacies, normally provide for the Health Services segment to receive purchase discounts from established list prices in one, or a combination, of the following forms: (i) a direct discount at the time of purchase, (ii) a discount for the prompt payment of invoices or (iii) when products are purchased indirectly from a manufacturer (e.g., through a wholesaler or retail pharmacy), a discount (or rebate) paid subsequent to dispensing. These rebates are recognized when prescriptions are dispensed and are generally calculated and billed to manufacturers within 30 days of the end of each completed quarter. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected has not been material to the Company’s operating results or financial condition. The Company accounts for the effect of any such differences as a change in accounting estimate in the period the reconciliation is completed. The Health Services segment also receives additional discounts under its wholesaler contracts if it exceeds contractually defined purchase volumes. In addition, the Health Services segment receives fees from pharmaceutical manufacturers for administrative services. Purchase discounts and administrative service fees are recorded as a reduction of cost of products sold.

Pharmacy & Consumer Wellness Segment
Vendor allowances received by the Pharmacy & Consumer Wellness segment reduce the carrying cost of inventory and are recognized in cost of products sold when the related inventory is sold, unless they are specifically identified as a reimbursement of incremental costs for promotional programs and/or other services provided. Amounts that are directly linked to advertising commitments are recognized as a reduction of advertising expense (included in operating expenses) when the related advertising commitment is satisfied. Any amounts received in excess of the actual cost incurred also reduce the carrying cost of inventory. The total value of any upfront payments received from vendors that are linked to purchase commitments is initially deferred. The deferred amounts are then amortized to reduce cost of products sold over the life of the contract based upon sales volume. The total value of any upfront payments received from vendors that are not linked to purchase commitments is also initially deferred. The deferred amounts are then amortized to reduce cost of products sold on a straight-line basis over the life of the related contract. The total amortization of these upfront payments was not material to the Company’s consolidated financial statements in any of the periods presented.

Advertising Costs

Advertising costs, which are reduced by the portion funded by vendors, are expensed when the related advertising takes place. Net advertising costs, which are included in operating expenses, were $989 million, $985 million and $745 million in 2024, 2023 and 2022, respectively.

Stock-Based Compensation

Stock-based compensation is measured at the grant date based on the fair value of the award and is recognized as expense over the requisite service period of the stock award (generally three to five years) using the straight-line method.

Income Taxes

The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements. Under this method, deferred tax assets and liabilities are determined on the basis of the differences between the
consolidated financial statements and tax basis of assets and liabilities using enacted tax rates in effect for the year or years in which the differences are expected to reverse. The effect of a change in the tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date of such change.

The Company recognizes deferred tax assets to the extent that it believes these assets are more likely than not to be realized. In making such a determination, the Company considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies, and the Company’s recent operating results. The Company establishes a valuation allowance when it does not consider it more likely than not that a deferred tax asset will be recovered.

The Company records uncertain tax positions on the basis of a two-step process whereby (1) the Company determines whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition threshold, the Company recognizes the largest amount of tax benefit that is more than 50% likely to be realized upon ultimate settlement with the related tax authority.

Interest and/or penalties related to uncertain tax positions are recognized in the income tax provision.

Measurement of Defined Benefit Pension and Other Postretirement Employee Benefit Plans

The Company sponsors defined benefit pension plans (“pension plans”) and other postretirement employee benefit plans (“OPEB plans”) for its employees and retirees. The Company recognizes the funded status of its pension and OPEB plans on the consolidated balance sheets based on the year-end measurements of plan assets and benefit obligations. When the fair value of plan assets are in excess of the plan benefit obligations, the amounts are reported in other current assets and other assets. When the fair value of plan benefit obligations are in excess of plan assets, the amounts are reported in accrued expenses and other current liabilities and other long-term liabilities based on the amount by which the actuarial present value of benefits payable in the next twelve months included in the benefit obligation exceeds the fair value of plan assets. The net periodic benefit income for the Company’s pension and OPEB plans do not contain a service cost component as these plans have been frozen for an extended period of time. Non-service cost components of pension and postretirement net periodic benefit income are included in other income in the consolidated statements of operations.

Earnings per Share

Earnings per share is computed using the treasury stock method. The Company calculates basic earnings per share based on the weighted average number of common shares outstanding for the period. See Note 16 ‘‘Earnings Per Share’’ for additional information.

Shares Held in Trust

The Company maintains grantor trusts, which held approximately one million shares of its common stock at both December 31, 2024 and 2023. These shares are designated for use under various employee compensation plans. Since the Company holds these shares, they are excluded from the computation of basic and diluted shares outstanding.

VIEs

The Company has various investments that are considered VIEs. The Company does not have a future obligation to fund losses or debts on behalf of these investments; however, it may voluntarily contribute funds. In evaluating whether the Company is the primary beneficiary of a VIE, the Company considers several factors, including whether the Company has (a) the power to direct the activities that most significantly impact the VIE’s economic performance and (b) the obligation to absorb losses and the right to receive benefits that could potentially be significant to the VIE.

VIEs - Primary Beneficiary

Red Oak Sourcing, LLC (“Red Oak”)
In 2014, the Company and Cardinal Health, Inc. (“Cardinal”) established Red Oak, a generic pharmaceutical sourcing entity in which the Company and Cardinal each own 50%. The Red Oak arrangement had an initial term of ten years. In 2021, the Red Oak arrangement was amended to extend the initial term an additional five years, for a total term of 15 years. Under this arrangement, the Company and Cardinal contributed their sourcing and supply chain expertise to Red Oak and agreed to source and negotiate generic pharmaceutical supply contracts for both companies through Red Oak; however, Red Oak does not own
or hold inventory on behalf of either company. No physical assets (e.g., property and equipment) were contributed to Red Oak by either company, and minimal funding was provided to capitalize Red Oak. The Company has determined that it is the primary beneficiary of this VIE because it has the ability to direct the activities of Red Oak. Consequently, the Company consolidates Red Oak in its consolidated financial statements within the Pharmacy & Consumer Wellness segment.

Cardinal is required to pay the Company quarterly payments, which began in October 2014 and will extend through June 2029. The Company received $126 million from Cardinal during the year ended December 31, 2024 and $183 million from Cardinal during each of the years ended December 31, 2023 and 2022. The payments reduce the Company’s carrying value of inventory and are recognized in cost of products sold when the related inventory is sold.

Physician Groups
The Company has entered into management and/or administrative services agreements with affiliated physician practice organizations (the “Physician Groups”). Physician Groups employ healthcare providers, contract with managed care payors and deliver healthcare services to patients in the markets that the Company serves. Oak Street Health, MSO LLC (“OSH MSO”), a wholly owned subsidiary of the Company, provides management services to the Physician Groups. Activities include but are not limited to operational support of the centers, marketing, information technology infrastructure and the sourcing and managing of health plan contracts. The Company concluded that it has variable interests in the Physician Groups on the basis of its administrative service agreement, which includes the reimbursement of costs and a management fee payable to the Company from the Physician Groups for the management services provided, which are eliminated in consolidation. The Physician Groups are considered VIEs as additional support is needed to finance their operations. Neither shareholders, employees nor their designees have the individual power to direct the activities of the Physician Groups that significantly impact its economic performance. The success or failure of OSH MSO in performing the activities impacting the growth of patients and management of healthcare services of the Physicians Groups’ patient base is significant to the economic performance of the Physician Groups. Therefore, the Company is the primary beneficiary of the Physician Groups and, consequently, consolidates the Physician Groups in its consolidated financial statements within the Health Services segment.

Physician Groups VIE assets and liabilities included on the consolidated balance sheet at December 31, 2024 and 2023 were as follows:

In millions
2024
2023
Total assets$2,144 $1,515 
Total liabilities2,104 1,503 
There are no restrictions on the Physician Groups’ assets or on the settlement of its liabilities. The assets of the Physician Groups are all current and can be used to settle obligations of the Company. The Physician Groups are included in the Company’s obligated group; thus, creditors of the Company have recourse to the assets owned by the Physician Groups. There are no liabilities for which creditors of the Physician Groups do not have recourse to the general credit of the Company. There are no restrictions placed on the retained earnings or net income of the Physician Groups with respect to potential dividend payments.

Physician Owned Entities
The Company’s consolidated VIEs include certain IHE related physician practices that require an individual physician to legally own the equity interests as certain state laws and regulations prohibit non-physician owned business entities from practicing medicine or employing licensed healthcare providers. The Company determined it was the primary beneficiary of these VIEs as it has the obligation to absorb the losses from and direct the activities of these operations. As a result, these VIEs are consolidated and any noncontrolling interest is not presented. The carrying amount of these VIEs’ assets and liabilities are not material to the consolidated balance sheets.

Accountable Care Organizations (“ACOs”)
The Company is the sole member of certain ACOs which are considered VIEs. CMS administers these programs where the goal of the program is to reward the ACO participants when specific quality metrics, established by the U.S. Department of Health and Human Services (“HHS”), are met and expenditures are lowered. These ACOs have a risk model such that the ACOs can either share in both savings and losses or share in only the savings. The governance structure of the VIEs does not provide the Company with the ultimate decision-making authority to direct the activities that most significantly impact the VIEs’ economic performance. For certain ACO VIEs, the Company is ultimately liable for losses incurred or is required to secure and have sole authority over all aspects of the repayment of any shared losses incurred in the program in exchange for a higher percentage of savings and, accordingly, the Company is taking on the risk to absorb losses, resulting in a financial responsibility to ensure that
these VIEs operate as designed. For these VIEs, the Company has determined it is the primary beneficiary and therefore consolidates the results of these ACOs. The carrying amount of these VIEs’ assets and liabilities are not material to the consolidated balance sheets.

VIEs - Other Variable Interest Holder
The Company has invested in certain VIEs for which it has determined that it is not the primary beneficiary, consisting of the following:

Hedge fund and private equity investments - The Company invests in hedge fund and private equity investments in order to generate investment returns for its investment portfolio supporting its insurance businesses.
Real estate partnerships - The Company invests in various real estate partnerships, including those that construct, own and manage low-income housing developments. For the low-income housing development investments, substantially all of the projected benefits to the Company are from tax credits and other tax benefits.

The Company is not the primary beneficiary of these VIEs because the nature of the Company’s involvement with the activities of these VIEs does not give the Company the power to direct the activities that most significantly impact their economic performance. The Company records the amount of its investment in these VIEs as long-term investments on the consolidated balance sheets and recognizes its share of each VIE’s income or losses in net income. The Company’s maximum exposure to loss from these VIEs is limited to its investment balances as disclosed below and the risk of recapture of previously recognized tax credits related to the real estate partnerships, which the Company does not consider significant.

Other variable interest holder VIE assets included in long-term investments on the consolidated balance sheets at December 31, 2024 and 2023 were as follows:
In millions20242023
Hedge fund investments$1,246 $859 
Private equity investments934 840 
Real estate partnerships438 319 
Total$2,618 $2,018 

Related Party Transactions

During the year ended December 31, 2022, the Company made charitable contributions of $25 million to the CVS Health Foundation, a non-profit entity that focuses on health, education and community involvement programs. The charitable contributions were recorded as operating expenses in the consolidated statements of operations within the Corporate/Other segment for the year ended December 31, 2022. The Company did not make any charitable contributions to the CVS Health Foundation during the years ended December 31, 2024 or 2023.

Discontinued Operations

In connection with certain business dispositions completed between 1995 and 1997, the Company retained guarantees on store lease obligations for a number of former subsidiaries, including Linens ‘n Things and Bob’s Stores, each of which subsequently filed for bankruptcy. The Company’s loss from discontinued operations includes lease-related costs that the Company believes it will likely be required to satisfy pursuant to these lease guarantees. See “Lease Guarantees” in Note 18 ‘‘Commitments and Contingencies’’ for additional information.

Results from discontinued operations were immaterial for the years ended December 31, 2024, 2023 and 2022.

New Accounting Pronouncements Recently Adopted

Segment Reporting
In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This standard requires the Company to disclose significant segment expenses that are regularly provided to the Chief Operating Decision Maker (“CODM”) and are included within each reported measure of segment operating results. The standard also requires the Company to disclose the total amount of any other items included in segment operating results which were not deemed to be significant expenses for separate disclosure, along with a qualitative description of the composition of these other items. In
addition, the standard also requires disclosure of the CODM’s title and position, as well as detail on how the CODM uses the reported measure of segment operating results to evaluate segment performance and allocate resources. The standard also aligns interim segment reporting disclosure requirements with annual segment reporting disclosure requirements. The Company adopted the standard on January 1, 2024 for fiscal year reporting and the standard became effective for interim reporting periods in fiscal years beginning after December 15, 2024. The standard requires retrospective application to all prior periods presented. While the standard requires additional disclosures related to the Company’s reportable segments, the standard did not have any impact on the Company’s consolidated operating results, financial condition or cash flows as of the date of adoption. Refer to Note 19 ‘‘Segment Reporting’’ for the Company’s segment reporting disclosures, including those newly required by this standard.

New Accounting Pronouncements Not Yet Adopted

Income Taxes
In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. The standard requires the Company to provide further disaggregated income tax disclosures for specific categories on the effective tax rate reconciliation, as well as additional information about federal, state/local and foreign income taxes. The standard also requires the Company to annually disclose its income taxes paid (net of refunds received), disaggregated by jurisdiction. The Company adopted the standard on January 1, 2025 for fiscal year reporting. The standard is to be applied on a prospective basis, although optional retrospective application is permitted. While the standard requires additional disclosures related to the Company’s income taxes, the standard did not have any impact on the Company’s consolidated operating results, financial condition or cash flows.

Disaggregation of Income Statement Expenses
In November 2024, the FASB issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. The standard requires the Company to provide further disaggregated information of relevant expense captions within its consolidated statements of operations, including the purchases of inventory, employee compensation, depreciation and intangible asset amortization, as well as the inclusion of other specific expenses, gains and losses required by existing GAAP. The new standard also requires the Company to disclose its total selling expenses and, on an annual basis, provide a qualitative description of its selling expenses. The standard is effective for fiscal years beginning after December 15, 2026 and interim periods within fiscal years beginning after December 15, 2027, with early adoption permitted. The standard may be applied prospectively or retrospectively. While the standard will require additional disclosures related to certain expenses included in the consolidated statements of operations, the standard is not expected to have any impact on the Company’s consolidated operating results, financial condition or cash flows.
v3.25.0.1
Acquisitions, Divestitures and Asset Sales
12 Months Ended
Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Acquisitions, Divestitures and Asset Sales Acquisitions, Divestitures and Asset Sales
Oak Street Health Acquisition

On May 2, 2023 (the “Oak Street Health Acquisition Date”), the Company acquired 100% of the outstanding shares and voting interest of Oak Street Health for cash (“Oak Street Health Acquisition”). Under the terms of the merger agreement, Oak Street Health stockholders received $39.00 per share in cash. The Company financed the transaction with borrowings of $5.0 billion from a term loan agreement entered into on May 1, 2023 as described in Note 10 ‘‘Borrowings and Credit Agreements’’ and cash on hand. Oak Street Health is a leading multi-payor, senior focused value-based primary care company. Oak Street Health is included within the Health Services segment. The Company acquired Oak Street Health to advance its value-based care strategy and broaden its platform into primary care.

The fair value of the consideration transferred on the date of acquisition consisted of the following:
In millions
Cash$9,579 
Fair value of replacement equity awards for pre-combination services (3.9 million shares) (1)
118 
Effective settlement of pre-existing relationship (2)
(29)
Total consideration transferred$9,668 
_____________________________________________
(1)The fair value of the replacement equity awards issued by the Company was determined as of the Oak Street Health Acquisition Date. The fair value of the awards attributed to pre-combination services of $118 million is included in the consideration transferred and the fair value of the awards attributed to post-combination services of $165 million has been, or will be, included in the Company’s post-combination financial statements as compensation costs.
(2)The purchase price included $29 million of effectively settled liabilities the Company owed to Oak Street Health from their pre-existing relationship.
The transaction has been accounted for using the acquisition method of accounting which requires, among other things, the assets acquired and liabilities assumed to be recognized at their fair values at the date of acquisition. The following table summarizes the fair values of the assets acquired and liabilities assumed at the date of acquisition:
In millions
Cash and cash equivalents$201 
Investments168 
Accounts receivable1,143 
Other current assets46 
Property and equipment180 
Operating lease right-of-use assets316 
Goodwill7,213 
Intangible assets4,233 
Other long-term assets
Total assets acquired13,507 
Health care costs payable 1,098 
Other current liabilities444 
Operating lease liabilities (current and long-term)378 
Debt (current and long-term)1,028 
Deferred income taxes796 
Other long-term liabilities 29 
Total liabilities assumed3,773 
Noncontrolling interests66 
Total consideration transferred$9,668 

The Company’s assessment of fair value of assets acquired and liabilities assumed was finalized during the second quarter of 2024. There were no measurement period adjustments to assets acquired and liabilities assumed during the year ended December 31, 2024.

Goodwill
Goodwill represents future economic benefits expected to arise from the Company’s expanded presence in the health services industry, the assembled workforce acquired, expected revenue and medical cost synergies, as well as operating efficiencies and cost savings. Goodwill was allocated to the Company’s business segments as follows:
In millions
Health Services$6,936 
Pharmacy & Consumer Wellness156 
Health Care Benefits121 
Total goodwill$7,213 

The amount of goodwill deductible for income tax purposes was not material.

Intangible Assets
The following table summarizes the fair values and weighted average useful lives for intangible assets acquired in the Oak Street Health Acquisition:
In millions, except weighted average useful lifeGross
Fair Value
Weighted
Average Useful
Life (years)
Customer relationships (1)
$3,620 19.9
Technology143 3.0
Trademark (definite-lived)470 8.0
Total intangible assets$4,233 18.0
_____________________________________________
(1) The substantial majority of the customer relationships intangible asset relates to relationships with health plan payors.
Deferred Income Taxes
The purchase price allocation includes net deferred tax liabilities of $796 million, primarily related to deferred tax liabilities established on the identifiable acquired intangible assets.

Consolidated Results of Operations
During the period from the Oak Street Health Acquisition Date through December 31, 2023, the Company’s consolidated results of operations included $2.1 billion of revenues and $520 million of operating losses, including $193 million of intangible asset amortization and $71 million of stock-based compensation, associated with the results of operations of Oak Street Health.

During the year ended December 31, 2023, the Company incurred transaction costs of $77 million associated with the Oak Street Health Acquisition, which were recorded in operating expenses.

Signify Health Acquisition

On March 29, 2023 (the “Signify Health Acquisition Date”), the Company acquired 100% of the outstanding shares and voting interest of Signify Health for cash (“Signify Health Acquisition”). Under the terms of the merger agreement, Signify Health stockholders received $30.50 per share in cash. The Company financed the transaction with cash on hand, which included approximately $6 billion of proceeds from the issuance of senior unsecured notes in February 2023. Signify Health is a leader in health risk assessments, value-based care and provider enablement services. Signify Health is included within the Health Services segment. The Company acquired Signify Health to advance its health care services strategy, growth in value-based care and new product offerings for other payers.

The fair value of the consideration transferred on the date of acquisition consisted of the following:
In millions
Cash$7,450 
Fair value of replacement equity awards for pre-combination services (3.2 million shares) (1)
14 
Effective settlement of pre-existing relationship (2)
(111)
Total consideration transferred$7,353 
_____________________________________________
(1)The fair value of the replacement equity awards issued by the Company was determined as of the Signify Health Acquisition Date. The fair value of the awards attributed to pre-combination services of $14 million is included in the consideration transferred and the fair value of the awards attributed to post-combination services of $167 million has been, or will be, included in the Company’s post-combination financial statements as compensation costs.
(2)The purchase price included $111 million of effectively settled liabilities the Company owed to Signify Health from their pre-existing relationship.
The transaction has been accounted for using the acquisition method of accounting which requires, among other things, the assets acquired and liabilities assumed to be recognized at their fair values at the date of acquisition. The following table summarizes the fair values of the assets acquired and liabilities assumed at the date of acquisition:
In millions
Cash and cash equivalents$376 
Accounts receivable190 
Other current assets (including restricted cash of $28)
147 
Property and equipment25 
Goodwill5,909 
Intangible assets1,920 
Other long-term assets23 
Total assets acquired8,590 
Other current liabilities606 
Debt (current and long-term)346 
Deferred income taxes259 
Other long-term liabilities 26 
Total liabilities assumed1,237 
Total consideration transferred$7,353 

The Company’s assessment of the fair value of assets acquired and liabilities assumed was finalized during the fourth quarter of 2023. Measurement period adjustments to assets acquired and liabilities assumed during the year ended December 31, 2023 were not material.

Goodwill
Goodwill represents future economic benefits expected to arise from the Company’s expanded presence in the health services industry, the assembled workforce acquired, expected revenue and medical cost synergies, as well as operating efficiencies and cost savings. Goodwill was allocated to the Company’s business segments as follows:
In millions
Health Services$3,406 
Health Care Benefits2,473 
Pharmacy & Consumer Wellness30 
Total goodwill$5,909 

Approximately $1.7 billion of goodwill is deductible for income tax purposes.

Intangible Assets
The following table summarizes the fair values and weighted average useful lives for intangible assets acquired in the Signify Health Acquisition:
In millions, except weighted average useful lifeGross
Fair Value
Weighted
Average Useful
Life (years)
Customer relationships$1,810 16.7
Technology 50 3.0
Trademark (definite-lived)60 5.0
Total intangible assets$1,920 16.0

Deferred Income Taxes
The purchase price allocation includes net deferred tax liabilities of $259 million, primarily related to deferred tax liabilities established on the identifiable acquired intangible assets.

Consolidated Results of Operations
During the period from the Signify Health Acquisition Date through December 31, 2023, the Company’s consolidated results of operations included $797 million of revenues and $123 million of operating income, including $106 million of intangible asset amortization and $72 million of stock-based compensation, associated with the results of operations of Signify Health.
During the year ended December 31, 2023, the Company incurred transaction costs of $37 million associated with the Signify Health Acquisition, which were recorded in operating expenses.

Assets Held For Sale

The Company continually evaluates its portfolio for non-strategic assets. The Company determined that its Omnicare® long-term care business (“LTC business”), which is included within the Pharmacy & Consumer Wellness segment, was no longer a strategic asset and during the third quarter of 2022 committed to a plan to sell the LTC business. At that time, the LTC business met the criteria to be classified as held for sale.

During 2022, the carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell. Accordingly, the Company recorded total losses on assets held for sale of $2.5 billion during the year ended December 31, 2022. During the first quarter of 2023, an incremental loss on assets held for sale of $349 million was recorded to write-down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflects its estimated fair value less costs to sell. The loss on assets held for sale represents the write-down of long-lived assets and was recorded in the Company’s consolidated statement of operations within the Pharmacy & Consumer Wellness segment. During the third quarter of 2023, the Company determined it was no longer probable that a sale would be completed in the near term. At that time, the Company concluded that the LTC business no longer met the criteria to be classified as held for sale and, accordingly, the assets and liabilities associated with this business were reclassified to held and used at their respective fair values on the consolidated balance sheet.

Divestiture of bswift

In November 2022, the Company sold its wholly-owned subsidiary bswift LLC (“bswift”) for approximately $735 million. bswift offers software and services that streamline benefits and human resource administration. The results of this business have historically been recorded within the Health Care Benefits segment. The Company recorded a pre-tax gain on the divestiture of $250 million in the year ended December 31, 2022, which was reflected as a reduction of operating expenses in the Company’s consolidated statement of operations within the Health Care Benefits segment.

Divestiture of PayFlex

In June 2022, the Company sold PayFlex for approximately $775 million. PayFlex provides services to employers, their employees, and their former employees in the areas of tax-advantaged account reimbursement administration (flexible spending, health reimbursement, health savings, transit and parking), Consolidated Omnibus Budget Reconciliation Act administration and special-member billing administration. The results of this business have historically been reported within the Health Care Benefits segment. The Company recorded a pre-tax gain on the divestiture of $225 million in the year ended December 31, 2022, which was reflected as a reduction of operating expenses in the Company’s consolidated statement of operations within the Health Care Benefits segment.

Divestiture of Thailand Health Care Business

In March 2022, the Company reached an agreement to sell its international health care business domiciled in Thailand (“Thailand business”), comprised of approximately 266,000 medical members, which was included in the Commercial Business reporting unit within the Health Care Benefits segment. At that time, a portion of the Commercial Business goodwill was specifically allocated to the Thailand business. The net assets of the Thailand business were accounted for as assets held for sale at March 31, 2022. The carrying value of the Thailand business was determined to be greater than its estimated fair value less costs to sell and, accordingly, the Company recorded a $41 million loss on assets held for sale within the Health Care Benefits segment during the first quarter of 2022. The sale of the Thailand business closed in the second quarter of 2022, and the consideration received and ultimate loss on the sale were not material.

International Health Care Benefits Renewal Rights Asset Sale

In May 2022, the Company sold the renewal rights of approximately 200,000 international medical members outside of the Americas, Thailand and India in connection with an Asset Purchase Agreement. As part of this agreement, the Company introduced and helped migrate these existing international medical members to the purchaser upon renewal. The migration process was completed during 2023. The Company ceased writing any new or renewal business for international medical
members outside of the Americas during the fourth quarter of 2022. The consideration received related to this agreement was not material.
v3.25.0.1
Restructuring
12 Months Ended
Dec. 31, 2024
Restructuring and Related Activities [Abstract]  
Restructuring Restructuring
2024 Restructuring Program

During the third quarter of 2024, the Company finalized an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs to partially offset the expected return of certain variable expenses in 2025. In connection with this restructuring plan, during 2024, the Company recorded pre-tax restructuring charges of approximately $1.2 billion, comprised of a $607 million store impairment charge, $293 million of costs associated with corporate workforce optimization, including severance and employee-related costs, a $10 million stock-based compensation charge associated with the impacted employees, which was reflected as an adjustment to common stock and capital surplus on the consolidated balance sheets, and $269 million of other asset impairments and related charges associated with the discontinuation of certain non-core assets.

Store impairment charge
The Company evaluates its retail store right-of-use and property and equipment assets for impairment at the retail store level, which is the lowest level at which cash flows can be identified. For retail stores where there is an indicator of impairment present, the Company first compares the carrying amount of the asset group to the estimated future cash flows associated with the asset group (undiscounted). If the estimated undiscounted future cash flows used in the analysis are less than the carrying amount of the asset group, an impairment loss calculation is prepared. The impairment loss calculation compares the carrying amount of the asset group to its estimated fair value which is the greater of the asset group’s estimated future cash flows (discounted), or the consideration of what a market participant would pay to lease the assets, net of leasing costs. The Company’s estimate of fair value considers historical results, current operating trends, consolidated sales, profitability and cash flow results and forecasts. For assets which the Company has determined it will be able to sublease, the estimated future cash flows include the estimated sublease income, net of estimated leasing costs. When the carrying value of an asset group exceeds its estimated fair value, an impairment loss is recorded to reduce the value of the asset group to its estimated fair value. As the impaired assets are measured at fair value on a nonrecurring basis primarily using unobservable inputs as of the measurement date, the assets are classified in Level 3 of the fair value hierarchy.

During the third quarter of 2024, in connection with its enterprise-wide restructuring plan, the Company completed a strategic review of its retail business, which included evaluating changes in population, consumer buying patterns and future health requirements to ensure continued alignment of its retail footprint with consumer needs. In connection with this initiative the Company determined it plans to close 271 retail stores in 2025. As a result, management determined that there were indicators of impairment with respect to the impacted stores’ asset groups, including the associated operating or financing lease right-of-use assets and property and equipment.

A long-lived asset impairment test was performed during the third quarter of 2024, the results of which indicated that the fair value of certain retail store asset groups was lower than their respective carrying values. Accordingly, at that time, the Company recorded a store impairment charge of $607 million, consisting of a write down of $483 million related to operating and financing lease right-of-use assets and $124 million related to property and equipment. The charge associated with the store impairments was included in the restructuring charges within the Pharmacy & Consumer Wellness segment. Subsequent to the impairment loss, the fair value of the associated operating and financing lease right-of-use assets and property and equipment were $100 million and $39 million, respectively.

Corporate workforce optimization costs
Corporate workforce optimization costs, including severance and employee-related costs, consist primarily of salary continuation benefits, prorated annual incentive compensation, continuation of health care benefits and outplacement services. Severance and employee-related benefits are determined pursuant to the Company’s written severance plans and are recognized when the benefits are determined to be probable of being paid and are reasonably estimable.

In connection with its enterprise-wide restructuring plan, the Company recorded corporate workforce optimization costs of $293 million, which were recorded in accrued expenses and other current liabilities on the consolidated balance sheet. The Company made payments of $88 million related to these costs during the year ended December 31, 2024. This restructuring plan is expected to be substantially complete by the end of 2025. The restructuring charge associated with the corporate workforce optimization costs is reflected within the Corporate/Other segment.
Other asset impairment charges
In connection with its enterprise-wide restructuring plan, the Company also conducted a review of its various strategic assets and determined that it would discontinue the use of certain non-core assets, including certain virtual care services and compounding infusion pharmacies and branches. As a result, management determined that there were indicators of impairment with respect to the impacted long-lived assets and a long-lived asset impairment test was performed during the third quarter of 2024. The results of the long-lived asset impairment test indicated that the respective fair values of certain impacted assets were lower than their respective carrying values and, accordingly, the Company recorded $269 million of other asset impairments and related charges associated with the discontinuation of these assets. The asset impairment charges were recorded as reductions to property and equipment, net and operating lease right-of-use assets on the consolidated balance sheet. The other asset impairment charges were included in the restructuring charges within the Corporate/ Other and Pharmacy & Consumer Wellness segments. Subsequent to the impairment charges, the fair value of the associated long-lived assets was not material.

2023 Restructuring Program

During the second quarter of 2023, the Company developed an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with the development of this plan and the completed acquisitions of Signify Health and Oak Street Health, the Company also conducted a strategic review of its various transformation initiatives and determined that it would terminate certain initiatives. In connection with the restructuring plan, during 2023, the Company recorded $507 million in pre-tax restructuring charges, comprised of $344 million of severance and employee-related costs associated with corporate workforce optimization, $152 million of asset impairment charges and an $11 million stock-based compensation charge associated with the impacted employees. These restructuring charges are reflected in the Corporate/Other segment. The severance and employee-related costs were recorded in accrued expenses and other current liabilities and the asset impairments were recorded as a reduction of property and equipment, net, while the stock-based compensation charge was reflected as an adjustment to common stock and capital surplus on the consolidated balance sheet.

Severance and employee-related costs consist primarily of salary continuation benefits, prorated annual incentive compensation, continuation of health care benefits and outplacement services. Severance and employee-related benefits are determined pursuant to the Company’s written severance plans and are recognized when the benefits are determined to be probable of being paid and are reasonably estimable. During the year ended December 31, 2023, the Company made payments of $194 million related to severance and employee-related costs associated with the 2023 restructuring program. During the year ended December 31, 2024, substantially all of the remaining liabilities were paid.
v3.25.0.1
Investments
12 Months Ended
Dec. 31, 2024
Investments [Abstract]  
Investments Investments
Total investments at December 31, 2024 and 2023 were as follows:
20242023
In millionsCurrentLong-termTotalCurrentLong-termTotal
Debt securities available for sale$2,256 $23,777 $26,033 $3,131 $18,582 $21,713 
Mortgage loans151 1,354 1,505 128 1,183 1,311 
Other investments— 3,803 3,803 — 3,254 3,254 
Total investments
$2,407 $28,934 $31,341 $3,259 $23,019 $26,278 

At December 31, 2024 and 2023, the Company held investments of $269 million and $307 million, respectively, related to the 2012 conversion of an existing group annuity contract from a participating to a non-participating contract. These investments are included in the total investments of large case pensions supporting non-experience-rated products. Although these investments are not accounted for as Separate Accounts assets, they are legally segregated and are not subject to claims that arise out of the Company’s business and only support future policy benefits obligations under that group annuity contract.

Debt Securities

Debt securities available for sale at December 31, 2024 and 2023 were as follows:
In millions
Amortized
 Cost (1)
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
December 31, 2024   
Debt securities:   
U.S. government securities$2,826 $$(38)$2,795 
States, municipalities and political subdivisions712 (18)698 
U.S. corporate securities13,043 94 (412)12,725 
Foreign securities2,608 27 (111)2,524 
Residential mortgage-backed securities792 (54)740 
Commercial mortgage-backed securities1,731 (67)1,673 
Other asset-backed securities4,834 35 (7)4,862 
Redeemable preferred securities16 — — 16 
Total debt securities (2)
$26,562 $178 $(707)$26,033 
December 31, 2023
Debt securities:
U.S. government securities$2,071 $19 $(54)$2,036 
States, municipalities and political subdivisions2,219 31 (35)2,215 
U.S. corporate securities10,156 133 (446)9,843 
Foreign securities2,593 41 (122)2,512 
Residential mortgage-backed securities862 (60)810 
Commercial mortgage-backed securities1,066 (100)975 
Other asset-backed securities3,294 26 (18)3,302 
Redeemable preferred securities21 — (1)20 
Total debt securities (2)
$22,282 $267 $(836)$21,713 
_____________________________________________
(1)There was no allowance for expected credit losses recorded on available-for-sale debt securities at December 31, 2024 or December 31, 2023.
(2)Investment risks associated with the Company’s experience-rated products generally do not impact the Company’s consolidated operating results. At December 31, 2024, debt securities with a fair value of $543 million, gross unrealized capital gains of $5 million and gross unrealized capital losses of $30 million, and at December 31, 2023, debt securities with a fair value of $592 million, gross unrealized capital gains of $10 million and gross
unrealized capital losses of $28 million were included in total debt securities, but support experience-rated products. Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive loss.

The amortized cost and fair value of debt securities at December 31, 2024 are shown below by contractual maturity. Actual maturities may differ from contractual maturities because securities may be restructured, called or prepaid, or the Company intends to sell a security prior to maturity.
In millions Amortized
Cost
Fair
Value
Due to mature: 
Less than one year$763 $761 
One year through five years10,599 10,510 
After five years through ten years4,683 4,578 
Greater than ten years3,160 2,909 
Residential mortgage-backed securities792 740 
Commercial mortgage-backed securities1,731 1,673 
Other asset-backed securities4,834 4,862 
Total$26,562 $26,033 

Mortgage-Backed and Other Asset-Backed Securities
All of the Company’s residential mortgage-backed securities at December 31, 2024 were issued by the Government National Mortgage Association, the Federal National Mortgage Association or the Federal Home Loan Mortgage Corporation and carry agency guarantees and explicit or implicit guarantees by the U.S. Government. At December 31, 2024, the Company’s residential mortgage-backed securities had an average credit quality rating of AA and a weighted average duration of 6.4 years.

The Company’s commercial mortgage-backed securities have underlying loans that are dispersed throughout the U.S. Significant market observable inputs used to value these securities include loss severity and probability of default. At December 31, 2024, these securities had an average credit quality rating of AAA and a weighted average duration of 4.9 years.

The Company’s other asset-backed securities have a variety of underlying collateral (e.g., automobile loans, credit card receivables, home equity loans and commercial loans). Significant market observable inputs used to value these securities include the unemployment rate, loss severity and probability of default. At December 31, 2024, these securities had an average credit quality rating of AA and a weighted average duration of less than one year.
Summarized below are the debt securities the Company held at December 31, 2024 and 2023 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 monthsGreater than 12 monthsTotal
In millions, except number of securitiesNumber
of
 Securities
Fair
Value
Unrealized
Losses
Number
of
 Securities
Fair
Value
Unrealized
Losses
Number
of
 Securities
Fair
Value
Unrealized
Losses
December 31, 2024
Debt securities:  
U.S. government securities266 $1,053 $18 155 $394 $20 421 $1,447 $38 
States, municipalities and political subdivisions100 181 137 201 15 237 382 18 
U.S. corporate securities3,119 4,144 64 2,602 3,395 348 5,721 7,539 412 
Foreign securities599 810 21 616 874 90 1,215 1,684 111 
Residential mortgage-backed securities89 267 361 342 49 450 609 54 
Commercial mortgage-backed securities186 628 11 237 464 56 423 1,092 67 
Other asset-backed securities139 414 62 58 201 472 
Redeemable preferred securities— — 15 — 
Total debt securities4,502 $7,506 $127 4,174 $5,734 $580 8,676 $13,240 $707 
December 31, 2023
Debt securities:
U.S. government securities74 $194 $280 $891 $52 354 $1,085 $54 
States, municipalities and political subdivisions95 181 455 733 34 550 914 35 
U.S. corporate securities576 672 14 4,120 5,602 432 4,696 6,274 446 
Foreign securities160 243 964 1,407 118 1,124 1,650 122 
Residential mortgage-backed securities33 97 461 517 59 494 614 60 
Commercial mortgage-backed securities44 94 287 581 98 331 675 100 
Other asset-backed securities196 449 443 867 14 639 1,316 18 
Redeemable preferred securities— 18 12 20 
Total debt securities1,182 $1,932 $28 7,018 $10,616 $808 8,200 $12,548 $836 

The Company reviewed the securities in the table above and concluded that they are performing assets generating investment income to support the needs of the Company’s business. In performing this review, the Company considered factors such as the quality of the investment security based on research performed by the Company’s internal credit analysts and external rating agencies and the prospects of realizing the carrying value of the security based on the investment’s current prospects for recovery. Unrealized capital losses at December 31, 2024 were generally caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. As of December 31, 2024, the Company did not intend to sell these securities, and did not believe it was more likely than not that it would be required to sell these securities prior to the anticipated recovery of their amortized cost basis.
The maturity dates for debt securities in an unrealized capital loss position at December 31, 2024 were as follows:
 Supporting experience-
rated products
Supporting remaining
products
Total
In millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Due to mature:      
Less than one year$— $— $420 $$420 $
One year through five years120 5,462 149 5,582 152 
After five years through ten years86 2,681 138 2,767 144 
Greater than ten years166 20 2,132 259 2,298 279 
Residential mortgage-backed securities— 603 54 609 54 
Commercial mortgage-backed securities1,086 66 1,092 67 
Other asset-backed securities12 — 460 472 
Total$396 $30 $12,844 $677 $13,240 $707 

Mortgage Loans

The Company’s mortgage loans are collateralized by commercial real estate. During the years ended December 31, 2024 and 2023, the Company had the following activity in its mortgage loan portfolio:
In millions20242023
New mortgage loans$323 $342 
Mortgage loans fully repaid104 43 
Mortgage loans foreclosed— — 

The Company assesses mortgage loans on a regular basis for credit impairments, and assigns a credit quality indicator to each loan. The Company’s credit quality indicator is internally developed and categorizes each loan in its portfolio on a scale from 1 to 7. These indicators are based upon several factors, including current loan-to-value ratios, current and future property cash flow, property condition, market trends, creditworthiness of the borrower and deal structure.

Category 1 - Represents loans of superior quality.
Categories 2 to 4 - Represent loans where credit risk is minimal to acceptable; however, these loans may display some susceptibility to economic changes.
Categories 5 and 6 - Represent loans where credit risk is not substantial, but these loans warrant management’s close attention.
Category 7 - Represents loans where collections are potentially at risk; if necessary, an impairment is recorded.
Based upon the Company’s assessments at December 31, 2024 and 2023, the amortized cost basis of the Company’s mortgage loans within each credit quality indicator by year of origination was as follows:

Amortized Cost Basis by Year of Origination
In millions, except credit quality indicator20242023202220212020PriorTotal
December 31, 2024
1$— $— $— $— $— $$
2 to 4315 292 320 205 35 285 1,452 
5 and 6— — 13 — 28 45 
7— — — — — — — 
Total$315 $292 $324 $218 $35 $321 $1,505 
December 31, 2023
1$— $— $— $— $11 $11 
2 to 4302 346 225 35 354 1,262 
5 and 6— — 13 — 19 32 
7— — — — 
Total$302 $346 $244 $35 $384 $1,311 

At December 31, 2024 scheduled mortgage loan principal repayments were as follows:
In millions
2025$151 
2026164 
2027249 
2028313 
2029297 
Thereafter331 
Total$1,505 

Net Investment Income

Sources of net investment income for the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Debt securities$1,136 $841 $702 
Mortgage loans76 59 51 
Other investments887 796 448 
Gross investment income2,099 1,696 1,201 
Investment expenses(63)(46)(43)
Net investment income (excluding net realized capital gains or losses)2,036 1,650 1,158 
Net realized capital gains (losses)
117 (497)(320)
Net investment income
$2,153 $1,153 $838 

Excluding amounts related to experience-rated products, proceeds from the sale of available-for-sale debt securities and the related gross realized capital gains and losses in the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Proceeds from sales$6,489 $5,031 $4,243 
Gross realized capital gains37 24 
Gross realized capital losses(190)420 177 
v3.25.0.1
Fair Value
12 Months Ended
Dec. 31, 2024
Fair Value Disclosures [Abstract]  
Fair Value Fair Value
The preparation of the Company’s consolidated financial statements requires certain assets and liabilities to be reflected at their fair value and others to be reflected on another basis, such as an adjusted historical cost basis. In this note, the Company provides details on the fair value of financial assets and liabilities and how it determines those fair values. The Company presents this information for those financial instruments that are measured at fair value for which the change in fair value impacts net income attributable to CVS Health or other comprehensive income (loss) separately from other financial assets and liabilities.

Financial Instruments Measured at Fair Value on the Consolidated Balance Sheets

Certain of the Company’s financial instruments are measured at fair value on the consolidated balance sheets. The fair values of these instruments are based on valuations that include inputs that can be classified within one of three levels of a hierarchy established by GAAP. The following are the levels of the hierarchy and a brief description of the type of valuation information (“valuation inputs”) that qualifies a financial asset or liability for each level:

Level 1 – Unadjusted quoted prices for identical assets or liabilities in active markets.
Level 2 – Valuation inputs other than Level 1 that are based on observable market data. These include: quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets, valuation inputs that are observable that are not prices (such as interest rates and credit risks) and valuation inputs that are derived from or corroborated by observable markets.
Level 3 – Developed from unobservable data, reflecting the Company’s assumptions.

Financial assets and liabilities are classified based upon the lowest level of input that is significant to the valuation. When quoted prices in active markets for identical assets and liabilities are available, the Company uses these quoted market prices to determine the fair value of financial assets and liabilities and classifies these assets and liabilities in Level 1. In other cases where a quoted market price for identical assets and liabilities in an active market is either not available or not observable, the Company estimates fair value using valuation methodologies based on available and observable market information or by using a matrix pricing model. These financial assets and liabilities are classified in Level 2. If quoted market prices are not available, the Company determines fair value using broker quotes or an internal analysis of each investment’s financial performance and cash flow projections. Thus, financial assets and liabilities may be classified in Level 3 even though there may be some significant inputs that may be observable.

The following is a description of the valuation methodologies used for the Company’s financial assets and liabilities that are measured at fair value, including the general classification of such assets and liabilities pursuant to the valuation hierarchy.

Cash and Cash Equivalents The carrying value of cash and cash equivalents approximates fair value as maturities are less than three months. When quoted prices are available in an active market, cash equivalents are classified in Level 1 of the fair value hierarchy. Fair values of cash equivalent instruments that do not trade on a regular basis in active markets are classified as Level 2.

Debt Securities Where quoted prices are available in an active market, debt securities are classified in Level 1 of the fair value hierarchy. The Company’s Level 1 debt securities consist primarily of U.S. Treasury securities.

The fair values of the Company’s Level 2 debt securities are obtained using models, such as matrix pricing, which use quoted market prices of debt securities with similar characteristics or discounted cash flows to estimate fair value. The Company reviews these prices to ensure they are based on observable market inputs that include quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets and inputs that are observable that are not prices (such as interest rates and credit risks). The Company also reviews the methodologies and the assumptions used to calculate prices from these observable inputs. On a quarterly basis, the Company selects a sample of its Level 2 debt securities’ prices and compares them to prices provided by a secondary source. Variances over a
specified threshold are identified and reviewed to confirm the price provided by the primary source represents an appropriate estimate of fair value. In addition, the Company’s internal investment team consistently compares the prices obtained for select Level 2 debt securities to the team’s own independent estimates of fair value for those securities. The Company obtained one price for each of its Level 2 debt securities and did not adjust any of those prices at December 31, 2024 or 2023.

The Company also values certain debt securities using Level 3 inputs. For Level 3 debt securities, fair values are determined by outside brokers or, in the case of certain private placement securities, are priced internally. Outside brokers determine the value of these debt securities through a combination of their knowledge of the current pricing environment and market flows. The Company did not have any broker quoted debt securities for the years ended December 31, 2024 and 2023. For some private placement securities, the Company’s internal staff determines the value of these debt securities by analyzing spreads of corporate and sector indices as well as interest spreads of comparable public bonds. Examples of these private placement Level 3 debt securities include certain U.S. and foreign securities and certain tax-exempt municipal securities.

Equity Securities The Company currently has two classifications of equity securities: those that are publicly traded and those that are privately placed. Publicly-traded equity securities are classified in Level 1 because quoted prices are available for these securities in an active market. For privately placed equity securities, there is no active market; therefore, these securities are classified in Level 3 because the Company prices these securities through an internal analysis of each investment’s financial statements and cash flow projections. Significant unobservable inputs consist of earnings and revenue multiples, discount for lack of marketability and comparability adjustments. An increase or decrease in any of these unobservable inputs would have resulted in a change in the fair value measurement.
There were no financial liabilities measured at fair value on a recurring basis on the consolidated balance sheets at December 31, 2024 or 2023. Financial assets measured at fair value on a recurring basis on the consolidated balance sheets at December 31, 2024 and 2023 were as follows:
In millionsLevel 1Level 2Level 3Total
December 31, 2024    
Cash and cash equivalents$4,948 $3,638 $— $8,586 
Debt securities:    
U.S. government securities2,777 18 — 2,795 
States, municipalities and political subdivisions— 698 — 698 
U.S. corporate securities— 12,687 38 12,725 
Foreign securities— 2,524 — 2,524 
Residential mortgage-backed securities— 740 — 740 
Commercial mortgage-backed securities— 1,673 — 1,673 
Other asset-backed securities— 4,862 — 4,862 
Redeemable preferred securities— 16 — 16 
Total debt securities2,777 23,218 38 26,033 
Equity securities234 — 126 360 
Total$7,959 $26,856 $164 $34,979 
December 31, 2023    
Cash and cash equivalents
$2,174 $6,022 $— $8,196 
Debt securities:
U.S. government securities2,013 23 — 2,036 
States, municipalities and political subdivisions— 2,215 — 2,215 
U.S. corporate securities— 9,814 29 9,843 
Foreign securities— 2,512 — 2,512 
Residential mortgage-backed securities— 810 — 810 
Commercial mortgage-backed securities— 975 — 975 
Other asset-backed securities— 3,302 — 3,302 
Redeemable preferred securities— 20 — 20 
Total debt securities2,013 19,671 29 21,713 
Equity securities194 — 79 273 
Total$4,381 $25,693 $108 $30,182 
The changes in the balances of Level 3 financial assets during the year ended December 31, 2024 were as follows:
In millions
Commercial
mortgage-
backed
securities
U.S.
corporate
securities
Other asset-
backed
securities
Equity
securities
Total
Beginning balance$— $29 $— $79 $108 
Net realized and unrealized capital gains (losses):
Included in earnings — (5)— 28 23 
Included in other comprehensive loss
— (1)— — (1)
Purchases52 15 15 19 101 
Sales— — — — — 
Transfers out of Level 3, net(52)— (15)— (67)
Ending balance$— $38 $— $126 $164 

The change in net unrealized capital losses included in other comprehensive loss associated with Level 3 financial assets which were held as of December 31, 2024 was $1 million during the year ended December 31, 2024.

The changes in the balances of Level 3 financial assets during the year ended December 31, 2023 were as follows:
In millions
Commercial
mortgage-
backed
securities
U.S.
corporate
securities
Foreign
securities
Equity
securities
Total
Beginning balance$— $61 $$60 $129 
Net realized and unrealized capital gains (losses):
Included in earnings— (8)— (2)(10)
Included in other comprehensive income
— — — 
Purchases13 — 23 41 
Sales— (1)— (2)(3)
Transfers out of Level 3, net(13)(29)(8)— (50)
Ending balance$— $29 $— $79 $108 

The change in net unrealized capital losses included in other comprehensive income associated with Level 3 financial assets which were held as of December 31, 2023 was $9 million during the year ended December 31, 2023.

The total gross transfers into (out of) Level 3 during the years ended December 31, 2024 and 2023 were as follows:
In millions20242023
Gross transfers into Level 3$— $— 
Gross transfers out of Level 3(67)(50)
Net transfers out of Level 3$(67)$(50)
Financial Instruments Not Measured at Fair Value on the Consolidated Balance Sheets

The carrying value and estimated fair value classified by level of fair value hierarchy for financial instruments carried on the consolidated balance sheets at adjusted cost or contract value at December 31, 2024 and 2023 were as follows:
Carrying
Value
 Estimated Fair Value
In millionsLevel 1Level 2Level 3Total
December 31, 2024
Assets: 
Mortgage loans$1,505 $— $— $1,468 $1,468 
Equity securities (1)
490 N/AN/AN/AN/A
Liabilities:
Investment contract liabilities:
With a fixed maturity— — 
Without a fixed maturity312 — — 272 272 
Long-term debt64,151 58,724 — — 58,724 
December 31, 2023
Assets:
Mortgage loans$1,311 $— $— $1,274 $1,274 
Equity securities (1)
534 N/AN/AN/AN/A
Liabilities:
Investment contract liabilities:
With a fixed maturity— — 
Without a fixed maturity312 — — 279 279 
Long-term debt
61,410 58,451 — — 58,451 
______________________________________
(1)It was not practical to estimate the fair value of these investments as it represents shares of unlisted companies. See Note 1 ‘‘Significant Accounting Policies’’ for additional information regarding the valuation of investments accounted for under the measurement alternative method.

Separate Accounts Measured at Fair Value on the Consolidated Balance Sheets

Separate Accounts assets relate to the Company’s large case pensions products which represent funds maintained to meet specific objectives of contract holders. Since contract holders bear the investment risk of these assets, a corresponding Separate Accounts liability has been established equal to the assets. These assets and liabilities are carried at fair value. Net investment income and capital gains and losses on Separate Accounts assets accrue directly to such contract holders. The assets of each account are legally segregated and are not subject to claims arising from the Company’s other businesses. Deposits, withdrawals, net investment income and realized and unrealized capital gains and losses on Separate Accounts assets are not reflected in the consolidated statements of operations, shareholders’ equity or cash flows.

Separate Accounts assets include debt and equity securities. The valuation methodologies used for these assets are similar to the methodologies described above in this Note 5 ‘‘Fair Value.’’ Separate Accounts assets also include investments in common/collective trusts that are carried at fair value. Common/collective trusts invest in other investment funds otherwise known as the underlying funds. The Separate Accounts’ interests in the common/collective trust funds are based on the fair values of the investments of the underlying funds and therefore are classified in Level 2. The assets in the underlying funds primarily consist of equity securities, U.S. corporate securities and U.S. government securities. Investments in common/collective trust funds are valued at their respective net asset value (“NAV”) per share/unit on the valuation date.
Separate Accounts financial assets at December 31, 2024 and 2023 were as follows:
December 31, 2024December 31, 2023
In millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Cash and cash equivalents$$164 $— $165 $$166 $— $168 
Debt securities186 669 856 558 1,949 — 2,507 
Common/collective trusts— 2,478 — 2,478 — 529 — 529 
Total (1)
$187 $3,311 $$3,499 $560 $2,644 $— $3,204 
_____________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.

During the years ended December 31, 2024 and 2023, the Company had no gross transfers of Separate Accounts financial assets into or out of Level 3.
v3.25.0.1
Goodwill and Other Intangibles
12 Months Ended
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangibles Goodwill and Other Intangibles
Goodwill

Below is a summary of the changes in the carrying amount of goodwill by segment for the years ended December 31, 2024 and 2023:
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Total
Balance at December 31, 2022$44,159 $23,615 $10,376 $78,150 
Segment realignment(109)109 — — 
Acquisitions2,594 10,342 186 13,122 
Balance at December 31, 202346,644 34,066 10,562 91,272 
Balance at December 31, 2024$46,644 $34,066 $10,562 $91,272 

There were no changes to the carrying amount of the Company’s goodwill during the year ended December 31, 2024.

During the year ended December 31, 2023, the increase in the carrying amount of goodwill was primarily driven by the acquisitions of Oak Street Health and Signify Health. See Note 2 ‘‘Acquisitions, Divestitures and Asset Sales’’ for additional information.

During the fourth quarter of 2024 and 2023, and the third quarter of 2022, the Company performed its required annual impairment tests of goodwill. The results of these impairment tests indicated that there was no impairment of goodwill.

At December 31, 2024 and 2023, cumulative goodwill impairments were $6.6 billion.
Intangible Assets

The following table is a summary of the Company’s intangible assets as of December 31, 2024 and 2023:
In millions, except weighted average lifeGross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Weighted
Average
Life (years)
2024
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete26,904 (13,889)13,015 14.2
Technology1,250 (1,167)83 3.0
Provider networks4,203 (1,282)2,921 20.0
Value of Business Acquired 590 (228)362 20.0
Other826 (382)444 9.3
Total$44,271 $(16,948)$27,323 14.5
2023
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete26,784 (12,241)14,543 14.2
Technology1,253 (1,104)149 3.0
Provider networks4,203 (1,072)3,131 20.0
Value of Business Acquired 590 (201)389 20.0
Other838 (314)524 9.3
Total
$44,166 $(14,932)$29,234 14.5

Amortization expense for intangible assets totaled $2.0 billion, $1.9 billion and $1.8 billion for the years ended December 31, 2024, 2023 and 2022, respectively. The projected annual amortization expense for the Company’s intangible assets for the next five years is as follows:
In millions
2025$1,981 
20261,704 
20271,590 
20281,316 
20291,239 
v3.25.0.1
Leases
12 Months Ended
Dec. 31, 2024
Leases [Abstract]  
Leases Leases
The Company leases most of its retail stores, mail order facilities and primary care centers, as well as certain distribution centers and corporate offices under operating or finance leases, typically with initial terms of 15 to 25 years. The Company also leases certain equipment and other assets under operating or finance leases, typically with initial terms of 3 to 10 years.

In addition, the Company leases pharmacy space at the stores of another retail chain for which the noncancelable contractual term of the pharmacy lease arrangement exceeds the remaining estimated economic life of the buildings. For these pharmacy lease arrangements, the Company concluded that for accounting purposes the lease term was the remaining estimated economic life of the buildings. Consequently, most of these individual pharmacy leases are finance leases.

The following table is a summary of the components of net lease cost for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Operating lease cost$2,423 $2,532 $2,579 
Finance lease cost:
Amortization of right-of-use assets92 84 79 
Interest on lease liabilities71 73 68 
Total finance lease costs163 157 147 
Short-term lease costs33 22 27 
Variable lease costs635 635 610 
Less: sublease income(67)(63)(61)
Net lease cost$3,187 $3,283 $3,302 

Supplemental cash flow information related to leases for the years ended December 31, 2024, 2023 and 2022 was as follows:
In millions202420232022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows paid for operating leases$2,733 $2,756 $2,689 
Operating cash flows paid for interest portion of finance leases71 73 68 
Financing cash flows paid for principal portion of finance leases74 70 62 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases852 1,132 591 
Finance leases30 (4)232 
Supplemental balance sheet information related to leases as of December 31, 2024 and 2023 is as follows:
In millions, except remaining lease term and discount rate20242023
Operating leases:
Operating lease right-of-use assets
$15,944$17,252
Current portion of operating lease liabilities$1,751$1,741
Long-term operating lease liabilities14,89916,034
Total operating lease liabilities
$16,650$17,775
Finance leases:
Property and equipment, gross$1,587$1,604
Accumulated depreciation(447)(375)
Property and equipment, net$1,140$1,229
Current portion of long-term debt$65$66
Long-term debt1,2951,325
Total finance lease liabilities$1,360$1,391
Weighted average remaining lease term (in years)
Operating leases10.711.4
Finance leases16.517.3
Weighted average discount rate
Operating leases4.6 %4.5 %
Finance leases5.1 %5.0 %

The following table summarizes the maturity of lease liabilities under finance and operating leases as of December 31, 2024:
In millionsFinance
Leases
Operating
Leases
(1)
Total
2025$144 $2,683 $2,827 
2026135 2,528 2,663 
2027132 2,343 2,475 
2028129 2,167 2,296 
2029127 1,911 2,038 
Thereafter1,371 9,557 10,928 
Total lease payments (2)
2,038 21,189 23,227 
Less: imputed interest(678)(4,539)(5,217)
Total lease liabilities$1,360 $16,650 $18,010 
_____________________________________________
(1)Future operating lease payments have not been reduced by minimum sublease rentals of $297 million due in the future under noncancelable subleases.
(2)The Company leases pharmacy and clinic space from Target Corporation. Amounts related to such finance and operating leases are reflected above. Pharmacy lease amounts due in excess of the remaining estimated economic life of the buildings of approximately $2.2 billion are not reflected in this table since the estimated economic life of the buildings is shorter than the contractual term of the pharmacy lease arrangement.

Store Impairment Charges
During the year ended December 31, 2024, the Company recorded a store impairment charge of $483 million related to operating and financing lease right-of-use assets in connection with its enterprise-wide restructuring plan. See Note 3 ‘‘Restructuring’’ for additional information on the Company’s store impairment charges.
Office Real Estate Optimization Charges
The Company evaluates its corporate office real estate space in response to its ongoing flexible work arrangement and evaluates its current real estate space and changes in employee work arrangement requirements to ensure it has the appropriate space to support the business. As a result of this assessment, the Company determined that it would vacate and abandon certain leased corporate office spaces. During the year ended December 31, 2022, the Company recorded office real estate optimization charges of $117 million, primarily consisting of $71 million related to operating lease right-of-use assets and $44 million related to property and equipment. During the year ended December 31, 2023, the Company recorded $46 million of office real estate optimization charges, primarily consisting of $20 million related to operating lease right-of-use assets and $18 million related to property and equipment. During the year ended December 31, 2024, the Company recorded $30 million of office real estate optimization charges, primarily consisting of $14 million related to operating lease right-of-use assets and $14 million related to property and equipment. The office real estate optimization charges were recorded in operating expenses within each segment.
Leases Leases
The Company leases most of its retail stores, mail order facilities and primary care centers, as well as certain distribution centers and corporate offices under operating or finance leases, typically with initial terms of 15 to 25 years. The Company also leases certain equipment and other assets under operating or finance leases, typically with initial terms of 3 to 10 years.

In addition, the Company leases pharmacy space at the stores of another retail chain for which the noncancelable contractual term of the pharmacy lease arrangement exceeds the remaining estimated economic life of the buildings. For these pharmacy lease arrangements, the Company concluded that for accounting purposes the lease term was the remaining estimated economic life of the buildings. Consequently, most of these individual pharmacy leases are finance leases.

The following table is a summary of the components of net lease cost for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Operating lease cost$2,423 $2,532 $2,579 
Finance lease cost:
Amortization of right-of-use assets92 84 79 
Interest on lease liabilities71 73 68 
Total finance lease costs163 157 147 
Short-term lease costs33 22 27 
Variable lease costs635 635 610 
Less: sublease income(67)(63)(61)
Net lease cost$3,187 $3,283 $3,302 

Supplemental cash flow information related to leases for the years ended December 31, 2024, 2023 and 2022 was as follows:
In millions202420232022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows paid for operating leases$2,733 $2,756 $2,689 
Operating cash flows paid for interest portion of finance leases71 73 68 
Financing cash flows paid for principal portion of finance leases74 70 62 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases852 1,132 591 
Finance leases30 (4)232 
Supplemental balance sheet information related to leases as of December 31, 2024 and 2023 is as follows:
In millions, except remaining lease term and discount rate20242023
Operating leases:
Operating lease right-of-use assets
$15,944$17,252
Current portion of operating lease liabilities$1,751$1,741
Long-term operating lease liabilities14,89916,034
Total operating lease liabilities
$16,650$17,775
Finance leases:
Property and equipment, gross$1,587$1,604
Accumulated depreciation(447)(375)
Property and equipment, net$1,140$1,229
Current portion of long-term debt$65$66
Long-term debt1,2951,325
Total finance lease liabilities$1,360$1,391
Weighted average remaining lease term (in years)
Operating leases10.711.4
Finance leases16.517.3
Weighted average discount rate
Operating leases4.6 %4.5 %
Finance leases5.1 %5.0 %

The following table summarizes the maturity of lease liabilities under finance and operating leases as of December 31, 2024:
In millionsFinance
Leases
Operating
Leases
(1)
Total
2025$144 $2,683 $2,827 
2026135 2,528 2,663 
2027132 2,343 2,475 
2028129 2,167 2,296 
2029127 1,911 2,038 
Thereafter1,371 9,557 10,928 
Total lease payments (2)
2,038 21,189 23,227 
Less: imputed interest(678)(4,539)(5,217)
Total lease liabilities$1,360 $16,650 $18,010 
_____________________________________________
(1)Future operating lease payments have not been reduced by minimum sublease rentals of $297 million due in the future under noncancelable subleases.
(2)The Company leases pharmacy and clinic space from Target Corporation. Amounts related to such finance and operating leases are reflected above. Pharmacy lease amounts due in excess of the remaining estimated economic life of the buildings of approximately $2.2 billion are not reflected in this table since the estimated economic life of the buildings is shorter than the contractual term of the pharmacy lease arrangement.

Store Impairment Charges
During the year ended December 31, 2024, the Company recorded a store impairment charge of $483 million related to operating and financing lease right-of-use assets in connection with its enterprise-wide restructuring plan. See Note 3 ‘‘Restructuring’’ for additional information on the Company’s store impairment charges.
Office Real Estate Optimization Charges
The Company evaluates its corporate office real estate space in response to its ongoing flexible work arrangement and evaluates its current real estate space and changes in employee work arrangement requirements to ensure it has the appropriate space to support the business. As a result of this assessment, the Company determined that it would vacate and abandon certain leased corporate office spaces. During the year ended December 31, 2022, the Company recorded office real estate optimization charges of $117 million, primarily consisting of $71 million related to operating lease right-of-use assets and $44 million related to property and equipment. During the year ended December 31, 2023, the Company recorded $46 million of office real estate optimization charges, primarily consisting of $20 million related to operating lease right-of-use assets and $18 million related to property and equipment. During the year ended December 31, 2024, the Company recorded $30 million of office real estate optimization charges, primarily consisting of $14 million related to operating lease right-of-use assets and $14 million related to property and equipment. The office real estate optimization charges were recorded in operating expenses within each segment.
v3.25.0.1
Health Care Costs Payable
12 Months Ended
Dec. 31, 2024
Health Care and Other Insurance Liabilities [Abstract]  
Health Care Costs Payable Health Care Costs Payable
The following is information about incurred and cumulative paid health care claims development as of December 31, 2024, net of reinsurance, and the total IBNR liabilities plus expected development on reported claims included within the net incurred claims amounts. See Note 1 ‘‘Significant Accounting Policies’’ for information on how the Company estimates IBNR reserves and health care costs payable as well as changes to those methodologies, if any. The Company’s estimate of IBNR liabilities is primarily based on trend and completion factors. Claim frequency is not used in the calculation of the Company’s liability. In addition, it is impracticable to disclose claim frequency information for health care claims due to the Company’s inability to gather consistent claim frequency information across its multiple claims processing systems. Any claim frequency count disclosure would not be comparable across the Company’s different claim processing systems and would not be consistent from period to period based on the volume of claims processed through each system. As a result, health care claim count frequency is not included in the disclosures below.

The information about incurred and paid health care claims development for the year ended December 31, 2023 is presented as required unaudited supplemental information.
In millionsIncurred Health Care Claims,
Net of Reinsurance
For the Years Ended December 31,
Date of Service20232024
(Unaudited)
2023$82,362 $81,559 
2024109,458 
Total$191,017 
In millionsCumulative Paid Health Care Claims,
Net of Reinsurance
For the Years Ended December 31,
Date of Service20232024
(Unaudited)
2023$72,175 $81,044 
202497,155 
Total$178,199 
All outstanding liabilities for health care costs payable prior to 2023, net of reinsurance
128 
Total outstanding liabilities for health care costs payable, net of reinsurance$12,946 

At December 31, 2024, the Company’s liabilities for IBNR plus expected development on reported claims totaled approximately $11.3 billion. Substantially all of the Company’s liabilities for IBNR plus expected development on reported claims at December 31, 2024 related to the current calendar year.

The reconciliation of the December 31, 2024 health care net incurred and paid claims development tables to the health care costs payable liability on the consolidated balance sheet were as follows:
In millionsDecember 31, 2024
Short-duration health care costs payable, net of reinsurance$12,946 
Reinsurance recoverables81 
Insurance lines other than short duration282 
Other non-insurance health care costs payable1,755 
Total health care costs payable$15,064 
The following table shows the components of the change in health care costs payable during the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Health care costs payable, beginning of period $12,049 $10,142 $8,678 
Less: Reinsurance recoverables
Less: Impact of discount rate on long-duration insurance reserves (1)
(23)— 
Health care costs payable, beginning of period, net12,067 10,129 8,670 
Acquisition, net— 1,098 — 
Add: Components of incurred health care costs
  Current year115,774 86,639 71,399 
  Prior years(947)(685)(654)
Total incurred health care costs (2)
114,827 85,954 70,745 
Less: Claims paid
  Current year101,583 75,529 61,640 
  Prior years10,327 9,585 7,646 
Total claims paid111,910 85,114 69,286 
Health care costs payable, end of period, net14,984 12,067 10,129 
Add: Reinsurance recoverables81 
Add: Impact of discount rate on long-duration insurance reserves (1)
(1)(23)
Health care costs payable, end of period$15,064 $12,049 $10,142 
_____________________________________
(1)Reflects the difference between the current discount rate and the locked-in discount rate on long-duration insurance reserves which is recorded within accumulated other comprehensive loss on the consolidated balance sheets.
(2)Total incurred health care costs for the years ended December 31, 2024, 2023 and 2022 in the table above exclude $107 million, $83 million and $79 million, respectively, of health care costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the consolidated balance sheets and $187 million, $210 million and $249 million, respectively, of health care costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the consolidated balance sheets.

The Company’s estimates of prior years’ health care costs payable decreased by $947 million, $685 million and $654 million in 2024, 2023 and 2022, respectively, because claims were settled for amounts less than originally estimated (i.e., the amount of claims incurred was lower than originally estimated), primarily due to lower health care cost trends as well as the actual claim submission time being faster than originally assumed (i.e., the Company’s completion factors were higher than originally assumed) in estimating health care costs payable at the end of the prior year. This development does not directly correspond to an increase in the Company’s operating results as these reductions were offset by estimated current period health care costs when the Company established the estimate of the current year health care costs payable.
v3.25.0.1
Other Insurance Liabilities and Separate Accounts
12 Months Ended
Dec. 31, 2024
Insurance [Abstract]  
Other Insurance Liabilities and Separate Accounts Other Insurance Liabilities and Separate Accounts
Future Policy Benefits

The following tables show the components of the change in the liability for future policy benefits, which is included in other insurance liabilities and other long-term insurance liabilities on the consolidated balance sheets, during the years ended December 31, 2024 and 2023:
2024
In millionsLarge Case
Pensions
Long-Term
Care
Present value of expected net premiums (1)
Liability for future policy benefits, beginning of period - current discount rate$293 
Beginning liability for future policy benefits at original (locked-in) discount rate$288 
Effect of changes in cash flow assumptions— 
Effect of actual variances from expected experience16 
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate304 
Interest accrual (using locked-in discount rate)14 
Net premiums (actual)(38)
Ending liability for future policy benefits at original (locked-in) discount rate280 
Effect of changes in discount rate assumptions(5)
Liability for future policy benefits, end of period - current discount rate$275 
Present value of expected future policy benefits
Liability for future policy benefits, beginning of period - current discount rate$2,139 $1,640 
Beginning liability for future policy benefits at original (locked-in) discount rate$2,251 $1,632 
Effect of changes in cash flow assumptions— — 
Effect of actual variances from expected experience(27)
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate2,224 1,638 
Issuances30 — 
Interest accrual (using locked-in discount rate)91 83 
Benefit payments (actual)(255)(74)
Ending liability for future policy benefits at original (locked-in) discount rate2,090 1,647 
Effect of changes in discount rate assumptions(173)(95)
Liability for future policy benefits, end of period - current discount rate$1,917 $1,552 
Net liability for future policy benefits$1,917 $1,277 
Less: Reinsurance recoverable— — 
Net liability for future policy benefits, net of reinsurance recoverable$1,917 $1,277 
_____________________________________________
(1)The present value of expected net premiums is equivalent to the present value of expected gross premiums for the long-term care insurance contracts as net premiums are set equal to gross premiums.
2023
In millionsLarge Case
Pensions
Long-Term
Care
Present value of expected net premiums (1)
Liability for future policy benefits, beginning of period - current discount rate$300 
Beginning liability for future policy benefits at original (locked-in) discount rate$302 
Effect of changes in cash flow assumptions— 
Effect of actual variances from expected experience10 
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate312 
Interest accrual (using locked-in discount rate)15 
Net premiums (actual)(39)
Ending liability for future policy benefits at original (locked-in) discount rate288 
Effect of changes in discount rate assumptions
Liability for future policy benefits, end of period - current discount rate$293 
Present value of expected future policy benefits
Liability for future policy benefits, beginning of period - current discount rate$2,253 $1,566 
Beginning liability for future policy benefits at original (locked-in) discount rate$2,425 $1,613 
Effect of changes in cash flow assumptions— — 
Effect of actual variances from expected experience(3)
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate2,422 1,621 
Issuances— 
Interest accrual (using locked-in discount rate)97 82 
Benefit payments (actual)(276)(71)
Ending liability for future policy benefits at original (locked-in) discount rate2,251 1,632 
Effect of changes in discount rate assumptions(112)
Liability for future policy benefits, end of period - current discount rate$2,139 $1,640 
Net liability for future policy benefits$2,139 $1,347 
Less: Reinsurance recoverable— — 
Net liability for future policy benefits, net of reinsurance recoverable$2,139 $1,347 
_____________________________________________
(1)The present value of expected net premiums is equivalent to the present value of expected gross premiums for the long-term care insurance contracts as net premiums are set equal to gross premiums.

The Company did not have any material differences between the actual experience and expected experience for the significant assumptions used in the computation of the liability for future policy benefits.
The amount of undiscounted expected gross premiums and expected future benefit payments for long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
In millions20242023
Large case pensions
Expected future benefit payments$3,024$3,266
Expected gross premiums
Long-term care
Expected future benefit payments$3,189$3,224
Expected gross premiums399414

The weighted-average interest rate used in the measurement of the long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
20242023
Large case pensions
Interest accretion rate4.20%4.20%
Current discount rate5.46%4.93%
Long-term care
Interest accretion rate5.11%5.11%
Current discount rate5.70%5.08%

The weighted-average durations (in years) of the long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
20242023
Large case pensions7.37.3
Long-term care11.712.1
Separate Accounts

The following table shows the fair value of assets, by major investment category, supporting Separate Accounts as of December 31, 2024 and 2023:
In millions20242023
Cash and cash equivalents$165 168 
Debt securities:
U.S. government securities186 573 
States, municipalities and political subdivisions14 28 
U.S. corporate securities524 1,632 
Foreign securities51 202 
Residential mortgage-backed securities71 51 
Commercial mortgage-backed securities
Other asset-backed securities15 
Total debt securities856 2,507 
Common/collective trusts2,478 529 
Total (1)
$3,499 $3,204 
_____________________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.

The following table shows the components of the change in Separate Accounts liabilities during the years ended December 31, 2024 and 2023:
In millions20242023
Separate Accounts liability, beginning of the period$3,250 $3,228 
Premiums and deposits964 860 
Surrenders and withdrawals(277)(9)
Benefit payments(978)(938)
Investment earnings348 100 
Net transfers from general account13 
Other(9)
Separate Accounts liability, end of the period$3,311 $3,250 
Cash surrender value, end of the period$1,987 $2,181 
The Company did not recognize any gains or losses on assets transferred to Separate Accounts during the years ended December 31, 2024 or 2023.
v3.25.0.1
Borrowings and Credit Agreements
12 Months Ended
Dec. 31, 2024
Debt Disclosure [Abstract]  
Borrowings and Credit Agreements Borrowings and Credit Agreements
The following table is a summary of the Company’s borrowings as of December 31, 2024 and 2023:
In millions20242023
Short-term debt
Commercial paper$2,119 $200 
Long-term debt
3.375% senior notes due August 2024
— 650 
2.625% senior notes due August 2024
— 1,000 
3.5% senior notes due November 2024
— 750 
5% senior notes due December 2024
— 299 
4.1% senior notes due March 2025
724 950 
3.875% senior notes due July 2025
2,828 2,828 
5% senior notes due February 2026
1,500 1,500 
2.875% senior notes due June 2026
1,750 1,750 
3% senior notes due August 2026
750 750 
3.625% senior notes due April 2027
750 750 
6.25% senior notes due June 2027
372 372 
1.3% senior notes due August 2027
2,250 2,250 
4.3% senior notes due March 2028
5,000 5,000 
5% senior notes due January 2029
1,000 1,000 
5.4% senior notes due June 2029
1,000 — 
3.25% senior notes due August 2029
1,750 1,750 
5.125% senior notes due February 2030
1,500 1,500 
3.75% senior notes due April 2030
1,500 1,500 
1.75% senior notes due August 2030
1,250 1,250 
5.25% senior notes due January 2031
750 750 
1.875% senior notes due February 2031
1,250 1,250 
5.55% senior notes due June 2031
1,000 — 
2.125% senior notes due September 2031
1,000 1,000 
5.25% senior notes due February 2033
1,750 1,750 
5.3% senior notes due June 2033
1,250 1,250 
5.7% senior notes due June 2034
1,250 — 
4.875% senior notes due July 2035
652 652 
6.625% senior notes due June 2036
771 771 
6.75% senior notes due December 2037
533 533 
4.78% senior notes due March 2038
5,000 5,000 
6.125% senior notes due September 2039
447 447 
4.125% senior notes due April 2040
602 1,000 
2.7% senior notes due August 2040
367 1,250 
5.75% senior notes due May 2041
133 133 
4.5% senior notes due May 2042
500 500 
4.125% senior notes due November 2042
226 500 
5.3% senior notes due December 2043
750 750 
4.75% senior notes due March 2044
375 375 
6% senior notes due June 2044
750 — 
5.125% senior notes due July 2045
3,500 3,500 
3.875% senior notes due August 2047
537 1,000 
5.05% senior notes due March 2048
8,000 8,000 
4.25% senior notes due April 2050
399 750 
5.625% senior notes due February 2053
1,250 1,250 
5.875% senior notes due June 2053
1,250 1,250 
6.05% senior notes due June 2054
1,000 — 
6% senior notes due June 2063
750 750 
6.75% series B junior subordinated notes due December 2054
750 — 
7% series A junior subordinated notes due March 2055
2,250 — 
Finance lease liabilities1,360 1,391 
Other302 309 
Total debt principal66,747 62,160 
Debt premiums170 186 
Debt discounts and deferred financing costs(647)(736)
66,270 61,610 
Less:
Short-term debt (commercial paper)(2,119)(200)
Current portion of long-term debt(3,624)(2,772)
Long-term debt$60,527 $58,638 

The following is a summary of the Company’s required repayments of long-term debt principal due during each of the next five years and thereafter, as of December 31, 2024:
In millions
2025$3,559 
20264,007 
20273,379 
20285,007 
20293,758 
Thereafter43,558 
Subtotal63,268 
Commercial paper2,119 
Finance lease liabilities (1)
1,360 
Total debt principal$66,747 
_____________________________________________
(1)See Note 7 ‘‘Leases’’ for a summary of maturities of the Company’s finance lease liabilities.

Short-term Borrowings

Commercial Paper and Back-up Credit Facilities
The Company had $2.1 billion of commercial paper outstanding at a weighted average interest rate of 4.98% as of December 31, 2024. The Company had $200 million of commercial paper outstanding at a weighted interest rate of 4.31% as of December 31, 2023. In connection with its commercial paper program, the Company maintains a $2.5 billion, five-year unsecured back-up revolving credit facility, which expires on May 11, 2027, a $2.5 billion, five-year unsecured back-up revolving credit facility, which expires on May 16, 2028, and a $2.5 billion, five-year unsecured back-up revolving credit facility, which expires on May 16, 2029. The credit facilities allow for borrowings at various rates that are dependent, in part, on the Company’s public debt ratings and require the Company to pay a weighted average quarterly facility fee of approximately 0.03%, regardless of usage. As of December 31, 2024 and 2023, there were no borrowings outstanding under any of the Company’s back-up credit facilities.

Term Loan Agreement
On March 25, 2024, the Company entered into a 364-day $3.0 billion term loan credit agreement. The term loan credit agreement allowed for borrowings at various rates that were dependent, in part, on the Company’s public debt ratings. On May 9, 2024, following the issuance of the $5.0 billion in senior notes described under “Long-term Borrowings” below, the term
loan credit agreement terminated. There were no borrowings under the term loan credit agreement through the date of termination.

On May 1, 2023, the Company entered into a 364-day $5.0 billion term loan agreement. The term loan agreement allowed for borrowings at various rates that were dependent, in part, on the Company’s debt ratings. On May 2, 2023, the Company borrowed $5.0 billion at an interest rate of approximately 6.2% under the term loan agreement to fund a portion of the Oak Street Health acquisition purchase price. On June 2, 2023, the Company repaid the outstanding balance under the term loan agreement.

FHLBB
A subsidiary of the Company is a member of the FHLBB. As a member, the subsidiary has the ability to obtain cash advances, subject to certain minimum collateral requirements. The maximum borrowing capacity available from the FHLBB as of December 31, 2024 was approximately $1.2 billion. As of December 31, 2024 and 2023, there were no outstanding advances from the FHLBB.

Long-term Borrowings

2024 Notes
On December 10, 2024, the Company issued $2.25 billion aggregate principal amount of 7.0% fixed-to-fixed rate series A junior subordinated notes due March 2055 and $750 million aggregate principal amount of 6.75% fixed-to-fixed rate series B junior subordinated notes due December 2054 for total proceeds of approximately $3.0 billion, net of discounts and underwriting fees. The series A junior subordinated notes bear interest at 7.0% per year until March 10, 2030, at which time the rate will reset March 10th of every fifth year, provided that the interest rate will not reset below the initial interest rate. The series B junior subordinated notes bear interest at 6.75% per year until December 10, 2034, at which time the rate will reset December 10th of every fifth year, provided that the interest rate will not reset below the initial interest rate. The series A and series B junior subordinated notes pay interest semi-annually and may be redeemed at any time beginning 90 days prior to their respective first interest rate reset date and on any interest payment date thereafter, in whole or in part at a defined redemption price plus accrued interest. The net proceeds of these offerings were used for the early extinguishment of certain of the Company’s senior notes as described below and the remaining proceeds after the early extinguishment of debt were used for general corporate purposes.

On May 9, 2024, the Company issued $1.0 billion aggregate principal amount of 5.4% senior notes due June 2029, $1.0 billion aggregate principal amount of 5.55% senior notes due June 2031, $1.25 billion aggregate principal amount of 5.7% senior notes due June 2034, $750 million aggregate principal amount of 6.0% senior notes due June 2044 and $1.0 billion aggregate principal amount of 6.05% senior notes due June 2054 for total proceeds of approximately $5.0 billion, net of discounts and underwriting fees. The net proceeds of these offerings were used for general corporate purposes.

2023 Notes
On June 2, 2023, the Company issued $1.0 billion aggregate principal amount of 5.0% senior notes due January 2029, $750 million aggregate principal amount of 5.25% senior notes due January 2031, $1.25 billion aggregate principal amount of 5.3% senior notes due June 2033, $1.25 billion aggregate principal amount of 5.875% senior notes due June 2053 and $750 million aggregate principal amount of 6.0% senior notes due June 2063 for total proceeds of approximately $4.9 billion, net of discounts and underwriting fees. The net proceeds of these offerings were used, along with cash on hand, to repay the outstanding balance under the term loan agreement described above.

On February 21, 2023, the Company issued $1.5 billion aggregate principal amount of 5.0% senior notes due February 2026, $1.5 billion aggregate principal amount of 5.125% senior notes due February 2030, $1.75 billion aggregate principal amount of 5.25% senior notes due February 2033 and $1.25 billion aggregate principal amount of 5.625% senior notes due February 2053 for total proceeds of approximately $6.0 billion, net of discounts and underwriting fees. The net proceeds of these offerings were used to fund general corporate purposes, including a portion of the Signify Health Acquisition purchase price.

Oak Street Health Convertible Notes
Prior to the Oak Street Health Acquisition, Oak Street Health held 0% convertible senior notes with an aggregate principal amount of $920 million (the “Convertible Notes”), which were assumed by the Company in connection with the Oak Street Health Acquisition. The Oak Street Health Acquisition constituted a fundamental change in the Convertible Notes giving the holders the right to require the Company to repurchase the Convertible Notes. The repurchase price was an amount in cash equal to 100% of the principal amount of the Convertible Notes. On May 31, 2023, the Company issued a notice of repurchase to the holders of the Convertible Notes. In connection with this notice, $917 million of the Convertible Notes were submitted
for repurchase and settled on July 21, 2023. Substantially all of the remaining $3 million of the Convertible Notes were submitted for repurchase and settled on October 20, 2023.

Gain on Early Extinguishment of Debt
In December 2024, pursuant to a cash tender offer, the Company repaid approximately $2.6 billion of its outstanding senior notes for a cash payment of approximately $2.0 billion. The senior notes purchased include: $226 million of its 4.1% senior notes due March 2025, $398 million of its 4.125% senior notes due April 2040, $883 million of its 2.7% senior notes due August 2040, $274 million of its 4.125% senior notes due November 2042, $463 million of its 3.875% senior notes due August 2047 and $351 million of its 4.25% senior notes due April 2050. In connection with the purchase of such senior notes, the Company recognized a total gain on early extinguishment of debt of $491 million, net of unamortized deferred financing costs and incurred fees.

Debt Covenants

The Company’s back-up revolving credit facilities and unsecured senior notes contain customary restrictive financial and operating covenants. These covenants do not include an acceleration of the Company’s debt maturities in the event of a downgrade in the Company’s credit ratings. The Company does not believe the restrictions contained in these covenants materially affect its financial or operating flexibility. As of December 31, 2024, the Company was in compliance with all of its debt covenants.
v3.25.0.1
Pension Plans and Other Postretirement Benefits
12 Months Ended
Dec. 31, 2024
Retirement Benefits [Abstract]  
Pension Plans and Other Postretirement Benefits Pension Plans and Other Postretirement Benefits
Defined Contribution Plans

As of December 31, 2024, the Company sponsors several active 401(k) savings plans that cover all employees who meet plan eligibility requirements.

The Company makes matching contributions consistent with the provisions of the respective plans. At the participant’s option, account balances, including the Company’s matching contribution, can be invested among various investment options under each plan. The CVS Health Future Fund 401(k) Plan offers CVS Health Corporation’s common stock fund as an investment option. The Company also maintains nonqualified, unfunded deferred compensation plans for certain key employees. The plans provide participants the opportunity to defer portions of their eligible compensation and for certain nonqualified plans, participants receive matching contributions equivalent to what they could have received under the CVS Health Future Fund 401(k) Plan absent certain restrictions and limitations under the Internal Revenue Code. The Company’s contributions under its defined contribution plans were $610 million, $581 million and $567 million in the years ended December 31, 2024, 2023 and 2022, respectively.

Defined Benefit Pension Plans

The Company sponsors a tax-qualified defined benefit pension plan that was frozen in 2010 and a nonqualified supplemental pension plan that was frozen in 2007. The Company also sponsors several other defined benefit pension plans that are unfunded nonqualified supplemental retirement plans.
Pension Benefit Obligation and Plan Assets
The following tables outline the change in pension benefit obligation and plan assets over the specified periods:
In millions20242023
Change in benefit obligation:
Benefit obligation, beginning of year$4,736 $4,740 
Interest cost222 231 
Actuarial loss (gain)(262)145 
Benefit payments(347)(380)
Benefit obligation, end of year4,349 4,736 
Change in plan assets:
Fair value of plan assets, beginning of year5,379 5,346 
Actual return on plan assets133 389 
Employer contributions23 24 
Benefit payments(347)(380)
Fair value of plan assets, end of year5,188 5,379 
Funded status$839 $643 

The change in the pension benefit obligation during the years ended December 31, 2024 and 2023 was primarily driven by the change in the discount rate during each respective period.

The assets (liabilities) recognized on the consolidated balance sheets at December 31, 2024 and 2023 for the defined benefit pension plans consisted of the following:
In millions20242023
Noncurrent assets reflected in other assets$1,030 $856 
Current liabilities reflected in accrued expenses and other current liabilities
(22)(24)
Noncurrent liabilities reflected in other long-term liabilities(169)(189)
Net assets$839 $643 

Net Periodic Benefit Cost (Income)
The components of net periodic benefit cost (income) for the years ended December 31, 2024, 2023 and 2022 are shown below:
In millions202420232022
Components of net periodic benefit cost (income):
Interest cost$222 $231 $132 
Expected return on plan assets(327)(326)(309)
Amortization of net actuarial loss
Settlement losses— — 
Net periodic benefit cost (income)$(104)$(94)$(173)

Pension Plan Assumptions
The Company uses a series of actuarial assumptions to determine its benefit obligation and net periodic benefit income, the most significant of which include discount rates and expected return on plan assets assumptions.

Discount Rates - The discount rate is determined using a yield curve as of the annual measurement date. The yield curve consists of a series of individual discount rates, with each discount rate corresponding to a single point in time, based on high-quality bonds. Projected benefit payments are discounted to the measurement date using the corresponding rate from the yield curve that is consistent with the maturity profile of the expected liability cash flows.
Expected Return on Plan Assets - The expected long-term rate of return on plan assets is determined by using the plan’s target allocation and return expectations based on many factors including forecasted long-term capital market real returns and the inflationary outlook on a plan by plan basis. See “Pension Plan Assets” below for additional details regarding the pension plan assets as of December 31, 2024 and 2023.

The Company also considers other assumptions including mortality, interest crediting rate, termination and retirement rates, and cost of living adjustments.

The Company determined its benefit obligation based on the following weighted average assumptions as of December 31, 2024 and 2023:
20242023
Discount rate5.6 %5.0 %

The Company determined its net periodic benefit cost (income) based on the following weighted average assumptions for the years ended December 31, 2024, 2023 and 2022:
202420232022
Discount rate4.9 %5.1 %2.3 %
Expected long-term rate of return on plan assets6.3 %6.3 %4.8 %

Pension Plan Assets
The Company’s pension plan assets primarily include debt and equity securities held in separate accounts, common/collective trusts, as well as Private Real Estate, Farmland, Public Real Estate and Public Infrastructure (collectively referred to as “Real Assets”) and private credit. The valuation methodologies used to value these debt and equity securities and common/collective trusts are similar to the methodologies described in Note 5 “Fair Value.” Pension plan assets also include investments in other assets that are carried at fair value. The following is a description of the valuation methodologies used to value private real estate investments and these additional investments, including the general classification pursuant to the fair value hierarchy.

Private real estate - Private real estate investments are valued by independent third-party appraisers. The appraisals comply with the Uniform Standards of Professional Appraisal Practice, which include, among other things, the income, cost, and sales comparison approaches to estimating property value. Therefore, these investments are classified in Level 3.

Private equity, private credit and hedge fund limited partnerships - Private equity and hedge fund limited partnerships are carried at fair value which is estimated using the NAV per unit as reported by the administrator of the underlying investment fund as a practical expedient to fair value. Therefore, these investments have been excluded from the fair value table below.
Pension plan assets with changes in fair value measured on a recurring basis at December 31, 2024 were as follows:
In millionsLevel 1Level 2Level 3Total
Cash and cash equivalents$32 $67 $— $99 
Debt securities:
    U.S. government securities481 — 487 
    States, municipalities and political subdivisions— 70 — 70 
    U.S. corporate securities— 2,752 2,753 
    Foreign securities— 98 — 98 
    Residential mortgage-backed securities— — 
    Commercial mortgage-backed securities— — 
    Other asset-backed securities— — 
    Redeemable preferred securities— — 
Total debt securities481 2,947 3,429 
Equity securities:
    U.S. domestic30 — — 30 
    International12 — — 12 
Total equity securities42 — — 42 
Other investments:
    Private real estate
— — 276 276 
    Common/collective trusts (1)
— 502 — 502 
    Derivatives— — 
Total other investments— 505 276 781 
Total pension investments (2)
$555 $3,519 $277 $4,351 
_____________________________________________
(1)The assets in the underlying funds of common/collective trusts consist of $288 million of equity securities and $214 million of debt securities.
(2)Excludes $267 million of other receivables as well as $290 million of private equity limited partnership investments and $280 million of hedge fund limited partnership investments as these amounts are measured at NAV per share or an equivalent and are not subject to leveling within the fair value hierarchy.
Pension plan assets with changes in fair value measured on a recurring basis at December 31, 2023 were as follows:
In millionsLevel 1Level 2Level 3Total
Cash and cash equivalents$12 $69 $— $81 
Debt securities:
    U.S. government securities518 — 522 
    States, municipalities and political subdivisions— 94 — 94 
    U.S. corporate securities— 2,649 — 2,649 
    Foreign securities— 106 — 106 
    Residential mortgage-backed securities— 17 — 17 
    Commercial mortgage-backed securities— — 
    Other asset-backed securities— — 
    Redeemable preferred securities— — 
Total debt securities518 2,888 — 3,406 
Equity securities:
    U.S. domestic150 — — 150 
    International34 — — 34 
Total equity securities184 — — 184 
Other investments:
    Private real estate
— — 290 290 
    Common/collective trusts (1)
— 405 — 405 
    Derivatives— (14)— (14)
Total other investments— 391 290 681 
Total pension investments (2)
$714 $3,348 $290 $4,352 
_____________________________________________
(1)The assets in the underlying funds of common/collective trusts consist of $114 million of equity securities and $291 million of debt securities.
(2)Excludes $314 million of other receivables as well as $461 million of private equity limited partnership investments and $252 million of hedge fund limited partnership investments as these amounts are measured at NAV per share or an equivalent and are not subject to leveling within the fair value hierarchy.

The changes in the balances of Level 3 pension plan assets during the year ended December 31, 2024 were as follows:
In millions
Private
real estate
U.S. corporate
securities
Total
Beginning balance$290 $— $290 
Actual return on plan assets— 
Purchases, sales and settlements(15)(14)
Transfers out of Level 3— — — 
Ending balance$276 $$277 

The changes in the balances of Level 3 pension plan assets during the year ended December 31, 2023 were as follows:

In millions
Private
real estate
Beginning balance$325 
Actual return on plan assets(23)
Purchases, sales and settlements(12)
Transfers out of Level 3— 
Ending balance$290 
The Company’s pension plan invests in a diversified mix of assets designed to generate returns that will enable the plan to meet its future benefit obligations. The risk of unexpected investment and actuarial outcomes is regularly evaluated. This evaluation is performed through forecasting and assessing ranges of investment outcomes over short- and long-term horizons and by assessing the pension plan’s liability characteristics. Complementary investment styles and strategies are utilized by professional investment management firms to further improve portfolio and operational risk characteristics. Public and private equity investments are used primarily to increase overall plan returns. Real Assets investments are viewed favorably for their diversification benefits and above-average dividend generation. Fixed income investments provide diversification benefits and liability hedging attributes that are desirable, especially in falling interest rate environments.

At December 31, 2024, target investment allocations for the Company’s pension plan were: 7% in equity securities, 75% in fixed income and debt securities, 7% in Real Assets, 5% in private equity limited partnerships, 2% in private credit limited partnerships and 4% in hedge funds. Actual asset allocations may differ from target allocations due to tactical decisions to overweight or underweight certain assets or as a result of normal fluctuations in asset values. Asset allocations are consistent with stated investment policies and, as a general rule, periodically rebalanced back to target asset allocations. Asset allocations and investment performance are formally reviewed periodically throughout the year by the pension plan’s Investment Subcommittee. Forecasting of asset and liability growth is performed at least annually.

Cash Flows
The Company generally contributes to its tax-qualified pension plan based on minimum funding requirements determined under applicable federal laws and regulations. Employer contributions related to the nonqualified supplemental pension plans generally represent payments to retirees for current benefits. The Company contributed $23 million, $24 million and $27 million to its pension plans during 2024, 2023 and 2022, respectively. No contributions were required for the tax-qualified pension plan in 2024. The Company expects to make an immaterial amount of contributions for all other pension plans in 2025.

The Company estimates the following future benefit payments, which are calculated using the same actuarial assumptions used to measure the pension benefit obligation as of December 31, 2024:
In millions
2025$389 
2026384 
2027380 
2028380 
2029371 
2030-2034
1,712 

Multiemployer Pension Plans
The Company also contributes to a number of multiemployer pension plans under the terms of collective-bargaining agreements that cover its union-represented employees. The risks of participating in these multiemployer plans are different from single-employer pension plans in the following respects: (i) assets contributed to the multiemployer plan by one employer may be used to provide benefits to employees of other participating employers, (ii) if a participating employer stops contributing to the plan, the unfunded obligations of the plan may be borne by the remaining participating employers, and (iii) if the Company chooses to stop participating in some of its multiemployer plans, the Company may be required to pay those plans an amount based on the underfunded status of the applicable plan, which is referred to as a withdrawal liability.

None of the multiemployer pension plans in which the Company participates are individually significant to the Company. The Company’s contributions to multiemployer pension plans were $19 million, $19 million and $20 million in 2024, 2023 and 2022, respectively.

Other Postretirement Benefits

The Company provides postretirement health care and life insurance benefits to certain retirees who meet eligibility requirements. The Company’s funding policy is generally to pay covered expenses as they are incurred. For retiree medical plan accounting, the Company reviews external data and its own historical trends for health care costs to determine the health care cost trend rates. As of December 31, 2024 and 2023, the Company’s other postretirement benefits had an accumulated postretirement benefit obligation of $147 million and $155 million, respectively. Net periodic benefit costs related to these other postretirement benefits were $6 million, $6 million and $4 million in 2024, 2023 and 2022, respectively.
The Company estimates the following future benefit payments, which are calculated using the same actuarial assumptions used to measure the accumulated other postretirement benefit obligation as of December 31, 2024:
In millions
2025$12 
202612 
202712 
202812 
202912 
2030-2034
59 
Pursuant to various collective bargaining agreements, the Company also contributes to multiemployer health and welfare plans that cover certain union-represented employees. The plans provide postretirement health care and life insurance benefits to certain employees who meet eligibility requirements. The Company’s contributions to multiemployer health and welfare plans totaled $63 million, $60 million and $62 million in 2024, 2023 and 2022, respectively.
v3.25.0.1
Income Taxes
12 Months Ended
Dec. 31, 2024
Income Tax Disclosure [Abstract]  
Income Taxes Income Taxes
The income tax provision consisted of the following for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Current:
Federal$1,658 $2,819 $2,803 
State476 662 735 
2,134 3,481 3,538 
Deferred:
Federal(453)(537)(1,526)
State(119)(139)(503)
(572)(676)(2,029)
Total$1,562 $2,805 $1,509 

The following table is a reconciliation of the statutory income tax rate to the Company’s effective income tax rate for the years ended December 31, 2024, 2023 and 2022:
202420232022
Statutory income tax rate21.0 %21.0 %21.0 %
State income taxes, net of federal tax benefit4.6 3.7 3.2 
Legal charges0.5 — 3.4 
Basis difference upon disposition of subsidiary— — 1.6 
Prior year refunds and unrecognized tax benefits— — (2.6)
Tax credits
(1.2)(0.3)(0.6)
Other0.5 0.7 (0.1)
Effective income tax rate25.4 %25.1 %25.9 %
The following table is a summary of the components of the Company’s deferred income tax assets and liabilities as of December 31, 2024 and 2023:
In millions20242023
Deferred income tax assets:
Lease and rents$4,763 $5,059 
Legal charges1,109 1,205 
Inventory68 94 
Employee benefits168 168 
Bad debts and other allowances593 606 
Net operating loss and capital loss carryforwards272 409 
Deferred income47 62 
Insurance reserves381 356 
Investments21 56 
Other486 372 
Valuation allowance(301)(385)
Total deferred income tax assets
7,607 8,002 
Deferred income tax liabilities:
Retirement benefits172 112 
Lease and rents4,125 4,469 
Depreciation and amortization7,116 7,732 
Total deferred income tax liabilities11,413 12,313 
Net deferred income tax liabilities$3,806 $4,311 

When evaluating the realizability of deferred tax assets, the Company considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies and the Company’s recent operating results. The Company established a valuation allowance of $301 million and $385 million as of December 31, 2024 and 2023, respectively, because it does not consider it more likely than not that certain deferred tax assets will be recovered.

As of December 31, 2024, the Company had net operating and capital loss carryovers of $272 million, a portion of which has an indefinite carryforward period, while the remainder expires between 2025 and 2044.

A reconciliation of the beginning and ending balance of unrecognized tax benefits in 2024, 2023 and 2022 is as follows:
In millions202420232022
Beginning balance$436 $446 $782 
Additions based on tax positions related to the current year— 
Additions based on tax positions related to prior years67 46 42 
Reductions for tax positions of prior years(49)(24)(166)
Expiration of statutes of limitation(29)(34)(4)
Settlements(1)— (213)
Ending balance$424 $436 $446 

CVS Health Corporation and most of its subsidiaries are subject to U.S. federal income tax as well as income tax of numerous state and local jurisdictions. The IRS has completed its examinations of the Company’s consolidated U.S. federal income tax returns for tax years through 2016, 2018 and 2019. The IRS has substantially completed its examination of the Company’s consolidated U.S. federal income tax return for tax year 2017.

CVS Health Corporation and its subsidiaries are also currently under income tax examinations by a number of state and local tax authorities. As of December 31, 2024, no examination has resulted in any proposed adjustments that would result in a material change to the Company’s operating results, financial condition or liquidity.
Substantially all material state and local income tax matters have been concluded for fiscal years through 2015. Certain state exams are likely to be concluded and certain state statutes of limitations will lapse in 2025, but the change in the balance of the Company’s uncertain tax positions is projected to be immaterial. In addition, it is reasonably possible that the Company’s unrecognized tax benefits could change within the next twelve months due to the anticipated conclusion of various examinations with the IRS for certain previous years. An estimate of the range of the possible change cannot be made at this time.

The Company records interest expense related to unrecognized tax benefits and penalties in the income tax provision. The Company accrued interest expense of approximately $45 million, $31 million and $29 million in 2024, 2023 and 2022, respectively. The Company had approximately $165 million and $134 million accrued for interest and penalties as of December 31, 2024 and 2023, respectively.

As of December 31, 2024, the total amount of unrecognized tax benefits that, if recognized, would affect the Company’s effective income tax rate is approximately $324 million, after considering the federal benefit of state income taxes.
v3.25.0.1
Stock Incentive Plans
12 Months Ended
Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]  
Stock Incentive Plans Stock Incentive Plans
The terms of the CVS Health 2017 Incentive Compensation Plan (“ICP”) provide for grants of annual incentive and long-term performance awards to executive officers and other officers and employees of the Company or any subsidiary of the Company, as well as equity compensation to outside directors of CVS Health Corporation. Payment of such annual incentive and long-term performance awards will be in cash, stock, other awards or other property, at the discretion of the Management Planning and Development Committee (the “MP&D Committee”) of the Board. The ICP allows for a maximum of 92 million shares of CVS Health Corporation common stock to be reserved and available for grants. As of December 31, 2024, there were approximately 33 million shares of CVS Health Corporation common stock available for future grants under the ICP.

As of the Oak Street Health Acquisition Date, Oak Street Health common stock subject to awards outstanding under the Oak Street Health, Inc. Omnibus Incentive Plan (the “Oak Street Health Plan”) was converted into approximately 3.9 million shares of CVS Health Corporation underlying replacement equity awards. In addition, in accordance with the merger agreement, shares which were available for future issuance under the Oak Street Health Plan were converted into approximately 7 million shares of CVS Health common stock which were reserved and available for issuance pursuant to future awards as of December 31, 2023. Subsequent to the cancellation of the Oak Street Health plan on May 16, 2024, the ICP is the only compensation plan under which the Company grants stock options, restricted stock and other stock-based awards to its employees.

As of the Signify Health Acquisition Date, Signify Health common stock subject to awards outstanding under the Signify Health, Inc. 2021 Long-Term Incentive Plan (the “Signify Plan”) was converted into approximately 3.2 million shares of CVS Health Corporation underlying replacement equity awards. In addition, in accordance with the merger agreement, shares which were available for future issuance under the Signify Plan were converted into approximately 9 million shares of CVS Health common stock which were reserved and available for issuance pursuant to future awards as of December 31, 2023. Subsequent to the cancellation of the Signify Plan on May 16, 2024, the ICP is the only compensation plan under which the Company grants stock options, restricted stock and other stock-based awards to its employees.

Stock-Based Compensation Expense

Stock-based compensation is measured at the grant date based on the fair value of the award and is recognized as expense over the requisite service period of the stock award (generally three to five years) using the straight-line method. The following table is a summary of stock-based compensation for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Restricted stock units and performance stock units
$461 $497 $369 
Stock options and stock appreciation rights (“SARs”) (1)
79 91 78 
Total stock-based compensation (2)
$540 $588 $447 
_____________________________________________
(1)Includes the Employee Stock Purchase Plan (“ESPP”).
(2)Total stock-based compensation for the year ended December 31, 2024 included $60 million and $41 million of post-combination expense associated with replacement equity awards granted in connection with the Oak Street Health and Signify Health acquisitions, respectively. Total stock-based
compensation for the year ended December 31, 2023 included $71 million and $72 million of post-combination expense associated with replacement equity awards granted in connection with the Oak Street Health and Signify Health acquisitions, respectively.

Restricted Stock Units and Performance Stock Units

The Company’s restricted stock units and performance stock units are considered nonvested share awards and require no payment from the employee. The fair value of the restricted stock units is based on the market price of CVS Health Corporation common stock on the grant date and is recognized on a straight-line basis over the vesting period. For each restricted stock unit granted, employees receive one share of common stock, net of taxes, at the end of the vesting period.

The Company’s performance stock units contain performance vesting conditions in addition to a service vesting condition. Vesting of the Company’s performance stock units is dependent upon the degree to which the Company achieves its performance goals, which are generally set for a three-year performance period and are approved at the time of grant by the MP&D Committee.

The fair value of performance stock units granted with service and performance vesting conditions is based on the market price of CVS Health Corporation common stock on the grant date and is recognized over the vesting period. Certain of the performance stock units also contain a market vesting condition based on the performance of CVS Health Corporation common stock relative to a comparator group. The fair value of these performance stock units is determined using a Monte Carlo simulation as of the grant date and is recognized over the vesting period.

As of December 31, 2024, there was $829 million of total unrecognized compensation cost related to the Company’s restricted stock units and performance stock units that are expected to vest. These costs are expected to be recognized over a weighted-average period of 2.2 years. The total fair value of restricted stock units vested during 2024, 2023 and 2022 was $497 million, $525 million and $328 million, respectively.

The following table is a summary of the restricted stock unit and performance stock unit activity for the year ended December 31, 2024:
In thousands, except weighted average grant date fair valueUnitsWeighted Average
Grant Date
Fair Value
Outstanding at beginning of year, nonvested16,994 $77.65 
Granted
9,978 $75.97 
Vested (1)
(6,532)$76.08 
Forfeited(1,928)$78.71 
Outstanding at end of year, nonvested18,512 $77.19 
_____________________________________________
(1)Vested performance stock units have been included at target level performance. Based on actual performance, the number of restricted stock units and performance stock units vested during the year ended December 31, 2024 was 6.6 million.

Stock Options and SARs

All stock option and SARs grants are awarded at fair value on the date of grant. The fair value of stock options and SARs are estimated using the Black-Scholes option pricing model, and stock-based compensation is recognized on a straight-line basis over the requisite service period. Stock options and SARs granted generally become exercisable over a four-year period from the grant date. Stock options granted through 2018 generally expire seven years after the grant date. Stock options and SARs granted subsequent to 2018 generally expire ten years after the grant date.

The following table is a summary of stock option and SAR activity that occurred for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Cash received from stock options exercised (including ESPP)
$361 $277 $551 
Payments for taxes for net share settlement of equity awards
185 181 370 
Intrinsic value of stock options and SARs exercised
33 31 118 
Fair value of stock options and SARs vested
225 227 219 
The fair value of each stock option and SAR is estimated using the Black-Scholes option pricing model based on the following assumptions at the time of grant:
202420232022
Dividend yield (1)
4.29 %3.27 %2.18 %
Expected volatility (2)
28.36 %28.15 %27.34 %
Risk-free interest rate (3)
4.13 %3.55 %2.46 %
Expected life (in years) (4)
5.35.96.3
Weighted-average grant date fair value$11.31 $21.78 $24.15 
_____________________________________________
(1)The dividend yield is based on annual dividends paid and the fair market value of CVS Health Corporation stock at the grant date.
(2)The expected volatility is estimated based on the historical volatility of CVS Health Corporation’s daily stock price over a period equal to the expected life of each option grant after adjustments for infrequent events such as stock splits.
(3)The risk-free interest rate is selected based on yields from U.S. Treasury zero-coupon issues with a remaining term equal to the expected term of the options being valued.
(4)The expected life represents the number of years the options are expected to be outstanding from grant date based on historical option or SAR holder exercise experience.

As of December 31, 2024, unrecognized compensation expense related to unvested stock options and SARs totaled $44 million, which the Company expects to be recognized over a weighted-average period of 2.24 years. After considering anticipated forfeitures, the Company expects approximately 7 million of the unvested stock options and SARs to vest over the requisite service period.

The following table is a summary of the Company’s stock option and SAR activity for the year ended December 31, 2024:
In thousands, except weighted average exercise price and remaining contractual termSharesWeighted
Average
Exercise
 Price
Weighted
Average
Remaining
Contractual
Term
Aggregate
Intrinsic
Value
Outstanding at beginning of year15,126 $68.13 
Granted
4,435 $68.91 
Exercised(2,806)$59.61 
Forfeited(1,046)$79.05 
Expired(690)$78.69 
Outstanding at end of year15,019 $68.69 5.10$3,279 
Exercisable at end of year7,579 $65.01 3.251,939 
Vested at end of year and expected to vest in the future14,646 $68.66 5.023,252 

ESPP

The Company’s ESPP provides for the purchase of up to 60 million shares of CVS Health Corporation common stock. Under the ESPP, eligible employees may purchase common stock at the end of each six month offering period at a purchase price equal to 90% of the lower of the fair market value on the first day or the last day of the offering period. During 2024, approximately 4 million shares of common stock were purchased under the provisions of the ESPP at an average price of $58.57 per share. As of December 31, 2024, approximately 23 million shares of common stock were available for issuance under the ESPP.

The fair value of stock-based compensation associated with the ESPP is estimated on the date of grant (the first day of the six-month offering period) using the Black-Scholes option pricing model.
The following table is a summary of the assumptions used to value the ESPP awards for the years ended December 31, 2024, 2023 and 2022:
202420232022
Dividend yield (1)
2.01 %1.54 %1.12 %
Expected volatility (2)
31.40 %25.61 %23.54 %
Risk-free interest rate (3)
5.31 %5.17 %1.42 %
Expected life (in years) (4)
0.50.50.5
Weighted-average grant date fair value$12.39 $14.26 $16.25 
_____________________________________________
(1)The dividend yield is calculated based on semi-annual dividends paid and the fair market value of CVS Health Corporation stock at the grant date.
(2)The expected volatility is estimated based on the historical volatility of CVS Health Corporation’s daily stock price over the previous six month period.
(3)The risk-free interest rate is selected based on the Treasury constant maturity interest rate whose term is consistent with the expected term of ESPP purchases (i.e., six months).
(4)The expected life is based on the semi-annual purchase period.
v3.25.0.1
Shareholders' Equity
12 Months Ended
Dec. 31, 2024
Equity [Abstract]  
Shareholders' Equity Shareholders’ Equity
Share Repurchases

The following share repurchase programs have been authorized by the Board:
In billions
Authorization Date
Authorized
Remaining as of
December 31, 2024
November 17, 2022 (“2022 Repurchase Program”)$10.0 $10.0 
December 9, 2021 (“2021 Repurchase Program”)10.0 1.5 

Each of the share Repurchase Programs was effective immediately and permit the Company to effect repurchases from time to time through a combination of open market repurchases, privately negotiated transactions, accelerated share repurchase (“ASR”) transactions, and/or other derivative transactions. Both the 2022 and 2021 Repurchase Programs can be modified or terminated by the Board at any time.

During the years ended December 31, 2024, 2023 and 2022, the Company repurchased an aggregate of 39.7 million shares of common stock for approximately $3.0 billion, an aggregate of 22.8 million shares of common stock for approximately $2.0 billion and an aggregate of 34.1 million shares of common stock for approximately $3.5 billion, respectively, each pursuant to the 2021 Repurchase Program. This activity includes the share repurchases under the ASR transactions described below.

Pursuant to the authorization under the 2021 Repurchase Program, the Company entered into a $3.0 billion fixed dollar ASR with Morgan Stanley & Co. LLC (“Morgan Stanley”). Upon payment of the $3.0 billion purchase price on January 4, 2024, the Company received a number of shares of CVS Health Corporation’s common stock equal to 85% of the $3.0 billion notional amount of the ASR or approximately 31.4 million shares, which were placed into treasury stock in January 2024. The ASR was accounted for as an initial treasury stock transaction for $2.6 billion and a forward contract for $0.4 billion. The forward contract was classified as an equity instrument and was recorded within capital surplus. In March 2024, the Company received approximately 8.3 million shares of CVS Health Corporation’s common stock, representing the remaining 15% of the $3.0 billion notional amount of the ASR, thereby concluding the ASR. These shares were placed into treasury and the forward contract was reclassified from capital surplus to treasury stock in March 2024.

Pursuant to the authorization under the 2021 Repurchase Program, the Company entered into a $2.0 billion fixed dollar ASR with Citibank, N.A. Upon payment of the $2.0 billion purchase price on January 4, 2023, the Company received a number of shares of CVS Health Corporation’s common stock equal to 80% of the $2.0 billion notional amount of the ASR or approximately 17.4 million shares, which were placed into treasury stock in January 2023. The ASR was accounted for as an initial treasury stock transaction for $1.6 billion and a forward contract for $0.4 billion. The forward contract was classified as an equity instrument and was recorded within capital surplus. In February 2023, the Company received approximately 5.4 million shares of CVS Health Corporation’s common stock, representing the remaining 20% of the $2.0 billion notional amount of the ASR, thereby concluding the ASR. These shares were placed into treasury stock and the forward contract was reclassified from capital surplus to treasury stock in February 2023.
Pursuant to the authorization under the 2021 Repurchase Program, the Company entered into a $1.5 billion fixed dollar ASR with Barclays Bank PLC. Upon payment of the $1.5 billion purchase price on January 4, 2022, the Company received a number of shares of CVS Health Corporation’s common stock equal to 80% of the $1.5 billion notional amount of the ASR or approximately 11.6 million shares, which were placed into treasury stock in January 2022. The ASR was accounted for as an initial treasury stock transaction for $1.2 billion and a forward contract for $0.3 billion. The forward contract was classified as an equity instrument and was recorded within capital surplus. In February 2022, the Company received approximately 2.7 million shares of CVS Health Corporation’s common stock, representing the remaining 20% of the $1.5 billion notional amount of the ASR, thereby concluding the ASR. These shares were placed into treasury stock and the forward contract was reclassified from capital surplus to treasury stock in February 2022.

At the time they were received, the initial and final receipt of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted average common shares outstanding for basic and diluted earnings per share.

Dividends

The quarterly cash dividend declared by the Board was $0.665, $0.605 and $0.55 per share in 2024, 2023 and 2022, respectively. CVS Health Corporation has paid cash dividends every quarter since becoming a public company. Future dividend payments will depend on the Company’s earnings, capital requirements, financial condition and other factors considered relevant by the Board.

Regulatory Requirements

The Company’s insurance business operations are conducted through subsidiaries that principally consist of health maintenance organizations (“HMOs”) and insurance companies. The Company’s HMO and insurance subsidiaries report their financial statements in accordance with accounting practices prescribed by state regulatory authorities which may differ from GAAP. The combined statutory net income for the years ended and estimated combined statutory and capital surplus at December 31, 2024, 2023 and 2022 for the Company’s insurance and HMO subsidiaries were as follows:
In millions202420232022
Statutory net income (loss)
$(1,185)$2,757 $2,851 
Estimated statutory capital and surplus
20,085 16,961 15,503 

The Company’s insurance and HMO subsidiaries paid $755 million of gross dividends to the Company for the year ended December 31, 2024.

In addition to general state law restrictions on payments of dividends and other distributions to stockholders applicable to all corporations, HMOs and insurance companies are subject to further regulations that, among other things, may require those companies to maintain certain levels of equity and restrict the amount of dividends and other distributions that may be paid to their equity holders. In addition, in connection with the acquisition of Aetna, the Company made certain undertakings that require prior regulatory approval of dividends by certain of its HMOs and insurance companies. At December 31, 2024, these amounts were as follows:
In millions
Estimated minimum statutory surplus required by regulators$11,691 
Investments on deposit with regulatory bodies713 
Estimated maximum dividend distributions permitted in 2025 without prior regulatory approval
1,561 

Noncontrolling Interests

At December 31, 2024 and 2023, noncontrolling interests were $170 million and $175 million, respectively, primarily related to third party interests in the Company’s operating entities. The noncontrolling entities’ share is included in total shareholders equity on the consolidated balance sheets.
v3.25.0.1
Other Comprehensive Income (Loss)
12 Months Ended
Dec. 31, 2024
Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Other Comprehensive Income (Loss) Other Comprehensive Income (Loss)
Shareholders’ equity included the following activity in accumulated other comprehensive loss in 2024, 2023 and 2022:
At December 31,
In millions202420232022
Net unrealized investment gains (losses):
Beginning of year balance$(429)$(1,519)$798 
Other comprehensive income (loss) before reclassifications ($(177), $612 and $(3,021) pretax)
(170)603 (2,556)
Amounts reclassified from accumulated other comprehensive income (loss) ($226, $566 and $315 pretax) (1)
200 487 239 
Other comprehensive income (loss)30 1,090 (2,317)
End of year balance(399)(429)(1,519)
Change in discount rate on long-duration insurance reserves:
Beginning of period balance152 219 (651)
Other comprehensive income (loss) before reclassifications ($146, $(92), and $1,126 pretax)
113 (67)870 
Other comprehensive income (loss)113 (67)870 
End of period balance265 152 219 
Foreign currency translation adjustments:
Beginning of year balance
— — — 
Other comprehensive loss before reclassifications(4)— — 
Other comprehensive loss(4)— — 
End of year balance
(4)— — 
Net cash flow hedges:
Beginning of year balance244 239 222 
Other comprehensive income before reclassifications ($0, $25 and $38 pretax)
— 19 28 
Amounts reclassified from accumulated other comprehensive income ($(20), $(19) and $(15) pretax) (2)
(15)(14)(11)
Other comprehensive income (loss)(15)17 
End of year balance229 244 239 
Pension and other postretirement benefits:
Beginning of year balance(264)(203)(35)
Other comprehensive income (loss) before reclassifications ($71, $(81) and $(229) pretax)
53 (61)(170)
Amounts reclassified from accumulated other comprehensive loss ($0, $0 and $3 pretax) (3)
— — 
Other comprehensive income (loss) 53 (61)(168)
End of year balance(211)(264)(203)
Total beginning of year accumulated other comprehensive income (loss)(297)(1,264)334 
Total other comprehensive income (loss)177 967 (1,598)
Total end of year accumulated other comprehensive loss
$(120)$(297)$(1,264)
_______________________________________
(1)Amounts reclassified from accumulated other comprehensive income (loss) for specifically identified debt securities are included in net investment income in the consolidated statements of operations.
(2)Amounts reclassified from accumulated other comprehensive income for specifically identified cash flow hedges are included within interest expense in the consolidated statements of operations. The Company expects to reclassify $16 million, net of tax, in net gains associated with its cash flow hedges into net income within the next 12 months.
(3)Amounts reclassified from accumulated other comprehensive loss for specifically identified pension and other postretirement benefits are included in other income in the consolidated statements of operations.
v3.25.0.1
Earnings Per Share
12 Months Ended
Dec. 31, 2024
Earnings Per Share [Abstract]  
Earnings Per Share Earnings Per Share
Earnings per share is computed using the treasury stock method. Stock options and SARs to purchase 8 million, 8 million and 4 million shares of common stock were outstanding, but were excluded from the calculation of diluted earnings per share for the years ended December 31, 2024, 2023 and 2022, respectively, because their exercise prices were greater than the average market price of the common shares and, therefore, the effect would be antidilutive.

The following is a reconciliation of basic and diluted earnings per share for the years ended December 31, 2024, 2023 and 2022:
In millions, except per share amounts202420232022
Numerator for earnings per share calculation:
Net income attributable to CVS Health$4,614 $8,344 $4,311 
Denominator for earnings per share calculation:
Weighted average shares, basic1,259 1,285 1,312 
Restricted stock units and performance stock units
Stock options and SARs
Weighted average shares, diluted1,262 1,290 1,323 
Earnings per share:
Basic$3.67 $6.49 $3.29 
Diluted$3.66 $6.47 $3.26 
v3.25.0.1
Reinsurance
12 Months Ended
Dec. 31, 2024
Reinsurance Disclosures [Abstract]  
Reinsurance Reinsurance
The Company utilizes reinsurance agreements primarily to: (a) reduce required capital and (b) facilitate the acquisition or disposition of certain insurance contracts. Ceded reinsurance agreements permit the Company to recover a portion of its losses from reinsurers, although they do not discharge the Company’s primary liability as the direct insurer of the risks reinsured.

In January 2025, the Company entered into three four-year reinsurance agreements with an unrelated reinsurer that allow it to reduce required capital and provide collateralized excess of loss reinsurance coverage on a portion of the Health Care Benefits segment’s group Commercial Insured business.

Reinsurance recoverables (recorded as other current assets or other assets on the consolidated balance sheets) at December 31, 2024 and 2023 were as follows:
In millions20242023
Reinsurer
Hartford Life and Accident Insurance Company$1,119 $1,314 
Lincoln Life & Annuity Company of New York444 480 
Individual State Reinsurance Programs
189 61 
Fresenius Medical Care Reinsurance Company (Cayman) Ltd. 75 54 
Resolution Life Group Holdings Ltd.33 35 
All Other67 54 
Total$1,927 $1,998 
Direct, assumed and ceded premiums earned for the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Direct$123,629 $99,753 $85,670 
Assumed471 350 432 
Ceded(1,204)(911)(772)
Net premiums$122,896 $99,192 $85,330 

The impact of reinsurance on health care costs for the years ended December 31, 2024, 2023 and 2022 was as follows:
In millions202420232022
Direct$115,974 $86,738 $71,357 
Assumed431 223 379 
Ceded(1,284)(714)(663)
Net health care costs
$115,121 $86,247 $71,073 

There is not a material difference between premiums on a written basis versus an earned basis.

The Company also has various agreements with unrelated reinsurers that do not qualify for reinsurance accounting under GAAP, and consequently are accounted for using deposit accounting. The Company entered into these contracts to reduce the risk of catastrophic loss which in turn reduces the Company’s capital and surplus requirements. Total deposit assets and liabilities related to reinsurance agreements that do not qualify for reinsurance accounting under GAAP were not material as of December 31, 2024 or 2023.
v3.25.0.1
Commitments and Contingencies
12 Months Ended
Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies Commitments and Contingencies
Guarantees

The Company had the following significant guarantee arrangements at December 31, 2024:

ASC Claim Funding Accounts - The Company has arrangements with certain banks for the processing of claim payments for its ASC customers. The banks maintain accounts to fund claims of the Company’s ASC customers. The customer is responsible for funding the amount paid by the bank each day. In these arrangements, the Company guarantees that the banks will not sustain losses if the responsible ASC customer does not properly fund its account. The aggregate maximum exposure under these arrangements is generally limited to $300 million. The Company can limit its exposure to these guarantees by suspending the payment of claims for ASC customers that have not adequately funded the amount paid by the bank.
Separate Accounts Assets - Certain Separate Accounts assets associated with the large case pensions business in the Corporate/Other segment represent funds maintained as a contractual requirement to fund specific pension annuities that the Company has guaranteed. Minimum contractual obligations underlying the guaranteed benefits in these Separate Accounts were approximately $857 million and $834 million at December 31, 2024 and 2023, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information on Separate Accounts. Contract holders assume all investment and mortality risk and are required to maintain Separate Accounts balances at or above a specified level. The level of required funds is a function of the risk underlying the Separate Account’s investment strategy. If contract holders do not maintain the required level of Separate Accounts assets to meet the annuity guarantees, the Company would establish an additional liability. Contract holders’ balances in the Separate Accounts at December 31, 2024 exceeded the value of the guaranteed benefit obligation. As a result, the Company was not required to maintain any additional liability for its related guarantees at December 31, 2024.

Lease Guarantees

Between 1995 and 1997, the Company sold or spun off a number of subsidiaries, including Bob’s Stores, Linens ‘n Things and Marshalls. In many cases, when a former subsidiary leased a store, the Company provided a guarantee of the former subsidiary’s lease obligations for the initial lease term and any extension thereof pursuant to a renewal option provided for in the lease prior to the time of the disposition. When the subsidiaries were disposed of and accounted for as discontinued operations, the Company’s guarantees remained in place, although each initial purchaser agreed to indemnify the Company for
any lease obligations the Company was required to satisfy. If any of the purchasers or any of the former subsidiaries fail to make the required payments under a store lease, the Company could be required to satisfy those obligations. As of December 31, 2024, the Company guaranteed 61 such store leases (excluding the lease guarantees related to Linens ‘n Things, which have been recorded as a liability on the consolidated balance sheets), with the maximum remaining lease term extending through 2035.

Guaranty Fund Assessments, Market Stabilization and Other Non-Voluntary Risk Sharing Pools

Under guaranty fund laws existing in all states, insurers doing business in those states can be assessed (in most states up to prescribed limits) for certain obligations of insolvent insurance companies to policyholders and claimants. The life and health insurance guaranty associations in which the Company participates that operate under these laws respond to insolvencies of long-term care insurers and life insurers as well as health insurers. The Company’s assessments generally are based on a formula relating to the Company’s health care premiums in the state compared to the premiums of other insurers. Certain states allow assessments to be recovered over time as offsets to premium taxes. Some states have similar laws relating to HMOs and/or other payors such as not-for-profit consumer-governed health plans established under the ACA.

In 2009, the Pennsylvania Insurance Commissioner placed long-term care insurer Penn Treaty Network America Insurance Company and one of its subsidiaries (collectively, “Penn Treaty”) in rehabilitation, an intermediate action before insolvency, and subsequently petitioned a state court to convert the rehabilitation into a liquidation. Penn Treaty was placed in liquidation in March 2017. The Company has recorded a liability for its estimated share of future assessments by applicable life and health insurance guaranty associations. It is reasonably possible that in the future the Company may record a liability and expense relating to other insolvencies which could have a material adverse effect on the Company’s operating results, financial condition and cash flows. While historically the Company has ultimately recovered more than half of guaranty fund assessments through statutorily permitted premium tax offsets, significant increases in assessments could lead to legislative and/or regulatory actions that limit future offsets.

HMOs in certain states in which the Company does business are subject to assessments, including market stabilization and other risk-sharing pools, for which the Company is assessed charges based on incurred claims, demographic membership mix and other factors. The Company establishes liabilities for these assessments based on applicable laws and regulations. In certain states, the ultimate assessments the Company pays are dependent upon the Company’s experience relative to other entities subject to the assessment, and the ultimate liability is not known at the financial statement date. While the ultimate amount of the assessment is dependent upon the experience of all pool participants, the Company believes it has adequate reserves to cover such assessments.

The Company’s total guaranty fund assessments liability was immaterial at both December 31, 2024 and 2023.

Litigation and Regulatory Proceedings

The Company has been involved or is currently involved in numerous legal proceedings, including litigation, arbitration, government investigations, audits, reviews and claims. These include routine, regular and special investigations, audits and reviews by CMS, state insurance and health and welfare departments, the U.S. Department of Justice (the “DOJ”), state Attorneys General, the U.S. Drug Enforcement Administration (the “DEA”), the U.S. Federal Trade Commission (the “FTC”) and other governmental authorities.

Legal proceedings, in general, and securities, class action and multi-district litigation, in particular, and governmental special investigations, audits and reviews can be expensive and disruptive. Some of the litigation matters may purport or be determined to be class actions and/or involve parties seeking large and/or indeterminate amounts, including punitive or exemplary damages, and may remain unresolved for several years. The Company also may be named from time to time in qui tam actions initiated by private third parties that could also be separately pursued by a governmental body. The results of legal proceedings, including government investigations, are often uncertain and difficult to predict, and the costs incurred in these matters can be substantial, regardless of the outcome.

The Company records accruals for outstanding legal matters when it believes it is probable that a loss will be incurred and the amount can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal matters that could affect the amount of any accrual and developments that would make a loss contingency both probable and reasonably estimable. If a loss contingency is not both probable and reasonably estimable, the Company does not establish an accrued liability. Other than the controlled substances litigation accruals described below, none of the Company’s accruals for outstanding legal matters are material individually or in the aggregate to the Company’s consolidated balance sheets.
Except as otherwise noted, the Company cannot predict with certainty the timing or outcome of the legal matters described below, and the Company is unable to reasonably estimate a possible loss or range of possible loss in excess of amounts already accrued for these matters. The Company believes that its defenses and assertions in pending legal proceedings have merit and does not believe that any of these pending matters, after consideration of applicable reserves and rights to indemnification, will have a material adverse effect on the Company’s financial position. Substantial unanticipated verdicts, fines and rulings, however, do sometimes occur, which could result in judgments against the Company, entry into settlements or a revision to its expectations regarding the outcome of certain matters, and such developments could have a material adverse effect on its results of operations. In addition, as a result of governmental investigations or proceedings, the Company may be subject to damages, civil or criminal fines or penalties, or other sanctions including possible suspension or loss of licensure and/or exclusion from participating in government programs. The outcome of such governmental investigations of proceedings could be material to the Company.

Usual and Customary Pricing Litigation

The Company is named as a defendant in a number of lawsuits that allege that the Company’s retail pharmacies overcharged for prescription drugs by not submitting the correct usual and customary price during the claims adjudication process. These actions are brought by a number of different types of plaintiffs, including plan members, private payors and government payors, and are based on different legal theories. Some of these cases are brought as putative class actions, and in some instances, classes have been certified. The Company is defending itself against these claims.

PBM Litigation and Investigations

The Company is named as a defendant in a number of lawsuits and is subject to a number of investigations concerning its PBM practices.

The Company is facing multiple lawsuits, including by the FTC, state Attorneys General, governmental subdivisions, private parties and several putative class actions, regarding drug pricing and its rebate arrangements with drug manufacturers. These complaints, brought by a number of different types of plaintiffs under a variety of legal theories, generally allege that rebate agreements between the drug manufacturers and PBMs caused inflated prices for certain drug products. The majority of these cases have now been transferred into a multi-district litigation in the U.S. District Court for the District of New Jersey. The Company is defending itself against these claims. The Company has also received subpoenas, civil investigative demands (“CIDs”), and other requests for documents and information from, and is being investigated by, the DOJ, the HHS, the FTC and Attorneys General of several states and the District of Columbia regarding its PBM practices, including pharmacy contracting practices and reimbursement, pricing and rebates. While the FTC has released a number of interim staff reports related to its studies of PBM practices under Section 6(b) of the FTC Act, which allows the FTC to conduct studies, among other activities, it has not yet released a final report. The Company has been providing documents and information in response to these subpoenas, CIDs, and requests for information. In September 2024, the FTC filed an administrative complaint against the three largest PBMs (the “PBM Group”) and their affiliated group purchasing organizations, including subsidiaries of the Company. The complaint alleged that the PBM Group and their affiliated group purchasing organizations engaged in anti-competitive and unfair practices that “artificially” increased insulin costs. The Company is aggressively defending itself against the complaint. In November 2024, the PBM Group filed a complaint in the U.S. District Court for the Eastern District of Missouri challenging the constitutionality of the FTC’s administrative complaint.

United States ex rel. Behnke v. CVS Caremark Corporation, et al. (U.S. District Court for the Eastern District of Pennsylvania). In April 2018, the Court unsealed a complaint filed in February 2014. The government has declined to intervene in this case. The relator alleges that the Company submitted, or caused to be submitted, to Part D of the Medicare program Prescription Drug Event data and/or Direct and Indirect Remuneration reports that misrepresented true prices paid by the Company’s PBM to pharmacies for drugs dispensed to Part D beneficiaries with prescription benefits administered by the Company’s PBM. The Company is defending itself against these claims.

Controlled Substances Litigation, Audits and Subpoenas

Forty-five states, the District of Columbia, and all eligible United States territories are participating in a settlement resolving substantially all opioid claims against Company entities by participating states and political subdivisions but not private plaintiffs. A high percentage of eligible subdivisions within the participating states also have elected to join the settlement. The settlement agreement is available at nationalopioidsettlement.com. The Company has separately entered into settlement
agreements with four states – Florida, West Virginia, New Mexico and Nevada – and a high percentage of eligible subdivisions within those states also have elected to participate.

The final settlement agreement contains certain contingencies related to payment obligations. Because these contingencies are inherently unpredictable, the assessment requires judgments about future events. The amount of ultimate loss may differ from the amount accrued by the Company.

The State of Maryland has elected not to participate, and thus subdivisions within the State of Maryland may not participate, in the settlement. The State of Maryland has issued a civil subpoena for information from the Company, and litigation is pending with certain subdivisions within the State of Maryland as well as other non-participating subdivisions in other geographies, including the City of Philadelphia, and private parties such as hospitals and third-party payors. The Company is defending itself against the claims made in these cases.

In November 2021, the Company was among the chain pharmacies found liable by a jury in a trial in federal court in Ohio; in August 2022, the court issued a judgment jointly against the three defendants in the amount of $651 million to be paid over 15 years and also ordered certain injunctive relief. In December 2024, following an appeal by the Company, the Supreme Court of Ohio ruled that Ohio law precluded the claim on which the verdict and judgment were based.

Because of the many uncertainties associated with any settlement arrangement or other resolution of opioid-related litigation matters, and because the Company continues to actively defend ongoing litigation for which it believes it has defenses and assertions that have merit, the Company is not able to reasonably estimate the range of ultimate possible loss for all opioid-related litigation matters at this time. The outcome of these legal matters could have a material effect on the Company’s business, financial condition, operating results and/or cash flows.

In December 2024, the DOJ intervened in a previously sealed qui tam action and filed an amended complaint in the U.S. District Court for the District of Rhode Island, alleging, among other claims, violations of the federal Controlled Substances Act and the federal False Claims Act based on the filling of opioid and other controlled substance prescriptions at CVS Pharmacy locations nationwide. The Company is defending itself against the claims made in this case. Separately, the Company was served in December 2024 with a subpoena issued by the U.S. Attorney’s Office for the Western District of Virginia, seeking records related to, among other things, commercial arrangements between the Company’s PBM and opioid manufacturers.

Prescription Processing Litigation and Investigations

The Company is named as a defendant in a number of lawsuits and is subject to a number of investigations concerning its prescription processing practices, including related to billing government payors for prescriptions, and the following:

U.S. ex rel. Bassan et al. v. Omnicare, Inc. and CVS Health Corp. (U.S. District Court for the Southern District of New York). In December 2019, the U.S. Attorney’s Office for the Southern District of New York filed a complaint-in-intervention in this previously sealed qui tam case. The complaint alleges that for certain non-skilled nursing facilities, Omnicare improperly filled prescriptions beyond one year where a valid prescription did not exist and that these dispensing events violated the federal False Claims Act. The Company is defending itself against these claims.

U.S. ex rel. Gill et al. v. CVS Health Corp. et al. (U.S. District Court for the Northern District of Illinois). In July 2022, the Delaware Attorney General’s Office moved for partial intervention as to allegations under the Delaware false claims act related to not escheating alleged overpayments in this previously sealed qui tam case. The federal government and the remaining states declined to intervene on other additional theories in the relator’s complaint, except that the federal government filed a notice of intervention for the limited purpose of defending the constitutionality of the qui tam provisions of the False Claims Act. The Company is defending itself against all of the claims.

Provider Proceedings

The Company is named as a defendant in purported class actions and individual lawsuits arising out of its practices related to the payment of claims for services rendered to its members by providers with whom the Company has a contract and with whom the Company does not have a contract (“out-of-network providers”). Among other things, these lawsuits allege that the Company paid too little to its health plan members and/or providers for out-of-network services (including COVID-19 testing) and/or otherwise allege that the Company failed to timely or appropriately pay or administer claims and benefits (including the
Company’s post payment audit and collection practices). Other major health insurers are the subject of similar litigation or have settled similar litigation.

The Company also has received subpoenas and/or requests for documents and other information from, and been investigated by, state Attorneys General and other state and/or federal regulators, legislators and agencies relating to claims payments, and the Company is involved in other litigation regarding its out-of-network benefit payment and administration practices. It is reasonably possible that others could initiate additional litigation or additional regulatory action against the Company with respect to its out-of-network benefit payment and/or administration practices.

CMS Actions

CMS regularly audits the Company’s performance to determine its compliance with CMS’s regulations and its contracts with CMS and to assess the quality of services it provides to Medicare beneficiaries. CMS uses various payment mechanisms to allocate and adjust premium payments to the Company’s and other companies’ Medicare plans by considering the applicable health status of Medicare members as supported by information prepared, maintained and provided by providers. The Company collects claim and encounter data from providers and generally relies on providers to appropriately code their submissions to the Company and document their medical records, including the diagnosis data submitted to the Company with claims. CMS pays increased premiums to Medicare Advantage plans and Medicare PDP plans for members who have certain medical conditions identified with specific diagnosis codes. Federal regulators review and audit the providers’ medical records to determine whether those records support the related diagnosis codes that determine the members’ health status and the resulting risk-adjusted premium payments to the Company. In that regard, CMS has instituted risk adjustment data validation (“RADV”) audits of various Medicare Advantage plans, including certain of the Company’s plans, to validate coding practices and supporting medical record documentation maintained by providers and the resulting risk-adjusted premium payments to the plans. CMS may require the Company to refund premium payments if the Company’s risk-adjusted premiums are not properly supported by medical record data. The Office of the Inspector General of the U.S. Department of Health and Human Services (the “OIG”) also is auditing the Company’s risk adjustment-related data and that of other companies. The Company expects CMS and the OIG to continue these types of audits.

In 2012, in the “Notice of Final Payment Error Calculation for Part C Medicare Advantage Risk Adjustment Validation Data (“RADV”) Contract-Level Audits,” CMS revised its audit methodology for RADV contract-level audits to determine refunds payable by Medicare Advantage plans for contract year 2011 and forward. Under the revised methodology, among other things, CMS announced extrapolation of the error rate identified in the audit sample along with the application of a process to account for errors in the government’s traditional fee-for-service Medicare program (“FFS Adjuster”). For contract years prior to 2011, CMS did not extrapolate sample error rates to the entire contract, nor did CMS propose to apply a FFS adjuster. By applying the FFS Adjuster, Medicare Advantage organizations would have been liable for repayments only to the extent that their extrapolated payment errors exceeded the error rate in Original Medicare, which could have impacted the extrapolated repayments to which Medicare Advantage organizations are subject. This revised contract-level audit methodology increased the Company’s exposure to premium refunds to CMS based on incomplete medical records maintained by providers. In the RADV audit methodology CMS used from 2011-2013, CMS selected only a few of the Company’s Medicare Advantage contracts for various contract years for contract-level RADV audits. In October 2018, CMS in the proposed rule announced a new methodology for RADV audits targeting certain health conditions and members with many diagnostic conditions along with extrapolation for the error rates identified without use of a FFS Adjuster. While the rule was under proposal, CMS initiated contract-level RADV audits for the years 2014 and 2015 with this new RADV methodology without a final rule.

On January 30, 2023, CMS released the final rule (“RADV Audit Rule”), announcing it may use extrapolation for payment years 2018 forward, for both RADV audits and OIG contract level audits, and eliminated the application of a FFS Adjuster in Part C contract-level RADV audits of Medicare Advantage organizations. In the RADV Audit Rule, CMS indicated that it will use more than one audit methodology going forward and indicated CMS will audit contracts it believes are at the highest risk for overpayments based on its statistical modeling, citing a 2016 Governmental Accountability Office report that recommended selection of contract-level RADV audits with a focus on contracts likely to have high rates of improper payment, the highest coding intensity scores, and contracts with high levels of unsupported diagnoses from prior RADV audits.

The Company is currently unable to predict which of its Medicare Advantage contracts will be selected for audit, the amounts of any retroactive refunds for years prior to 2018 or prospective adjustments to Medicare Advantage premium payments made to the Company, the effect of any such refunds or adjustments on the actuarial soundness of the Company’s Medicare Advantage bids, or whether any RADV audit findings would require the Company to change its method of estimating future premium revenue in future bid submissions to CMS or compromise premium assumptions made in the Company’s bids for prior contract years, the current contract year or future contract years. Any premium or fee refunds or adjustments resulting
from regulatory audits, whether as a result of RADV, Public Exchange-related or other audits by CMS, the OIG or otherwise, including audits of the Company’s minimum loss ratio rebates, methodology and/or reports, could be material and could adversely affect the Company’s operating results, cash flows and/or financial condition.

The RADV Audit Rule does not apply to the CMS Part C Improper Payment Measures audits nor the HHS RADV programs.

Medicare and Medicaid Litigation and Investigations

The Company has received CIDs from the Civil Division of the DOJ in connection with investigations of the Company’s identification and/or submission of diagnosis codes related to risk adjustment payments, including patient chart review processes, under Parts C and D of the Medicare program. The Company is cooperating with the government and providing documents and information in response to these CIDs.

In May 2017, the Company received a CID from the U.S. Attorney’s Office for the Southern District of New York requesting documents and information concerning possible false claims submitted to Medicare in connection with reimbursements for prescription drugs under the Medicare Part D program. The Company has been cooperating with the government and providing documents and information in response to this CID.

Since January 2022, the U.S. Attorney’s Office for the District of Massachusetts has issued subpoenas to Aetna Life Insurance Company seeking, among other things, information in connection with its relationship and compensation arrangements with certain brokers, and the Company may receive similar inquiries in the future. The Company is cooperating with the investigation.

Stockholder Matters

Beginning in February 2019, multiple class action complaints, as well as a derivative complaint, were filed by putative plaintiffs against the Company and certain current and former officers and directors. The plaintiffs in these cases assert a variety of causes of action under federal securities laws that are premised on allegations that the defendants made certain omissions and misrepresentations relating to the performance of the Company’s LTC business unit. Since filing, several of the cases have been consolidated, and two have resolved. In February 2025, the District of Rhode Island granted the Company’s motion to dismiss In re CVS Health Corp. Securities Act Litigation (formerly known as Waterford). A derivative case in the District of Rhode Island, Lovoi v. Aguirre, had been stayed pending the outcome of the Waterford case, and the court has scheduled a status conference. In In re CVS Health Corp. Securities Litigation (formerly known as City of Warren and Freundlich), the Rhode Island Supreme Court affirmed the superior court’s order granting the Company’s motion to dismiss in January 2025. The Company and its current and former officers and directors are defending themselves against remaining claims.

Beginning in December 2021, the Company has received three demands for inspection of books and records pursuant to Delaware General Corporation Law Section 220 (“Section 220 demands”), as well as a derivative complaint (Vladimir Gusinsky Revocable Trust v. Lynch, et al.) that was filed in January 2023, which the defendants moved to dismiss. The Section 220 demands and the complaint purport to be related to potential breaches of fiduciary duties by the Board in relation to certain matters concerning opioids. Following the Company’s response to the Section 220 demands, two of the three stockholders sent demand letters to the Board containing allegations substantially similar to those made in the earlier Section 220 demands and the derivative matter, and requested that it take certain actions, including consideration of its governance and policies with respect to controlled substances. The Board deferred consideration of these two demands until after the motion to dismiss the Gusinsky case was decided. In July 2024, the court granted the defendants’ motion to dismiss the Gusinsky case. In September 2024, the Board received a third demand letter containing similar allegations and requesting the Board take action. The Board has formed a demand review committee to evaluate the demands.

In January 2022, a shareholder class action complaint was filed in the Northern District of Illinois, Allison v. Oak Street Health, Inc., et al. Defendants include Oak Street Health and certain of its pre-acquisition officers and directors. The putative plaintiffs assert causes of action under various securities laws premised on allegations that defendants made omissions and misrepresentations to investors relating to marketing conduct they allege may violate the False Claims Act. In May 2024, the parties reached agreement in principle to settle this action for an amount immaterial to the Company. The court granted approval of the settlement in December 2024.

Beginning in July 2024, two purported class action complaints, as well as multiple derivative complaints, were filed by putative plaintiffs against the Company and certain current and former officers and directors. The plaintiffs in these cases assert a variety of causes of action under federal securities laws and state law that are premised on allegations that the defendants made certain
omissions and misrepresentations relating to the profitability of the Health Care Benefits segment. Two purported class actions were filed and have been consolidated in U.S. District Court for the Southern District of New York under Nixon v. CVS Health Corporation, et al. Two derivative cases were also filed in the Southern District of New York and have been consolidated as In re CVS Health Corporation Derivative Litigation. Two derivative cases filed in the District of Rhode Island have been consolidated as In re CVS Health Corporation Stockholder Derivative Litigation. The consolidated derivative actions have been stayed pending the outcome of any motion to dismiss in the consolidated Nixon securities class action. Three additional derivative cases were filed in Rhode Island Superior Court: Goff v. Lynch, et al., Brodin v. Lynch, et al., and Davidow v. Lynch, et al. The Company and the individual defendants are defending themselves against these claims. In January 2025, the Board received a stockholder demand containing allegations substantially similar to those made in the class action and derivative matters, and requesting that it take certain actions, including investigating whether any Board members or officers breached their fiduciary duties related to those allegations, and bringing litigation to recover the Company’s damages if any such misconduct is found. The Board is evaluating the demand.

Other Legal and Regulatory Proceedings

The Company is also a party to other legal proceedings and is subject to government investigations, inquiries and audits, and has received and is cooperating with the government in response to CIDs, subpoenas, or similar process from various governmental agencies requesting information. These other legal proceedings and government actions include claims of or relating to bad faith, medical or professional malpractice, breach of fiduciary duty, claims processing, dispensing of medications, the use of medical testing devices in the in-home evaluation setting, non-compliance with state and federal regulatory regimes, marketing misconduct, denial of or failure to timely or appropriately pay or administer claims and benefits, provider network structure (including the use of performance-based networks and termination of provider contracts), rescission of insurance coverage, improper disclosure or use of personal information, anticompetitive practices, the Company’s participation in the 340B program, general contractual matters, product liability, intellectual property litigation, discrimination and employment litigation. Some of these other legal proceedings are or are purported to be class actions or derivative claims. The Company is defending itself against the claims brought in these matters.

Awards to the Company and others of certain government contracts, particularly Medicaid contracts and other contracts with government customers in the Company’s Health Care Benefits segment, frequently are subject to protests by unsuccessful bidders. These protests may result in awards to the Company being reversed, delayed, or modified. The loss or delay in implementation of any government contract could adversely affect the Company’s operating results. The Company will continue to defend contract awards it receives.

There also continues to be a heightened level of review and/or audit by regulatory authorities and legislators of, and increased litigation regarding, the Company’s and the rest of the health care and related benefits industry’s business and reporting practices, including premium rate increases, utilization management, development and application of medical policies, complaint, grievance and appeal processing, information privacy, provider network structure (including provider network adequacy, the use of performance-based networks and termination of provider contracts), provider directory accuracy, calculation of minimum MLRs and/or payment of related rebates, delegated arrangements, rescission of insurance coverage, limited benefit health products, student health products, PBM practices (including manufacturers’ rebates, pricing, the use of narrow networks and the placement of drugs in formulary tiers), sales practices, customer service practices, vendor oversight, and claim payment practices (including payments to out-of-network providers).

As a leading national health solutions company, the Company regularly is the subject of government actions of the types described above. These government actions may prevent or delay the Company from implementing planned premium rate increases and may result, and have resulted, in restrictions on the Company’s businesses, changes to or clarifications of the Company’s business practices, retroactive adjustments to premiums, refunds or other payments to members, beneficiaries, states or the federal government, withholding of premium payments to the Company by government agencies, assessments of damages, civil or criminal fines or penalties, or other sanctions, including the possible suspension or loss of licensure and/or suspension or exclusion from participation in government programs.

The Company can give no assurance that its businesses, financial condition, operating results and/or cash flows will not be materially adversely affected, or that the Company will not be required to materially change its business practices, based on: (i) future enactment of new health care or other laws or regulations; (ii) the interpretation or application of existing laws or regulations as they may relate to one or more of the Company’s businesses, one or more of the industries in which the Company competes and/or the health care industry generally; (iii) pending or future federal or state government investigations of one or more of the Company’s businesses, one or more of the industries in which the Company competes and/or the health care industry generally; (iv) pending or future government audits, investigations or enforcement actions against the Company; (v)
adverse developments in any pending qui tam lawsuit against the Company, whether sealed or unsealed, or in any future qui tam lawsuit that may be filed against the Company; or (vi) adverse developments in pending or future legal proceedings against the Company or affecting one or more of the industries in which the Company competes and/or the health care industry generally.
v3.25.0.1
Segment Reporting
12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company has four reportable segments: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other. The Company’s segments maintain separate financial information, and the CODM, the Company’s Chief Executive Officer, evaluates the segments’ operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company’s segments based on adjusted operating income. Total assets by segment are not used by the CODM to assess the performance of, or allocate resources to, the Company’s segments, therefore total assets by segment are not disclosed.

Adjusted operating income (loss) is defined as operating income (loss) (GAAP measure) excluding the impact of amortization of intangible assets, net realized capital gains or losses, and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance. The CODM uses adjusted operating income as its principal measure of segment performance as it enhances the Company’s ability to compare past financial performance with current performance and analyze underlying business performance and trends. Non-GAAP financial measures the Company discloses, such as consolidated adjusted operating income, should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP.

In 2024, 2023 and 2022, revenues from the federal government accounted for 24%, 19% and 18%, respectively, of the Company’s consolidated total revenues, primarily related to contracts with CMS for coverage of Medicare-eligible individuals within the Health Care Benefits segment.

The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
Year Ended December 31, 2024
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$129,120 $158,016 $83,464 $56 $370,656 
Intersegment revenues72 15,304 41,036 — 56,412 
Net investment income
1,473 285 — 395 2,153 
Total revenues130,665 173,605 124,500 451 429,221 
Intersegment eliminations (2)
(56,412)
Total consolidated revenues$372,809 
Less: Net realized capital gains (losses)
(97)289 — (75)
Cost of products sold— 160,036 99,337 — 
Health care costs113,659 3,407 — 187 
Other segment items (3)
16,796 2,630 19,389 1,687 
Adjusted operating income (loss)$307 $7,243 $5,774 $(1,348)$11,976 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
2,025 
Net realized capital gains (5)
(117)
Acquisition-related integration costs (6)
243 
Restructuring charges (7)
1,179 
Office real estate optimization charges (8)
30 
Opioid litigation charge (9)
100 
Operating income (GAAP measure)8,516 
Interest expense2,958 
Gain on early extinguishment of debt (12)
(491)
Other income(99)
Income before income tax provision$6,148 
Depreciation and amortization$1,599 $1,059 $1,543 $396 $4,597 
Year Ended December 31, 2023
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$104,800 $174,018 $77,748 $57 $356,623 
Intersegment revenues81 12,826 39,020 — 51,927 
Net investment income (loss)765 (1)(5)394 1,153 
Total revenues105,646 186,843 116,763 451 409,703 
Intersegment eliminations (2)
(51,927)
Total consolidated revenues$357,776 
Less: Net realized capital losses(402)— (5)(90)
Cost of products sold— 175,424 91,447 
Health care costs85,504 1,607 — 210 
Other segment items (3)
14,967 2,500 19,358 1,648 
Adjusted operating income (loss)$5,577 $7,312 $5,963 $(1,318)$17,534 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,905 
Net realized capital losses (5)
497 
Acquisition-related transaction and integration costs (6)
487 
Restructuring charges (7)
507 
Office real estate optimization charges (8)
46 
Loss on assets held for sale (10)
349 
Operating income (GAAP measure)13,743 
Interest expense2,658 
Other income(88)
Income before income tax provision$11,173 
Depreciation and amortization$1,572 $880 $1,549 $365 $4,366 
Year Ended December 31, 2022
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$90,798 $157,968 $72,739 $124 $321,629 
Intersegment revenues76 11,608 35,901 — 47,585 
Net investment income (loss)476 — (44)406 838 
Total revenues91,350 169,576 108,596 530 370,052 
Intersegment eliminations (2)
(47,585)
Total consolidated revenues$322,467 
Less: Net realized capital losses(225)— (44)(51)
Cost of products sold— 160,738 82,063 42 
Health care costs71,473 — — 249 
Other segment items (3)
13,764 2,057 20,046 1,903 
Adjusted operating income (loss)$6,338 $6,781 $6,531 $(1,613)$18,037 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,785 
Net realized capital losses (5)
320 
Office real estate optimization charges (8)
117 
Opioid litigation charge (9)
5,803 
Loss on assets held for sale (10)
2,533 
Gain on divestiture of subsidiaries (11)
(475)
Operating income (GAAP measure)7,954 
Interest expense2,287 
Other income(169)
Income before income tax provision$5,836 
Depreciation and amortization$1,579 $519 $1,889 $237 $4,224 
_____________________________________________
(1)Total revenues of the Health Services segment include approximately $11.4 billion, $13.7 billion and $12.6 billion of retail co-payments for 2024, 2023 and 2022, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information about retail co-payments.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment.
(3)Other segment items for each reportable segment includes operating expenses, which primarily consists of selling, general and administrative expenses. Other segment items excludes the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance.
(4)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(5)The Company’s net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company’s business, and the amount and timing of these capital gains and losses do not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Accordingly, the Company believes excluding net realized capital gains and losses enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends.
(6)In 2024, the acquisition-related integration costs relate to the acquisitions of Signify Health and Oak Street Health. In 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in operating expenses within the Corporate/Other segment.
(7)In 2024, the restructuring charges are primarily comprised of a store impairment charge, corporate workforce optimization costs, including severance and employee-related costs, other asset impairment and related charges associated with the discontinuation of certain non-core assets and a stock-based compensation charge. During the third quarter of 2024, the Company finalized an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with this restructuring plan, the Company completed a strategic review of its retail business and determined that it plans to close 271 retail stores in 2025, and, accordingly, it recorded a store impairment charge to write down the associated operating or financing lease right-of-use assets and property and equipment. In addition, during the third quarter of 2024, the Company also conducted a review of its various strategic assets and determined that it would discontinue the use of certain non-core assets, at which time impairment losses were recorded to write down the carrying value of these assets to the Company’s best estimate of their fair value. In 2023, the restructuring charges are primarily comprised of severance and employee-related costs, asset impairment charges and a stock-based compensation charge. The restructuring charges associated with the store impairments are reflected within the Pharmacy & Consumer Wellness segment, other asset impairments and related charges are reflected within the Corporate/Other and Pharmacy & Consumer Wellness segments and corporate workforce optimization costs, including severance and employee-related costs, as well as stock-based compensation charges, are reflected within the Corporate/Other segment.
(8)In 2024, 2023 and 2022, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the Company’s evaluation of corporate office real estate space in response to its ongoing flexible work arrangement. The office real estate optimization charges are reflected in operating expenses within each segment.
(9)In 2024, the opioid litigation charge relates to a change in the Company’s accrual related to ongoing opioid litigation matters. In 2022, the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate/Other segment.
(10)In 2023 and 2022, the loss on assets held for sale relates to the LTC business within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and, accordingly, the Company recorded a loss on assets held for sale during 2022. During the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflected its estimated fair value less costs to sell. As of the third quarter of 2023, the Company determined the LTC business no longer met the criteria for held-for-sale accounting and, accordingly, the net assets associated with the LTC business were reclassified to held and used at their respective fair values. During 2022, the loss on assets held for sale also relates to the Company’s Thailand business, which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(11)In 2022, the gain on divestiture of subsidiaries represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022, and the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. The gains on divestitures are reflected as a reduction of operating expenses within the Health Care Benefits segment.
(12)In 2024, the gain on early extinguishment of debt relates to the Company’s repayment of approximately $2.6 billion of its outstanding senior notes in December 2024, pursuant to its tender offer for such senior notes.
v3.25.0.1
Pay vs Performance Disclosure - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pay vs Performance Disclosure      
Net Income (Loss) $ 4,614 $ 8,344 $ 4,311
v3.25.0.1
Insider Trading Arrangements
3 Months Ended
Dec. 31, 2024
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.25.0.1
Insider Trading Policies and Procedures
12 Months Ended
Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]  
Insider Trading Policies and Procedures Adopted true
v3.25.0.1
Cybersecurity Risk Management and Strategy Disclosure
12 Months Ended
Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]
Cybersecurity is an important and integrated part of the Company’s enterprise risk management strategy. Safeguarding the Company’s business information, intellectual property, customer, patient and employee data and technology systems is essential for the continuity of its businesses, meeting applicable regulatory requirements and maintaining the trust of its stakeholders.
To help protect the Company from a major cybersecurity incident that could have a material impact on operations or the Company’s financial results, the Company has implemented a robust information security program and has made technology investments that focus on cybersecurity incident prevention, detection and mitigation. The steps the Company takes to reduce its vulnerability and to mitigate the impacts from cybersecurity incidents include, but are not limited to: comprehensive information security policies and standards, implementing logical and technical controls through processes and technologies, monitoring its information technology systems for cybersecurity threats, assessing cybersecurity risk profiles of key third-parties, implementing cybersecurity training and collaborating with public and private organizations on cyber threat information
and best practices. The Company is currently in material compliance with applicable information privacy and cybersecurity standards.

The Company has implemented a Cybersecurity Incident Response Plan (the “Plan”), which is integrated into its overall crisis management program. The Plan provides a framework for responding to cybersecurity incidents. The Plan identifies applicable requirements for incident disclosure and reporting as well as provides protocols for incident evaluation, including the use of third-party service providers and partners, processes for notification and internal escalation of information to the Company’s senior management, the disclosure committee, the Board and appropriate Board committees. The Plan also addresses requirements for the Company’s external reporting obligations. The Plan is reviewed and updated, as necessary, under the leadership of the Company’s Chief Information Security Officer (“CISO”) and Chief Privacy Officer (“CPO”).

The Company’s information technology systems and processes are regularly assessed internally as well as by independent third parties for compliance with the following standards: HIPAA; NIST 800-53; System and Organization Controls (“SOC”) 1; SOC 2 Type 2; HI-TRUST; Payment Card Industry Data Security Standards; and the National Association of Insurance Commissioners. The Company annually purchases a cybersecurity risk insurance policy that is expected to help defray the costs associated with a covered cybersecurity incident if it occurred.

Although the Company did not experience a material cybersecurity incident during the year ended December 31, 2024, it did experience previously-disclosed impacts from the Change Healthcare cybersecurity incident in February 2024. See the Company’s Form 10-Q for the three months ended March 31, 2024 for more information. The scope and impact of any future direct or third-party cybersecurity incident cannot be predicted. See “Item 1A. Risk Factors” for more information on the Company’s cybersecurity-related risks.
Cybersecurity Risk Management Processes Integrated [Flag] true
Cybersecurity Risk Management Processes Integrated [Text Block] Cybersecurity is an important and integrated part of the Company’s enterprise risk management strategy.
Cybersecurity Risk Management Third Party Engaged [Flag] true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] false
Cybersecurity Risk Board of Directors Oversight [Text Block]
The Board is actively engaged in overseeing and reviewing the Company’s strategic direction and objectives, taking into account, among other considerations, the Company’s risk profile and related exposures. As part of this oversight the Board has delegated certain of these responsibilities to committees of the Board. The Board has delegated the responsibility for the oversight of the Company’s cybersecurity risks to the Audit Committee. As part of this oversight, the Audit Committee reviews the Company’s cybersecurity program periodically, and at least annually. The Company’s CDDATO and CISO update the Audit Committee periodically, and at least annually, and the full Board as needed, on the Company’s cybersecurity program, including particular cybersecurity threats, incidents and new developments in the Company’s risk profile. The CISO is a member of the Company’s Disclosure Committee, and the CPO advises the Disclosure Committee on cybersecurity matters on an as-needed basis.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block] The Board has delegated the responsibility for the oversight of the Company’s cybersecurity risks to the Audit Committee.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block] The Company’s CDDATO and CISO update the Audit Committee periodically, and at least annually, and the full Board as needed, on the Company’s cybersecurity program, including particular cybersecurity threats, incidents and new developments in the Company’s risk profile.
Cybersecurity Risk Role of Management [Text Block]
Management has responsibility to manage risk and bring to the Board’s attention the most material near-term and long-term risks to the Company. The Company’s CISO leads management’s assessment and management of cybersecurity risk. The CISO reports to the Company’s Chief Digital, Data, Analytics & Technology Officer (the “CDDATO”), who reports directly to the Company’s Chief Executive Officer. The CDDATO, CISO and the CPO, regularly review cybersecurity matters with management. The current CDDATO, CISO and CPO each has more than 10 years of experience managing risks or advising on cybersecurity issues.
Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]
Management has responsibility to manage risk and bring to the Board’s attention the most material near-term and long-term risks to the Company. The Company’s CISO leads management’s assessment and management of cybersecurity risk. The CISO reports to the Company’s Chief Digital, Data, Analytics & Technology Officer (the “CDDATO”), who reports directly to the Company’s Chief Executive Officer. The CDDATO, CISO and the CPO, regularly review cybersecurity matters with management. The current CDDATO, CISO and CPO each has more than 10 years of experience managing risks or advising on cybersecurity issues.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] The current CDDATO, CISO and CPO each has more than 10 years of experience managing risks or advising on cybersecurity issues.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block] Management has responsibility to manage risk and bring to the Board’s attention the most material near-term and long-term risks to the Company. The Company’s CISO leads management’s assessment and management of cybersecurity risk. The CISO reports to the Company’s Chief Digital, Data, Analytics & Technology Officer (the “CDDATO”), who reports directly to the Company’s Chief Executive Officer. The CDDATO, CISO and the CPO, regularly review cybersecurity matters with management.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.0.1
Significant Accounting Policies (Policies)
12 Months Ended
Dec. 31, 2024
Accounting Policies [Abstract]  
Segment Reporting
The Company has four reportable segments: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other, which are described below.

Health Care Benefits Segment
The Health Care Benefits segment operates as one of the nation’s leading diversified health care benefits providers. The Health Care Benefits segment has the information and resources to help members, in consultation with their health care professionals, make more informed decisions about their health care. The Health Care Benefits segment offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, medical management capabilities, Medicare Advantage and Medicare Supplement plans, PDPs and Medicaid health care management services. The Health Care Benefits segment’s primary customers, its members, primarily access the segment’s products and services through employer groups, government-sponsored plans or individually. The Health Care Benefits segment also serves customers who purchase products and services that are ancillary to its health insurance products. The Company refers to insurance products (where it assumes all or a majority of the risk for medical and dental care costs) as “Insured” and administrative services contract products (where the plan sponsor assumes all or a majority of the risk for medical and dental care costs) as “ASC.” The Company sold Insured plans directly to individual consumers through the individual public health insurance exchanges (“Public Exchanges”) in 17 states as of December 31, 2024.

Health Services Segment
The Health Services segment provides a full range of pharmacy benefit management (“PBM”) solutions, delivers health care services in its medical clinics, virtually, and in the home, and offers provider enablement solutions. PBM solutions include plan design offerings and administration, formulary management, retail pharmacy network management services, and specialty and mail order pharmacy services. In addition, the Company provides clinical services, disease management services, medical spend management and pharmacy and/or other administrative services for providers and federal 340B drug pricing program covered entities (“Covered Entities”). The Company operates a group purchasing organization that negotiates pricing for the purchase of pharmaceuticals and rebates with pharmaceutical manufacturers on behalf of its participants and provides various administrative, management and reporting services to pharmaceutical manufacturers. During 2023, the Company completed the acquisition of two key health care delivery assets – Signify Health, Inc. (“Signify Health”), a leader in health risk assessments, value-based care and provider enablement services, and Oak Street Health, Inc. (“Oak Street Health”), a leading multi-payor operator of value-based primary care centers serving Medicare eligible patients. The Company also launched CordavisTM, a wholly owned subsidiary that works directly with pharmaceutical manufacturers to commercialize and/or co-produce high quality biosimilar products. The Health Services segment’s clients and customers are primarily employers, insurance companies, unions, government employee groups, health plans, PDPs, Medicaid managed care plans, the U.S. Centers for Medicare & Medicaid Services (“CMS”), plans offered on public and private health insurance exchanges and other sponsors of health benefit plans throughout the U.S., patients who receive care in the Health Services segment’s medical clinics, virtually or in the home, as well as Covered Entities.

Pharmacy & Consumer Wellness Segment
The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy
consulting and ancillary services to long-term care facilities and other care settings, and provides pharmacy fulfillment services to support the Health Services segment’s specialty and mail order pharmacy offerings. As of December 31, 2024, the Pharmacy & Consumer Wellness segment operated more than 9,000 retail locations, as well as online retail pharmacy websites, LTC pharmacies and on-site pharmacies, retail specialty pharmacy stores, compounding pharmacies and branches for infusion and enteral nutrition services.

Corporate/Other Segment
The Company presents the remainder of its financial results in the Corporate/Other segment, which primarily consists of:

Management and administrative expenses to support the Company’s overall operations, which include certain aspects of executive management and the corporate relations, legal, compliance, human resources and finance departments, information technology, digital, data and analytics, as well as acquisition-related transaction and integration costs; and
Products for which the Company no longer solicits or accepts new customers such as its large case pensions and long-term care insurance products.
Basis of Presentation
Basis of Presentation

The accompanying consolidated financial statements of CVS Health and its subsidiaries have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). The consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.
Reclassifications
Reclassifications

Certain prior year amounts have been reclassified to conform with the current year presentation.
Use of Estimates
Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
Cash and Cash Equivalents and Restricted Cash
Cash and Cash Equivalents

Cash and cash equivalents consist of cash and temporary investments with maturities of three months or less when purchased. The Company invests in short-term money market funds, commercial paper and time deposits, as well as other debt securities that are classified as cash equivalents within the accompanying consolidated balance sheets, as these funds are highly liquid and readily convertible to known amounts of cash.

Restricted Cash

Restricted cash included in other current assets on the consolidated balance sheets primarily represents funds held on behalf of members and funds held in escrow in connection with agreements with accountable care organizations. Restricted cash included in other assets on the consolidated balance sheets represents amounts held in a trust in one of the Company’s captive insurance companies to satisfy collateral requirements associated with the assignment of certain insurance policies. All restricted cash is invested in demand deposits, time deposits and money market funds.
Investments
Investments

Debt Securities
Debt securities consist primarily of U.S. Treasury and agency securities, mortgage-backed securities, corporate and foreign bonds and other debt securities. Debt securities are classified as either current or long-term investments based on their contractual maturities unless the Company intends to sell an investment within the next twelve months, in which case it is classified as current on the consolidated balance sheets. Debt securities are classified as available for sale and are carried at fair value. See Note 5 ‘‘Fair Value’’ for additional information on how the Company estimates the fair value of these investments.

If a debt security is in an unrealized loss position and the Company has the intent to sell the security, or it is more likely than not that the Company will have to sell the security before recovery of its amortized cost basis, the amortized cost basis of the security is written down to its fair value and the difference is recognized in net income. If a debt security is in an unrealized loss position and the Company does not have the intent to sell and it is more likely than not that the Company will not have to sell such security before recovery of its amortized cost basis, the Company bifurcates the impairment into credit-related and non-credit related (yield-related) components. In evaluating whether a credit related loss exists, the Company considers a variety of factors including: the extent to which the fair value is less than the amortized cost basis; adverse conditions specifically related to the issuer of a security, an industry or geographic area; the payment structure of the security; the failure of the issuer of the security to make scheduled interest or principal payments; and any changes to the rating of the security by a rating agency. The amount of the credit-related component is recorded as an allowance for credit losses and recognized in net income, and the amount of the non-credit related component is included in other comprehensive income (loss). Interest is not accrued on debt securities when management believes the collection of interest is unlikely.

The credit-related component is determined by comparing the present value of cash flows expected to be collected from the security, considering all reasonably available information relevant to the collectability of the security, with the amortized cost basis of the security. If the present value of cash flows expected to be collected is less than the amortized cost basis of the security, the Company records an allowance for credit losses, which is limited by the amount that the fair value is less than amortized cost basis.

For mortgage-backed and other asset-backed securities, the Company recognizes income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The Company’s investment in the security is adjusted to the amount that would have existed had the new effective yield been applied since the acquisition of the security, with adjustments recognized in net income.

Equity Securities
Equity securities with readily available fair values are measured at fair value with changes in fair value recognized in net income.

Mortgage Loans
Mortgage loan investments on the consolidated balance sheets are valued at the unpaid principal balance, net of an allowance for credit losses. Mortgage loans with a maturity date or a committed prepayment date within twelve months are classified as current on the consolidated balance sheets. The Company assesses whether its loans share similar risk characteristics and, if so, groups such loans in a risk pool when measuring expected credit losses. The Company considers the following characteristics when evaluating whether its loans share similar risk characteristics: loan-to-value ratios, property type (e.g., office, retail, apartment, industrial), geographic location, vacancy rates and property condition.

Credit loss reserves are determined using a loss rate method that multiplies the unpaid principal balance of each loan within a risk pool group by an estimated loss rate percentage. The loss rate percentage considers both the expected loan loss severity and the probability of loan default. For periods where the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions (e.g., gross domestic product, employment), the Company adjusts its expected loss rates to reflect these forecasted economic conditions. For periods beyond which the Company is able to make or obtain reasonable and supportable forecasts of expected economic conditions, the Company reverts to historical loss rates in determining expected credit losses.

Interest income on a potential problem loan (i.e., high probability of default) or restructured loan is accrued to the extent it is deemed to be collectible and the loan continues to perform under its original or restructured terms. Interest income on problem loans (i.e., more than 60 days delinquent, in bankruptcy or in process of foreclosure) is recognized on a cash basis. Cash payments on loans in the process of foreclosure are treated as a return of principal.
Other Investments
Other investments consist primarily of the following:

Private equity and hedge fund limited partnerships, which are accounted for using the equity method of accounting. Under this method, the carrying value of the investment is based on the value of the Company’s equity ownership of the underlying investment funds provided by the general partner or manager of the investments, the financial statements of which generally are audited. As a result of the timing of the receipt of the valuation information provided by the fund managers, these investments are generally reported on up to a three month lag. The Company reviews investments for impairment at least quarterly and monitors their performance throughout the year through discussions with the administrators, managers and/or general partners. If the Company becomes aware of an impairment of a limited partnership’s investments through its review or prior to receiving the limited partnership’s financial statements at the financial statement date, an impairment will be recognized by recording a reduction in the carrying value of the limited partnership with a corresponding charge to net investment income.
Investment real estate, which is carried on the consolidated balance sheets at depreciated cost, including capital additions, net of write-downs for other-than-temporary declines in fair value. Depreciation is calculated using the straight-line method based on the estimated useful life of each asset. If any real estate investment is considered held-for-sale, it is carried at the lower of its carrying value or fair value less estimated selling costs. The Company generally estimates fair value using net operating income and applying a capitalization rate in conjunction with comparable sales information. At the time of the sale, the difference between the sales price and the carrying value is recorded as a realized capital gain or loss.
Privately-placed equity securities, which are carried on the consolidated balance sheets using the measurement alternative, at cost less impairments, plus or minus subsequent adjustments for observable price changes. Additionally, as a member of the Federal Home Loan Bank of Boston (“FHLBB”), a subsidiary of the Company is required to purchase and hold shares of the FHLBB. These shares are restricted and carried at cost.

Net Investment Income
Net investment income on the Company’s investments is recorded when earned and is reflected in the Company’s net income (other than net investment income on assets supporting experience-rated products). Experience-rated products are products in the large case pensions business where the contract holder, not the Company, assumes investment and other risks, subject to, among other things, minimum guarantees provided by the Company. The effect of investment performance on experience-rated products is allocated to contract holders’ accounts daily, based on the underlying investment experience and, therefore, does not impact the Company’s net income (as long as the contract’s minimum guarantees are not triggered). Net investment income on assets supporting large case pensions’ experience-rated products is included in net investment income in the consolidated statements of operations and is credited to contract holders’ accounts through a charge to benefit costs. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.

Realized capital gains and losses on investments (other than realized capital gains and losses on investments supporting experience-rated products) are included as a component of net investment income in the consolidated statements of operations. Realized capital gains and losses are determined on a specific identification basis. Purchases and sales of debt and equity securities and alternative investments are reflected on the trade date. Purchases and sales of mortgage loans and investment real estate are reflected on the closing date.

Realized capital gains and losses on investments supporting large case pensions’ experience-rated products are not included in realized capital gains and losses in the consolidated statements of operations and instead are credited directly to contract holders’ accounts. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.

Unrealized capital gains and losses on investments (other than unrealized capital gains and losses on investments supporting experience-rated products) are reflected in shareholders’ equity, net of tax, as a component of accumulated other comprehensive income (loss). Unrealized capital gains and losses on investments supporting large case pensions’ experience-rated products are credited directly to contract holders’ accounts. The contract holders’ accounts are reflected in accrued expenses and other current liabilities on the consolidated balance sheets.
Derivative Financial Instruments
Derivative Financial Instruments

The Company uses derivative financial instruments in order to manage interest rate and foreign exchange risk and credit exposure. The Company’s use of these derivatives is generally limited to hedging risk and has principally consisted of using interest rate swaps, treasury rate locks, forward contracts, futures contracts, warrants, put options and credit default swaps.
Accounts Receivable
Accounts Receivable
Accounts receivable are stated net of allowances for credit losses, customer credit allowances, contractual allowances and estimated terminations.
Accounts Receivable, Allowance for Credit Losses When developing an estimate of the Company’s expected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days.
Inventories
Inventories
Inventories are valued at the lower of cost or net realizable value using the weighted average cost method. Physical inventory counts are taken on a regular basis in each retail store and pharmacy, and a continuous cycle count process is the primary procedure used to validate the inventory balances on hand in each distribution center and mail facility to ensure that the amounts reflected in the consolidated financial statements are properly stated. During the interim period between physical inventory counts, the Company accrues for anticipated physical inventory losses on a location-by-location basis based on historical results and current physical inventory trends.
Reinsurance Recoverables
Reinsurance Recoverables
The Company utilizes reinsurance agreements primarily to: (a) reduce required capital and (b) facilitate the acquisition or disposition of certain insurance contracts. Ceded reinsurance agreements permit the Company to recover a portion of its losses from reinsurers, although they do not discharge the Company’s primary liability as the direct insurer of the risks reinsured. Failure of reinsurers to indemnify the Company could result in losses; however, the Company does not expect charges for unrecoverable reinsurance to have a material effect on its consolidated operating results or financial condition. The Company evaluates the financial condition of its reinsurers and monitors concentrations of credit risk arising from similar geographic regions, activities or economic characteristics of its reinsurers. At December 31, 2024, the Company’s reinsurance recoverables consisted primarily of amounts due from third parties that are rated consistent with companies that are considered to have the ability to meet their obligations. Reinsurance recoverables are recorded as other current assets or other assets on the consolidated balance sheets.
Health Care Contract Acquisition Costs
Health Care Contract Acquisition Costs
Insurance products included in the Health Care Benefits segment are cancellable by either the customer or the member monthly upon written notice. Acquisition costs related to prepaid health care and health indemnity contracts are generally expensed as incurred. For certain long-duration insurance contracts, acquisition costs directly related to the successful acquisition of a new or renewal insurance contract, including commissions, are deferred and are recorded as other current assets or other assets on the consolidated balance sheets. Contracts are grouped by product and issue year into cohorts consistent with the grouping used in estimating the associated liability and are amortized on a constant level basis based on the remaining in-force policies over the estimated term of the contracts to approximate straight-line amortization. Changes to the Company’s assumptions, including assumptions related to persistency, are reflected at the cohort level at the time of change and are recognized prospectively over the estimated terms of the contract. The amortization of deferred acquisition costs is recorded in operating expenses in the consolidated statements of operations.
Property and Equipment
Property and Equipment
Property and equipment is reported at historical cost, net of accumulated depreciation. Property, equipment and improvements to leased premises are depreciated using the straight-line method over the estimated useful lives of the assets, or when applicable, the term of the lease, whichever is shorter. Estimated useful lives generally range from 1 to 40 years for buildings, building improvements and leasehold improvements and 3 to 10 years for fixtures, equipment and internally developed software. Repair and maintenance costs are charged directly to expense as incurred. Major renewals or replacements that substantially extend the useful life of an asset are capitalized and depreciated. Application development stage costs for significant internally developed software projects are capitalized and depreciated.
Right-of-Use Assets and Lease Liabilities
Right-of-Use Assets and Lease Liabilities

The Company determines if an arrangement contains a lease at the inception of a contract. Right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Right-of-use assets and lease liabilities are recognized at the commencement date of the lease, renewal date of the lease or significant remodeling of the lease space based on the present value of the remaining future minimum lease payments. As the interest rate implicit in the Company’s leases is not readily determinable, the Company utilizes its incremental borrowing rate, determined by class of underlying asset, to discount the lease payments. The operating lease right-of-use assets also include lease payments made before commencement and are reduced by lease incentives.

The Company’s real estate leases typically contain options that permit renewals for additional periods of up to five years each. For real estate leases, the options to extend are not considered reasonably certain at lease commencement because the Company reevaluates each lease on a regular basis to consider the economic and strategic incentives of exercising the renewal options and regularly opens or closes stores to align with its operating strategy. Generally, the renewal option periods are not included within the lease term and the associated payments are not included in the measurement of the right-of-use asset and lease liability. Similarly, renewal options are not included in the lease term for non-real estate leases because they are not considered reasonably certain of being exercised at lease commencement. Leases with an initial term of 12 months or less are not recorded on the balance sheets, and lease expense is recognized on a straight-line basis over the term of the short-term lease.

For real estate leases, the Company accounts for lease components and nonlease components as a single lease component. Certain real estate leases require additional payments based on sales volume, as well as reimbursement for real estate taxes, common area maintenance and insurance, which are expensed as incurred as variable lease costs. Other real estate leases
contain one fixed lease payment that includes real estate taxes, common area maintenance and insurance. These fixed payments are considered part of the lease payment and included in the right-of-use assets and lease liabilities.
Goodwill
Goodwill
The Company accounts for business combinations using the acquisition method of accounting, which requires the excess cost of an acquisition over the fair value of net assets acquired and identifiable intangible assets to be recorded as goodwill. Goodwill is not amortized, but is subject to impairment reviews annually, or more frequently, if necessary, as further described in “Recoverability of Long-Lived Assets” below.
Intangible Assets
Intangible Assets

The Company’s identifiable intangible assets consist primarily of trademarks, trade names, customer contracts/relationships, covenants not to compete, technology and provider networks. These intangible assets arise primarily from the determination of their respective fair market values at the date of acquisition. Amounts assigned to identifiable intangible assets, and their related useful lives, are derived from established valuation techniques and management estimates.

The Company’s definite-lived intangible assets are amortized over their estimated useful lives based upon the pattern of future cash flows attributable to the asset. Definite-lived intangible assets are amortized using the straight-line method. Indefinite-lived intangible assets are not amortized but are tested for impairment annually, or more frequently, if necessary, as further described in “Recoverability of Long-Lived Assets” below.
Recoverability of Long-Lived Assets
Recoverability of Long-Lived Assets

The Company evaluates the recoverability of long-lived assets, excluding goodwill and indefinite-lived intangible assets, which are tested for impairment using separate tests described below, whenever events or changes in circumstances indicate that the carrying value of such asset may not be recoverable. The Company groups and evaluates these long-lived assets for impairment at the lowest level at which individual cash flows can be identified. If indicators of impairment are present, the Company first compares the carrying amount of the asset group to the estimated future cash flows associated with the asset group (undiscounted). If the estimated future cash flows used in the analysis are less than the carrying amount of the asset group, an impairment loss calculation is prepared. The impairment loss calculation compares the carrying amount of the asset group to the asset group’s estimated future cash flows (discounted). If required, an impairment loss is recorded for the portion of the asset group’s carrying value that exceeds the asset group’s estimated future cash flows (discounted).

During the year ended December 31, 2024, in connection with its enterprise-wide restructuring plan described in Note 3 ‘‘Restructuring’’, the Company recorded a store impairment charge of $607 million, consisting of a write down of $483 million related to operating and financing lease right-of-use assets and $124 million related to property and equipment. In addition, in connection with its enterprise-wide restructuring plan the Company recorded $269 million of other asset impairments and related charges associated with the discontinuation of certain non-core long-lived assets recorded as reductions to property and equipment, net and operating lease right-of-use assets. During the year ended December 31, 2023, in connection with its 2023 restructuring program, the Company recorded $152 million of asset impairment charges in connection with the termination of certain transformation initiatives.

See Note 3 ‘‘Restructuring’’ for additional information about the Company’s restructuring plan.

During the years ended December 31, 2024, 2023, and 2022, the Company recorded office real estate optimization charges of $30 million, $46 million, and $117 million, respectively, primarily related to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the planned reduction of corporate office real estate space in response to its ongoing flexible work arrangement.

See Note 7 ‘‘Leases’’ for additional information about the right-of-use asset charges.
When evaluating goodwill for potential impairment, the Company compares the fair value of its reporting units to their respective carrying amounts. The Company estimates the fair value of its reporting units using a combination of a discounted cash flow method and a market multiple method. If the carrying amount of a reporting unit exceeds its estimated fair value, an impairment loss is recognized in an amount equal to that excess.

During the fourth quarter of 2024, the Company performed its required annual impairment test of goodwill and concluded there were no goodwill impairments as of the testing date. During the third quarter of 2024, the Company performed an interim goodwill impairment test of the Government reporting unit after determining there were indicators that the Government reporting unit’s goodwill may be impaired. The results of the interim impairment test showed that the fair value of the Government reporting unit exceeded its carrying value, therefore there was no impairment of goodwill as of the interim testing date.

During the fourth quarter of 2023 and the third quarter of 2022, the Company performed its required annual impairment test of goodwill and concluded there were no goodwill impairments as of the testing date or during the years ended December 31, 2023 and 2022.
Indefinite-lived intangible assets are tested for impairment by comparing the estimated fair value of the asset to its carrying value. The Company estimates the fair value of its indefinite-lived trademarks using the relief from royalty method under the income approach. If the carrying value of the asset exceeds its estimated fair value, an impairment loss is recognized, and the asset is written down to its estimated fair value.
Separate Accounts
Separate Accounts

Separate Accounts assets and liabilities related to large case pensions products represent funds maintained to meet specific objectives of contract holders who bear the investment risk. These assets and liabilities are carried at fair value. Net investment income (including net realized capital gains and losses) accrue directly to such contract holders. The assets of each account are legally segregated and are not subject to claims arising from the Company’s other businesses. Deposits, withdrawals and net investment income (including net realized and net unrealized capital gains and losses) on Separate Accounts assets are not reflected in the consolidated statements of operations or cash flows. Management fees charged to contract holders are included in services revenue and recognized over the period earned.
Health Care Costs Payable
Health Care Costs Payable

Health care costs payable within the Health Care Benefits segment consist principally of unpaid fee-for-service medical, dental and pharmacy claims, capitation costs, other amounts due to providers pursuant to risk-sharing arrangements related to the Health Care Benefits segment’s Insured Commercial, Medicare and Medicaid products and accruals for state assessments. Unpaid health care claims include an estimate of payments the Company will make for (i) services rendered to the Company’s Insured members but not yet reported to the Company and (ii) claims which have been reported to the Company but not yet paid, each as of the financial statement date (collectively, “IBNR”). Health care costs payable also include an estimate of the cost of services that will continue to be rendered after the financial statement date if the Company is obligated to pay for such services in accordance with contractual or regulatory requirements. Such estimates are developed using actuarial principles and assumptions which consider, among other things, historical and projected claim submission and processing patterns, assumed and historical medical cost trends, historical utilization of medical services, claim inventory levels, changes in Insured membership and product mix, seasonality and other relevant factors. The Company reflects changes in these estimates in benefit costs in the Company’s consolidated operating results in the period they are determined. Capitation costs represent contractual monthly fees paid to participating physicians and other medical providers for providing medical care, regardless of the volume of medical services provided to the Insured member. Amounts due under risk-sharing arrangements are based on the terms of the underlying contracts with the providers and consider claims experience under the contracts through the financial statement date. Within the Health Services segment, health care costs payable includes estimates of the Company’s obligations for medical care services that have been rendered by third parties on behalf of consumers for which the Company is contractually obligated to pay, but for which claims have either not yet been received, processed or paid.

The Company develops its estimate of IBNR using actuarial principles and assumptions that consider numerous factors. Of those factors, the Company considers the analysis of historical and projected claim payment patterns (including claims submission and processing patterns) and the assumed health care cost trend rate (the year-over-year change in per member per month health care costs) to be the most critical assumptions. In developing its IBNR estimate, the Company consistently applies
these actuarial principles and assumptions each period, with consideration to the variability of related factors. There have been no significant changes to the methodologies or assumptions used to develop the Company’s estimate of IBNR in 2024.

The Company analyzes historical claim payment patterns by comparing claim incurred dates (i.e., the date services were provided) to claim payment dates to estimate “completion factors.” The Company uses completion factors predominantly to estimate the ultimate cost of claims incurred more than three months before the financial statement date. The Company estimates completion factors by aggregating claim data based on the month of service and month of claim payment and estimating the percentage of claims incurred for a given month that are complete by each month thereafter. For any given month, substantially all claims are paid within six months of the date of service, but it can take up to 48 months or longer after the date of service before all of the claims are completely resolved and paid. These historically-derived completion factors are then applied to claims paid through the financial statement date to estimate the ultimate claim cost for a given month’s incurred claim activity. The difference between the estimated ultimate claim cost and the claims paid through the financial statement date represents the Company’s estimate of claims remaining to be paid as of the financial statement date and is included in the Company’s health care costs payable. The completion factors the Company uses reflect judgments and possible adjustments based on data such as claim inventory levels, claim submission and processing patterns and, to a lesser extent, other factors such as changes in health care cost trend rates, changes in Insured membership and changes in product mix. If claims are submitted or processed on a faster (slower) pace than prior periods, the actual claims may be more (less) complete than originally estimated using the Company’s completion factors, which may result in reserves that are higher (lower) than the ultimate cost of claims.

Because claims incurred within three months before the financial statement date are less mature, the Company uses a combination of historically-derived completion factors and the assumed health care cost trend rate to estimate the ultimate cost of claims incurred for these months. The Company applies its actuarial judgment and places a greater emphasis on the assumed health care cost trend rate for the most recent claim incurred dates as these months may be influenced by seasonal patterns and changes in membership and product mix.

The Company’s health care cost trend rate is affected by changes in per member utilization of medical services as well as changes in the unit cost of such services. Many factors influence the health care cost trend rate, including the Company’s ability to manage benefit costs through product design, negotiation of favorable provider contracts and medical management programs, as well as the mix of the Company’s business. The health status of the Company’s Insured members, aging of the population and other demographic characteristics, advances in medical technology and other factors continue to contribute to rising per member utilization and unit costs. Changes in health care practices, inflation, new technologies, increases in the cost of prescription drugs (including specialty pharmacy drugs), direct-to-consumer marketing by pharmaceutical companies, clusters of high-cost cases, claim intensity, changes in the regulatory environment, health care provider or member fraud and numerous other factors also contribute to the cost of health care and the Company’s health care cost trend rate.

For each reporting period, the Company uses an extensive degree of judgment in the process of estimating its health care costs payable. As a result, considerable variability and uncertainty is inherent in such estimates, particularly with respect to claims with claim incurred dates of three months or less before the financial statement date; and the adequacy of such estimates is highly sensitive to changes in assumed completion factors and the assumed health care cost trend rates. For each reporting period the Company recognizes the actuarial best estimate of health care costs payable considering the potential volatility in assumed completion factors and health care cost trend rates, as well as other factors. The Company believes its estimate of health care costs payable is reasonable and adequate to cover its obligations at December 31, 2024; however, actual claim payments may differ from the Company’s estimates. A worsening (or improvement) of the Company’s health care cost trend rates or changes in completion factors from those that the Company assumed in estimating health care costs payable at December 31, 2024 would cause these estimates to change in the near term, and such a change could be material.

Each quarter, the Company re-examines previously established health care costs payable estimates based on actual claim payments for prior periods and other changes in facts and circumstances. Given the extensive degree of judgment in this estimate, it is possible that the Company’s estimates of health care costs payable could develop either favorably (that is, its actual health care costs for the period were less than estimated) or unfavorably. The changes in the Company’s estimate of health care costs payable may relate to a prior quarter, prior year or earlier periods. For a roll forward of the Company’s health care costs payable, see Note 8 ‘‘Health Care Costs Payable.’’ The Company’s reserving practice is to consistently recognize the actuarial best estimate of its ultimate liability for health care costs payable.
Other Insurance Liabilities
Other Insurance Liabilities

Unpaid Claims
Unpaid claims consist primarily of reserves associated with certain short-duration group disability and term life insurance contracts, including an estimate for IBNR as of the financial statement date. Reserves associated with certain short-duration group disability and term life insurance contracts are based upon the Company’s estimate of the present value of future benefits, which is based on assumed investment yields and assumptions regarding mortality, morbidity and recoveries from the U.S. Social Security Administration. The Company develops its estimate of IBNR using actuarial principles and assumptions which consider, among other things, contractual requirements, claim incidence rates, claim recovery rates, seasonality and other relevant factors. The Company discounts certain claim liabilities related to group long-term disability and life insurance waiver of premium contracts. The discount rates generally reflect the Company’s expected investment returns for the investments supporting all incurral years of these liabilities. The discount rates for retrospectively-rated contracts are set at contractually specified levels. The Company’s estimates of unpaid claims are subject to change due to changes in the underlying experience of the insurance contracts, changes in investment yields or other factors, and these changes are recorded in current and future benefits in the consolidated statements of operations in the period they are determined. The Company estimates its reserve for claims IBNR for life products largely based on completion factors. The completion factors used are based on the Company’s historical experience and reflect judgments and possible adjustments based on data such as claim inventory levels, claim payment patterns, changes in business volume and other factors. If claims are submitted or processed on a faster (slower) pace than historical periods, the actual claims may be more (less) complete than originally estimated using completion factors, which may result in reserves that are higher (lower) than required to cover future life benefit payments. There have been no significant changes to the methodologies or assumptions used to develop the Company’s estimate of unpaid claims IBNR in 2024. As of December 31, 2024, unpaid claims balances of $280 million and $713 million were recorded in other insurance liabilities and other long-term insurance liabilities, respectively. As of December 31, 2023, unpaid claims balances of $285 million and $834 million were recorded in other insurance liabilities and other long-term insurance liabilities, respectively.

Substantially all life and disability insurance liabilities have been fully ceded to unrelated third parties through indemnity reinsurance agreements; however, the Company remains directly obligated to the policyholders.

Future Policy Benefits
Future policy benefits consist primarily of reserves for products for which the Company no longer solicits or accepts new customers, including limited payment pension and annuity contracts and long-term care insurance contracts. Contracts are grouped into cohorts by contract type and issue year. The liability for future policy benefits is adjusted for differences between actual and expected experience.

Reserves for limited payment pension and annuity contracts represent the Company’s estimate of the present value of future benefits to be paid to or on behalf of policyholders and are computed using actuarial principles that consider, among other things, assumptions reflecting anticipated mortality and retirement experience. On an annual basis, or more frequently if necessary, the Company reviews mortality assumptions against both industry standards and its experience.

Reserves for long-term care insurance contracts represent the Company’s estimate of the present value of future benefits and settlement costs to be paid to or on behalf of policyholders less the present value of future net premiums. The Company’s estimate of the present value of future benefits under such contracts is based upon mortality, morbidity, lapse and interest rate assumptions. On an annual basis, or more frequently if necessary, the Company reviews its mortality, morbidity and lapse assumptions against its experience. Annually, or each time the assumptions are changed, the net premium ratio used to calculate the future policy benefit liability is updated to reflect actual experience, as well as the impact of any change in assumptions on the Company’s future cash flows.

The Company discounts its future policy benefit liability using a curve of spot rates derived from Single A rated fixed income instruments. At each reporting date, the Company will measure its liability for future policy benefits using both the current spot rate curve and the locked-in discount rate at each cohort’s inception. Any difference between the measured liabilities is recorded in other comprehensive income (loss).
Premium Deficiency Reserves
Premium Deficiency Reserves

The Company evaluates its short-duration insurance contracts to determine if it is probable that a loss will be incurred. For purposes of determining premium deficiency losses, contracts are grouped consistent with the Company’s method of acquiring, servicing and measuring the profitability of such contracts. For each contract grouping, a premium deficiency reserve is recognized when it is probable that expected future incurred claims, including costs to maintain the contract grouping exceed anticipated future premiums and reinsurance recoveries. Anticipated investment income is not considered in the calculation of premium deficiency reserves. A premium deficiency is first recognized by charging any unamortized acquisition costs to operating expenses, and to the extent the premium deficiency is greater than the unamortized acquisition costs, a premium deficiency reserve liability is established and reflected in health care costs payable on the consolidated balance sheets. Losses recognized as a premium deficiency reserve result in a beneficial effect in subsequent periods as subsequent costs under these contracts are then charged to this previously established liability.
Self-Insurance Liabilities
Self-Insurance Liabilities
The Company is self-insured for certain losses related to general liability, workers’ compensation and auto liability. The Company obtains third party insurance coverage to limit exposure from these claims. The Company is also self-insured for certain losses related to health and medical liabilities. The Company’s self-insurance accruals, which include reported claims and claims incurred but not reported, are calculated using standard insurance industry actuarial assumptions and the Company’s historical claims experience.
Foreign Currency Translation and Transactions
Foreign Currency Translation and Transactions

For non-U.S. dollar functional currency locations, (i) assets and liabilities are translated at end-of-period exchange rates, (ii) revenues and expenses are translated at average exchange rates in effect during the period and (iii) equity is translated at historical exchange rates. The resulting cumulative translation adjustments are included as a component of accumulated other comprehensive loss.

For U.S. dollar functional currency locations, foreign currency assets and liabilities are remeasured into U.S. dollars at end-of-period exchange rates, except for nonmonetary balance sheet accounts which are remeasured at historical exchange rates. Revenues and expenses are remeasured at average exchange rates in effect during each period, except for those expenses related to the nonmonetary balance sheet amounts which are remeasured at historical exchange rates. Gains or losses from foreign currency remeasurement are included in net income.
Revenue Recognition
Revenue Recognition

Health Care Benefits Segment
Health Care Benefits revenue is principally derived from insurance premiums and fees billed to customers. Revenue is recognized based on customer billings, which, in the Company’s Commercial business, reflect contracted rates per member and
the number of covered members recorded in the Company’s records at the time the billings are prepared. Billings are generally sent monthly for coverage during the following month. Revenue related to the Company’s Government business is collected monthly from the U.S. federal government and various government agencies based on fixed payment rates and member eligibility.

The Company’s billings may be subsequently adjusted to reflect enrollment changes due to member terminations or other factors. These adjustments are known as retroactivity adjustments. In each period, the Company estimates the amount of future retroactivity and adjusts the recorded revenue accordingly. As information regarding actual retroactivity amounts becomes known, the Company refines its estimates and records any required adjustments to revenues in the period in which they arise.

Premium Revenue
Premiums are recognized as revenue in the month in which the enrollee is entitled to receive health care services. Premiums are reported net of an allowance for estimated terminations and uncollectible amounts. Additionally, premium revenue subject to the minimum medical loss ratio (“MLR”) rebate requirements of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (as amended, collectively, the “ACA”) is recorded net of the estimated minimum MLR rebates for the current calendar year. Premiums related to unexpired contractual coverage periods (unearned premiums) are reported as other insurance liabilities on the consolidated balance sheets and recognized as revenue when earned.

Some of the Company’s contracts allow for premiums to be adjusted to reflect actual experience or the relative health status of Insured members. Such adjustments are reasonably estimable at the outset of the contract, and adjustments to those estimates are made based on actual experience of the customer emerging under the contract and the terms of the underlying contract.

The ACA established a permanent risk adjustment program to transfer funds from qualified individual and small group insurance plans with below average risk scores to plans with above average risk scores. Based on the risk of the Company’s qualified plan members relative to the average risk of members of other qualified plans in comparable markets, as defined by the ACA, the Company estimates its ultimate risk adjustment receivable (recorded in accounts receivable) or payable (recorded in accrued expenses and other current liabilities) for the current calendar year and reflects the pro-rata year-to-date impact as an adjustment to premium revenue.

Services Revenue
Services revenue relates to contracts that can include various combinations of services or series of services which generally are capable of being distinct and accounted for as separate performance obligations. The Health Care Benefits segment’s services revenue primarily consists of ASC fees received in exchange for performing certain claim processing and member services for ASC members. ASC fee revenue is recognized over the period the service is provided. Some of the Company’s administrative services contracts include guarantees with respect to certain functions, such as customer service response time, claim processing accuracy and claim processing turnaround time, as well as certain guarantees that a plan sponsor’s benefit claim experience will fall within a certain range. With any of these guarantees, the Company is financially at risk if the conditions of the arrangements are not met, although the maximum amount at risk typically is limited to a percentage of the fees otherwise payable to the Company by the customer involved. Each period the Company estimates its obligations under the terms of these guarantees and records its estimate as an offset to services revenues.

Accounting for Medicare Part D
Revenues include insurance premiums earned by the Company’s PDPs, which are determined based on the PDP’s annual bid and related contractual arrangements with CMS. The insurance premiums include a beneficiary premium, which is the responsibility of the PDP member, and can be subsidized by CMS in the case of low-income members, and a direct premium paid by CMS. Premiums collected in advance are initially recorded within other insurance liabilities and are then recognized ratably as revenue over the period in which members are entitled to receive benefits.

Revenues also include a risk-sharing feature of the Medicare Part D program design referred to as the risk corridor. The Company estimates variable consideration in the form of amounts payable to, or receivable from, CMS under the risk corridor, and adjusts revenue based on calculations of additional subsidies to be received from or owed to CMS at the end of the reporting year.

In addition to Medicare Part D premiums, the Company receives additional payments each month from CMS related to catastrophic reinsurance, low-income cost-sharing subsidies and coverage gap benefits. If the subsidies received differ from the amounts earned from actual prescriptions transferred, the difference is recorded in either accounts receivable, net or accrued expenses.
Health Services Segment

Pharmacy Services
The Health Services segment sells prescription drugs directly through its specialty and mail order pharmacy offerings and indirectly through the Company’s retail pharmacy network. The Company’s pharmacy benefit arrangements are accounted for in a manner consistent with a master supply arrangement as there are no contractual minimum volumes and each prescription is considered a separate purchasing decision and distinct performance obligation transferred at a point in time. PBM services performed in connection with each prescription claim are considered part of a single performance obligation which culminates in the fulfillment of prescription drugs.

The Company recognizes revenue using the gross method at the contract price negotiated with its clients when the Company has concluded it controls the prescription drug before it is transferred to the client plan members. The Company controls prescriptions fulfilled indirectly through its retail pharmacy network because it has separate contractual arrangements with those pharmacies, has discretion in setting the price for the transaction and assumes primary responsibility for fulfilling the promise to provide prescription drugs to its client plan members while also performing the related PBM services.

Revenues include (i) the portion of the price the client pays directly to the Company, net of any discounts earned on brand name drugs or other discounts and refunds paid back to the client (see “Drug Discounts” and “Guarantees” below), (ii) the price paid to the Company by client plan members for mail order prescriptions and the price paid to retail network pharmacies by client plan members for retail prescriptions (“retail co-payments”), and (iii) claims based administrative fees for retail pharmacy network contracts. Sales taxes are not included in revenues.

The Company recognizes revenue when control of the prescription drugs is transferred to customers, in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those prescription drugs. The Company has established the following revenue recognition policies for the Health Services segment:

Revenues generated from prescription drugs sold by third party pharmacies in the Company’s retail pharmacy network and associated administrative fees are recognized at the Company’s point-of-sale, which is when the claim is adjudicated by the Company’s online claims processing system and the Company has transferred control of the prescription drug and completed all of its performance obligations.
Revenues generated from prescription drugs sold by specialty and mail order pharmacies are recognized when the prescription drug is delivered to the client plan member. At the time of delivery, the Company has performed substantially all of its performance obligations under its client contracts and does not experience a significant level of returns or reshipments.

For contracts under which the Company acts as an agent or does not control the prescription drugs prior to transfer to the client plan member, revenue is recognized using the net method.

Drug Discounts
The Company records revenue net of manufacturers’ rebates earned by its clients based on their plan members’ utilization of brand-name formulary drugs. The Company estimates these rebates at period-end based on actual and estimated claims data and its estimates of the manufacturers’ rebates earned by its clients. The estimates are based on the best available data at period-end and recent history for the various factors that can affect the amount of rebates due to the client. The Company adjusts its rebates payable to clients to the actual amounts paid when these rebates are paid or as significant events occur. Any cumulative effect of these adjustments is recorded against revenues at the time it is identified. Adjustments generally result from contract changes with clients or manufacturers that have retroactive rebate adjustments, differences between the estimated and actual product mix subject to rebates, or whether the brand name drug was included in the applicable formulary. The effect of adjustments between estimated and actual manufacturers’ rebate amounts has not been material to the Company’s operating results or financial condition.

Guarantees
The Company also adjusts revenues for refunds owed to clients resulting from pricing guarantees and performance against defined service and performance metrics. The inputs to these estimates are not subject to a high degree of subjectivity or volatility. The effect of adjustments between estimated and actual pricing and performance refund amounts has not been material to the Company’s operating results or financial condition.
Walk-In Medical Clinics
For services provided by the Company’s walk-in medical clinics, revenue recognition occurs for completed services provided to patients, with adjustments taken for third party payor contractual obligations and patient direct bill historical collection rates.

Primary Care Capitated Revenue
Capitated revenue related to the Company’s primary care operations consists primarily of capitated fees for medical services it provides under capitated or capitation arrangements directly made with various Medicare Advantage managed care payors or CMS. Under the risk contracts, the Company receives from the third-party payor a fixed payment per patient per month for a defined patient population, and the Company is then responsible for providing, managing and paying for healthcare services for that patient population, including those not provided by the Company. The Company recognizes revenue using the gross method as the Company is the principal in arranging, providing and controlling the managed healthcare services provided to the defined patient population. The Company considers all contracts with customers (enrolled patients) as a single performance obligation to stand ready to provide healthcare services. This performance obligation is satisfied over time as the Company stands ready to fulfill its obligation to enrolled patients.

In-Home Health Evaluations (“IHEs”)
Revenue generated from IHEs relates to the assessments performed either within the patient’s home, virtually or at a healthcare provider facility as well as certain in-home clinical evaluations performed by the Company’s mobile network of providers. Revenue is recognized when the IHEs are submitted to customers on a daily basis. Submission to the customer occurs after the IHEs are completed and coded, a process which may take one to several days after completion of the evaluation. The pricing for the IHEs is generally based on a fixed transaction fee, which is directly linked to the usage of the service by the customer during a distinct service period. Customers are invoiced for evaluations performed each month and remit payment accordingly. Each IHE represents a single performance obligation for which revenue is recognized at a point in time when control is transferred to the customer upon submission of the completed and coded evaluation.

Pharmacy & Consumer Wellness Segment

Retail Pharmacy
The Company’s retail drugstores recognize revenue at the time the customer takes possession of the merchandise. For pharmacy sales, each prescription claim is its own arrangement with the customer and is a performance obligation, separate and distinct from other prescription claims under other retail network arrangements. Revenues are adjusted for refunds owed to third party payers resulting from pricing guarantees and performance against defined value-based service and performance metrics. The inputs to these estimates are not subject to a high degree of subjectivity or volatility. The effect of adjustments between estimated and actual pricing and performance refund amounts has not been material to the Company’s operating results or financial condition.

Revenue from Company gift cards purchased by customers is deferred as a contract liability until goods or services are transferred. Any amounts not expected to be redeemed by customers (i.e., breakage) are recognized based on historical redemption patterns.

Customer returns are not material to the Company’s operating results or financial condition. Sales taxes are not included in revenues.

Loyalty and Other Programs
The Company’s customer loyalty program, ExtraCare®, consists of two components, ExtraSavingsTM and ExtraBucks® Rewards. ExtraSavings are coupons that are recorded as a reduction of revenue when redeemed as the Company concluded that they do not represent a promise to the customer to deliver additional goods or services at the time of issuance because they are not tied to a specific transaction or spending level.

ExtraBucks Rewards are accumulated by customers based on their historical spending levels. Thus, the Company has determined that there is an additional performance obligation to those customers at the time of the initial transaction. The Company allocates the transaction price to the initial transaction and the ExtraBucks Rewards transaction based upon the relative standalone selling price, which considers historical redemption patterns for the rewards. Revenue allocated to ExtraBucks Rewards is recognized as those rewards are redeemed. At the end of each period, unredeemed ExtraBucks Rewards are reflected as a contract liability.

The Company also offers a subscription-based membership program, ExtraCare PlusTM, under which members are entitled to a suite of benefits delivered over the course of the subscription period, as well as a promotional reward that can be redeemed for
future goods and services. Subscriptions are paid for on a monthly or annual basis at the time of or in advance of the Company delivering the goods and services. Revenue from these arrangements is recognized as the performance obligations are satisfied.

Long-term Care
Revenue is recognized when control of the promised goods or services is transferred to customers in an amount that reflects the consideration the Company expects to be entitled to receive in exchange for those goods or services. Each prescription claim represents a separate performance obligation of the Company, separate and distinct from other prescription claims under customer arrangements. A significant portion of long-term care revenue from sales of pharmaceutical and medical products is reimbursed by the federal Medicare Part D program and, to a lesser extent, state Medicaid programs. The Company monitors its revenues and receivables from these reimbursement sources, as well as long-term care facilities and other third-party insurance payors, and reduces revenue at the revenue recognition date to properly account for the variable consideration due to anticipated differences between billed and reimbursed amounts. Accordingly, the total revenues and receivables reported in the Company’s consolidated financial statements are recorded at the amount expected to be ultimately received from these payors.

Patient co-payments associated with Medicare Part D, certain state Medicaid programs, Medicare Part B and certain third-party payors typically are not collected at the time products are delivered or services are rendered, but are billed to the individuals as part of normal billing procedures and subject to normal accounts receivable collections procedures.
Contract Balances
Contract liabilities primarily represent the Company’s obligation to transfer additional goods or services to a customer for which the Company has received consideration, and include ExtraBucks Rewards and unredeemed Company gift cards. The consideration received remains a contract liability until goods or services have been provided to the customer. In addition, the Company recognizes breakage on Company gift cards based on historical redemption patterns.
Cost of Products Sold
Cost of Products Sold

The Company accounts for cost of products sold as follows:

Health Services Segment
Cost of products sold includes: (i) the cost of prescription drugs sold during the reporting period directly through the Company’s specialty and mail order pharmacies and indirectly through the Company’s retail pharmacy network, (ii) the cost of care provided within the Company’s primary care centers, (iii) direct operating costs associated with generating revenues related to services provided, including fees paid to clinicians for performing IHEs, (iv) administrative service fees paid to the Pharmacy & Consumer Wellness segment for specialty and mail order pharmacy fulfillment services and (v) shipping and handling costs.

The cost of prescription drugs sold component of cost of products sold includes: (i) the cost of the prescription drugs purchased from manufacturers or distributors and shipped to members in clients’ benefit plans from the Company’s mail order pharmacies, net of any volume-related or other discounts (see “Vendor Allowances and Purchase Discounts” below) and (ii) the cost of prescription drugs sold (including retail co-payments) through the Company’s retail pharmacy network under contracts where the Company is the principal, net of any volume-related or other discounts.
The cost of care provided within the Company’s costs of products sold includes the costs incurred to operate the primary care centers and care model. These costs consist of care team and patient support employee-related costs, occupancy costs, patient transportation, medical supplies, insurance, fees paid to specialists and other operating costs.

Pharmacy & Consumer Wellness Segment
Cost of products sold includes: the cost of merchandise sold during the reporting period, including the costs of prescription drugs sold through its retail pharmacies, net of any volume-related or other discounts, the related purchasing costs, warehousing and delivery costs (including depreciation and amortization), the operating costs of the Company’s specialty and mail order pharmacy fulfillment operations and inventory losses.
Vendor Allowances and Purchase Discounts
Vendor Allowances and Purchase Discounts

The Company accounts for vendor allowances and purchase discounts as follows:

Health Services Segment
The Health Services segment receives purchase discounts on pharmaceutical products purchased. Contractual arrangements with vendors, including manufacturers, wholesalers and retail pharmacies, normally provide for the Health Services segment to receive purchase discounts from established list prices in one, or a combination, of the following forms: (i) a direct discount at the time of purchase, (ii) a discount for the prompt payment of invoices or (iii) when products are purchased indirectly from a manufacturer (e.g., through a wholesaler or retail pharmacy), a discount (or rebate) paid subsequent to dispensing. These rebates are recognized when prescriptions are dispensed and are generally calculated and billed to manufacturers within 30 days of the end of each completed quarter. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected has not been material to the Company’s operating results or financial condition. The Company accounts for the effect of any such differences as a change in accounting estimate in the period the reconciliation is completed. The Health Services segment also receives additional discounts under its wholesaler contracts if it exceeds contractually defined purchase volumes. In addition, the Health Services segment receives fees from pharmaceutical manufacturers for administrative services. Purchase discounts and administrative service fees are recorded as a reduction of cost of products sold.

Pharmacy & Consumer Wellness Segment
Vendor allowances received by the Pharmacy & Consumer Wellness segment reduce the carrying cost of inventory and are recognized in cost of products sold when the related inventory is sold, unless they are specifically identified as a reimbursement of incremental costs for promotional programs and/or other services provided. Amounts that are directly linked to advertising commitments are recognized as a reduction of advertising expense (included in operating expenses) when the related advertising commitment is satisfied. Any amounts received in excess of the actual cost incurred also reduce the carrying cost of inventory. The total value of any upfront payments received from vendors that are linked to purchase commitments is initially deferred. The deferred amounts are then amortized to reduce cost of products sold over the life of the contract based upon sales volume. The total value of any upfront payments received from vendors that are not linked to purchase commitments is also initially deferred. The deferred amounts are then amortized to reduce cost of products sold on a straight-line basis over the life of the related contract. The total amortization of these upfront payments was not material to the Company’s consolidated financial statements in any of the periods presented.
Advertising Costs
Advertising Costs
Advertising costs, which are reduced by the portion funded by vendors, are expensed when the related advertising takes place. Net advertising costs, which are included in operating expenses, were $989 million, $985 million and $745 million in 2024, 2023 and 2022, respectively.
Stock-Based Compensation
Stock-Based Compensation
Stock-based compensation is measured at the grant date based on the fair value of the award and is recognized as expense over the requisite service period of the stock award (generally three to five years) using the straight-line method.
Income Taxes
Income Taxes

The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements. Under this method, deferred tax assets and liabilities are determined on the basis of the differences between the
consolidated financial statements and tax basis of assets and liabilities using enacted tax rates in effect for the year or years in which the differences are expected to reverse. The effect of a change in the tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date of such change.

The Company recognizes deferred tax assets to the extent that it believes these assets are more likely than not to be realized. In making such a determination, the Company considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies, and the Company’s recent operating results. The Company establishes a valuation allowance when it does not consider it more likely than not that a deferred tax asset will be recovered.

The Company records uncertain tax positions on the basis of a two-step process whereby (1) the Company determines whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition threshold, the Company recognizes the largest amount of tax benefit that is more than 50% likely to be realized upon ultimate settlement with the related tax authority.

Interest and/or penalties related to uncertain tax positions are recognized in the income tax provision.
Measurement of Defined Benefit Pension and Other Postretirement Employee Benefit Plans
Measurement of Defined Benefit Pension and Other Postretirement Employee Benefit Plans

The Company sponsors defined benefit pension plans (“pension plans”) and other postretirement employee benefit plans (“OPEB plans”) for its employees and retirees. The Company recognizes the funded status of its pension and OPEB plans on the consolidated balance sheets based on the year-end measurements of plan assets and benefit obligations. When the fair value of plan assets are in excess of the plan benefit obligations, the amounts are reported in other current assets and other assets. When the fair value of plan benefit obligations are in excess of plan assets, the amounts are reported in accrued expenses and other current liabilities and other long-term liabilities based on the amount by which the actuarial present value of benefits payable in the next twelve months included in the benefit obligation exceeds the fair value of plan assets. The net periodic benefit income for the Company’s pension and OPEB plans do not contain a service cost component as these plans have been frozen for an extended period of time. Non-service cost components of pension and postretirement net periodic benefit income are included in other income in the consolidated statements of operations.
Earnings per Share
Earnings per Share

Earnings per share is computed using the treasury stock method. The Company calculates basic earnings per share based on the weighted average number of common shares outstanding for the period. See Note 16 ‘‘Earnings Per Share’’ for additional information.
Shares Held in Trust
Shares Held in Trust
The Company maintains grantor trusts, which held approximately one million shares of its common stock at both December 31, 2024 and 2023. These shares are designated for use under various employee compensation plans. Since the Company holds these shares, they are excluded from the computation of basic and diluted shares outstanding.
VIEs
VIEs

The Company has various investments that are considered VIEs. The Company does not have a future obligation to fund losses or debts on behalf of these investments; however, it may voluntarily contribute funds. In evaluating whether the Company is the primary beneficiary of a VIE, the Company considers several factors, including whether the Company has (a) the power to direct the activities that most significantly impact the VIE’s economic performance and (b) the obligation to absorb losses and the right to receive benefits that could potentially be significant to the VIE.

VIEs - Primary Beneficiary

Red Oak Sourcing, LLC (“Red Oak”)
In 2014, the Company and Cardinal Health, Inc. (“Cardinal”) established Red Oak, a generic pharmaceutical sourcing entity in which the Company and Cardinal each own 50%. The Red Oak arrangement had an initial term of ten years. In 2021, the Red Oak arrangement was amended to extend the initial term an additional five years, for a total term of 15 years. Under this arrangement, the Company and Cardinal contributed their sourcing and supply chain expertise to Red Oak and agreed to source and negotiate generic pharmaceutical supply contracts for both companies through Red Oak; however, Red Oak does not own
or hold inventory on behalf of either company. No physical assets (e.g., property and equipment) were contributed to Red Oak by either company, and minimal funding was provided to capitalize Red Oak. The Company has determined that it is the primary beneficiary of this VIE because it has the ability to direct the activities of Red Oak. Consequently, the Company consolidates Red Oak in its consolidated financial statements within the Pharmacy & Consumer Wellness segment.

Cardinal is required to pay the Company quarterly payments, which began in October 2014 and will extend through June 2029. The Company received $126 million from Cardinal during the year ended December 31, 2024 and $183 million from Cardinal during each of the years ended December 31, 2023 and 2022. The payments reduce the Company’s carrying value of inventory and are recognized in cost of products sold when the related inventory is sold.

Physician Groups
The Company has entered into management and/or administrative services agreements with affiliated physician practice organizations (the “Physician Groups”). Physician Groups employ healthcare providers, contract with managed care payors and deliver healthcare services to patients in the markets that the Company serves. Oak Street Health, MSO LLC (“OSH MSO”), a wholly owned subsidiary of the Company, provides management services to the Physician Groups. Activities include but are not limited to operational support of the centers, marketing, information technology infrastructure and the sourcing and managing of health plan contracts. The Company concluded that it has variable interests in the Physician Groups on the basis of its administrative service agreement, which includes the reimbursement of costs and a management fee payable to the Company from the Physician Groups for the management services provided, which are eliminated in consolidation. The Physician Groups are considered VIEs as additional support is needed to finance their operations. Neither shareholders, employees nor their designees have the individual power to direct the activities of the Physician Groups that significantly impact its economic performance. The success or failure of OSH MSO in performing the activities impacting the growth of patients and management of healthcare services of the Physicians Groups’ patient base is significant to the economic performance of the Physician Groups. Therefore, the Company is the primary beneficiary of the Physician Groups and, consequently, consolidates the Physician Groups in its consolidated financial statements within the Health Services segment.
There are no restrictions on the Physician Groups’ assets or on the settlement of its liabilities. The assets of the Physician Groups are all current and can be used to settle obligations of the Company. The Physician Groups are included in the Company’s obligated group; thus, creditors of the Company have recourse to the assets owned by the Physician Groups. There are no liabilities for which creditors of the Physician Groups do not have recourse to the general credit of the Company. There are no restrictions placed on the retained earnings or net income of the Physician Groups with respect to potential dividend payments.

Physician Owned Entities
The Company’s consolidated VIEs include certain IHE related physician practices that require an individual physician to legally own the equity interests as certain state laws and regulations prohibit non-physician owned business entities from practicing medicine or employing licensed healthcare providers. The Company determined it was the primary beneficiary of these VIEs as it has the obligation to absorb the losses from and direct the activities of these operations. As a result, these VIEs are consolidated and any noncontrolling interest is not presented. The carrying amount of these VIEs’ assets and liabilities are not material to the consolidated balance sheets.

Accountable Care Organizations (“ACOs”)
The Company is the sole member of certain ACOs which are considered VIEs. CMS administers these programs where the goal of the program is to reward the ACO participants when specific quality metrics, established by the U.S. Department of Health and Human Services (“HHS”), are met and expenditures are lowered. These ACOs have a risk model such that the ACOs can either share in both savings and losses or share in only the savings. The governance structure of the VIEs does not provide the Company with the ultimate decision-making authority to direct the activities that most significantly impact the VIEs’ economic performance. For certain ACO VIEs, the Company is ultimately liable for losses incurred or is required to secure and have sole authority over all aspects of the repayment of any shared losses incurred in the program in exchange for a higher percentage of savings and, accordingly, the Company is taking on the risk to absorb losses, resulting in a financial responsibility to ensure that
these VIEs operate as designed. For these VIEs, the Company has determined it is the primary beneficiary and therefore consolidates the results of these ACOs. The carrying amount of these VIEs’ assets and liabilities are not material to the consolidated balance sheets.

VIEs - Other Variable Interest Holder
The Company has invested in certain VIEs for which it has determined that it is not the primary beneficiary, consisting of the following:

Hedge fund and private equity investments - The Company invests in hedge fund and private equity investments in order to generate investment returns for its investment portfolio supporting its insurance businesses.
Real estate partnerships - The Company invests in various real estate partnerships, including those that construct, own and manage low-income housing developments. For the low-income housing development investments, substantially all of the projected benefits to the Company are from tax credits and other tax benefits.

The Company is not the primary beneficiary of these VIEs because the nature of the Company’s involvement with the activities of these VIEs does not give the Company the power to direct the activities that most significantly impact their economic performance. The Company records the amount of its investment in these VIEs as long-term investments on the consolidated balance sheets and recognizes its share of each VIE’s income or losses in net income. The Company’s maximum exposure to loss from these VIEs is limited to its investment balances as disclosed below and the risk of recapture of previously recognized tax credits related to the real estate partnerships, which the Company does not consider significant.
Related Party Transactions
Related Party Transactions

During the year ended December 31, 2022, the Company made charitable contributions of $25 million to the CVS Health Foundation, a non-profit entity that focuses on health, education and community involvement programs. The charitable contributions were recorded as operating expenses in the consolidated statements of operations within the Corporate/Other segment for the year ended December 31, 2022. The Company did not make any charitable contributions to the CVS Health Foundation during the years ended December 31, 2024 or 2023.
Discontinued Operations
Discontinued Operations
In connection with certain business dispositions completed between 1995 and 1997, the Company retained guarantees on store lease obligations for a number of former subsidiaries, including Linens ‘n Things and Bob’s Stores, each of which subsequently filed for bankruptcy. The Company’s loss from discontinued operations includes lease-related costs that the Company believes it will likely be required to satisfy pursuant to these lease guarantees.
New Accounting Pronouncements Recently Adopted and New Accounting Pronouncements Not Yet Adopted
New Accounting Pronouncements Recently Adopted

Segment Reporting
In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This standard requires the Company to disclose significant segment expenses that are regularly provided to the Chief Operating Decision Maker (“CODM”) and are included within each reported measure of segment operating results. The standard also requires the Company to disclose the total amount of any other items included in segment operating results which were not deemed to be significant expenses for separate disclosure, along with a qualitative description of the composition of these other items. In
addition, the standard also requires disclosure of the CODM’s title and position, as well as detail on how the CODM uses the reported measure of segment operating results to evaluate segment performance and allocate resources. The standard also aligns interim segment reporting disclosure requirements with annual segment reporting disclosure requirements. The Company adopted the standard on January 1, 2024 for fiscal year reporting and the standard became effective for interim reporting periods in fiscal years beginning after December 15, 2024. The standard requires retrospective application to all prior periods presented. While the standard requires additional disclosures related to the Company’s reportable segments, the standard did not have any impact on the Company’s consolidated operating results, financial condition or cash flows as of the date of adoption. Refer to Note 19 ‘‘Segment Reporting’’ for the Company’s segment reporting disclosures, including those newly required by this standard.

New Accounting Pronouncements Not Yet Adopted

Income Taxes
In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. The standard requires the Company to provide further disaggregated income tax disclosures for specific categories on the effective tax rate reconciliation, as well as additional information about federal, state/local and foreign income taxes. The standard also requires the Company to annually disclose its income taxes paid (net of refunds received), disaggregated by jurisdiction. The Company adopted the standard on January 1, 2025 for fiscal year reporting. The standard is to be applied on a prospective basis, although optional retrospective application is permitted. While the standard requires additional disclosures related to the Company’s income taxes, the standard did not have any impact on the Company’s consolidated operating results, financial condition or cash flows.

Disaggregation of Income Statement Expenses
In November 2024, the FASB issued ASU 2024-03, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. The standard requires the Company to provide further disaggregated information of relevant expense captions within its consolidated statements of operations, including the purchases of inventory, employee compensation, depreciation and intangible asset amortization, as well as the inclusion of other specific expenses, gains and losses required by existing GAAP. The new standard also requires the Company to disclose its total selling expenses and, on an annual basis, provide a qualitative description of its selling expenses. The standard is effective for fiscal years beginning after December 15, 2026 and interim periods within fiscal years beginning after December 15, 2027, with early adoption permitted. The standard may be applied prospectively or retrospectively. While the standard will require additional disclosures related to certain expenses included in the consolidated statements of operations, the standard is not expected to have any impact on the Company’s consolidated operating results, financial condition or cash flows.
v3.25.0.1
Significant Accounting Policies (Tables)
12 Months Ended
Dec. 31, 2024
Accounting Policies [Abstract]  
Schedule of Reconciliation of Cash and Cash Equivalents
The following is a reconciliation of cash and cash equivalents on the consolidated balance sheets to total cash, cash equivalents and restricted cash on the consolidated statements of cash flows as of December 31, 2024, 2023 and 2022:
In millions202420232022
Cash and cash equivalents$8,586 $8,196 $12,945 
Restricted cash (included in other current assets)95 90 144 
Restricted cash (included in other assets)203 239 216 
Total cash, cash equivalents and restricted cash in the consolidated statements of cash flows$8,884 $8,525 $13,305 
Schedule of Accounts Receivable, Net Accounts receivable, net was composed of the following at December 31, 2024 and 2023:
In millions20242023
Trade receivables$9,881 $11,908 
Vendor and manufacturer receivables13,891 15,711 
Premium receivables4,731 3,714 
Other receivables7,966 3,894 
   Total accounts receivable, net
$36,469 $35,227 
Rollforward of Deferred Acquisition Costs
The following is a roll forward of deferred acquisition costs for the years ended December 31, 2024 and 2023:
In millions20242023
Deferred acquisition costs, beginning of the period$1,502 $1,219 
Capitalizations544 548 
Amortization expense(299)(265)
Deferred acquisition costs, end of the period$1,747 $1,502 
Schedule of Property and Equipment
Property and equipment consisted of the following at December 31, 2024 and 2023:
In millions20242023
Land$1,847 $1,958 
Building and improvements4,632 4,571 
Fixtures and equipment11,716 11,024 
Leasehold improvements6,725 6,511 
Software11,520 9,818 
Total property and equipment36,440 33,882 
Accumulated depreciation and amortization(23,447)(20,699)
Property and equipment, net
$12,993 $13,183 
Schedule of Disaggregation of Revenue
The following table disaggregates the Company’s revenue by major source in each segment for the years ended December 31, 2024, 2023 and 2022:
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
2024
Major goods/services lines:
Pharmacy$— $162,527 $100,687 $— $(52,942)$210,272 
Front Store— — 21,522 — — 21,522 
Premiums122,849 — — 47 — 122,896 
Net investment income
1,473 285 — 395 — 2,153 
Other6,343 10,793 2,291 (3,470)15,966 
Total$130,665 $173,605 $124,500 $451 $(56,412)$372,809 
Health Services distribution channel:
Pharmacy network (1)
$91,650 
Mail & specialty (2)
70,877 
Net investment income
285 
Other10,793 
Total$173,605 
2023
Major goods/services lines:
Pharmacy$— $180,710 $92,111 $— $(49,369)$223,452 
Front Store— — 22,458 — — 22,458 
Premiums99,144 — — 48 — 99,192 
Net investment income (loss)765 (1)(5)394 — 1,153 
Other5,737 6,134 2,199 (2,558)11,521 
Total$105,646 $186,843 $116,763 $451 $(51,927)$357,776 
Health Services distribution channel:
Pharmacy network (1)
$112,718 
Mail & specialty (2)
67,992 
Net investment income (loss)
(1)
Other6,134 
Total$186,843 
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
2022
Major goods/services lines:
Pharmacy$— $166,793 $83,480 $— $(45,154)$205,119 
Front Store— — 22,780 — — 22,780 
Premiums85,274 — — 56 — 85,330 
Net investment income (loss)
476 — (44)406 — 838 
Other5,600 2,783 2,380 68 (2,431)8,400 
Total$91,350 $169,576 $108,596 $530 $(47,585)$322,467 
Health Services distribution channel:
Pharmacy network (1)
$102,968 
Mail & specialty (2)
63,825 
Other2,783 
Total$169,576 
_____________________________________________
(1)Health Services pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, as well as activity associated with Maintenance Choice®, which permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS pharmacy retail store for the same price as mail order.
(2)Health Services mail & specialty is defined as specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as mail order and specialty claims fulfilled by the Pharmacy & Consumer Wellness segment.
Schedule of Receivables and Contract Liabilities from Contracts with Customers
The following table provides information about receivables and contract liabilities from contracts with customers as of December 31, 2024 and 2023:
In millions20242023
Trade receivables (included in accounts receivable, net)$9,881 $11,908 
Contract liabilities (included in accrued expenses and other current liabilities)
144 149 
Schedule of Variable Interest Entities
Physician Groups VIE assets and liabilities included on the consolidated balance sheet at December 31, 2024 and 2023 were as follows:

In millions
2024
2023
Total assets$2,144 $1,515 
Total liabilities2,104 1,503 
Other variable interest holder VIE assets included in long-term investments on the consolidated balance sheets at December 31, 2024 and 2023 were as follows:
In millions20242023
Hedge fund investments$1,246 $859 
Private equity investments934 840 
Real estate partnerships438 319 
Total$2,618 $2,018 
v3.25.0.1
Acquisitions, Divestitures and Asset Sales (Tables)
12 Months Ended
Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Schedule of Fair Value of Consideration Transferred
The fair value of the consideration transferred on the date of acquisition consisted of the following:
In millions
Cash$9,579 
Fair value of replacement equity awards for pre-combination services (3.9 million shares) (1)
118 
Effective settlement of pre-existing relationship (2)
(29)
Total consideration transferred$9,668 
_____________________________________________
(1)The fair value of the replacement equity awards issued by the Company was determined as of the Oak Street Health Acquisition Date. The fair value of the awards attributed to pre-combination services of $118 million is included in the consideration transferred and the fair value of the awards attributed to post-combination services of $165 million has been, or will be, included in the Company’s post-combination financial statements as compensation costs.
(2)The purchase price included $29 million of effectively settled liabilities the Company owed to Oak Street Health from their pre-existing relationship.
The fair value of the consideration transferred on the date of acquisition consisted of the following:
In millions
Cash$7,450 
Fair value of replacement equity awards for pre-combination services (3.2 million shares) (1)
14 
Effective settlement of pre-existing relationship (2)
(111)
Total consideration transferred$7,353 
_____________________________________________
(1)The fair value of the replacement equity awards issued by the Company was determined as of the Signify Health Acquisition Date. The fair value of the awards attributed to pre-combination services of $14 million is included in the consideration transferred and the fair value of the awards attributed to post-combination services of $167 million has been, or will be, included in the Company’s post-combination financial statements as compensation costs.
(2)The purchase price included $111 million of effectively settled liabilities the Company owed to Signify Health from their pre-existing relationship.
Summary of Fair Values of Assets Acquired and Liabilities Assumed The following table summarizes the fair values of the assets acquired and liabilities assumed at the date of acquisition:
In millions
Cash and cash equivalents$201 
Investments168 
Accounts receivable1,143 
Other current assets46 
Property and equipment180 
Operating lease right-of-use assets316 
Goodwill7,213 
Intangible assets4,233 
Other long-term assets
Total assets acquired13,507 
Health care costs payable 1,098 
Other current liabilities444 
Operating lease liabilities (current and long-term)378 
Debt (current and long-term)1,028 
Deferred income taxes796 
Other long-term liabilities 29 
Total liabilities assumed3,773 
Noncontrolling interests66 
Total consideration transferred$9,668 
The transaction has been accounted for using the acquisition method of accounting which requires, among other things, the assets acquired and liabilities assumed to be recognized at their fair values at the date of acquisition. The following table summarizes the fair values of the assets acquired and liabilities assumed at the date of acquisition:
In millions
Cash and cash equivalents$376 
Accounts receivable190 
Other current assets (including restricted cash of $28)
147 
Property and equipment25 
Goodwill5,909 
Intangible assets1,920 
Other long-term assets23 
Total assets acquired8,590 
Other current liabilities606 
Debt (current and long-term)346 
Deferred income taxes259 
Other long-term liabilities 26 
Total liabilities assumed1,237 
Total consideration transferred$7,353 
Summary of the Valuation of Goodwill Allocated to Business Segments Goodwill was allocated to the Company’s business segments as follows:
In millions
Health Services$6,936 
Pharmacy & Consumer Wellness156 
Health Care Benefits121 
Total goodwill$7,213 
Goodwill was allocated to the Company’s business segments as follows:
In millions
Health Services$3,406 
Health Care Benefits2,473 
Pharmacy & Consumer Wellness30 
Total goodwill$5,909 
Summary of Fair Values and Weighted Average Useful Lives for Intangible Assets Acquired
The following table summarizes the fair values and weighted average useful lives for intangible assets acquired in the Oak Street Health Acquisition:
In millions, except weighted average useful lifeGross
Fair Value
Weighted
Average Useful
Life (years)
Customer relationships (1)
$3,620 19.9
Technology143 3.0
Trademark (definite-lived)470 8.0
Total intangible assets$4,233 18.0
_____________________________________________
(1) The substantial majority of the customer relationships intangible asset relates to relationships with health plan payors.
The following table summarizes the fair values and weighted average useful lives for intangible assets acquired in the Signify Health Acquisition:
In millions, except weighted average useful lifeGross
Fair Value
Weighted
Average Useful
Life (years)
Customer relationships$1,810 16.7
Technology 50 3.0
Trademark (definite-lived)60 5.0
Total intangible assets$1,920 16.0
v3.25.0.1
Investments (Tables)
12 Months Ended
Dec. 31, 2024
Investments [Abstract]  
Schedule of Total Investments
Total investments at December 31, 2024 and 2023 were as follows:
20242023
In millionsCurrentLong-termTotalCurrentLong-termTotal
Debt securities available for sale$2,256 $23,777 $26,033 $3,131 $18,582 $21,713 
Mortgage loans151 1,354 1,505 128 1,183 1,311 
Other investments— 3,803 3,803 — 3,254 3,254 
Total investments
$2,407 $28,934 $31,341 $3,259 $23,019 $26,278 
Schedule of Debt Securities Available For Sale
Debt securities available for sale at December 31, 2024 and 2023 were as follows:
In millions
Amortized
 Cost (1)
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
December 31, 2024   
Debt securities:   
U.S. government securities$2,826 $$(38)$2,795 
States, municipalities and political subdivisions712 (18)698 
U.S. corporate securities13,043 94 (412)12,725 
Foreign securities2,608 27 (111)2,524 
Residential mortgage-backed securities792 (54)740 
Commercial mortgage-backed securities1,731 (67)1,673 
Other asset-backed securities4,834 35 (7)4,862 
Redeemable preferred securities16 — — 16 
Total debt securities (2)
$26,562 $178 $(707)$26,033 
December 31, 2023
Debt securities:
U.S. government securities$2,071 $19 $(54)$2,036 
States, municipalities and political subdivisions2,219 31 (35)2,215 
U.S. corporate securities10,156 133 (446)9,843 
Foreign securities2,593 41 (122)2,512 
Residential mortgage-backed securities862 (60)810 
Commercial mortgage-backed securities1,066 (100)975 
Other asset-backed securities3,294 26 (18)3,302 
Redeemable preferred securities21 — (1)20 
Total debt securities (2)
$22,282 $267 $(836)$21,713 
_____________________________________________
(1)There was no allowance for expected credit losses recorded on available-for-sale debt securities at December 31, 2024 or December 31, 2023.
(2)Investment risks associated with the Company’s experience-rated products generally do not impact the Company’s consolidated operating results. At December 31, 2024, debt securities with a fair value of $543 million, gross unrealized capital gains of $5 million and gross unrealized capital losses of $30 million, and at December 31, 2023, debt securities with a fair value of $592 million, gross unrealized capital gains of $10 million and gross
unrealized capital losses of $28 million were included in total debt securities, but support experience-rated products. Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive loss.
Schedule of Amortized Cost and Fair Value of Debt Securities by Contractual Maturity
The amortized cost and fair value of debt securities at December 31, 2024 are shown below by contractual maturity. Actual maturities may differ from contractual maturities because securities may be restructured, called or prepaid, or the Company intends to sell a security prior to maturity.
In millions Amortized
Cost
Fair
Value
Due to mature: 
Less than one year$763 $761 
One year through five years10,599 10,510 
After five years through ten years4,683 4,578 
Greater than ten years3,160 2,909 
Residential mortgage-backed securities792 740 
Commercial mortgage-backed securities1,731 1,673 
Other asset-backed securities4,834 4,862 
Total$26,562 $26,033 
Schedule of Debt Securities In An Unrealized Capital Loss Position
Summarized below are the debt securities the Company held at December 31, 2024 and 2023 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 monthsGreater than 12 monthsTotal
In millions, except number of securitiesNumber
of
 Securities
Fair
Value
Unrealized
Losses
Number
of
 Securities
Fair
Value
Unrealized
Losses
Number
of
 Securities
Fair
Value
Unrealized
Losses
December 31, 2024
Debt securities:  
U.S. government securities266 $1,053 $18 155 $394 $20 421 $1,447 $38 
States, municipalities and political subdivisions100 181 137 201 15 237 382 18 
U.S. corporate securities3,119 4,144 64 2,602 3,395 348 5,721 7,539 412 
Foreign securities599 810 21 616 874 90 1,215 1,684 111 
Residential mortgage-backed securities89 267 361 342 49 450 609 54 
Commercial mortgage-backed securities186 628 11 237 464 56 423 1,092 67 
Other asset-backed securities139 414 62 58 201 472 
Redeemable preferred securities— — 15 — 
Total debt securities4,502 $7,506 $127 4,174 $5,734 $580 8,676 $13,240 $707 
December 31, 2023
Debt securities:
U.S. government securities74 $194 $280 $891 $52 354 $1,085 $54 
States, municipalities and political subdivisions95 181 455 733 34 550 914 35 
U.S. corporate securities576 672 14 4,120 5,602 432 4,696 6,274 446 
Foreign securities160 243 964 1,407 118 1,124 1,650 122 
Residential mortgage-backed securities33 97 461 517 59 494 614 60 
Commercial mortgage-backed securities44 94 287 581 98 331 675 100 
Other asset-backed securities196 449 443 867 14 639 1,316 18 
Redeemable preferred securities— 18 12 20 
Total debt securities1,182 $1,932 $28 7,018 $10,616 $808 8,200 $12,548 $836 
The maturity dates for debt securities in an unrealized capital loss position at December 31, 2024 were as follows:
 Supporting experience-
rated products
Supporting remaining
products
Total
In millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Due to mature:      
Less than one year$— $— $420 $$420 $
One year through five years120 5,462 149 5,582 152 
After five years through ten years86 2,681 138 2,767 144 
Greater than ten years166 20 2,132 259 2,298 279 
Residential mortgage-backed securities— 603 54 609 54 
Commercial mortgage-backed securities1,086 66 1,092 67 
Other asset-backed securities12 — 460 472 
Total$396 $30 $12,844 $677 $13,240 $707 
Schedule of Activity in Mortgage Loan Portfolio
The Company’s mortgage loans are collateralized by commercial real estate. During the years ended December 31, 2024 and 2023, the Company had the following activity in its mortgage loan portfolio:
In millions20242023
New mortgage loans$323 $342 
Mortgage loans fully repaid104 43 
Mortgage loans foreclosed— — 
At December 31, 2024 scheduled mortgage loan principal repayments were as follows:
In millions
2025$151 
2026164 
2027249 
2028313 
2029297 
Thereafter331 
Total$1,505 
Schedule of Mortgage Loan Amortized Cost and Credit Quality Indicator
Based upon the Company’s assessments at December 31, 2024 and 2023, the amortized cost basis of the Company’s mortgage loans within each credit quality indicator by year of origination was as follows:

Amortized Cost Basis by Year of Origination
In millions, except credit quality indicator20242023202220212020PriorTotal
December 31, 2024
1$— $— $— $— $— $$
2 to 4315 292 320 205 35 285 1,452 
5 and 6— — 13 — 28 45 
7— — — — — — — 
Total$315 $292 $324 $218 $35 $321 $1,505 
December 31, 2023
1$— $— $— $— $11 $11 
2 to 4302 346 225 35 354 1,262 
5 and 6— — 13 — 19 32 
7— — — — 
Total$302 $346 $244 $35 $384 $1,311 
Schedule of Net Investment Income
Sources of net investment income for the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Debt securities$1,136 $841 $702 
Mortgage loans76 59 51 
Other investments887 796 448 
Gross investment income2,099 1,696 1,201 
Investment expenses(63)(46)(43)
Net investment income (excluding net realized capital gains or losses)2,036 1,650 1,158 
Net realized capital gains (losses)
117 (497)(320)
Net investment income
$2,153 $1,153 $838 
Schedule of Proceeds and Related Gross Realized Capital Gains and Losses From the Sale of Debt Securities
Excluding amounts related to experience-rated products, proceeds from the sale of available-for-sale debt securities and the related gross realized capital gains and losses in the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Proceeds from sales$6,489 $5,031 $4,243 
Gross realized capital gains37 24 
Gross realized capital losses(190)420 177 
v3.25.0.1
Fair Value (Tables)
12 Months Ended
Dec. 31, 2024
Fair Value Disclosures [Abstract]  
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis Financial assets measured at fair value on a recurring basis on the consolidated balance sheets at December 31, 2024 and 2023 were as follows:
In millionsLevel 1Level 2Level 3Total
December 31, 2024    
Cash and cash equivalents$4,948 $3,638 $— $8,586 
Debt securities:    
U.S. government securities2,777 18 — 2,795 
States, municipalities and political subdivisions— 698 — 698 
U.S. corporate securities— 12,687 38 12,725 
Foreign securities— 2,524 — 2,524 
Residential mortgage-backed securities— 740 — 740 
Commercial mortgage-backed securities— 1,673 — 1,673 
Other asset-backed securities— 4,862 — 4,862 
Redeemable preferred securities— 16 — 16 
Total debt securities2,777 23,218 38 26,033 
Equity securities234 — 126 360 
Total$7,959 $26,856 $164 $34,979 
December 31, 2023    
Cash and cash equivalents
$2,174 $6,022 $— $8,196 
Debt securities:
U.S. government securities2,013 23 — 2,036 
States, municipalities and political subdivisions— 2,215 — 2,215 
U.S. corporate securities— 9,814 29 9,843 
Foreign securities— 2,512 — 2,512 
Residential mortgage-backed securities— 810 — 810 
Commercial mortgage-backed securities— 975 — 975 
Other asset-backed securities— 3,302 — 3,302 
Redeemable preferred securities— 20 — 20 
Total debt securities2,013 19,671 29 21,713 
Equity securities194 — 79 273 
Total$4,381 $25,693 $108 $30,182 
Schedule of Changes in Level 3 Financial Assets
The changes in the balances of Level 3 financial assets during the year ended December 31, 2024 were as follows:
In millions
Commercial
mortgage-
backed
securities
U.S.
corporate
securities
Other asset-
backed
securities
Equity
securities
Total
Beginning balance$— $29 $— $79 $108 
Net realized and unrealized capital gains (losses):
Included in earnings — (5)— 28 23 
Included in other comprehensive loss
— (1)— — (1)
Purchases52 15 15 19 101 
Sales— — — — — 
Transfers out of Level 3, net(52)— (15)— (67)
Ending balance$— $38 $— $126 $164 
The changes in the balances of Level 3 financial assets during the year ended December 31, 2023 were as follows:
In millions
Commercial
mortgage-
backed
securities
U.S.
corporate
securities
Foreign
securities
Equity
securities
Total
Beginning balance$— $61 $$60 $129 
Net realized and unrealized capital gains (losses):
Included in earnings— (8)— (2)(10)
Included in other comprehensive income
— — — 
Purchases13 — 23 41 
Sales— (1)— (2)(3)
Transfers out of Level 3, net(13)(29)(8)— (50)
Ending balance$— $29 $— $79 $108 
The total gross transfers into (out of) Level 3 during the years ended December 31, 2024 and 2023 were as follows:
In millions20242023
Gross transfers into Level 3$— $— 
Gross transfers out of Level 3(67)(50)
Net transfers out of Level 3$(67)$(50)
Schedule of Carrying Value and Fair Value By Level of Fair Value Hierarchy
The carrying value and estimated fair value classified by level of fair value hierarchy for financial instruments carried on the consolidated balance sheets at adjusted cost or contract value at December 31, 2024 and 2023 were as follows:
Carrying
Value
 Estimated Fair Value
In millionsLevel 1Level 2Level 3Total
December 31, 2024
Assets: 
Mortgage loans$1,505 $— $— $1,468 $1,468 
Equity securities (1)
490 N/AN/AN/AN/A
Liabilities:
Investment contract liabilities:
With a fixed maturity— — 
Without a fixed maturity312 — — 272 272 
Long-term debt64,151 58,724 — — 58,724 
December 31, 2023
Assets:
Mortgage loans$1,311 $— $— $1,274 $1,274 
Equity securities (1)
534 N/AN/AN/AN/A
Liabilities:
Investment contract liabilities:
With a fixed maturity— — 
Without a fixed maturity312 — — 279 279 
Long-term debt
61,410 58,451 — — 58,451 
______________________________________
(1)It was not practical to estimate the fair value of these investments as it represents shares of unlisted companies. See Note 1 ‘‘Significant Accounting Policies’’ for additional information regarding the valuation of investments accounted for under the measurement alternative method.
Schedule of Fair Value of Separate Accounts by Major Category of Investment
Separate Accounts financial assets at December 31, 2024 and 2023 were as follows:
December 31, 2024December 31, 2023
In millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Cash and cash equivalents$$164 $— $165 $$166 $— $168 
Debt securities186 669 856 558 1,949 — 2,507 
Common/collective trusts— 2,478 — 2,478 — 529 — 529 
Total (1)
$187 $3,311 $$3,499 $560 $2,644 $— $3,204 
_____________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.
The following table shows the fair value of assets, by major investment category, supporting Separate Accounts as of December 31, 2024 and 2023:
In millions20242023
Cash and cash equivalents$165 168 
Debt securities:
U.S. government securities186 573 
States, municipalities and political subdivisions14 28 
U.S. corporate securities524 1,632 
Foreign securities51 202 
Residential mortgage-backed securities71 51 
Commercial mortgage-backed securities
Other asset-backed securities15 
Total debt securities856 2,507 
Common/collective trusts2,478 529 
Total (1)
$3,499 $3,204 
_____________________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.
v3.25.0.1
Goodwill and Other Intangibles (Tables)
12 Months Ended
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Summary of Changes in Carrying Amount of Goodwill
Below is a summary of the changes in the carrying amount of goodwill by segment for the years ended December 31, 2024 and 2023:
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Total
Balance at December 31, 2022$44,159 $23,615 $10,376 $78,150 
Segment realignment(109)109 — — 
Acquisitions2,594 10,342 186 13,122 
Balance at December 31, 202346,644 34,066 10,562 91,272 
Balance at December 31, 2024$46,644 $34,066 $10,562 $91,272 
Summary of Intangible Assets
The following table is a summary of the Company’s intangible assets as of December 31, 2024 and 2023:
In millions, except weighted average lifeGross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Weighted
Average
Life (years)
2024
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete26,904 (13,889)13,015 14.2
Technology1,250 (1,167)83 3.0
Provider networks4,203 (1,282)2,921 20.0
Value of Business Acquired 590 (228)362 20.0
Other826 (382)444 9.3
Total$44,271 $(16,948)$27,323 14.5
2023
Trademarks (indefinite-lived)$10,498 $— $10,498 N/A
Customer contracts/relationships and covenants not to compete26,784 (12,241)14,543 14.2
Technology1,253 (1,104)149 3.0
Provider networks4,203 (1,072)3,131 20.0
Value of Business Acquired 590 (201)389 20.0
Other838 (314)524 9.3
Total
$44,166 $(14,932)$29,234 14.5
Schedule of Projected Annual Amortization Expense for Intangible Assets for Next Five Years The projected annual amortization expense for the Company’s intangible assets for the next five years is as follows:
In millions
2025$1,981 
20261,704 
20271,590 
20281,316 
20291,239 
v3.25.0.1
Leases (Tables)
12 Months Ended
Dec. 31, 2024
Leases [Abstract]  
Summary of the Components of Net Lease Cost and Supplemental Cash Flow Information
The following table is a summary of the components of net lease cost for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Operating lease cost$2,423 $2,532 $2,579 
Finance lease cost:
Amortization of right-of-use assets92 84 79 
Interest on lease liabilities71 73 68 
Total finance lease costs163 157 147 
Short-term lease costs33 22 27 
Variable lease costs635 635 610 
Less: sublease income(67)(63)(61)
Net lease cost$3,187 $3,283 $3,302 

Supplemental cash flow information related to leases for the years ended December 31, 2024, 2023 and 2022 was as follows:
In millions202420232022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows paid for operating leases$2,733 $2,756 $2,689 
Operating cash flows paid for interest portion of finance leases71 73 68 
Financing cash flows paid for principal portion of finance leases74 70 62 
Right-of-use assets obtained in exchange for lease obligations:
Operating leases852 1,132 591 
Finance leases30 (4)232 
Supplemental Balance Sheet Information
Supplemental balance sheet information related to leases as of December 31, 2024 and 2023 is as follows:
In millions, except remaining lease term and discount rate20242023
Operating leases:
Operating lease right-of-use assets
$15,944$17,252
Current portion of operating lease liabilities$1,751$1,741
Long-term operating lease liabilities14,89916,034
Total operating lease liabilities
$16,650$17,775
Finance leases:
Property and equipment, gross$1,587$1,604
Accumulated depreciation(447)(375)
Property and equipment, net$1,140$1,229
Current portion of long-term debt$65$66
Long-term debt1,2951,325
Total finance lease liabilities$1,360$1,391
Weighted average remaining lease term (in years)
Operating leases10.711.4
Finance leases16.517.3
Weighted average discount rate
Operating leases4.6 %4.5 %
Finance leases5.1 %5.0 %
Maturities of Operating Lease Liabilities
The following table summarizes the maturity of lease liabilities under finance and operating leases as of December 31, 2024:
In millionsFinance
Leases
Operating
Leases
(1)
Total
2025$144 $2,683 $2,827 
2026135 2,528 2,663 
2027132 2,343 2,475 
2028129 2,167 2,296 
2029127 1,911 2,038 
Thereafter1,371 9,557 10,928 
Total lease payments (2)
2,038 21,189 23,227 
Less: imputed interest(678)(4,539)(5,217)
Total lease liabilities$1,360 $16,650 $18,010 
_____________________________________________
(1)Future operating lease payments have not been reduced by minimum sublease rentals of $297 million due in the future under noncancelable subleases.
(2)The Company leases pharmacy and clinic space from Target Corporation. Amounts related to such finance and operating leases are reflected above. Pharmacy lease amounts due in excess of the remaining estimated economic life of the buildings of approximately $2.2 billion are not reflected in this table since the estimated economic life of the buildings is shorter than the contractual term of the pharmacy lease arrangement.
Maturities of Finance Lease Liabilities
The following table summarizes the maturity of lease liabilities under finance and operating leases as of December 31, 2024:
In millionsFinance
Leases
Operating
Leases
(1)
Total
2025$144 $2,683 $2,827 
2026135 2,528 2,663 
2027132 2,343 2,475 
2028129 2,167 2,296 
2029127 1,911 2,038 
Thereafter1,371 9,557 10,928 
Total lease payments (2)
2,038 21,189 23,227 
Less: imputed interest(678)(4,539)(5,217)
Total lease liabilities$1,360 $16,650 $18,010 
_____________________________________________
(1)Future operating lease payments have not been reduced by minimum sublease rentals of $297 million due in the future under noncancelable subleases.
(2)The Company leases pharmacy and clinic space from Target Corporation. Amounts related to such finance and operating leases are reflected above. Pharmacy lease amounts due in excess of the remaining estimated economic life of the buildings of approximately $2.2 billion are not reflected in this table since the estimated economic life of the buildings is shorter than the contractual term of the pharmacy lease arrangement.
v3.25.0.1
Health Care Costs Payable (Tables)
12 Months Ended
Dec. 31, 2024
Health Care and Other Insurance Liabilities [Abstract]  
Information about Incurred and Paid Health Care Claims Development
The information about incurred and paid health care claims development for the year ended December 31, 2023 is presented as required unaudited supplemental information.
In millionsIncurred Health Care Claims,
Net of Reinsurance
For the Years Ended December 31,
Date of Service20232024
(Unaudited)
2023$82,362 $81,559 
2024109,458 
Total$191,017 
In millionsCumulative Paid Health Care Claims,
Net of Reinsurance
For the Years Ended December 31,
Date of Service20232024
(Unaudited)
2023$72,175 $81,044 
202497,155 
Total$178,199 
All outstanding liabilities for health care costs payable prior to 2023, net of reinsurance
128 
Total outstanding liabilities for health care costs payable, net of reinsurance$12,946 
Schedule of Liability for Unpaid Claims and Claims Adjustment Expense
The reconciliation of the December 31, 2024 health care net incurred and paid claims development tables to the health care costs payable liability on the consolidated balance sheet were as follows:
In millionsDecember 31, 2024
Short-duration health care costs payable, net of reinsurance$12,946 
Reinsurance recoverables81 
Insurance lines other than short duration282 
Other non-insurance health care costs payable1,755 
Total health care costs payable$15,064 
Components of Change in Health Care Costs Payable
The following table shows the components of the change in health care costs payable during the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Health care costs payable, beginning of period $12,049 $10,142 $8,678 
Less: Reinsurance recoverables
Less: Impact of discount rate on long-duration insurance reserves (1)
(23)— 
Health care costs payable, beginning of period, net12,067 10,129 8,670 
Acquisition, net— 1,098 — 
Add: Components of incurred health care costs
  Current year115,774 86,639 71,399 
  Prior years(947)(685)(654)
Total incurred health care costs (2)
114,827 85,954 70,745 
Less: Claims paid
  Current year101,583 75,529 61,640 
  Prior years10,327 9,585 7,646 
Total claims paid111,910 85,114 69,286 
Health care costs payable, end of period, net14,984 12,067 10,129 
Add: Reinsurance recoverables81 
Add: Impact of discount rate on long-duration insurance reserves (1)
(1)(23)
Health care costs payable, end of period$15,064 $12,049 $10,142 
_____________________________________
(1)Reflects the difference between the current discount rate and the locked-in discount rate on long-duration insurance reserves which is recorded within accumulated other comprehensive loss on the consolidated balance sheets.
(2)Total incurred health care costs for the years ended December 31, 2024, 2023 and 2022 in the table above exclude $107 million, $83 million and $79 million, respectively, of health care costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the consolidated balance sheets and $187 million, $210 million and $249 million, respectively, of health care costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the consolidated balance sheets.
v3.25.0.1
Other Insurance Liabilities and Separate Accounts (Tables)
12 Months Ended
Dec. 31, 2024
Insurance [Abstract]  
Schedule of Changes in Liability for Future Policy Benefits
The following tables show the components of the change in the liability for future policy benefits, which is included in other insurance liabilities and other long-term insurance liabilities on the consolidated balance sheets, during the years ended December 31, 2024 and 2023:
2024
In millionsLarge Case
Pensions
Long-Term
Care
Present value of expected net premiums (1)
Liability for future policy benefits, beginning of period - current discount rate$293 
Beginning liability for future policy benefits at original (locked-in) discount rate$288 
Effect of changes in cash flow assumptions— 
Effect of actual variances from expected experience16 
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate304 
Interest accrual (using locked-in discount rate)14 
Net premiums (actual)(38)
Ending liability for future policy benefits at original (locked-in) discount rate280 
Effect of changes in discount rate assumptions(5)
Liability for future policy benefits, end of period - current discount rate$275 
Present value of expected future policy benefits
Liability for future policy benefits, beginning of period - current discount rate$2,139 $1,640 
Beginning liability for future policy benefits at original (locked-in) discount rate$2,251 $1,632 
Effect of changes in cash flow assumptions— — 
Effect of actual variances from expected experience(27)
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate2,224 1,638 
Issuances30 — 
Interest accrual (using locked-in discount rate)91 83 
Benefit payments (actual)(255)(74)
Ending liability for future policy benefits at original (locked-in) discount rate2,090 1,647 
Effect of changes in discount rate assumptions(173)(95)
Liability for future policy benefits, end of period - current discount rate$1,917 $1,552 
Net liability for future policy benefits$1,917 $1,277 
Less: Reinsurance recoverable— — 
Net liability for future policy benefits, net of reinsurance recoverable$1,917 $1,277 
_____________________________________________
(1)The present value of expected net premiums is equivalent to the present value of expected gross premiums for the long-term care insurance contracts as net premiums are set equal to gross premiums.
2023
In millionsLarge Case
Pensions
Long-Term
Care
Present value of expected net premiums (1)
Liability for future policy benefits, beginning of period - current discount rate$300 
Beginning liability for future policy benefits at original (locked-in) discount rate$302 
Effect of changes in cash flow assumptions— 
Effect of actual variances from expected experience10 
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate312 
Interest accrual (using locked-in discount rate)15 
Net premiums (actual)(39)
Ending liability for future policy benefits at original (locked-in) discount rate288 
Effect of changes in discount rate assumptions
Liability for future policy benefits, end of period - current discount rate$293 
Present value of expected future policy benefits
Liability for future policy benefits, beginning of period - current discount rate$2,253 $1,566 
Beginning liability for future policy benefits at original (locked-in) discount rate$2,425 $1,613 
Effect of changes in cash flow assumptions— — 
Effect of actual variances from expected experience(3)
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate2,422 1,621 
Issuances— 
Interest accrual (using locked-in discount rate)97 82 
Benefit payments (actual)(276)(71)
Ending liability for future policy benefits at original (locked-in) discount rate2,251 1,632 
Effect of changes in discount rate assumptions(112)
Liability for future policy benefits, end of period - current discount rate$2,139 $1,640 
Net liability for future policy benefits$2,139 $1,347 
Less: Reinsurance recoverable— — 
Net liability for future policy benefits, net of reinsurance recoverable$2,139 $1,347 
_____________________________________________
(1)The present value of expected net premiums is equivalent to the present value of expected gross premiums for the long-term care insurance contracts as net premiums are set equal to gross premiums.
The amount of undiscounted expected gross premiums and expected future benefit payments for long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
In millions20242023
Large case pensions
Expected future benefit payments$3,024$3,266
Expected gross premiums
Long-term care
Expected future benefit payments$3,189$3,224
Expected gross premiums399414

The weighted-average interest rate used in the measurement of the long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
20242023
Large case pensions
Interest accretion rate4.20%4.20%
Current discount rate5.46%4.93%
Long-term care
Interest accretion rate5.11%5.11%
Current discount rate5.70%5.08%

The weighted-average durations (in years) of the long-duration insurance liabilities as of December 31, 2024 and 2023 were as follows:
20242023
Large case pensions7.37.3
Long-term care11.712.1
Schedule of Fair Value of Separate Accounts by Major Category of Investment
Separate Accounts financial assets at December 31, 2024 and 2023 were as follows:
December 31, 2024December 31, 2023
In millionsLevel 1Level 2Level 3TotalLevel 1Level 2Level 3Total
Cash and cash equivalents$$164 $— $165 $$166 $— $168 
Debt securities186 669 856 558 1,949 — 2,507 
Common/collective trusts— 2,478 — 2,478 — 529 — 529 
Total (1)
$187 $3,311 $$3,499 $560 $2,644 $— $3,204 
_____________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.
The following table shows the fair value of assets, by major investment category, supporting Separate Accounts as of December 31, 2024 and 2023:
In millions20242023
Cash and cash equivalents$165 168 
Debt securities:
U.S. government securities186 573 
States, municipalities and political subdivisions14 28 
U.S. corporate securities524 1,632 
Foreign securities51 202 
Residential mortgage-backed securities71 51 
Commercial mortgage-backed securities
Other asset-backed securities15 
Total debt securities856 2,507 
Common/collective trusts2,478 529 
Total (1)
$3,499 $3,204 
_____________________________________________
(1)Excludes $188 million of other payables and $46 million of other receivables at December 31, 2024 and 2023, respectively.
Roll Forward of Separate Accounts
The following table shows the components of the change in Separate Accounts liabilities during the years ended December 31, 2024 and 2023:
In millions20242023
Separate Accounts liability, beginning of the period$3,250 $3,228 
Premiums and deposits964 860 
Surrenders and withdrawals(277)(9)
Benefit payments(978)(938)
Investment earnings348 100 
Net transfers from general account13 
Other(9)
Separate Accounts liability, end of the period$3,311 $3,250 
Cash surrender value, end of the period$1,987 $2,181 
v3.25.0.1
Borrowings and Credit Agreements (Tables)
12 Months Ended
Dec. 31, 2024
Debt Disclosure [Abstract]  
Summary of Company's Borrowings
The following table is a summary of the Company’s borrowings as of December 31, 2024 and 2023:
In millions20242023
Short-term debt
Commercial paper$2,119 $200 
Long-term debt
3.375% senior notes due August 2024
— 650 
2.625% senior notes due August 2024
— 1,000 
3.5% senior notes due November 2024
— 750 
5% senior notes due December 2024
— 299 
4.1% senior notes due March 2025
724 950 
3.875% senior notes due July 2025
2,828 2,828 
5% senior notes due February 2026
1,500 1,500 
2.875% senior notes due June 2026
1,750 1,750 
3% senior notes due August 2026
750 750 
3.625% senior notes due April 2027
750 750 
6.25% senior notes due June 2027
372 372 
1.3% senior notes due August 2027
2,250 2,250 
4.3% senior notes due March 2028
5,000 5,000 
5% senior notes due January 2029
1,000 1,000 
5.4% senior notes due June 2029
1,000 — 
3.25% senior notes due August 2029
1,750 1,750 
5.125% senior notes due February 2030
1,500 1,500 
3.75% senior notes due April 2030
1,500 1,500 
1.75% senior notes due August 2030
1,250 1,250 
5.25% senior notes due January 2031
750 750 
1.875% senior notes due February 2031
1,250 1,250 
5.55% senior notes due June 2031
1,000 — 
2.125% senior notes due September 2031
1,000 1,000 
5.25% senior notes due February 2033
1,750 1,750 
5.3% senior notes due June 2033
1,250 1,250 
5.7% senior notes due June 2034
1,250 — 
4.875% senior notes due July 2035
652 652 
6.625% senior notes due June 2036
771 771 
6.75% senior notes due December 2037
533 533 
4.78% senior notes due March 2038
5,000 5,000 
6.125% senior notes due September 2039
447 447 
4.125% senior notes due April 2040
602 1,000 
2.7% senior notes due August 2040
367 1,250 
5.75% senior notes due May 2041
133 133 
4.5% senior notes due May 2042
500 500 
4.125% senior notes due November 2042
226 500 
5.3% senior notes due December 2043
750 750 
4.75% senior notes due March 2044
375 375 
6% senior notes due June 2044
750 — 
5.125% senior notes due July 2045
3,500 3,500 
3.875% senior notes due August 2047
537 1,000 
5.05% senior notes due March 2048
8,000 8,000 
4.25% senior notes due April 2050
399 750 
5.625% senior notes due February 2053
1,250 1,250 
5.875% senior notes due June 2053
1,250 1,250 
6.05% senior notes due June 2054
1,000 — 
6% senior notes due June 2063
750 750 
6.75% series B junior subordinated notes due December 2054
750 — 
7% series A junior subordinated notes due March 2055
2,250 — 
Finance lease liabilities1,360 1,391 
Other302 309 
Total debt principal66,747 62,160 
Debt premiums170 186 
Debt discounts and deferred financing costs(647)(736)
66,270 61,610 
Less:
Short-term debt (commercial paper)(2,119)(200)
Current portion of long-term debt(3,624)(2,772)
Long-term debt$60,527 $58,638 
Schedule of Maturities of Long-Term Debt
The following is a summary of the Company’s required repayments of long-term debt principal due during each of the next five years and thereafter, as of December 31, 2024:
In millions
2025$3,559 
20264,007 
20273,379 
20285,007 
20293,758 
Thereafter43,558 
Subtotal63,268 
Commercial paper2,119 
Finance lease liabilities (1)
1,360 
Total debt principal$66,747 
_____________________________________________
(1)See Note 7 ‘‘Leases’’ for a summary of maturities of the Company’s finance lease liabilities.
v3.25.0.1
Pension Plans and Other Postretirement Benefits (Tables)
12 Months Ended
Dec. 31, 2024
Retirement Benefits [Abstract]  
Schedule of Changes in Benefit Obligations
The following tables outline the change in pension benefit obligation and plan assets over the specified periods:
In millions20242023
Change in benefit obligation:
Benefit obligation, beginning of year$4,736 $4,740 
Interest cost222 231 
Actuarial loss (gain)(262)145 
Benefit payments(347)(380)
Benefit obligation, end of year4,349 4,736 
Change in plan assets:
Fair value of plan assets, beginning of year5,379 5,346 
Actual return on plan assets133 389 
Employer contributions23 24 
Benefit payments(347)(380)
Fair value of plan assets, end of year5,188 5,379 
Funded status$839 $643 
Schedule of Changes in Plan Assets
The following tables outline the change in pension benefit obligation and plan assets over the specified periods:
In millions20242023
Change in benefit obligation:
Benefit obligation, beginning of year$4,736 $4,740 
Interest cost222 231 
Actuarial loss (gain)(262)145 
Benefit payments(347)(380)
Benefit obligation, end of year4,349 4,736 
Change in plan assets:
Fair value of plan assets, beginning of year5,379 5,346 
Actual return on plan assets133 389 
Employer contributions23 24 
Benefit payments(347)(380)
Fair value of plan assets, end of year5,188 5,379 
Funded status$839 $643 
Schedule of Assets (Liabilities) Recognized in Balance Sheet
The assets (liabilities) recognized on the consolidated balance sheets at December 31, 2024 and 2023 for the defined benefit pension plans consisted of the following:
In millions20242023
Noncurrent assets reflected in other assets$1,030 $856 
Current liabilities reflected in accrued expenses and other current liabilities
(22)(24)
Noncurrent liabilities reflected in other long-term liabilities(169)(189)
Net assets$839 $643 
Schedule of Net Periodic Benefit Cost (Income)
The components of net periodic benefit cost (income) for the years ended December 31, 2024, 2023 and 2022 are shown below:
In millions202420232022
Components of net periodic benefit cost (income):
Interest cost$222 $231 $132 
Expected return on plan assets(327)(326)(309)
Amortization of net actuarial loss
Settlement losses— — 
Net periodic benefit cost (income)$(104)$(94)$(173)
Weighted Average Assumptions Used in Determining Benefit Obligations and Net Benefit Costs
The Company determined its benefit obligation based on the following weighted average assumptions as of December 31, 2024 and 2023:
20242023
Discount rate5.6 %5.0 %

The Company determined its net periodic benefit cost (income) based on the following weighted average assumptions for the years ended December 31, 2024, 2023 and 2022:
202420232022
Discount rate4.9 %5.1 %2.3 %
Expected long-term rate of return on plan assets6.3 %6.3 %4.8 %
Schedule of Changes in Fair Value of Plan Assets
Pension plan assets with changes in fair value measured on a recurring basis at December 31, 2024 were as follows:
In millionsLevel 1Level 2Level 3Total
Cash and cash equivalents$32 $67 $— $99 
Debt securities:
    U.S. government securities481 — 487 
    States, municipalities and political subdivisions— 70 — 70 
    U.S. corporate securities— 2,752 2,753 
    Foreign securities— 98 — 98 
    Residential mortgage-backed securities— — 
    Commercial mortgage-backed securities— — 
    Other asset-backed securities— — 
    Redeemable preferred securities— — 
Total debt securities481 2,947 3,429 
Equity securities:
    U.S. domestic30 — — 30 
    International12 — — 12 
Total equity securities42 — — 42 
Other investments:
    Private real estate
— — 276 276 
    Common/collective trusts (1)
— 502 — 502 
    Derivatives— — 
Total other investments— 505 276 781 
Total pension investments (2)
$555 $3,519 $277 $4,351 
_____________________________________________
(1)The assets in the underlying funds of common/collective trusts consist of $288 million of equity securities and $214 million of debt securities.
(2)Excludes $267 million of other receivables as well as $290 million of private equity limited partnership investments and $280 million of hedge fund limited partnership investments as these amounts are measured at NAV per share or an equivalent and are not subject to leveling within the fair value hierarchy.
Pension plan assets with changes in fair value measured on a recurring basis at December 31, 2023 were as follows:
In millionsLevel 1Level 2Level 3Total
Cash and cash equivalents$12 $69 $— $81 
Debt securities:
    U.S. government securities518 — 522 
    States, municipalities and political subdivisions— 94 — 94 
    U.S. corporate securities— 2,649 — 2,649 
    Foreign securities— 106 — 106 
    Residential mortgage-backed securities— 17 — 17 
    Commercial mortgage-backed securities— — 
    Other asset-backed securities— — 
    Redeemable preferred securities— — 
Total debt securities518 2,888 — 3,406 
Equity securities:
    U.S. domestic150 — — 150 
    International34 — — 34 
Total equity securities184 — — 184 
Other investments:
    Private real estate
— — 290 290 
    Common/collective trusts (1)
— 405 — 405 
    Derivatives— (14)— (14)
Total other investments— 391 290 681 
Total pension investments (2)
$714 $3,348 $290 $4,352 
_____________________________________________
(1)The assets in the underlying funds of common/collective trusts consist of $114 million of equity securities and $291 million of debt securities.
(2)Excludes $314 million of other receivables as well as $461 million of private equity limited partnership investments and $252 million of hedge fund limited partnership investments as these amounts are measured at NAV per share or an equivalent and are not subject to leveling within the fair value hierarchy.
Schedule of Change in Level 3 Plan Assets
The changes in the balances of Level 3 pension plan assets during the year ended December 31, 2024 were as follows:
In millions
Private
real estate
U.S. corporate
securities
Total
Beginning balance$290 $— $290 
Actual return on plan assets— 
Purchases, sales and settlements(15)(14)
Transfers out of Level 3— — — 
Ending balance$276 $$277 

The changes in the balances of Level 3 pension plan assets during the year ended December 31, 2023 were as follows:

In millions
Private
real estate
Beginning balance$325 
Actual return on plan assets(23)
Purchases, sales and settlements(12)
Transfers out of Level 3— 
Ending balance$290 
Schedule of Expected Future Benefits Payments
The Company estimates the following future benefit payments, which are calculated using the same actuarial assumptions used to measure the pension benefit obligation as of December 31, 2024:
In millions
2025$389 
2026384 
2027380 
2028380 
2029371 
2030-2034
1,712 
The Company estimates the following future benefit payments, which are calculated using the same actuarial assumptions used to measure the accumulated other postretirement benefit obligation as of December 31, 2024:
In millions
2025$12 
202612 
202712 
202812 
202912 
2030-2034
59 
v3.25.0.1
Income Taxes (Tables)
12 Months Ended
Dec. 31, 2024
Income Tax Disclosure [Abstract]  
Schedule of Income Tax Provision
The income tax provision consisted of the following for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Current:
Federal$1,658 $2,819 $2,803 
State476 662 735 
2,134 3,481 3,538 
Deferred:
Federal(453)(537)(1,526)
State(119)(139)(503)
(572)(676)(2,029)
Total$1,562 $2,805 $1,509 
Schedule of Effective Income Tax Rate Reconciliation
The following table is a reconciliation of the statutory income tax rate to the Company’s effective income tax rate for the years ended December 31, 2024, 2023 and 2022:
202420232022
Statutory income tax rate21.0 %21.0 %21.0 %
State income taxes, net of federal tax benefit4.6 3.7 3.2 
Legal charges0.5 — 3.4 
Basis difference upon disposition of subsidiary— — 1.6 
Prior year refunds and unrecognized tax benefits— — (2.6)
Tax credits
(1.2)(0.3)(0.6)
Other0.5 0.7 (0.1)
Effective income tax rate25.4 %25.1 %25.9 %
Schedule of Deferred Tax Assets and Liabilities
The following table is a summary of the components of the Company’s deferred income tax assets and liabilities as of December 31, 2024 and 2023:
In millions20242023
Deferred income tax assets:
Lease and rents$4,763 $5,059 
Legal charges1,109 1,205 
Inventory68 94 
Employee benefits168 168 
Bad debts and other allowances593 606 
Net operating loss and capital loss carryforwards272 409 
Deferred income47 62 
Insurance reserves381 356 
Investments21 56 
Other486 372 
Valuation allowance(301)(385)
Total deferred income tax assets
7,607 8,002 
Deferred income tax liabilities:
Retirement benefits172 112 
Lease and rents4,125 4,469 
Depreciation and amortization7,116 7,732 
Total deferred income tax liabilities11,413 12,313 
Net deferred income tax liabilities$3,806 $4,311 
Schedule of Unrecognized Tax Benefits Rollforward
A reconciliation of the beginning and ending balance of unrecognized tax benefits in 2024, 2023 and 2022 is as follows:
In millions202420232022
Beginning balance$436 $446 $782 
Additions based on tax positions related to the current year— 
Additions based on tax positions related to prior years67 46 42 
Reductions for tax positions of prior years(49)(24)(166)
Expiration of statutes of limitation(29)(34)(4)
Settlements(1)— (213)
Ending balance$424 $436 $446 
v3.25.0.1
Stock Incentive Plans (Tables)
12 Months Ended
Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]  
Summary of Stock-Based Compensation The following table is a summary of stock-based compensation for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Restricted stock units and performance stock units
$461 $497 $369 
Stock options and stock appreciation rights (“SARs”) (1)
79 91 78 
Total stock-based compensation (2)
$540 $588 $447 
_____________________________________________
(1)Includes the Employee Stock Purchase Plan (“ESPP”).
(2)Total stock-based compensation for the year ended December 31, 2024 included $60 million and $41 million of post-combination expense associated with replacement equity awards granted in connection with the Oak Street Health and Signify Health acquisitions, respectively. Total stock-based
compensation for the year ended December 31, 2023 included $71 million and $72 million of post-combination expense associated with replacement equity awards granted in connection with the Oak Street Health and Signify Health acquisitions, respectively.
Restricted Stock Unit and Performance Stock Unit Activity
The following table is a summary of the restricted stock unit and performance stock unit activity for the year ended December 31, 2024:
In thousands, except weighted average grant date fair valueUnitsWeighted Average
Grant Date
Fair Value
Outstanding at beginning of year, nonvested16,994 $77.65 
Granted
9,978 $75.97 
Vested (1)
(6,532)$76.08 
Forfeited(1,928)$78.71 
Outstanding at end of year, nonvested18,512 $77.19 
_____________________________________________
(1)Vested performance stock units have been included at target level performance. Based on actual performance, the number of restricted stock units and performance stock units vested during the year ended December 31, 2024 was 6.6 million.
Summary of Stock Option and SAR Activity
The following table is a summary of stock option and SAR activity that occurred for the years ended December 31, 2024, 2023 and 2022:
In millions202420232022
Cash received from stock options exercised (including ESPP)
$361 $277 $551 
Payments for taxes for net share settlement of equity awards
185 181 370 
Intrinsic value of stock options and SARs exercised
33 31 118 
Fair value of stock options and SARs vested
225 227 219 
Schedule of Valuation Assumptions
The fair value of each stock option and SAR is estimated using the Black-Scholes option pricing model based on the following assumptions at the time of grant:
202420232022
Dividend yield (1)
4.29 %3.27 %2.18 %
Expected volatility (2)
28.36 %28.15 %27.34 %
Risk-free interest rate (3)
4.13 %3.55 %2.46 %
Expected life (in years) (4)
5.35.96.3
Weighted-average grant date fair value$11.31 $21.78 $24.15 
_____________________________________________
(1)The dividend yield is based on annual dividends paid and the fair market value of CVS Health Corporation stock at the grant date.
(2)The expected volatility is estimated based on the historical volatility of CVS Health Corporation’s daily stock price over a period equal to the expected life of each option grant after adjustments for infrequent events such as stock splits.
(3)The risk-free interest rate is selected based on yields from U.S. Treasury zero-coupon issues with a remaining term equal to the expected term of the options being valued.
(4)The expected life represents the number of years the options are expected to be outstanding from grant date based on historical option or SAR holder exercise experience.
Schedule of Stock Options and Stock Appreciation Rights Award Activity
The following table is a summary of the Company’s stock option and SAR activity for the year ended December 31, 2024:
In thousands, except weighted average exercise price and remaining contractual termSharesWeighted
Average
Exercise
 Price
Weighted
Average
Remaining
Contractual
Term
Aggregate
Intrinsic
Value
Outstanding at beginning of year15,126 $68.13 
Granted
4,435 $68.91 
Exercised(2,806)$59.61 
Forfeited(1,046)$79.05 
Expired(690)$78.69 
Outstanding at end of year15,019 $68.69 5.10$3,279 
Exercisable at end of year7,579 $65.01 3.251,939 
Vested at end of year and expected to vest in the future14,646 $68.66 5.023,252 
Schedule ESPP Valuation Assumptions
The following table is a summary of the assumptions used to value the ESPP awards for the years ended December 31, 2024, 2023 and 2022:
202420232022
Dividend yield (1)
2.01 %1.54 %1.12 %
Expected volatility (2)
31.40 %25.61 %23.54 %
Risk-free interest rate (3)
5.31 %5.17 %1.42 %
Expected life (in years) (4)
0.50.50.5
Weighted-average grant date fair value$12.39 $14.26 $16.25 
_____________________________________________
(1)The dividend yield is calculated based on semi-annual dividends paid and the fair market value of CVS Health Corporation stock at the grant date.
(2)The expected volatility is estimated based on the historical volatility of CVS Health Corporation’s daily stock price over the previous six month period.
(3)The risk-free interest rate is selected based on the Treasury constant maturity interest rate whose term is consistent with the expected term of ESPP purchases (i.e., six months).
(4)The expected life is based on the semi-annual purchase period.
v3.25.0.1
Shareholders' Equity (Tables)
12 Months Ended
Dec. 31, 2024
Equity [Abstract]  
Share Repurchase Programs
The following share repurchase programs have been authorized by the Board:
In billions
Authorization Date
Authorized
Remaining as of
December 31, 2024
November 17, 2022 (“2022 Repurchase Program”)$10.0 $10.0 
December 9, 2021 (“2021 Repurchase Program”)10.0 1.5 
Schedule of Regulatory Requirements The combined statutory net income for the years ended and estimated combined statutory and capital surplus at December 31, 2024, 2023 and 2022 for the Company’s insurance and HMO subsidiaries were as follows:
In millions202420232022
Statutory net income (loss)
$(1,185)$2,757 $2,851 
Estimated statutory capital and surplus
20,085 16,961 15,503 
Statutory Accounting Practices Disclosure At December 31, 2024, these amounts were as follows:
In millions
Estimated minimum statutory surplus required by regulators$11,691 
Investments on deposit with regulatory bodies713 
Estimated maximum dividend distributions permitted in 2025 without prior regulatory approval
1,561 
v3.25.0.1
Other Comprehensive Income (Loss) (Tables)
12 Months Ended
Dec. 31, 2024
Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Schedule of Accumulated Other Comprehensive Income (Loss)
Shareholders’ equity included the following activity in accumulated other comprehensive loss in 2024, 2023 and 2022:
At December 31,
In millions202420232022
Net unrealized investment gains (losses):
Beginning of year balance$(429)$(1,519)$798 
Other comprehensive income (loss) before reclassifications ($(177), $612 and $(3,021) pretax)
(170)603 (2,556)
Amounts reclassified from accumulated other comprehensive income (loss) ($226, $566 and $315 pretax) (1)
200 487 239 
Other comprehensive income (loss)30 1,090 (2,317)
End of year balance(399)(429)(1,519)
Change in discount rate on long-duration insurance reserves:
Beginning of period balance152 219 (651)
Other comprehensive income (loss) before reclassifications ($146, $(92), and $1,126 pretax)
113 (67)870 
Other comprehensive income (loss)113 (67)870 
End of period balance265 152 219 
Foreign currency translation adjustments:
Beginning of year balance
— — — 
Other comprehensive loss before reclassifications(4)— — 
Other comprehensive loss(4)— — 
End of year balance
(4)— — 
Net cash flow hedges:
Beginning of year balance244 239 222 
Other comprehensive income before reclassifications ($0, $25 and $38 pretax)
— 19 28 
Amounts reclassified from accumulated other comprehensive income ($(20), $(19) and $(15) pretax) (2)
(15)(14)(11)
Other comprehensive income (loss)(15)17 
End of year balance229 244 239 
Pension and other postretirement benefits:
Beginning of year balance(264)(203)(35)
Other comprehensive income (loss) before reclassifications ($71, $(81) and $(229) pretax)
53 (61)(170)
Amounts reclassified from accumulated other comprehensive loss ($0, $0 and $3 pretax) (3)
— — 
Other comprehensive income (loss) 53 (61)(168)
End of year balance(211)(264)(203)
Total beginning of year accumulated other comprehensive income (loss)(297)(1,264)334 
Total other comprehensive income (loss)177 967 (1,598)
Total end of year accumulated other comprehensive loss
$(120)$(297)$(1,264)
_______________________________________
(1)Amounts reclassified from accumulated other comprehensive income (loss) for specifically identified debt securities are included in net investment income in the consolidated statements of operations.
(2)Amounts reclassified from accumulated other comprehensive income for specifically identified cash flow hedges are included within interest expense in the consolidated statements of operations. The Company expects to reclassify $16 million, net of tax, in net gains associated with its cash flow hedges into net income within the next 12 months.
(3)Amounts reclassified from accumulated other comprehensive loss for specifically identified pension and other postretirement benefits are included in other income in the consolidated statements of operations.
v3.25.0.1
Earnings Per Share (Tables)
12 Months Ended
Dec. 31, 2024
Earnings Per Share [Abstract]  
Reconciliation of Basic and Diluted Earnings Per Share
The following is a reconciliation of basic and diluted earnings per share for the years ended December 31, 2024, 2023 and 2022:
In millions, except per share amounts202420232022
Numerator for earnings per share calculation:
Net income attributable to CVS Health$4,614 $8,344 $4,311 
Denominator for earnings per share calculation:
Weighted average shares, basic1,259 1,285 1,312 
Restricted stock units and performance stock units
Stock options and SARs
Weighted average shares, diluted1,262 1,290 1,323 
Earnings per share:
Basic$3.67 $6.49 $3.29 
Diluted$3.66 $6.47 $3.26 
v3.25.0.1
Reinsurance (Tables)
12 Months Ended
Dec. 31, 2024
Reinsurance Disclosures [Abstract]  
Schedule of Reinsurance Recoverables
Reinsurance recoverables (recorded as other current assets or other assets on the consolidated balance sheets) at December 31, 2024 and 2023 were as follows:
In millions20242023
Reinsurer
Hartford Life and Accident Insurance Company$1,119 $1,314 
Lincoln Life & Annuity Company of New York444 480 
Individual State Reinsurance Programs
189 61 
Fresenius Medical Care Reinsurance Company (Cayman) Ltd. 75 54 
Resolution Life Group Holdings Ltd.33 35 
All Other67 54 
Total$1,927 $1,998 
Schedule of Effects of Reinsurance
Direct, assumed and ceded premiums earned for the years ended December 31, 2024, 2023 and 2022 were as follows:
In millions202420232022
Direct$123,629 $99,753 $85,670 
Assumed471 350 432 
Ceded(1,204)(911)(772)
Net premiums$122,896 $99,192 $85,330 

The impact of reinsurance on health care costs for the years ended December 31, 2024, 2023 and 2022 was as follows:
In millions202420232022
Direct$115,974 $86,738 $71,357 
Assumed431 223 379 
Ceded(1,284)(714)(663)
Net health care costs
$115,121 $86,247 $71,073 
v3.25.0.1
Segment Reporting (Tables)
12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Reconciliation of Financial Measures of Segments to Consolidated Totals
The following is a reconciliation of financial measures of the Company’s segments to the consolidated totals:
Year Ended December 31, 2024
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$129,120 $158,016 $83,464 $56 $370,656 
Intersegment revenues72 15,304 41,036 — 56,412 
Net investment income
1,473 285 — 395 2,153 
Total revenues130,665 173,605 124,500 451 429,221 
Intersegment eliminations (2)
(56,412)
Total consolidated revenues$372,809 
Less: Net realized capital gains (losses)
(97)289 — (75)
Cost of products sold— 160,036 99,337 — 
Health care costs113,659 3,407 — 187 
Other segment items (3)
16,796 2,630 19,389 1,687 
Adjusted operating income (loss)$307 $7,243 $5,774 $(1,348)$11,976 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
2,025 
Net realized capital gains (5)
(117)
Acquisition-related integration costs (6)
243 
Restructuring charges (7)
1,179 
Office real estate optimization charges (8)
30 
Opioid litigation charge (9)
100 
Operating income (GAAP measure)8,516 
Interest expense2,958 
Gain on early extinguishment of debt (12)
(491)
Other income(99)
Income before income tax provision$6,148 
Depreciation and amortization$1,599 $1,059 $1,543 $396 $4,597 
Year Ended December 31, 2023
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$104,800 $174,018 $77,748 $57 $356,623 
Intersegment revenues81 12,826 39,020 — 51,927 
Net investment income (loss)765 (1)(5)394 1,153 
Total revenues105,646 186,843 116,763 451 409,703 
Intersegment eliminations (2)
(51,927)
Total consolidated revenues$357,776 
Less: Net realized capital losses(402)— (5)(90)
Cost of products sold— 175,424 91,447 
Health care costs85,504 1,607 — 210 
Other segment items (3)
14,967 2,500 19,358 1,648 
Adjusted operating income (loss)$5,577 $7,312 $5,963 $(1,318)$17,534 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,905 
Net realized capital losses (5)
497 
Acquisition-related transaction and integration costs (6)
487 
Restructuring charges (7)
507 
Office real estate optimization charges (8)
46 
Loss on assets held for sale (10)
349 
Operating income (GAAP measure)13,743 
Interest expense2,658 
Other income(88)
Income before income tax provision$11,173 
Depreciation and amortization$1,572 $880 $1,549 $365 $4,366 
Year Ended December 31, 2022
In millions
Health Care
Benefits
Health
Services (1)
Pharmacy &
Consumer
Wellness
Corporate/
Other
Consolidated
Totals
Revenues from external customers$90,798 $157,968 $72,739 $124 $321,629 
Intersegment revenues76 11,608 35,901 — 47,585 
Net investment income (loss)476 — (44)406 838 
Total revenues91,350 169,576 108,596 530 370,052 
Intersegment eliminations (2)
(47,585)
Total consolidated revenues$322,467 
Less: Net realized capital losses(225)— (44)(51)
Cost of products sold— 160,738 82,063 42 
Health care costs71,473 — — 249 
Other segment items (3)
13,764 2,057 20,046 1,903 
Adjusted operating income (loss)$6,338 $6,781 $6,531 $(1,613)$18,037 
Reconciliation of principal measure of segment performance to consolidated operating income:
Amortization of intangible assets (4)
1,785 
Net realized capital losses (5)
320 
Office real estate optimization charges (8)
117 
Opioid litigation charge (9)
5,803 
Loss on assets held for sale (10)
2,533 
Gain on divestiture of subsidiaries (11)
(475)
Operating income (GAAP measure)7,954 
Interest expense2,287 
Other income(169)
Income before income tax provision$5,836 
Depreciation and amortization$1,579 $519 $1,889 $237 $4,224 
_____________________________________________
(1)Total revenues of the Health Services segment include approximately $11.4 billion, $13.7 billion and $12.6 billion of retail co-payments for 2024, 2023 and 2022, respectively. See Note 1 ‘‘Significant Accounting Policies’’ for additional information about retail co-payments.
(2)Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment.
(3)Other segment items for each reportable segment includes operating expenses, which primarily consists of selling, general and administrative expenses. Other segment items excludes the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company’s business nor reflect the Company’s underlying business performance.
(4)The Company’s acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in operating expenses within each segment. Although intangible assets contribute to the Company’s revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company’s acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company’s GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
(5)The Company’s net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company’s business, and the amount and timing of these capital gains and losses do not directly relate to the underwriting of the Company’s insurance products, the services performed for the Company’s customers or the sale of the Company’s products or services. Accordingly, the Company believes excluding net realized capital gains and losses enhances the Company’s and investors’ ability to compare the Company’s past financial performance with its current performance and to analyze underlying business performance and trends.
(6)In 2024, the acquisition-related integration costs relate to the acquisitions of Signify Health and Oak Street Health. In 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in operating expenses within the Corporate/Other segment.
(7)In 2024, the restructuring charges are primarily comprised of a store impairment charge, corporate workforce optimization costs, including severance and employee-related costs, other asset impairment and related charges associated with the discontinuation of certain non-core assets and a stock-based compensation charge. During the third quarter of 2024, the Company finalized an enterprise-wide restructuring plan intended to streamline and simplify the organization, improve efficiency and reduce costs. In connection with this restructuring plan, the Company completed a strategic review of its retail business and determined that it plans to close 271 retail stores in 2025, and, accordingly, it recorded a store impairment charge to write down the associated operating or financing lease right-of-use assets and property and equipment. In addition, during the third quarter of 2024, the Company also conducted a review of its various strategic assets and determined that it would discontinue the use of certain non-core assets, at which time impairment losses were recorded to write down the carrying value of these assets to the Company’s best estimate of their fair value. In 2023, the restructuring charges are primarily comprised of severance and employee-related costs, asset impairment charges and a stock-based compensation charge. The restructuring charges associated with the store impairments are reflected within the Pharmacy & Consumer Wellness segment, other asset impairments and related charges are reflected within the Corporate/Other and Pharmacy & Consumer Wellness segments and corporate workforce optimization costs, including severance and employee-related costs, as well as stock-based compensation charges, are reflected within the Corporate/Other segment.
(8)In 2024, 2023 and 2022, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the Company’s evaluation of corporate office real estate space in response to its ongoing flexible work arrangement. The office real estate optimization charges are reflected in operating expenses within each segment.
(9)In 2024, the opioid litigation charge relates to a change in the Company’s accrual related to ongoing opioid litigation matters. In 2022, the opioid litigation charges relate to agreements to resolve substantially all opioid claims against the Company by certain states and governmental entities. The opioid litigation charges are reflected within the Corporate/Other segment.
(10)In 2023 and 2022, the loss on assets held for sale relates to the LTC business within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. The carrying value of the LTC business was determined to be greater than its estimated fair value less costs to sell and, accordingly, the Company recorded a loss on assets held for sale during 2022. During the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company’s best estimate of the ultimate selling price which reflected its estimated fair value less costs to sell. As of the third quarter of 2023, the Company determined the LTC business no longer met the criteria for held-for-sale accounting and, accordingly, the net assets associated with the LTC business were reclassified to held and used at their respective fair values. During 2022, the loss on assets held for sale also relates to the Company’s Thailand business, which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
(11)In 2022, the gain on divestiture of subsidiaries represents the pre-tax gain on the sale of bswift, which the Company sold in November 2022, and the pre-tax gain on the sale of PayFlex, which the Company sold in June 2022. The gains on divestitures are reflected as a reduction of operating expenses within the Health Care Benefits segment.
(12)In 2024, the gain on early extinguishment of debt relates to the Company’s repayment of approximately $2.6 billion of its outstanding senior notes in December 2024, pursuant to its tender offer for such senior notes.
v3.25.0.1
Significant Accounting Policies - Narrative (Details)
store in Thousands, shares in Millions, people in Millions, patient in Millions, $ in Millions
3 Months Ended 12 Months Ended
Sep. 30, 2024
USD ($)
Dec. 31, 2024
USD ($)
state
people
segment
clinic
store
patient
shares
Dec. 31, 2023
USD ($)
business
shares
Dec. 31, 2022
USD ($)
shares
Dec. 31, 2021
Dec. 31, 2014
Significant Accounting Policies [Line Items]            
Number of pharmacy plan members | people   90        
Number of patients served per year (more than) | patient   0.8        
Number of reportable segments | segment   4        
Number of businesses acquired | business     2      
Allowance for credit losses   $ 407 $ 343      
Depreciation   2,600 2,500 $ 2,400    
Asset impairment charges     152      
Office real estate optimization charges   30 46 117    
Goodwill impairment   0 0 0    
Impairment of intangible assets, indefinite-lived   0 0 0    
Premium deficiency reserve   0 0      
Self insurance liabilities   $ 1,100 1,100      
Pharmacy rebate period   30 days        
Advertising costs   $ 989 $ 985 $ 745    
Treasury shares held in trust (in shares) | shares   1 1 1    
Charitable contribution to CVS Health Foundation   $ 0 $ 0 $ 25    
Variable Interest Entity, Primary Beneficiary, Red Oak Sourcing, LLC            
Significant Accounting Policies [Line Items]            
VIE, ownership percentage           50.00%
Initial contractual term (in years)           10 years
Amended contract extension term         5 years  
Amended contract term (in years)         15 years  
Proceeds from VIE   126 183 $ 183    
Medicare Product Line            
Significant Accounting Policies [Line Items]            
Total premium deficiency reserve $ 766          
Premium deficiency reserve, write-off of unamortized acquisition costs 383          
Premium deficiency reserve, charge to health care costs 383          
Premium deficiency reserve   0        
Individual Exchange Product Line            
Significant Accounting Policies [Line Items]            
Total premium deficiency reserve 270          
Premium deficiency reserve, write-off of unamortized acquisition costs 11          
Premium deficiency reserve, charge to health care costs 259          
Premium deficiency reserve   0        
Other Insurance Liabilities            
Significant Accounting Policies [Line Items]            
Liability for unpaid claims   280 285      
Liability for future policy benefits   371 393      
Other Long-Term Insurance Liabilities            
Significant Accounting Policies [Line Items]            
Liability for unpaid claims   713 834      
Liability for future policy benefits   4,200 $ 4,600      
Government Reporting Unit            
Significant Accounting Policies [Line Items]            
Goodwill impairment 0          
Retail Stores            
Significant Accounting Policies [Line Items]            
Asset impairment charges 607 607        
Impairment of operating and financing lease right-of-use assets 483 483        
Impairment of property and equipment $ 124 124        
Non-Core Assets            
Significant Accounting Policies [Line Items]            
Asset impairment charges   $ 269        
Minimum            
Significant Accounting Policies [Line Items]            
Period after date of service a claim is paid   6 months        
Award vesting period   3 years        
Minimum | Buildings, building improvements and leasehold improvements            
Significant Accounting Policies [Line Items]            
Useful life of property plant and equipment   1 year        
Minimum | Fixtures, equipment and internally developed software            
Significant Accounting Policies [Line Items]            
Useful life of property plant and equipment   3 years        
Maximum            
Significant Accounting Policies [Line Items]            
Lease renewal term   5 years        
Period after date of service a claim is paid   48 months        
Award vesting period   5 years        
Maximum | Buildings, building improvements and leasehold improvements            
Significant Accounting Policies [Line Items]            
Useful life of property plant and equipment   40 years        
Maximum | Fixtures, equipment and internally developed software            
Significant Accounting Policies [Line Items]            
Useful life of property plant and equipment   10 years        
Pharmacy & Consumer Wellness            
Significant Accounting Policies [Line Items]            
Number of retail locations (more than) | store   9        
Health Services            
Significant Accounting Policies [Line Items]            
Number of walk-in medical clinics (more than) | clinic   1,000        
Health Care Benefits            
Significant Accounting Policies [Line Items]            
Number of people served (more than) | people   36        
Number of states in which the Company has entered the individual public health insurance exchange | state   17        
v3.25.0.1
Significant Accounting Policies - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Accounting Policies [Abstract]        
Cash and cash equivalents $ 8,586 $ 8,196 $ 12,945  
Restricted cash (included in other current assets) 95 90 144  
Restricted cash (included in other assets) 203 239 216  
Total cash, cash equivalents and restricted cash in the consolidated statements of cash flows $ 8,884 $ 8,525 $ 13,305 $ 12,691
v3.25.0.1
Significant Accounting Policies - Accounts Receivable (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Accounting Policies [Abstract]    
Trade receivables $ 9,881 $ 11,908
Vendor and manufacturer receivables 13,891 15,711
Premium receivables 4,731 3,714
Other receivables 7,966 3,894
Total accounts receivable, net $ 36,469 $ 35,227
v3.25.0.1
Significant Accounting Policies - Deferred Acquisition Costs (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Movement Analysis of Deferred Policy Acquisition Costs [Roll Forward]    
Deferred acquisition costs, beginning of the period $ 1,502 $ 1,219
Capitalizations 544 548
Amortization expense (299) (265)
Deferred acquisition costs, end of the period $ 1,747 $ 1,502
v3.25.0.1
Significant Accounting Policies - Property and Equipment (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Property, Plant and Equipment [Line Items]    
Total property and equipment $ 36,440 $ 33,882
Accumulated depreciation and amortization (23,447) (20,699)
Property and equipment, net 12,993 13,183
Land    
Property, Plant and Equipment [Line Items]    
Total property and equipment 1,847 1,958
Building and improvements    
Property, Plant and Equipment [Line Items]    
Total property and equipment 4,632 4,571
Fixtures and equipment    
Property, Plant and Equipment [Line Items]    
Total property and equipment 11,716 11,024
Leasehold improvements    
Property, Plant and Equipment [Line Items]    
Total property and equipment 6,725 6,511
Software    
Property, Plant and Equipment [Line Items]    
Total property and equipment $ 11,520 $ 9,818
v3.25.0.1
Significant Accounting Policies - Disaggregation of Revenue (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Disaggregation of Revenue [Line Items]      
Revenues $ 370,656 $ 356,623 $ 321,629
Net investment income (loss) 2,153 1,153 838
Total revenues 372,809 357,776 322,467
Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues 210,272 223,452 205,119
Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 21,522 22,458 22,780
Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 122,896 99,192 85,330
Other      
Disaggregation of Revenue [Line Items]      
Revenues 15,966 11,521 8,400
Health Care Benefits      
Disaggregation of Revenue [Line Items]      
Revenues 129,120 104,800 90,798
Net investment income (loss) 1,473 765 476
Health Services      
Disaggregation of Revenue [Line Items]      
Revenues 158,016 174,018 157,968
Net investment income (loss) 285 (1) 0
Pharmacy & Consumer Wellness      
Disaggregation of Revenue [Line Items]      
Revenues 83,464 77,748 72,739
Net investment income (loss) 0 (5) (44)
Corporate/ Other      
Disaggregation of Revenue [Line Items]      
Revenues 56 57 124
Net investment income (loss) 395 394 406
Operating Segments | Health Care Benefits      
Disaggregation of Revenue [Line Items]      
Net investment income (loss) 1,473 765 476
Total revenues 130,665 105,646 91,350
Operating Segments | Health Care Benefits | Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Operating Segments | Health Care Benefits | Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Operating Segments | Health Care Benefits | Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 122,849 99,144 85,274
Operating Segments | Health Care Benefits | Other      
Disaggregation of Revenue [Line Items]      
Revenues 6,343 5,737 5,600
Operating Segments | Health Services      
Disaggregation of Revenue [Line Items]      
Net investment income (loss) 285 (1) 0
Total revenues 173,605 186,843 169,576
Operating Segments | Health Services | Pharmacy network      
Disaggregation of Revenue [Line Items]      
Total revenues 91,650 112,718 102,968
Operating Segments | Health Services | Mail choice      
Disaggregation of Revenue [Line Items]      
Total revenues 70,877 67,992 63,825
Operating Segments | Health Services | Other      
Disaggregation of Revenue [Line Items]      
Total revenues 10,793 6,134 2,783
Operating Segments | Health Services | Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues 162,527 180,710 166,793
Operating Segments | Health Services | Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Operating Segments | Health Services | Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Operating Segments | Health Services | Other      
Disaggregation of Revenue [Line Items]      
Revenues 10,793 6,134 2,783
Operating Segments | Pharmacy & Consumer Wellness      
Disaggregation of Revenue [Line Items]      
Net investment income (loss) 0 (5) (44)
Total revenues 124,500 116,763 108,596
Operating Segments | Pharmacy & Consumer Wellness | Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues 100,687 92,111 83,480
Operating Segments | Pharmacy & Consumer Wellness | Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 21,522 22,458 22,780
Operating Segments | Pharmacy & Consumer Wellness | Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Operating Segments | Pharmacy & Consumer Wellness | Other      
Disaggregation of Revenue [Line Items]      
Revenues 2,291 2,199 2,380
Corporate/ Other | Corporate/ Other      
Disaggregation of Revenue [Line Items]      
Net investment income (loss) 395 394 406
Total revenues 451 451 530
Corporate/ Other | Corporate/ Other | Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Corporate/ Other | Corporate/ Other | Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Corporate/ Other | Corporate/ Other | Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 47 48 56
Corporate/ Other | Corporate/ Other | Other      
Disaggregation of Revenue [Line Items]      
Revenues 9 9 68
Intersegment Eliminations      
Disaggregation of Revenue [Line Items]      
Net investment income (loss) 0 0 0
Total revenues (56,412) (51,927) (47,585)
Intersegment Eliminations | Pharmacy      
Disaggregation of Revenue [Line Items]      
Revenues (52,942) (49,369) (45,154)
Intersegment Eliminations | Front Store      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Intersegment Eliminations | Premiums      
Disaggregation of Revenue [Line Items]      
Revenues 0 0 0
Intersegment Eliminations | Other      
Disaggregation of Revenue [Line Items]      
Revenues (3,470) (2,558) (2,431)
Intersegment Eliminations | Health Care Benefits      
Disaggregation of Revenue [Line Items]      
Total revenues (72) (81) (76)
Intersegment Eliminations | Health Services      
Disaggregation of Revenue [Line Items]      
Total revenues (15,304) (12,826) (11,608)
Intersegment Eliminations | Pharmacy & Consumer Wellness      
Disaggregation of Revenue [Line Items]      
Total revenues $ (41,036) $ (39,020) $ (35,901)
v3.25.0.1
Significant Accounting Policies - Receivables and Contract Balances (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Accounting Policies [Abstract]    
Trade receivables (included in accounts receivable, net) $ 9,881 $ 11,908
Contract liabilities (included in accrued expenses and other current liabilities) $ 144 $ 149
v3.25.0.1
Significant Accounting Policies - Variable Interest Entities Balances (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Variable Interest Entity [Line Items]    
Total assets $ 253,215 $ 249,728
Total liabilities 177,485 173,092
Long-term investments 28,934 23,019
Variable Interest Entity, Primary Beneficiary, Physicians Groups    
Variable Interest Entity [Line Items]    
Total assets 2,144 1,515
Total liabilities 2,104 1,503
Variable Interest Entity, Not Primary Beneficiary    
Variable Interest Entity [Line Items]    
Long-term investments 2,618 2,018
Variable Interest Entity, Not Primary Beneficiary | Hedge fund investments    
Variable Interest Entity [Line Items]    
Long-term investments 1,246 859
Variable Interest Entity, Not Primary Beneficiary | Private equity investments    
Variable Interest Entity [Line Items]    
Long-term investments 934 840
Variable Interest Entity, Not Primary Beneficiary | Real estate partnerships    
Variable Interest Entity [Line Items]    
Long-term investments $ 438 $ 319
v3.25.0.1
Acquisitions, Divestitures and Asset Sales - Narrative (Details)
$ / shares in Units, member in Thousands, $ in Millions
1 Months Ended 3 Months Ended 8 Months Ended 9 Months Ended 12 Months Ended
Dec. 10, 2024
USD ($)
May 09, 2024
USD ($)
Jun. 02, 2023
USD ($)
May 01, 2023
USD ($)
Feb. 21, 2023
USD ($)
Feb. 28, 2023
USD ($)
Nov. 30, 2022
USD ($)
Jun. 30, 2022
USD ($)
Mar. 31, 2023
USD ($)
Mar. 31, 2022
USD ($)
member
Dec. 31, 2023
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
May 02, 2023
USD ($)
$ / shares
Mar. 29, 2023
USD ($)
$ / shares
May 31, 2022
member
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Proceeds from debt $ 3,000 $ 5,000 $ 4,900 $ 5,000 $ 6,000 $ 6,000                        
Intangible asset amortization since acquisition date                         $ 2,025 $ 1,905 $ 1,785      
Stock-based compensation expense since acquisition date                         540 588 447      
Loss on assets held for sale                         0 349 2,533      
Gain on sale of subsidiaries                         0 0 475      
Disposal Group, Disposed of by Sale, Not Discontinued Operations | International Health Care Renewal Rights                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Number of international health care members, renewal rights sold | member                                   200
Health Care Benefits | Disposal Group, Disposed of by Sale, Not Discontinued Operations | bswift LLC                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Proceeds from divestiture of subsidiary             $ 735                      
Gain on sale of subsidiaries                             250      
Health Care Benefits | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Payflex                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Proceeds from divestiture of subsidiary               $ 775                    
Gain on sale of subsidiaries                             225      
Health Care Benefits | Disposal Group, Disposed of by Sale, Not Discontinued Operations | Thailand Business                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Loss on assets held for sale                   $ 41                
Number of medical members | member                   266                
Pharmacy & Consumer Wellness | Disposal Group, Held-for-sale, Not Discontinued Operations | Omnicare Long-Term Care Business                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Loss on assets held for sale                 $ 349           $ 2,500      
Oak Street Health Inc.                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Percentage of voting interests acquired                               100.00%    
Cash to be received by shareholders in acquisition (in dollars per share) | $ / shares                               $ 39.00    
Net deferred tax liabilities                               $ 796    
Revenue since acquisition date                     $ 2,100              
Operating income (losses) since acquisition date                     (520)              
Intangible asset amortization since acquisition date                     193              
Stock-based compensation expense since acquisition date                     $ 71   60          
Transaction costs                           77        
Signify Health, Inc.                                    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]                                    
Percentage of voting interests acquired                                 100.00%  
Cash to be received by shareholders in acquisition (in dollars per share) | $ / shares                                 $ 30.50  
Net deferred tax liabilities                                 $ 259  
Revenue since acquisition date                       $ 797            
Operating income (losses) since acquisition date                       123            
Intangible asset amortization since acquisition date                       106            
Stock-based compensation expense since acquisition date                       $ 72 $ 41          
Goodwill deductible for income tax purposes                                 $ 1,700  
Transaction costs                           $ 37        
v3.25.0.1
Acquisitions, Divestitures and Asset Sales - Schedule of Fair Value of Consideration Transferred (Details) - USD ($)
shares in Millions, $ in Millions
May 02, 2023
Mar. 29, 2023
Oak Street Health Inc.    
Business Acquisition [Line Items]    
Cash $ 9,579  
Effective settlement of pre-existing relationship (29)  
Total consideration transferred 9,668  
Oak Street Health Inc. | Pre-combination services    
Business Acquisition [Line Items]    
Fair value of replacement equity awards for pre-combination services $ 118  
Replacement equity awards for pre-combination services (in shares) 3.9  
Oak Street Health Inc. | Post-combination services    
Business Acquisition [Line Items]    
Fair value of replacement equity awards for pre-combination services $ 165  
Signify Health, Inc.    
Business Acquisition [Line Items]    
Cash   $ 7,450
Effective settlement of pre-existing relationship   (111)
Total consideration transferred   7,353
Signify Health, Inc. | Pre-combination services    
Business Acquisition [Line Items]    
Fair value of replacement equity awards for pre-combination services   $ 14
Replacement equity awards for pre-combination services (in shares)   3.2
Signify Health, Inc. | Post-combination services    
Business Acquisition [Line Items]    
Fair value of replacement equity awards for pre-combination services   $ 167
v3.25.0.1
Acquisitions, Divestitures and Asset Sales - Schedule of Fair Values of Assets Acquired and Liabilities Assumed (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
May 02, 2023
Mar. 29, 2023
Dec. 31, 2022
Business Acquisition [Line Items]          
Goodwill $ 91,272 $ 91,272     $ 78,150
Oak Street Health Inc.          
Business Acquisition [Line Items]          
Cash and cash equivalents     $ 201    
Investments     168    
Accounts receivable     1,143    
Other current assets (including restricted cash)     46    
Property and equipment     180    
Operating lease right-of-use assets     316    
Goodwill     7,213    
Intangible assets     4,233    
Other long-term assets     7    
Total assets acquired     13,507    
Health care costs payable     1,098    
Other current liabilities     444    
Operating lease liabilities (current and long-term)     378    
Debt (current and long-term)     1,028    
Deferred income taxes     796    
Other long-term liabilities     29    
Total liabilities assumed     3,773    
Noncontrolling interests     66    
Total consideration transferred     $ 9,668    
Signify Health, Inc.          
Business Acquisition [Line Items]          
Cash and cash equivalents       $ 376  
Accounts receivable       190  
Other current assets (including restricted cash)       147  
Property and equipment       25  
Goodwill       5,909  
Intangible assets       1,920  
Other long-term assets       23  
Total assets acquired       8,590  
Other current liabilities       606  
Debt (current and long-term)       346  
Deferred income taxes       259  
Other long-term liabilities       26  
Total liabilities assumed       1,237  
Total consideration transferred       7,353  
Restricted cash       $ 28  
v3.25.0.1
Acquisitions, Divestitures and Asset Sales - Summary of the Valuation of Goodwill Allocated to Business Segments (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
May 02, 2023
Mar. 29, 2023
Dec. 31, 2022
Business Acquisition [Line Items]          
Goodwill $ 91,272 $ 91,272     $ 78,150
Health Services          
Business Acquisition [Line Items]          
Goodwill 34,066 34,066     23,615
Pharmacy & Consumer Wellness          
Business Acquisition [Line Items]          
Goodwill 10,562 10,562     10,376
Health Care Benefits          
Business Acquisition [Line Items]          
Goodwill $ 46,644 $ 46,644     $ 44,159
Oak Street Health Inc.          
Business Acquisition [Line Items]          
Goodwill     $ 7,213    
Oak Street Health Inc. | Health Services          
Business Acquisition [Line Items]          
Goodwill     6,936    
Oak Street Health Inc. | Pharmacy & Consumer Wellness          
Business Acquisition [Line Items]          
Goodwill     156    
Oak Street Health Inc. | Health Care Benefits          
Business Acquisition [Line Items]          
Goodwill     $ 121    
Signify Health, Inc.          
Business Acquisition [Line Items]          
Goodwill       $ 5,909  
Signify Health, Inc. | Health Services          
Business Acquisition [Line Items]          
Goodwill       3,406  
Signify Health, Inc. | Pharmacy & Consumer Wellness          
Business Acquisition [Line Items]          
Goodwill       30  
Signify Health, Inc. | Health Care Benefits          
Business Acquisition [Line Items]          
Goodwill       $ 2,473  
v3.25.0.1
Acquisitions, Divestitures and Asset Sales - Summary of Fair Values and Weighted Average Useful Lives for Intangible Assets Acquired (Details) - USD ($)
$ in Millions
May 02, 2023
Mar. 29, 2023
Oak Street Health Inc.    
Business Acquisition [Line Items]    
Gross Fair Value $ 4,233  
Weighted Average Useful Life (years) 18 years  
Oak Street Health Inc. | Customer Relationships    
Business Acquisition [Line Items]    
Gross Fair Value $ 3,620  
Weighted Average Useful Life (years) 19 years 10 months 24 days  
Oak Street Health Inc. | Technology    
Business Acquisition [Line Items]    
Gross Fair Value $ 143  
Weighted Average Useful Life (years) 3 years  
Oak Street Health Inc. | Trademarks    
Business Acquisition [Line Items]    
Gross Fair Value $ 470  
Weighted Average Useful Life (years) 8 years  
Signify Health, Inc.    
Business Acquisition [Line Items]    
Gross Fair Value   $ 1,920
Weighted Average Useful Life (years)   16 years
Signify Health, Inc. | Customer Relationships    
Business Acquisition [Line Items]    
Gross Fair Value   $ 1,810
Weighted Average Useful Life (years)   16 years 8 months 12 days
Signify Health, Inc. | Technology    
Business Acquisition [Line Items]    
Gross Fair Value   $ 50
Weighted Average Useful Life (years)   3 years
Signify Health, Inc. | Trademarks    
Business Acquisition [Line Items]    
Gross Fair Value   $ 60
Weighted Average Useful Life (years)   5 years
v3.25.0.1
Restructuring (Details)
$ in Millions
3 Months Ended 12 Months Ended
Sep. 30, 2024
USD ($)
store
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Restructuring Cost and Reserve [Line Items]        
Restructuring charges   $ 1,179 $ 507 $ 0
Asset impairment charges     152  
Severance and employee-related costs   293 344  
Stock-based compensation charge   10 11  
Number of stores, planned closure | store 271      
Fair value of operating and finance lease right-of-use assets $ 100      
Fair value of property and equipment 39      
Payments related to severance and employee-related costs   88 $ 194  
Retail Stores        
Restructuring Cost and Reserve [Line Items]        
Asset impairment charges 607 607    
Impairment of operating and financing lease right-of-use assets 483 483    
Impairment of property and equipment $ 124 124    
Non-Core Assets        
Restructuring Cost and Reserve [Line Items]        
Asset impairment charges   $ 269    
v3.25.0.1
Investments - Total Investments Schedule (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Total Investments [Line Items]    
Current $ 2,407 $ 3,259
Long-term 28,934 23,019
Total 31,341 26,278
Debt securities available for sale    
Total Investments [Line Items]    
Current 2,256 3,131
Long-term 23,777 18,582
Total 26,033 21,713
Mortgage loans    
Total Investments [Line Items]    
Current 151 128
Long-term 1,354 1,183
Total 1,505 1,311
Other investments    
Total Investments [Line Items]    
Current 0 0
Long-term 3,803 3,254
Total $ 3,803 $ 3,254
v3.25.0.1
Investments - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]    
Investments related to 2012 contract conversion $ 269 $ 307
Residential mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Weighted average duration of securities 6 years 4 months 24 days  
Commercial mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Weighted average duration of securities 4 years 10 months 24 days  
Other asset-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Weighted average duration of securities 1 year  
v3.25.0.1
Investments - Debt Securities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost $ 26,562 $ 22,282
Gross Unrealized Gains 178 267
Gross Unrealized Losses (707) (836)
Fair Value 26,033 21,713
Allowance for expected credit losses 0 0
U.S. government securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 2,826 2,071
Gross Unrealized Gains 7 19
Gross Unrealized Losses (38) (54)
Fair Value 2,795 2,036
States, municipalities and political subdivisions    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 712 2,219
Gross Unrealized Gains 4 31
Gross Unrealized Losses (18) (35)
Fair Value 698 2,215
U.S. corporate securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 13,043 10,156
Gross Unrealized Gains 94 133
Gross Unrealized Losses (412) (446)
Fair Value 12,725 9,843
Foreign securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 2,608 2,593
Gross Unrealized Gains 27 41
Gross Unrealized Losses (111) (122)
Fair Value 2,524 2,512
Residential mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 792 862
Gross Unrealized Gains 2 8
Gross Unrealized Losses (54) (60)
Fair Value 740 810
Commercial mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 1,731 1,066
Gross Unrealized Gains 9 9
Gross Unrealized Losses (67) (100)
Fair Value 1,673 975
Other asset-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 4,834 3,294
Gross Unrealized Gains 35 26
Gross Unrealized Losses (7) (18)
Fair Value 4,862 3,302
Redeemable preferred securities    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 16 21
Gross Unrealized Gains 0 0
Gross Unrealized Losses 0 (1)
Fair Value 16 20
Supporting experience- rated products    
Debt Securities, Available-for-sale [Line Items]    
Gross Unrealized Gains 5 10
Gross Unrealized Losses (30) (28)
Fair Value $ 543 $ 592
v3.25.0.1
Investments - Debt Securities by Maturity (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Amortized Cost    
Less than one year $ 763  
One year through five years 10,599  
After five years through ten years 4,683  
Greater than ten years 3,160  
Amortized Cost 26,562 $ 22,282
Fair Value    
Less than one year 761  
One year through five years 10,510  
After five years through ten years 4,578  
Greater than ten years 2,909  
Total 26,033 21,713
Residential mortgage-backed securities    
Amortized Cost    
Debt securities, maturity, without single maturity date 792  
Amortized Cost 792 862
Fair Value    
Debt securities, maturity, without single maturity date 740  
Total 740 810
Commercial mortgage-backed securities    
Amortized Cost    
Debt securities, maturity, without single maturity date 1,731  
Amortized Cost 1,731 1,066
Fair Value    
Debt securities, maturity, without single maturity date 1,673  
Total 1,673 975
Other asset-backed securities    
Amortized Cost    
Debt securities, maturity, without single maturity date 4,834  
Amortized Cost 4,834 3,294
Fair Value    
Debt securities, maturity, without single maturity date 4,862  
Total $ 4,862 $ 3,302
v3.25.0.1
Investments - Unrealized Loss Position (Details)
$ in Millions
Dec. 31, 2024
USD ($)
security
Dec. 31, 2023
USD ($)
security
Number of Securities    
Number of Securities, Less than 12 months | security 4,502 1,182
Number of Securities, Greater than 12 months | security 4,174 7,018
Number of Securities | security 8,676 8,200
Fair Value    
Fair Value, Less than 12 months $ 7,506 $ 1,932
Fair Value, Greater than 12 months 5,734 10,616
Fair Value 13,240 12,548
Unrealized Losses    
Unrealized Losses, Less than 12 months 127 28
Unrealized Losses, Greater than 12 months 580 808
Unrealized Losses $ 707 $ 836
U.S. government securities    
Number of Securities    
Number of Securities, Less than 12 months | security 266 74
Number of Securities, Greater than 12 months | security 155 280
Number of Securities | security 421 354
Fair Value    
Fair Value, Less than 12 months $ 1,053 $ 194
Fair Value, Greater than 12 months 394 891
Fair Value 1,447 1,085
Unrealized Losses    
Unrealized Losses, Less than 12 months 18 2
Unrealized Losses, Greater than 12 months 20 52
Unrealized Losses $ 38 $ 54
States, municipalities and political subdivisions    
Number of Securities    
Number of Securities, Less than 12 months | security 100 95
Number of Securities, Greater than 12 months | security 137 455
Number of Securities | security 237 550
Fair Value    
Fair Value, Less than 12 months $ 181 $ 181
Fair Value, Greater than 12 months 201 733
Fair Value 382 914
Unrealized Losses    
Unrealized Losses, Less than 12 months 3 1
Unrealized Losses, Greater than 12 months 15 34
Unrealized Losses $ 18 $ 35
U.S. corporate securities    
Number of Securities    
Number of Securities, Less than 12 months | security 3,119 576
Number of Securities, Greater than 12 months | security 2,602 4,120
Number of Securities | security 5,721 4,696
Fair Value    
Fair Value, Less than 12 months $ 4,144 $ 672
Fair Value, Greater than 12 months 3,395 5,602
Fair Value 7,539 6,274
Unrealized Losses    
Unrealized Losses, Less than 12 months 64 14
Unrealized Losses, Greater than 12 months 348 432
Unrealized Losses $ 412 $ 446
Foreign securities    
Number of Securities    
Number of Securities, Less than 12 months | security 599 160
Number of Securities, Greater than 12 months | security 616 964
Number of Securities | security 1,215 1,124
Fair Value    
Fair Value, Less than 12 months $ 810 $ 243
Fair Value, Greater than 12 months 874 1,407
Fair Value 1,684 1,650
Unrealized Losses    
Unrealized Losses, Less than 12 months 21 4
Unrealized Losses, Greater than 12 months 90 118
Unrealized Losses $ 111 $ 122
Residential mortgage-backed securities    
Number of Securities    
Number of Securities, Less than 12 months | security 89 33
Number of Securities, Greater than 12 months | security 361 461
Number of Securities | security 450 494
Fair Value    
Fair Value, Less than 12 months $ 267 $ 97
Fair Value, Greater than 12 months 342 517
Fair Value 609 614
Unrealized Losses    
Unrealized Losses, Less than 12 months 5 1
Unrealized Losses, Greater than 12 months 49 59
Unrealized Losses $ 54 $ 60
Commercial mortgage-backed securities    
Number of Securities    
Number of Securities, Less than 12 months | security 186 44
Number of Securities, Greater than 12 months | security 237 287
Number of Securities | security 423 331
Fair Value    
Fair Value, Less than 12 months $ 628 $ 94
Fair Value, Greater than 12 months 464 581
Fair Value 1,092 675
Unrealized Losses    
Unrealized Losses, Less than 12 months 11 2
Unrealized Losses, Greater than 12 months 56 98
Unrealized Losses $ 67 $ 100
Other asset-backed securities    
Number of Securities    
Number of Securities, Less than 12 months | security 139 196
Number of Securities, Greater than 12 months | security 62 443
Number of Securities | security 201 639
Fair Value    
Fair Value, Less than 12 months $ 414 $ 449
Fair Value, Greater than 12 months 58 867
Fair Value 472 1,316
Unrealized Losses    
Unrealized Losses, Less than 12 months 5 4
Unrealized Losses, Greater than 12 months 2 14
Unrealized Losses $ 7 $ 18
Redeemable preferred securities    
Number of Securities    
Number of Securities, Less than 12 months | security 4 4
Number of Securities, Greater than 12 months | security 4 8
Number of Securities | security 8 12
Fair Value    
Fair Value, Less than 12 months $ 9 $ 2
Fair Value, Greater than 12 months 6 18
Fair Value 15 20
Unrealized Losses    
Unrealized Losses, Less than 12 months 0 0
Unrealized Losses, Greater than 12 months 0 1
Unrealized Losses $ 0 $ 1
v3.25.0.1
Investments - Unrealized Loss Position Maturities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Fair Value    
Less than one year $ 420  
One year through five years 5,582  
After five years through ten years 2,767  
Greater than ten years 2,298  
Fair Value 13,240 $ 12,548
Unrealized Losses    
Less than one year 4  
One year through five years 152  
After five years through ten years 144  
Greater than ten years 279  
Unrealized Losses 707 836
Residential mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 609  
Fair Value 609 614
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 54  
Unrealized Losses 54 60
Commercial mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 1,092  
Fair Value 1,092 675
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 67  
Unrealized Losses 67 100
Other asset-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 472  
Fair Value 472 1,316
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 7  
Unrealized Losses 7 $ 18
Supporting experience- rated products    
Fair Value    
Less than one year 0  
One year through five years 120  
After five years through ten years 86  
Greater than ten years 166  
Fair Value 396  
Unrealized Losses    
Less than one year 0  
One year through five years 3  
After five years through ten years 6  
Greater than ten years 20  
Unrealized Losses 30  
Supporting experience- rated products | Residential mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 6  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 0  
Supporting experience- rated products | Commercial mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 6  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 1  
Supporting experience- rated products | Other asset-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 12  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 0  
Supporting remaining products    
Fair Value    
Less than one year 420  
One year through five years 5,462  
After five years through ten years 2,681  
Greater than ten years 2,132  
Fair Value 12,844  
Unrealized Losses    
Less than one year 4  
One year through five years 149  
After five years through ten years 138  
Greater than ten years 259  
Unrealized Losses 677  
Supporting remaining products | Residential mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 603  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 54  
Supporting remaining products | Commercial mortgage-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 1,086  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses 66  
Supporting remaining products | Other asset-backed securities    
Fair Value    
Debt securities, maturity, without single maturity date, fair value 460  
Unrealized Losses    
Debt securities, maturity, without single maturity date, unrealized losses $ 7  
v3.25.0.1
Investments - Mortgage Loans (Details) - Commercial Real Estate - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Mortgage Loans on Real Estate [Line Items]    
New mortgage loans $ 323 $ 342
Mortgage loans fully repaid 104 43
Mortgage loans foreclosed $ 0 $ 0
v3.25.0.1
Investments - Mortgage Loans Credit Ratings Indicator (Details) - Commercial Real Estate - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans $ 1,505 $ 1,311
2024    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 315  
2023    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 292 302
2022    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 324 346
2021    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 218 244
2020    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 35 35
Prior    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 321 384
1    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 8 11
1 | 2024    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0  
1 | 2023    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
1 | 2022    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
1 | 2021    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
1 | 2020    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
1 | Prior    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 8 11
2 to 4    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 1,452 1,262
2 to 4 | 2024    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 315  
2 to 4 | 2023    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 292 302
2 to 4 | 2022    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 320 346
2 to 4 | 2021    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 205 225
2 to 4 | 2020    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 35 35
2 to 4 | Prior    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 285 354
5 and 6    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 45 32
5 and 6 | 2024    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0  
5 and 6 | 2023    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
5 and 6 | 2022    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 4 0
5 and 6 | 2021    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 13 13
5 and 6 | 2020    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
5 and 6 | Prior    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 28 19
7    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 6
7 | 2024    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0  
7 | 2023    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
7 | 2022    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
7 | 2021    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 6
7 | 2020    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans 0 0
7 | Prior    
Mortgage Loans on Real Estate [Line Items]    
Mortgage loans $ 0 $ 0
v3.25.0.1
Investments - Mortgage Loan Principal Repayments (Details) - Commercial Real Estate
$ in Millions
Dec. 31, 2024
USD ($)
Mortgage Loans on Real Estate [Line Items]  
2025 $ 151
2026 164
2027 249
2028 313
2029 297
Thereafter 331
Total $ 1,505
v3.25.0.1
Investments - Net Investment Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Schedule of Investment Income, Reported Amounts, by Category [Line Items]      
Gross investment income $ 2,099 $ 1,696 $ 1,201
Investment expenses (63) (46) (43)
Net investment income (excluding net realized capital gains or losses) 2,036 1,650 1,158
Less: Net realized capital gains (losses) 117 (497) (320)
Net investment income 2,153 1,153 838
Debt securities      
Schedule of Investment Income, Reported Amounts, by Category [Line Items]      
Gross investment income 1,136 841 702
Mortgage loans      
Schedule of Investment Income, Reported Amounts, by Category [Line Items]      
Gross investment income 76 59 51
Other investments      
Schedule of Investment Income, Reported Amounts, by Category [Line Items]      
Gross investment income $ 887 $ 796 $ 448
v3.25.0.1
Investments - Realized Gains (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Investments [Abstract]      
Proceeds from sales $ 6,489 $ 5,031 $ 4,243
Gross realized capital gains 37 9 24
Gross realized capital losses $ (190) $ 420 $ 177
v3.25.0.1
Fair Value - Measurement on a Recurring Basis (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities $ 26,033 $ 21,713
U.S. government securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,795 2,036
States, municipalities and political subdivisions    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 698 2,215
U.S. corporate securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 12,725 9,843
Foreign securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,524 2,512
Residential mortgage-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 740 810
Commercial mortgage-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 1,673 975
Other asset-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 4,862 3,302
Redeemable preferred securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 16 20
Recurring    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Financial liabilities measured at fair value on a recurring basis 0 0
Cash and cash equivalents 8,586 8,196
Debt securities 26,033 21,713
Equity securities 360 273
Total 34,979 30,182
Recurring | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Cash and cash equivalents 4,948 2,174
Debt securities 2,777 2,013
Equity securities 234 194
Total 7,959 4,381
Recurring | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Cash and cash equivalents 3,638 6,022
Debt securities 23,218 19,671
Equity securities 0 0
Total 26,856 25,693
Recurring | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Cash and cash equivalents 0 0
Debt securities 38 29
Equity securities 126 79
Total 164 108
Recurring | U.S. government securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,795 2,036
Recurring | U.S. government securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,777 2,013
Recurring | U.S. government securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 18 23
Recurring | U.S. government securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | States, municipalities and political subdivisions    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 698 2,215
Recurring | States, municipalities and political subdivisions | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | States, municipalities and political subdivisions | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 698 2,215
Recurring | States, municipalities and political subdivisions | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | U.S. corporate securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 12,725 9,843
Recurring | U.S. corporate securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | U.S. corporate securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 12,687 9,814
Recurring | U.S. corporate securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 38 29
Recurring | Foreign securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,524 2,512
Recurring | Foreign securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Foreign securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 2,524 2,512
Recurring | Foreign securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Residential mortgage-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 740 810
Recurring | Residential mortgage-backed securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Residential mortgage-backed securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 740 810
Recurring | Residential mortgage-backed securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Commercial mortgage-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 1,673 975
Recurring | Commercial mortgage-backed securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Commercial mortgage-backed securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 1,673 975
Recurring | Commercial mortgage-backed securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Other asset-backed securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 4,862 3,302
Recurring | Other asset-backed securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Other asset-backed securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 4,862 3,302
Recurring | Other asset-backed securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Redeemable preferred securities    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 16 20
Recurring | Redeemable preferred securities | Level 1    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 0 0
Recurring | Redeemable preferred securities | Level 2    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities 16 20
Recurring | Redeemable preferred securities | Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Debt securities $ 0 $ 0
v3.25.0.1
Fair Value - Changes in Level 3 Financial Assets (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Net realized and unrealized capital gains (losses):    
Fair Value Recurring Basis, Unobservable Input Reconciliation Asset Gain (Loss), Statement Of Income, Extensible List, Not Disclosed Flag Included in earnings Included in earnings
Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance $ 108 $ 129
Net realized and unrealized capital gains (losses):    
Included in earnings 23 (10)
Included in other comprehensive income (loss) (1) 1
Purchases 101 41
Sales 0 (3)
Gross transfers out of level 3 (67) (50)
Ending balance 164 108
Commercial mortgage-backed securities | Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 0 0
Net realized and unrealized capital gains (losses):    
Included in earnings 0 0
Included in other comprehensive income (loss) 0 0
Purchases 52 13
Sales 0 0
Gross transfers out of level 3 (52) (13)
Ending balance 0 0
U.S. corporate securities | Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 29 61
Net realized and unrealized capital gains (losses):    
Included in earnings (5) (8)
Included in other comprehensive income (loss) (1) 1
Purchases 15 5
Sales 0 (1)
Gross transfers out of level 3 0 (29)
Ending balance 38 29
Other asset-backed securities | Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 0  
Net realized and unrealized capital gains (losses):    
Included in earnings 0  
Included in other comprehensive income (loss) 0  
Purchases 15  
Sales 0  
Gross transfers out of level 3 (15)  
Ending balance 0 0
Foreign securities | Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 0 8
Net realized and unrealized capital gains (losses):    
Included in earnings   0
Included in other comprehensive income (loss)   0
Purchases   0
Sales   0
Gross transfers out of level 3   (8)
Ending balance   0
Equity securities | Recurring    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 79 60
Net realized and unrealized capital gains (losses):    
Included in earnings 28 (2)
Included in other comprehensive income (loss) 0 0
Purchases 19 23
Sales 0 (2)
Gross transfers out of level 3 0 0
Ending balance $ 126 $ 79
v3.25.0.1
Fair Value - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Change in unrealized capital losses included in OCI associated with Level 3 financial assets $ 1 $ 9
Level 3 | Recurring    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Gross transfers into Level 3 0 0
Gross transfers out of Level 3 67 50
Level 3 | Recurring | Separate Accounts, financial assets    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Gross transfers into Level 3 0 0
Gross transfers out of Level 3 $ 0 $ 0
v3.25.0.1
Fair Value - Gross Transfers Into (Out of) Level 3 (Details) - Recurring - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Net transfers out of Level 3 $ (67) $ (50)
Level 3    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Gross transfers into Level 3 0 0
Gross transfers out of Level 3 (67) (50)
Net transfers out of Level 3 $ (67) $ (50)
v3.25.0.1
Fair Value - Carrying Value and Fair Value Classified by Level (Details) - Nonrecurring - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Carrying Value    
Assets:    
Mortgage loans $ 1,505 $ 1,311
Equity securities 490 534
Liabilities:    
Investment contract liabilities with a fixed maturity 1 1
Investment contracts liabilities without a fixed maturity 312 312
Long-term debt 64,151 61,410
Estimated Fair Value    
Assets:    
Mortgage loans 1,468 1,274
Liabilities:    
Investment contract liabilities with a fixed maturity 1 1
Investment contracts liabilities without a fixed maturity 272 279
Long-term debt 58,724 58,451
Level 1 | Estimated Fair Value    
Assets:    
Mortgage loans 0 0
Liabilities:    
Investment contract liabilities with a fixed maturity 0 0
Investment contracts liabilities without a fixed maturity 0 0
Long-term debt 58,724 58,451
Level 2 | Estimated Fair Value    
Assets:    
Mortgage loans 0 0
Liabilities:    
Investment contract liabilities with a fixed maturity 0 0
Investment contracts liabilities without a fixed maturity 0 0
Long-term debt 0 0
Level 3 | Estimated Fair Value    
Assets:    
Mortgage loans 1,468 1,274
Liabilities:    
Investment contract liabilities with a fixed maturity 1 1
Investment contracts liabilities without a fixed maturity 272 279
Long-term debt $ 0 $ 0
v3.25.0.1
Fair Value - Separate Accounts Fair Value (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets $ 3,311 $ 3,250  
Separate accounts liabilities 3,311 3,250 $ 3,228
Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 3,499 3,204  
Recurring | Other Payables      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts liabilities 188    
Recurring | Other Receivables      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets   46  
Recurring | Cash and cash equivalents      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 165 168  
Recurring | Debt securities      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 856 2,507  
Recurring | Common/collective trusts      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 2,478 529  
Recurring | Level 1      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 187 560  
Recurring | Level 1 | Cash and cash equivalents      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 1 2  
Recurring | Level 1 | Debt securities      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 186 558  
Recurring | Level 1 | Common/collective trusts      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 0 0  
Recurring | Level 2      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 3,311 2,644  
Recurring | Level 2 | Cash and cash equivalents      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 164 166  
Recurring | Level 2 | Debt securities      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 669 1,949  
Recurring | Level 2 | Common/collective trusts      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 2,478 529  
Recurring | Level 3      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 1 0  
Recurring | Level 3 | Cash and cash equivalents      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 0 0  
Recurring | Level 3 | Debt securities      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 1 0  
Recurring | Level 3 | Common/collective trusts      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets $ 0 $ 0  
v3.25.0.1
Goodwill and Other Intangibles - Goodwill (Details)
$ in Millions
12 Months Ended
Dec. 31, 2023
USD ($)
Goodwill [Roll Forward]  
Balance, beginning of the period $ 78,150
Segment realignment 0
Acquisitions 13,122
Balance, end of the period 91,272
Health Care Benefits  
Goodwill [Roll Forward]  
Balance, beginning of the period 44,159
Segment realignment (109)
Acquisitions 2,594
Balance, end of the period 46,644
Health Services  
Goodwill [Roll Forward]  
Balance, beginning of the period 23,615
Segment realignment 109
Acquisitions 10,342
Balance, end of the period 34,066
Pharmacy & Consumer Wellness  
Goodwill [Roll Forward]  
Balance, beginning of the period 10,376
Segment realignment 0
Acquisitions 186
Balance, end of the period $ 10,562
v3.25.0.1
Goodwill and Other Intangibles - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]      
Changes in the carrying amount of goodwill $ 0    
Goodwill impairment 0 $ 0 $ 0
Cumulative goodwill impairments 6,600 6,600  
Amortization of intangible assets $ 2,025 $ 1,905 $ 1,785
v3.25.0.1
Goodwill and Other Intangibles - Intangible Assets (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Other Intangible Assets[Line Items]    
Indefinite-lived intangible assets, Trademarks $ 10,498 $ 10,498
Intangible assets, gross 44,271 44,166
Finite-lived intangible assets, accumulated amortization (16,948) (14,932)
Intangible assets, net $ 27,323 $ 29,234
Weighted Average Life (years) 14 years 6 months 14 years 6 months
Customer contracts/relationships and covenants not to compete    
Other Intangible Assets[Line Items]    
Finite-lived intangible assets, gross carrying amount $ 26,904 $ 26,784
Finite-lived intangible assets, accumulated amortization (13,889) (12,241)
Finite-lived intangible assets, net carrying amount $ 13,015 $ 14,543
Weighted Average Life (years) 14 years 2 months 12 days 14 years 2 months 12 days
Technology    
Other Intangible Assets[Line Items]    
Finite-lived intangible assets, gross carrying amount $ 1,250 $ 1,253
Finite-lived intangible assets, accumulated amortization (1,167) (1,104)
Finite-lived intangible assets, net carrying amount $ 83 $ 149
Weighted Average Life (years) 3 years 3 years
Provider networks    
Other Intangible Assets[Line Items]    
Finite-lived intangible assets, gross carrying amount $ 4,203 $ 4,203
Finite-lived intangible assets, accumulated amortization (1,282) (1,072)
Finite-lived intangible assets, net carrying amount $ 2,921 $ 3,131
Weighted Average Life (years) 20 years 20 years
Value of Business Acquired    
Other Intangible Assets[Line Items]    
Finite-lived intangible assets, gross carrying amount $ 590 $ 590
Finite-lived intangible assets, accumulated amortization (228) (201)
Finite-lived intangible assets, net carrying amount $ 362 $ 389
Weighted Average Life (years) 20 years 20 years
Other    
Other Intangible Assets[Line Items]    
Finite-lived intangible assets, gross carrying amount $ 826 $ 838
Finite-lived intangible assets, accumulated amortization (382) (314)
Finite-lived intangible assets, net carrying amount $ 444 $ 524
Weighted Average Life (years) 9 years 3 months 18 days 9 years 3 months 18 days
v3.25.0.1
Goodwill and Other Intangibles - Future Amortization Expense (Details)
$ in Millions
Dec. 31, 2024
USD ($)
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]  
2025 $ 1,981
2026 1,704
2027 1,590
2028 1,316
2029 $ 1,239
v3.25.0.1
Leases - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 12 Months Ended
Sep. 30, 2024
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Operating Leased Assets [Line Items]        
Office real estate optimization charges   $ 30 $ 46 $ 117
Retail Stores        
Operating Leased Assets [Line Items]        
Impairment of operating and financing lease right-of-use assets $ 483 483    
Operating lease right-of-use asset        
Operating Leased Assets [Line Items]        
Office real estate optimization charges   $ 14 20 71
Distribution centers and Corporate offices | Minimum        
Operating Leased Assets [Line Items]        
Operating lease term (in years)   15 years    
Finance lease term (in years)   15 years    
Distribution centers and Corporate offices | Maximum        
Operating Leased Assets [Line Items]        
Operating lease term (in years)   25 years    
Finance lease term (in years)   25 years    
Equipment | Minimum        
Operating Leased Assets [Line Items]        
Operating lease term (in years)   3 years    
Finance lease term (in years)   3 years    
Equipment | Maximum        
Operating Leased Assets [Line Items]        
Operating lease term (in years)   10 years    
Finance lease term (in years)   10 years    
Property and equipment        
Operating Leased Assets [Line Items]        
Office real estate optimization charges   $ 14 $ 18 $ 44
v3.25.0.1
Leases - Summary of the Components of Net Lease Cost (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Leases [Abstract]      
Operating lease cost $ 2,423 $ 2,532 $ 2,579
Finance lease cost:      
Amortization of right-of-use assets 92 84 79
Interest on lease liabilities 71 73 68
Total finance lease costs 163 157 147
Short-term lease costs 33 22 27
Variable lease costs 635 635 610
Less: sublease income (67) (63) (61)
Net lease cost $ 3,187 $ 3,283 $ 3,302
v3.25.0.1
Leases - Supplemental Cash Flow Information (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash flows paid for operating leases $ 2,733 $ 2,756 $ 2,689
Operating cash flows paid for interest portion of finance leases 71 73 68
Financing cash flows paid for principal portion of finance leases 74 70 62
Right-of-use assets obtained in exchange for lease obligations:      
Operating leases 852 1,132 591
Finance leases $ 30   $ 232
Finance leases   $ (4)  
v3.25.0.1
Leases - Supplemental Balance Sheet Information (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Operating leases:    
Operating lease right-of-use assets $ 15,944 $ 17,252
Current portion of operating lease liabilities 1,751 1,741
Long-term operating lease liabilities 14,899 16,034
Total operating lease liabilities 16,650 17,775
Finance leases:    
Property and equipment, gross 1,587 1,604
Accumulated depreciation $ (447) $ (375)
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] Property and equipment, net Property and equipment, net
Property and equipment, net $ 1,140 $ 1,229
Current portion of long-term debt 65 66
Long-term debt 1,295 1,325
Total finance lease liabilities $ 1,360 $ 1,391
Weighted average remaining lease term (in years)    
Operating leases 10 years 8 months 12 days 11 years 4 months 24 days
Finance leases 16 years 6 months 17 years 3 months 18 days
Weighted average discount rate    
Operating leases 4.60% 4.50%
Finance leases 5.10% 5.00%
v3.25.0.1
Leases - Maturities of Operating and Finance Lease Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Finance Leases    
2025 $ 144  
2026 135  
2027 132  
2028 129  
2029 127  
Thereafter 1,371  
Total lease payments 2,038  
Less: imputed interest (678)  
Total finance lease liabilities 1,360 $ 1,391
Operating Leases    
2025 2,683  
2026 2,528  
2027 2,343  
2028 2,167  
2029 1,911  
Thereafter 9,557  
Total lease payments 21,189  
Less: imputed interest (4,539)  
Total operating lease liabilities 16,650 $ 17,775
Total    
2025 2,827  
2026 2,663  
2027 2,475  
2028 2,296  
2029 2,038  
Thereafter 10,928  
Total lease payments 23,227  
Less: imputed interest (5,217)  
Total lease liabilities 18,010  
Future noncancelable subleases, future minimum payments 297  
Leases, amount due in excess of remaining estimated economic life $ 2,200  
v3.25.0.1
Health Care Costs Payable - Incurred and Paid Health Care Claims Development (Details) - Health Insurance Product Line - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Claims Development [Line Items]    
Incurred Health Care Claims, Net of Reinsurance $ 191,017  
Cumulative Paid Health Care Claims, Net of Reinsurance 178,199  
All outstanding liabilities for health care costs payable prior to 2023, net of reinsurance 128  
Total outstanding liabilities for health care costs payable, net of reinsurance 12,946  
2023    
Claims Development [Line Items]    
Incurred Health Care Claims, Net of Reinsurance 81,559 $ 82,362
Cumulative Paid Health Care Claims, Net of Reinsurance 81,044 $ 72,175
2024    
Claims Development [Line Items]    
Incurred Health Care Claims, Net of Reinsurance 109,458  
Cumulative Paid Health Care Claims, Net of Reinsurance $ 97,155  
v3.25.0.1
Health Care Costs Payable - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Liability for Claims and Claims Adjustment Expense [Line Items]      
Decrease in prior years' healthcare costs payable $ 947 $ 685  
Health Insurance Product Line      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Decrease in prior years' healthcare costs payable     $ 654
Health Care Benefits      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Liabilities for IBNR plus expected development on reported claims $ 11,300    
v3.25.0.1
Health Care Costs Payable - Liability for Unpaid Claims and Claims Adjustment Expense (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Short-duration Insurance Contracts, Reconciliation of Claims Development to Liability [Line Items]        
Reinsurance recoverables $ 81 $ 5    
Other non-insurance health care costs payable 1,755      
Total health care costs payable 15,064 $ 12,049    
Health Insurance Product Line        
Short-duration Insurance Contracts, Reconciliation of Claims Development to Liability [Line Items]        
Total outstanding liabilities for health care costs payable, net of reinsurance 12,946      
Reinsurance recoverables 81   $ 5 $ 8
Insurance lines other than short duration $ 282      
v3.25.0.1
Health Care Costs Payable - Components of Change in Health Care Costs Payable (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Health care costs payable, beginning of period $ 12,049    
Less: Reinsurance recoverables 5    
Less: Impact of discount rate on long-duration insurance reserves (23)    
Health care costs payable, beginning of period, net 12,067    
Acquisition, net 0 $ 1,098  
Add: Components of incurred health care costs      
Current year 115,774 86,639  
Prior years (947) (685)  
Total incurred health care costs 114,827 85,954  
Less: Claims paid      
Current year 101,583 75,529  
Prior years 10,327 9,585  
Total claims paid 111,910 85,114  
Health care costs payable, end of period, net 14,984 12,067  
Add: Reinsurance recoverables 81 5  
Add: Impact of discount rate on long-duration insurance reserves (1) (23)  
Health care costs payable, end of period 15,064 12,049  
Health Care Benefits      
Less: Claims paid      
Health care costs recorded in other insurance liabilities 107 83 $ 79
Corporate/ Other      
Less: Claims paid      
Health care costs recorded in other insurance liabilities 187 210 249
Health Insurance Product Line      
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Health care costs payable, beginning of period   10,142 8,678
Less: Reinsurance recoverables   5 8
Less: Impact of discount rate on long-duration insurance reserves   8 0
Health care costs payable, beginning of period, net   $ 10,129 8,670
Acquisition, net     0
Add: Components of incurred health care costs      
Current year     71,399
Prior years     (654)
Total incurred health care costs     70,745
Less: Claims paid      
Current year     61,640
Prior years     7,646
Total claims paid     69,286
Health care costs payable, end of period, net     10,129
Add: Reinsurance recoverables $ 81   5
Add: Impact of discount rate on long-duration insurance reserves     8
Health care costs payable, end of period     $ 10,142
v3.25.0.1
Other Insurance Liabilities and Separate Accounts - Changes in Liability for Future Policy Benefits (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Present value of expected future policy benefits      
Effect of changes in discount rate assumptions $ (1) $ (23)  
Large Case Pensions      
Present value of expected future policy benefits      
Liability for future policy benefits, beginning of period - current discount rate 2,139 2,253  
Beginning liability for future policy benefits at original (locked-in) discount rate 2,251 2,425  
Effect of changes in cash flow assumptions   0 $ 0
Effect of actual variances from expected experience   (27) (3)
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate   2,224 2,422
Issuances 30 8  
Interest accrual (using locked-in discount rate) 91 97  
Benefit payments (actual) (255) (276)  
Ending liability for future policy benefits at original (locked-in) discount rate 2,090 2,251  
Effect of changes in discount rate assumptions (173) (112)  
Liability for future policy benefits, end of period - current discount rate 1,917 2,139  
Net liability for future policy benefits 1,917 2,139  
Less: Reinsurance recoverable 0 0  
Net liability for future policy benefits, net of reinsurance recoverable 1,917 2,139  
Long-Term Care      
Present value of expected net premiums      
Liability for future policy benefits, beginning of period - current discount rate 293 300  
Beginning liability for future policy benefits at original (locked-in) discount rate 288 302  
Effect of changes in cash flow assumptions   0 0
Effect of actual variances from expected experience   16 10
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate   304 312
Interest accrual (using locked-in discount rate) 14 15  
Net premiums (actual) (38) (39)  
Ending liability for future policy benefits at original (locked-in) discount rate 280 288  
Effect of changes in discount rate assumptions (5) 5  
Liability for future policy benefits, end of period - current discount rate 275 293  
Present value of expected future policy benefits      
Liability for future policy benefits, beginning of period - current discount rate 1,640 1,566  
Beginning liability for future policy benefits at original (locked-in) discount rate 1,632 1,613  
Effect of changes in cash flow assumptions   0 0
Effect of actual variances from expected experience   6 8
Adjusted beginning liability for future policy benefits - original (locked-in) discount rate   1,638 $ 1,621
Issuances 0 0  
Interest accrual (using locked-in discount rate) 83 82  
Benefit payments (actual) (74) (71)  
Ending liability for future policy benefits at original (locked-in) discount rate 1,647 1,632  
Effect of changes in discount rate assumptions (95) 8  
Liability for future policy benefits, end of period - current discount rate 1,552 1,640  
Net liability for future policy benefits 1,277 1,347  
Less: Reinsurance recoverable 0 0  
Net liability for future policy benefits, net of reinsurance recoverable $ 1,277 $ 1,347  
v3.25.0.1
Other Insurance Liabilities and Separate Accounts - Undiscounted Expected Gross Premiums and Expected Future Benefit Payments (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Large Case Pensions    
Liability for Future Policy Benefit, Activity [Line Items]    
Expected future benefit payments $ 3,024 $ 3,266
Expected gross premiums 0 0
Long-Term Care    
Liability for Future Policy Benefit, Activity [Line Items]    
Expected future benefit payments 3,189 3,224
Expected gross premiums $ 399 $ 414
v3.25.0.1
Other Insurance Liabilities and Separate Accounts - Weighted-average Interest Rates and Durations (Details)
Dec. 31, 2024
Dec. 31, 2023
Large Case Pensions    
Liability for Future Policy Benefit, Activity [Line Items]    
Interest accretion rate 4.20% 4.20%
Current discount rate 5.46% 4.93%
Weighted-average duration of long-duration insurance liabilities 7 years 3 months 18 days 7 years 3 months 18 days
Long-Term Care    
Liability for Future Policy Benefit, Activity [Line Items]    
Interest accretion rate 5.11% 5.11%
Current discount rate 5.70% 5.08%
Weighted-average duration of long-duration insurance liabilities 11 years 8 months 12 days 12 years 1 month 6 days
v3.25.0.1
Other Insurance Liabilities and Separate Accounts - Separate Account Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets $ 3,311 $ 3,250  
Separate accounts liabilities 3,311 3,250 $ 3,228
Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 3,499 3,204  
Other Payables | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts liabilities 188    
Other Receivables | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets   46  
Cash and cash equivalents | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 165 168  
Debt securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 856 2,507  
Debt securities | U.S. government securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 186 573  
Debt securities | States, municipalities and political subdivisions | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 14 28  
Debt securities | U.S. corporate securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 524 1,632  
Debt securities | Foreign securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 51 202  
Mortgage-backed securities | Residential mortgage-backed securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 71 51  
Mortgage-backed securities | Commercial mortgage-backed securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 3 6  
Other asset-backed securities | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets 7 15  
Common/collective trusts | Recurring      
Fair Value, Separate Account Investment [Line Items]      
Separate accounts assets $ 2,478 $ 529  
v3.25.0.1
Other Insurance Liabilities and Separate Accounts - Roll Forward of Separate Accounts (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Separate Account, Liability [Roll Forward]    
Separate Accounts liability, beginning of the period $ 3,250 $ 3,228
Premiums and deposits 964 860
Surrenders and withdrawals (277) (9)
Benefit payments (978) (938)
Investment earnings 348 100
Net transfers from general account 13 7
Other (9) 2
Separate Accounts liability, end of the period 3,311 3,250
Cash surrender value, end of the period $ 1,987 $ 2,181
v3.25.0.1
Borrowings and Credit Agreements - Schedule of Borrowings (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 10, 2024
May 09, 2024
Dec. 31, 2023
Jun. 02, 2023
Feb. 21, 2023
Debt Instrument [Line Items]            
Commercial Paper $ 2,119     $ 200    
Long-term debt 63,268          
Finance lease liabilities 1,360     1,391    
Total debt principal 66,747     62,160    
Debt premiums 170     186    
Debt discounts and deferred financing costs (647)     (736)    
Long-term debt and lease obligation 66,270     61,610    
Short-term debt (commercial paper) (2,119)     (200)    
Current portion of long-term debt (3,624)     (2,772)    
Long-term debt $ 60,527     $ 58,638    
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration] Long-term debt     Long-term debt    
Senior Notes | 3.375% senior notes due August 2024            
Debt Instrument [Line Items]            
Debt interest rate       3.375%    
Long-term debt $ 0     $ 650    
Senior Notes | 2.625% senior notes due August 2024            
Debt Instrument [Line Items]            
Debt interest rate       2.625%    
Long-term debt 0     $ 1,000    
Senior Notes | 3.5% senior notes due November 2024            
Debt Instrument [Line Items]            
Debt interest rate       3.50%    
Long-term debt 0     $ 750    
Senior Notes | 5% senior notes due December 2024            
Debt Instrument [Line Items]            
Debt interest rate       5.00%    
Long-term debt $ 0     $ 299    
Senior Notes | 4.1% senior notes due March 2025            
Debt Instrument [Line Items]            
Debt interest rate 4.10%          
Long-term debt $ 724     950    
Senior Notes | 3.875% senior notes due July 2025            
Debt Instrument [Line Items]            
Debt interest rate 3.875%          
Long-term debt $ 2,828     2,828    
Senior Notes | 5% senior notes due February 2026            
Debt Instrument [Line Items]            
Debt interest rate 5.00%         5.00%
Long-term debt $ 1,500     1,500    
Senior Notes | 2.875% senior notes due June 2026            
Debt Instrument [Line Items]            
Debt interest rate 2.875%          
Long-term debt $ 1,750     1,750    
Senior Notes | 3% senior notes due August 2026            
Debt Instrument [Line Items]            
Debt interest rate 3.00%          
Long-term debt $ 750     750    
Senior Notes | 3.625% senior notes due April 2027            
Debt Instrument [Line Items]            
Debt interest rate 3.625%          
Long-term debt $ 750     750    
Senior Notes | 6.25% senior notes due June 2027            
Debt Instrument [Line Items]            
Debt interest rate 6.25%          
Long-term debt $ 372     372    
Senior Notes | 1.3% senior notes due August 2027            
Debt Instrument [Line Items]            
Debt interest rate 1.30%          
Long-term debt $ 2,250     2,250    
Senior Notes | 4.3% senior notes due March 2028            
Debt Instrument [Line Items]            
Debt interest rate 4.30%          
Long-term debt $ 5,000     5,000    
Senior Notes | 5% senior notes due January 2029            
Debt Instrument [Line Items]            
Debt interest rate 5.00%       5.00%  
Long-term debt $ 1,000     1,000    
Senior Notes | 5.4% senior notes due June 2029            
Debt Instrument [Line Items]            
Debt interest rate 5.40%   5.40%      
Long-term debt $ 1,000     0    
Senior Notes | 3.25% senior notes due August 2029            
Debt Instrument [Line Items]            
Debt interest rate 3.25%          
Long-term debt $ 1,750     1,750    
Senior Notes | 5.125% senior notes due February 2030            
Debt Instrument [Line Items]            
Debt interest rate 5.125%         5.125%
Long-term debt $ 1,500     1,500    
Senior Notes | 3.75% senior notes due April 2030            
Debt Instrument [Line Items]            
Debt interest rate 3.75%          
Long-term debt $ 1,500     1,500    
Senior Notes | 1.75% senior notes due August 2030            
Debt Instrument [Line Items]            
Debt interest rate 1.75%          
Long-term debt $ 1,250     1,250    
Senior Notes | 5.25% senior notes due January 2031            
Debt Instrument [Line Items]            
Debt interest rate 5.25%       5.25%  
Long-term debt $ 750     750    
Senior Notes | 1.875% senior notes due February 2031            
Debt Instrument [Line Items]            
Debt interest rate 1.875%          
Long-term debt $ 1,250     1,250    
Senior Notes | 5.55% senior notes due June 2031            
Debt Instrument [Line Items]            
Debt interest rate 5.55%   5.55%      
Long-term debt $ 1,000     0    
Senior Notes | 2.125% senior notes due September 2031            
Debt Instrument [Line Items]            
Debt interest rate 2.125%          
Long-term debt $ 1,000     1,000    
Senior Notes | 5.25% senior notes due February 2033            
Debt Instrument [Line Items]            
Debt interest rate 5.25%         5.25%
Long-term debt $ 1,750     1,750    
Senior Notes | 5.3% senior notes due June 2033            
Debt Instrument [Line Items]            
Debt interest rate 5.30%       5.30%  
Long-term debt $ 1,250     1,250    
Senior Notes | 5.7% senior notes due June 2034            
Debt Instrument [Line Items]            
Debt interest rate 5.70%   5.70%      
Long-term debt $ 1,250     0    
Senior Notes | 4.875% senior notes due July 2035            
Debt Instrument [Line Items]            
Debt interest rate 4.875%          
Long-term debt $ 652     652    
Senior Notes | 6.625% senior notes due June 2036            
Debt Instrument [Line Items]            
Debt interest rate 6.625%          
Long-term debt $ 771     771    
Senior Notes | 6.75% senior notes due December 2037            
Debt Instrument [Line Items]            
Debt interest rate 6.75%          
Long-term debt $ 533     533    
Senior Notes | 4.78% senior notes due March 2038            
Debt Instrument [Line Items]            
Debt interest rate 4.78%          
Long-term debt $ 5,000     5,000    
Senior Notes | 6.125% senior notes due September 2039            
Debt Instrument [Line Items]            
Debt interest rate 6.125%          
Long-term debt $ 447     447    
Senior Notes | 4.125% senior notes due April 2040            
Debt Instrument [Line Items]            
Debt interest rate 4.125%          
Long-term debt $ 602     1,000    
Senior Notes | 2.7% senior notes due August 2040            
Debt Instrument [Line Items]            
Debt interest rate 2.70%          
Long-term debt $ 367     1,250    
Senior Notes | 5.75% senior notes due May 2041            
Debt Instrument [Line Items]            
Debt interest rate 5.75%          
Long-term debt $ 133     133    
Senior Notes | 4.5% senior notes due May 2042            
Debt Instrument [Line Items]            
Debt interest rate 4.50%          
Long-term debt $ 500     500    
Senior Notes | 4.125% senior notes due November 2042            
Debt Instrument [Line Items]            
Debt interest rate 4.125%          
Long-term debt $ 226     500    
Senior Notes | 5.3% senior notes due December 2043            
Debt Instrument [Line Items]            
Debt interest rate 5.30%          
Long-term debt $ 750     750    
Senior Notes | 4.75% senior notes due March 2044            
Debt Instrument [Line Items]            
Debt interest rate 4.75%          
Long-term debt $ 375     375    
Senior Notes | 6% senior notes due June 2044            
Debt Instrument [Line Items]            
Debt interest rate 6.00%   6.00%      
Long-term debt $ 750     0    
Senior Notes | 5.125% senior notes due July 2045            
Debt Instrument [Line Items]            
Debt interest rate 5.125%          
Long-term debt $ 3,500     3,500    
Senior Notes | 3.875% senior notes due August 2047            
Debt Instrument [Line Items]            
Debt interest rate 3.875%          
Long-term debt $ 537     1,000    
Senior Notes | 5.05% senior notes due March 2048            
Debt Instrument [Line Items]            
Debt interest rate 5.05%          
Long-term debt $ 8,000     8,000    
Senior Notes | 4.25% senior notes due April 2050            
Debt Instrument [Line Items]            
Debt interest rate 4.25%          
Long-term debt $ 399     750    
Senior Notes | 5.625% senior notes due February 2053            
Debt Instrument [Line Items]            
Debt interest rate 5.625%         5.625%
Long-term debt $ 1,250     1,250    
Senior Notes | 5.875% senior notes due June 2053            
Debt Instrument [Line Items]            
Debt interest rate 5.875%       5.875%  
Long-term debt $ 1,250     1,250    
Senior Notes | 6.05% senior notes due June 2054            
Debt Instrument [Line Items]            
Debt interest rate 6.05%   6.05%      
Long-term debt $ 1,000     0    
Senior Notes | 6% senior notes due June 2063            
Debt Instrument [Line Items]            
Debt interest rate 6.00%       6.00%  
Long-term debt $ 750     750    
Junior Subordinated Debt | 6.75% series B junior subordinated notes due December 2054            
Debt Instrument [Line Items]            
Debt interest rate 6.75% 6.75%        
Long-term debt $ 750     0    
Junior Subordinated Debt | 7% series A junior subordinated notes due March 2055            
Debt Instrument [Line Items]            
Debt interest rate 7.00% 7.00%        
Long-term debt $ 2,250     0    
Other Debt Obligations            
Debt Instrument [Line Items]            
Long-term debt $ 302     $ 309    
v3.25.0.1
Borrowings and Credit Agreements - Debt Maturities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Long-term Debt, Fiscal Year Maturity [Abstract]    
2025 $ 3,559  
2026 4,007  
2027 3,379  
2028 5,007  
2029 3,758  
Thereafter 43,558  
Subtotal 63,268  
Commercial Paper 2,119 $ 200
Finance lease liabilities 1,360 1,391
Total debt principal $ 66,747 $ 62,160
v3.25.0.1
Borrowings and Credit Agreements - Short-term Borrowings (Details) - USD ($)
1 Months Ended 12 Months Ended
Dec. 10, 2024
May 09, 2024
Mar. 25, 2024
Jun. 02, 2023
May 02, 2023
May 01, 2023
Feb. 21, 2023
Feb. 28, 2023
Dec. 31, 2024
Dec. 31, 2023
Short-term Debt [Line Items]                    
Short-term debt                 $ 2,119,000,000 $ 200,000,000
Proceeds from debt $ 3,000,000,000 $ 5,000,000,000   $ 4,900,000,000   $ 5,000,000,000 $ 6,000,000,000 $ 6,000,000,000    
Federal Home Loan Bank advances maximum amount available                 1,200,000,000  
Commercial Paper                    
Short-term Debt [Line Items]                    
Short-term debt                 $ 2,100,000,000 $ 200,000,000
Short-term debt, weighted average interest rate                 4.98% 4.31%
Line of Credit | Back-Up Credit Facilities                    
Short-term Debt [Line Items]                    
Short-term debt                 $ 0 $ 0
Commitment fee percentage                 0.03%  
Line of Credit | Revolving Credit Facility, Expiring May 11, 2027                    
Short-term Debt [Line Items]                    
Maximum borrowing capacity                 $ 2,500,000,000  
Debt instrument term                 5 years  
Line of Credit | Revolving Credit Facility, Expiring May 16, 2028                    
Short-term Debt [Line Items]                    
Maximum borrowing capacity                 $ 2,500,000,000  
Debt instrument term                 5 years  
Line of Credit | Revolving Credit Facility, Expiring May 16, 2029                    
Short-term Debt [Line Items]                    
Maximum borrowing capacity                 $ 2,500,000,000  
Debt instrument term                 5 years  
Loans Payable | 364-day Term Loan Agreement                    
Short-term Debt [Line Items]                    
Short-term debt   $ 0                
Debt instrument term     364 days     364 days        
Debt face amount     $ 3,000,000,000     $ 5,000,000,000        
Proceeds from debt         $ 5,000,000,000          
Debt interest rate         6.20%          
Federal Home Loan Bank Advances                    
Short-term Debt [Line Items]                    
Short-term debt                 $ 0 $ 0
v3.25.0.1
Borrowings and Credit Agreements - Long-term Borrowings (Details) - USD ($)
1 Months Ended 12 Months Ended
Dec. 10, 2034
Mar. 10, 2030
Dec. 10, 2024
May 09, 2024
Oct. 20, 2023
Jul. 21, 2023
Jun. 02, 2023
May 02, 2023
May 01, 2023
Feb. 21, 2023
Dec. 31, 2024
Feb. 28, 2023
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Debt Instrument [Line Items]                              
Proceeds from debt     $ 3,000,000,000 $ 5,000,000,000     $ 4,900,000,000   $ 5,000,000,000 $ 6,000,000,000   $ 6,000,000,000      
Cash payment of debt                         $ 4,773,000,000 $ 3,166,000,000 $ 4,211,000,000
Gain on early extinguishment of debt                         $ 491,000,000 $ 0 $ 0
Junior Subordinated Debt | 7% series A junior subordinated notes due March 2055                              
Debt Instrument [Line Items]                              
Debt face amount     $ 2,250,000,000                        
Debt interest rate     7.00%               7.00%   7.00%    
Initial redemption period prior to first interest rate date     90 days                        
Junior Subordinated Debt | 7% series A junior subordinated notes due March 2055 | Forecast                              
Debt Instrument [Line Items]                              
Interest rate recurring reset period   5 years                          
Junior Subordinated Debt | 6.75% series B junior subordinated notes due December 2054                              
Debt Instrument [Line Items]                              
Debt face amount     $ 750,000,000                        
Debt interest rate     6.75%               6.75%   6.75%    
Initial redemption period prior to first interest rate date     90 days                        
Junior Subordinated Debt | 6.75% series B junior subordinated notes due December 2054 | Forecast                              
Debt Instrument [Line Items]                              
Interest rate recurring reset period 5 years                            
Senior Notes                              
Debt Instrument [Line Items]                              
Debt face amount       5,000,000,000                      
Principal amount of debt repaid                     $ 2,600,000,000        
Cash payment of debt                     2,000,000,000.0        
Gain on early extinguishment of debt                     $ 491,000,000        
Senior Notes | 5.4% senior notes due June 2029                              
Debt Instrument [Line Items]                              
Debt face amount       $ 1,000,000,000                      
Debt interest rate       5.40%             5.40%   5.40%    
Senior Notes | 5.55% senior notes due June 2031                              
Debt Instrument [Line Items]                              
Debt face amount       $ 1,000,000,000                      
Debt interest rate       5.55%             5.55%   5.55%    
Senior Notes | 5.7% senior notes due June 2034                              
Debt Instrument [Line Items]                              
Debt face amount       $ 1,250,000,000                      
Debt interest rate       5.70%             5.70%   5.70%    
Senior Notes | 6% senior notes due June 2044                              
Debt Instrument [Line Items]                              
Debt face amount       $ 750,000,000                      
Debt interest rate       6.00%             6.00%   6.00%    
Senior Notes | 6.05% senior notes due June 2054                              
Debt Instrument [Line Items]                              
Debt face amount       $ 1,000,000,000                      
Debt interest rate       6.05%             6.05%   6.05%    
Senior Notes | 5% senior notes due January 2029                              
Debt Instrument [Line Items]                              
Debt face amount             $ 1,000,000,000                
Debt interest rate             5.00%       5.00%   5.00%    
Senior Notes | 5.25% senior notes due January 2031                              
Debt Instrument [Line Items]                              
Debt face amount             $ 750,000,000                
Debt interest rate             5.25%       5.25%   5.25%    
Senior Notes | 5.3% senior notes due June 2033                              
Debt Instrument [Line Items]                              
Debt face amount             $ 1,250,000,000                
Debt interest rate             5.30%       5.30%   5.30%    
Senior Notes | 5.875% senior notes due June 2053                              
Debt Instrument [Line Items]                              
Debt face amount             $ 1,250,000,000                
Debt interest rate             5.875%       5.875%   5.875%    
Senior Notes | 6% senior notes due June 2063                              
Debt Instrument [Line Items]                              
Debt face amount             $ 750,000,000                
Debt interest rate             6.00%       6.00%   6.00%    
Senior Notes | 5% senior notes due February 2026                              
Debt Instrument [Line Items]                              
Debt face amount                   $ 1,500,000,000          
Debt interest rate                   5.00% 5.00%   5.00%    
Senior Notes | 5.125% senior notes due February 2030                              
Debt Instrument [Line Items]                              
Debt face amount                   $ 1,500,000,000          
Debt interest rate                   5.125% 5.125%   5.125%    
Senior Notes | 5.25% senior notes due February 2033                              
Debt Instrument [Line Items]                              
Debt face amount                   $ 1,750,000,000          
Debt interest rate                   5.25% 5.25%   5.25%    
Senior Notes | 5.625% senior notes due February 2053                              
Debt Instrument [Line Items]                              
Debt face amount                   $ 1,250,000,000          
Debt interest rate                   5.625% 5.625%   5.625%    
Senior Notes | 4.1% senior notes due March 2025                              
Debt Instrument [Line Items]                              
Debt interest rate                     4.10%   4.10%    
Principal amount of debt repaid                     $ 226,000,000        
Senior Notes | 4.125% senior notes due April 2040                              
Debt Instrument [Line Items]                              
Debt interest rate                     4.125%   4.125%    
Principal amount of debt repaid                     $ 398,000,000        
Senior Notes | 2.7% senior notes due August 2040                              
Debt Instrument [Line Items]                              
Debt interest rate                     2.70%   2.70%    
Principal amount of debt repaid                     $ 883,000,000        
Senior Notes | 4.125% senior notes due November 2042                              
Debt Instrument [Line Items]                              
Debt interest rate                     4.125%   4.125%    
Principal amount of debt repaid                     $ 274,000,000        
Senior Notes | 3.875% senior notes due August 2047                              
Debt Instrument [Line Items]                              
Debt interest rate                     3.875%   3.875%    
Principal amount of debt repaid                     $ 463,000,000        
Senior Notes | 4.25% senior notes due April 2050                              
Debt Instrument [Line Items]                              
Debt interest rate                     4.25%   4.25%    
Principal amount of debt repaid                     $ 351,000,000        
Convertible Debt | 0% convertible senior notes due March 2026                              
Debt Instrument [Line Items]                              
Repurchase price of convertible senior notes, as a percent of principal               100.00%              
Conversion of convertible senior notes with cash         $ 3,000,000 $ 917,000,000                  
Convertible Debt | 0% convertible senior notes due March 2026 | Oak Street Health Inc.                              
Debt Instrument [Line Items]                              
Debt face amount                 $ 920,000,000            
Debt interest rate                 0.00%            
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Defined Benefit Plan Disclosure [Line Items]      
Defined contribution plan, employer contributions $ 610 $ 581 $ 567
Pension Plan      
Defined Benefit Plan Disclosure [Line Items]      
Employer contributions 23 24 27
Multiemployer plans, plan contributions 19 19 20
Benefit obligation 4,349 4,736 4,740
Net periodic benefit cost $ (104) (94) (173)
Pension Plan | Equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 7.00%    
Pension Plan | Debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 75.00%    
Pension Plan | Real assets      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 7.00%    
Pension Plan | Private equity limited partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 5.00%    
Pension Plan | Private credit limited partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 2.00%    
Pension Plan | Hedge funds      
Defined Benefit Plan Disclosure [Line Items]      
Target investment allocations 4.00%    
Other Postretirement Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Multiemployer plans, plan contributions $ 63 60 62
Benefit obligation 147 155  
Net periodic benefit cost $ 6 $ 6 $ 4
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Benefit Obligations and Plan Assets (Details) - Pension Plan - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Change in benefit obligation:      
Benefit obligation, beginning of year $ 4,736 $ 4,740  
Interest cost 222 231 $ 132
Actuarial loss (gain) (262) 145  
Benefit payments (347) (380)  
Benefit obligation, end of year 4,349 4,736 4,740
Change in plan assets:      
Beginning balance 5,379 5,346  
Actual return on plan assets 133 389  
Employer contributions 23 24 27
Benefit payments (347) (380)  
Ending balance 5,188 5,379 $ 5,346
Funded status 839 643  
Assets (liabilities) recognized on the consolidated balance sheet      
Noncurrent assets reflected in other assets 1,030 856  
Current liabilities reflected in accrued expenses and other current liabilities (22) (24)  
Noncurrent liabilities reflected in other long-term liabilities (169) (189)  
Net assets $ 839 $ 643  
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Net Periodic Benefit Cost (Income) (Details) - Pension Plan - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Components of net periodic benefit cost (income):      
Interest cost $ 222 $ 231 $ 132
Expected return on plan assets (327) (326) (309)
Amortization of net actuarial loss 1 1 3
Settlement losses 0 0 1
Net periodic benefit cost (income) $ (104) $ (94) $ (173)
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Weighted Average Assumptions Used (Details)
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Assumptions used to determine benefit obligations      
Discount rate 5.60% 5.00%  
Assumptions used to determine net benefit costs      
Discount rate 4.90% 5.10% 2.30%
Expected long-term rate of return on plan assets 6.30% 6.30% 4.80%
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Fair Value of Pension Plan Assets (Details) - Pension Plan - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets $ 5,188 $ 5,379 $ 5,346
Total Fair Value, Inputs, Level 1, 2 and 3      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 4,351 4,352  
Total Fair Value, Inputs, Level 1, 2 and 3 | Cash and cash equivalents      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 99 81  
Total Fair Value, Inputs, Level 1, 2 and 3 | Total debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 3,429 3,406  
Total Fair Value, Inputs, Level 1, 2 and 3 | U.S. government securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 487 522  
Total Fair Value, Inputs, Level 1, 2 and 3 | States, municipalities and political subdivisions      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 70 94  
Total Fair Value, Inputs, Level 1, 2 and 3 | U.S. corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 2,753 2,649  
Total Fair Value, Inputs, Level 1, 2 and 3 | Foreign securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 98 106  
Total Fair Value, Inputs, Level 1, 2 and 3 | Residential mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 7 17  
Total Fair Value, Inputs, Level 1, 2 and 3 | Commercial mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 9 9  
Total Fair Value, Inputs, Level 1, 2 and 3 | Other asset-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 4 8  
Total Fair Value, Inputs, Level 1, 2 and 3 | Redeemable preferred securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 1 1  
Total Fair Value, Inputs, Level 1, 2 and 3 | Total equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 42 184  
Total Fair Value, Inputs, Level 1, 2 and 3 | U.S. domestic      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 30 150  
Total Fair Value, Inputs, Level 1, 2 and 3 | International      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 12 34  
Total Fair Value, Inputs, Level 1, 2 and 3 | Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 781 681  
Total Fair Value, Inputs, Level 1, 2 and 3 | Private real estate      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 276 290  
Total Fair Value, Inputs, Level 1, 2 and 3 | Common/collective trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 502 405  
Total Fair Value, Inputs, Level 1, 2 and 3 | Derivatives      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 3 (14)  
Level 1      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 555 714  
Level 1 | Cash and cash equivalents      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 32 12  
Level 1 | Total debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 481 518  
Level 1 | U.S. government securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 481 518  
Level 1 | States, municipalities and political subdivisions      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | U.S. corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Foreign securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Residential mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Commercial mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Other asset-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Redeemable preferred securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Total equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 42 184  
Level 1 | U.S. domestic      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 30 150  
Level 1 | International      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 12 34  
Level 1 | Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Private real estate      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Common/collective trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 1 | Derivatives      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 2      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 3,519 3,348  
Level 2 | Cash and cash equivalents      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 67 69  
Level 2 | Total debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 2,947 2,888  
Level 2 | U.S. government securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 6 4  
Level 2 | States, municipalities and political subdivisions      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 70 94  
Level 2 | U.S. corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 2,752 2,649  
Level 2 | Foreign securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 98 106  
Level 2 | Residential mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 7 17  
Level 2 | Commercial mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 9 9  
Level 2 | Other asset-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 4 8  
Level 2 | Redeemable preferred securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 1 1  
Level 2 | Total equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 2 | U.S. domestic      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 2 | International      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 2 | Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 505 391  
Level 2 | Private real estate      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 2 | Common/collective trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 502 405  
Level 2 | Common/collective trusts, Equity Securities      
Defined Benefit Plan Disclosure [Line Items]      
Plan assets, investment within plan asset category, amount 288 114  
Level 2 | Common/collective trusts, Debt Securities      
Defined Benefit Plan Disclosure [Line Items]      
Plan assets, investment within plan asset category, amount 214 291  
Level 2 | Derivatives      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 3 (14)  
Level 3      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 277 290  
Level 3 | Cash and cash equivalents      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Total debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 1 0  
Level 3 | U.S. government securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | States, municipalities and political subdivisions      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | U.S. corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 1 0  
Level 3 | Foreign securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Residential mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Commercial mortgage-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Other asset-backed securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Redeemable preferred securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Total equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | U.S. domestic      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | International      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 276 290  
Level 3 | Private real estate      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 276 290 $ 325
Level 3 | Common/collective trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Level 3 | Derivatives      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 0 0  
Fair Value Measured at Net Asset Value Per Share | Other Receivables      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 267 314  
Fair Value Measured at Net Asset Value Per Share | Private equity limited partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 290 461  
Fair Value Measured at Net Asset Value Per Share | Hedge fund limited partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets $ 280 $ 252  
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Changes in Level 3 Pension Plan Assets (Details) - Pension Plan - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Change in plan assets:    
Beginning balance $ 5,379 $ 5,346
Ending balance 5,188 5,379
Level 3    
Change in plan assets:    
Beginning balance 290  
Actual return on plan assets 1  
Purchases, sales and settlements (14)  
Transfers out of Level 3 0  
Ending balance 277 290
Private real estate | Level 3    
Change in plan assets:    
Beginning balance 290 325
Actual return on plan assets 1 (23)
Purchases, sales and settlements (15) (12)
Transfers out of Level 3 0 0
Ending balance 276 290
U.S. corporate securities | Level 3    
Change in plan assets:    
Beginning balance 0  
Actual return on plan assets 0  
Purchases, sales and settlements 1  
Transfers out of Level 3 0  
Ending balance $ 1 $ 0
v3.25.0.1
Pension Plans and Other Postretirement Benefits - Defined Benefit Plans Expected Benefit (Details)
$ in Millions
Dec. 31, 2024
USD ($)
Pension Plan  
Defined Benefit Plan Disclosure [Line Items]  
2025 $ 389
2026 384
2027 380
2028 380
2029 371
2030-2034 1,712
Other Postretirement Benefits  
Defined Benefit Plan Disclosure [Line Items]  
2025 12
2026 12
2027 12
2028 12
2029 12
2030-2034 $ 59
v3.25.0.1
Income Taxes - Income Tax Provision (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Current:      
Federal $ 1,658 $ 2,819 $ 2,803
State 476 662 735
Total current taxes 2,134 3,481 3,538
Deferred:      
Federal (453) (537) (1,526)
State (119) (139) (503)
Total deferred income taxes (572) (676) (2,029)
Total $ 1,562 $ 2,805 $ 1,509
v3.25.0.1
Income Taxes - Effective Tax Rate Reconciliation (Details)
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Income Tax Disclosure [Abstract]      
Statutory income tax rate 21.00% 21.00% 21.00%
State income taxes, net of federal tax benefit 4.60% 3.70% 3.20%
Legal charges 0.50% 0.00% 3.40%
Basis difference upon disposition of subsidiary 0.00% 0.00% 1.60%
Prior year refunds and unrecognized tax benefits 0.00% 0.00% (2.60%)
Tax credits (1.20%) (0.30%) (0.60%)
Other 0.50% 0.70% (0.10%)
Effective income tax rate 25.40% 25.10% 25.90%
v3.25.0.1
Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Deferred income tax assets:    
Lease and rents $ 4,763 $ 5,059
Legal charges 1,109 1,205
Inventory 68 94
Employee benefits 168 168
Bad debts and other allowances 593 606
Net operating loss and capital loss carryforwards 272 409
Deferred income 47 62
Insurance reserves 381 356
Investments 21 56
Other 486 372
Valuation allowance (301) (385)
Total deferred income tax assets 7,607 8,002
Deferred income tax liabilities:    
Retirement benefits 172 112
Lease and rents 4,125 4,469
Depreciation and amortization 7,116 7,732
Total deferred income tax liabilities 11,413 12,313
Net deferred income tax liabilities $ 3,806 $ 4,311
v3.25.0.1
Income Taxes - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Income Tax Disclosure [Abstract]      
Valuation allowance $ 301 $ 385  
Net operating loss and capital loss carryforwards 272 409  
Income tax penalties and interest expense 45 31 $ 29
Income tax penalties and interest accrued 165 $ 134  
Unrecognized tax benefits that would impact effective tax rate $ 324    
v3.25.0.1
Income Taxes - Unrecognized Tax Benefits (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Unrecognized Tax Benefits [Roll Forward]      
Beginning balance $ 436 $ 446 $ 782
Additions based on tax positions related to the current year 0 2 5
Additions based on tax positions related to prior years 67 46 42
Reductions for tax positions of prior years (49) (24) (166)
Expiration of statutes of limitation (29) (34) (4)
Settlements (1) 0 (213)
Ending balance $ 424 $ 436 $ 446
v3.25.0.1
Stock Incentive Plans - Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
12 Months Ended
May 02, 2023
Mar. 29, 2023
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Shares of common stock received for each restricted stock unit granted (in shares)     1    
Shares issued employee stock purchase plan (in shares)     4,000,000    
Average purchase price of shares purchased (in dollars per share)     $ 58.57    
Restricted stock units and performance stock units          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Compensation not yet recognized, other than options     $ 829    
Compensation not yet recognized, period for recognition     2 years 2 months 12 days    
Vested in period, fair value     $ 497 $ 525 $ 328
Performance stock units          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Award vesting period     3 years    
Employee Stock Option          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Award vesting period     4 years    
Stock options granted through 2018          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Expiration period     7 years    
Stock options granted subsequent to 2018          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Expiration period     10 years    
SARs          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Award vesting period     4 years    
Expiration period     10 years    
Stock options and SARs          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Compensation not yet recognized, period for recognition     2 years 2 months 26 days    
Compensation not yet recognized, options     $ 44    
Expected to vest (in shares)     7,000,000    
Employee Stock          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Number of shares authorized (in shares)     60,000,000    
Number of shares available for grant (in shares)     23,000,000    
Offering period     6 months    
Purchase price of common stock percent     90.00%    
Minimum          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Award vesting period     3 years    
Maximum          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Award vesting period     5 years    
Oak Street Health Inc. | Pre-combination services          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Replacement equity awards for pre-combination services (in shares) 3,900,000        
Signify Health, Inc. | Pre-combination services          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Replacement equity awards for pre-combination services (in shares)   3,200,000      
CVS Health 2017 Incentive Compensation Plan          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Number of shares authorized (in shares)     92,000,000    
Number of shares available for grant (in shares)     33,000,000    
Oak Street Health Plan          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Number of shares authorized (in shares)       7,000,000  
Signify Plan          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Number of shares authorized (in shares)       9,000,000  
v3.25.0.1
Stock Incentive Plans - Stock-Based Compensation Expense (Details) - USD ($)
$ in Millions
8 Months Ended 9 Months Ended 12 Months Ended
Dec. 31, 2023
Dec. 31, 2023
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Stock-based compensation expense     $ 540 $ 588 $ 447
Oak Street Health Inc.          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Stock-based compensation expense $ 71   60    
Signify Health, Inc.          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Stock-based compensation expense   $ 72 41    
Restricted stock units and performance stock units          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Stock-based compensation expense     461 497 369
Stock options and SARs          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Stock-based compensation expense     $ 79 $ 91 $ 78
v3.25.0.1
Stock Incentive Plans - Restricted Stock Unit and Performance Stock Unit Activity (Details) - Restricted stock units and performance stock units
shares in Thousands
12 Months Ended
Dec. 31, 2024
$ / shares
shares
Units  
Unvested at beginning of period (in shares) 16,994
Granted (in shares) 9,978
Vested (in shares) (6,532)
Forfeited (in shares) (1,928)
Unvested at end of period (in shares) 18,512
Weighted average grant date fair value (in dollars per share)  
Unvested at beginning of year (in dollars per share) | $ / shares $ 77.65
Granted (in dollars per share) | $ / shares 75.97
Vested (in dollars per share) | $ / shares 76.08
Forfeited (in dollars per share) | $ / shares 78.71
Unvested at end of year (in dollars per share) | $ / shares $ 77.19
Restricted stock units and performance stock units vested if actual payout rates are applied (in shares) 6,600
v3.25.0.1
Stock Incentive Plans - Stock Option and SAR Activity (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Cash received from stock options exercised (including ESPP) $ 361,000 $ 277,000 $ 551,000
Payments for taxes for net share settlement of equity awards 185,000 181,000 370,000
Stock options and SARs      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Cash received from stock options exercised (including ESPP) 361,000 277,000 551,000
Payments for taxes for net share settlement of equity awards 185,000 181,000 370,000
Intrinsic value of stock options and SARs exercised 33,000 31,000 118,000
Fair value of stock options and SARs vested $ 225,000 $ 227,000 $ 219,000
Shares      
Shares, Outstanding at beginning of year (in shares) 15,126    
Shares granted (in shares) 4,435    
Shares exercised (in shares) (2,806)    
Shares forfeited (in shares) (1,046)    
Shares expired (in shares) (690)    
Shares, Outstanding at end of year (in shares) 15,019 15,126  
Weighted Average Exercise  Price      
Outstanding at beginning of year (in dollars per share) $ 68.13    
Granted (in dollars per share) 68.91    
Exercised (in dollars per share) 59.61    
Forfeited (in dollars per share) 79.05    
Expired (in dollars per share) 78.69    
Outstanding at end of year (in dollars per share) $ 68.69 $ 68.13  
Additional Disclosures      
Weighted average contractual term, outstanding at end of year 5 years 1 month 6 days    
Aggregate Intrinsic value outstanding at end of year $ 3,279    
Shares exercisable at end of year (in shares) 7,579    
Weighted average exercise price exercisable at end of year (in dollars per share) $ 65.01    
Weighted average remaining contractual term exercisable at end of year 3 years 3 months    
Aggregate intrinsic value exercisable at end of year $ 1,939    
Shares vested at end of year and expected to vest in the future (in shares) 14,646    
Weighted average exercise price vested at end of year and expected to vest in the future (in dollars per share) $ 68.66    
Weighted average remaining contractual term vested at end of year and expected to vest in the future 5 years 7 days    
Aggregate intrinsic value vested at end of year and expected to vest in the future $ 3,252    
v3.25.0.1
Stock Incentive Plans - Valuation Assumptions (Details) - $ / shares
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Stock Options      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Dividend yield 4.29% 3.27% 2.18%
Expected volatility 28.36% 28.15% 27.34%
Risk-free interest rate 4.13% 3.55% 2.46%
Expected life (in years) 5 years 3 months 18 days 5 years 10 months 24 days 6 years 3 months 18 days
Weighted-average grant date fair value (in dollars per share) $ 11.31 $ 21.78 $ 24.15
Employee Stock      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Dividend yield 2.01% 1.54% 1.12%
Expected volatility 31.40% 25.61% 23.54%
Risk-free interest rate 5.31% 5.17% 1.42%
Expected life (in years) 6 months 6 months 6 months
Weighted-average grant date fair value (in dollars per share) $ 12.39 $ 14.26 $ 16.25
SARs      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Dividend yield 4.29% 3.27% 2.18%
Expected volatility 28.36% 28.15% 27.34%
Risk-free interest rate 4.13% 3.55% 2.46%
Expected life (in years) 5 years 3 months 18 days 5 years 10 months 24 days 6 years 3 months 18 days
Weighted-average grant date fair value (in dollars per share) $ 11.31 $ 21.78 $ 24.15
v3.25.0.1
Shareholders' Equity - Share Repurchases (Details) - USD ($)
shares in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Nov. 17, 2022
Dec. 09, 2021
2022 Repurchase Program          
Equity, Class of Treasury Stock [Line Items]          
Stock repurchase program, authorized amount       $ 10,000,000,000.0  
Stock repurchase program, remaining authorized repurchase amount $ 10,000,000,000.0        
2021 Repurchase Program          
Equity, Class of Treasury Stock [Line Items]          
Stock repurchase program, authorized amount         $ 10,000,000,000.0
Stock repurchase program, remaining authorized repurchase amount $ 1,500,000,000        
Stock repurchased during the period (in shares) 39.7 22.8 34.1    
Stock repurchased during period, value $ 3,000,000,000 $ 2,000,000,000 $ 3,500,000,000    
v3.25.0.1
Shareholders' Equity - Accelerated Share Repurchases (Details) - 2021 Repurchase Program - USD ($)
shares in Millions, $ in Billions
Jan. 04, 2024
Jan. 04, 2023
Jan. 04, 2022
Mar. 31, 2024
Feb. 28, 2023
Feb. 28, 2022
Morgan Stanley            
Equity, Class of Treasury Stock [Line Items]            
ASR agreement, amount $ 3.0     $ 3.0    
Payments for ASR, amount $ 3.0          
ASR percent of notional amount received in shares 85.00%          
Shares repurchased under ASR agreement (in shares) 31.4     8.3    
Transfer of shares to treasury stock value $ 2.6          
ASR, shares to be received at the end of program as a percent of notional amount       15.00%    
Morgan Stanley | Forward Contracts            
Equity, Class of Treasury Stock [Line Items]            
Forward contract, notional amount $ 0.4          
Citibank, N.A.            
Equity, Class of Treasury Stock [Line Items]            
ASR agreement, amount   $ 2.0     $ 2.0  
Payments for ASR, amount   $ 2.0        
ASR percent of notional amount received in shares   80.00%        
Shares repurchased under ASR agreement (in shares)   17.4     5.4  
Transfer of shares to treasury stock value   $ 1.6        
ASR, shares to be received at the end of program as a percent of notional amount         20.00%  
Citibank, N.A. | Forward Contracts            
Equity, Class of Treasury Stock [Line Items]            
Forward contract, notional amount   $ 0.4        
Barclays Bank            
Equity, Class of Treasury Stock [Line Items]            
ASR agreement, amount     $ 1.5     $ 1.5
Payments for ASR, amount     $ 1.5      
ASR percent of notional amount received in shares     80.00%      
Shares repurchased under ASR agreement (in shares)     11.6     2.7
Transfer of shares to treasury stock value     $ 1.2      
ASR, shares to be received at the end of program as a percent of notional amount           20.00%
Barclays Bank | Forward Contracts            
Equity, Class of Treasury Stock [Line Items]            
Forward contract, notional amount     $ 0.3      
v3.25.0.1
Shareholders' Equity - Dividends (Details) - $ / shares
3 Months Ended 12 Months Ended
Dec. 31, 2024
Sep. 30, 2024
Jun. 30, 2024
Mar. 31, 2024
Dec. 31, 2023
Sep. 30, 2023
Jun. 30, 2023
Mar. 31, 2023
Dec. 31, 2022
Sep. 30, 2022
Jun. 30, 2022
Mar. 31, 2022
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Equity [Abstract]                              
Dividends declared per share (in dollars per share) $ 0.665 $ 0.665 $ 0.665 $ 0.665 $ 0.605 $ 0.605 $ 0.605 $ 0.605 $ 0.55 $ 0.55 $ 0.55 $ 0.55 $ 2.66 $ 2.42 $ 2.20
v3.25.0.1
Shareholders' Equity - Regulatory Requirements (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Statutory Accounting Practices [Line Items]      
Estimated minimum statutory surplus required by regulators $ 11,691    
Investments on deposit with regulatory bodies 713    
Estimated maximum dividend distributions permitted in 2025 without prior regulatory approval 1,561    
Insurance and HMO      
Statutory Accounting Practices [Line Items]      
Statutory net income (loss) (1,185) $ 2,757 $ 2,851
Estimated statutory capital and surplus 20,085 $ 16,961 $ 15,503
Dividends paid $ 755    
v3.25.0.1
Shareholders' Equity - Noncontrolling Interests (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Equity [Abstract]    
Noncontrolling interests $ 170 $ 175
v3.25.0.1
Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance $ 76,636 $ 71,769 $ 74,841
Other comprehensive income (loss) 177 967 (1,598)
End of year balance 75,730 76,636 71,769
AOCI Including Portion Attributable to Noncontrolling Interest      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance (297) (1,264) 334
End of year balance (120) (297) (1,264)
Net unrealized investment gains (losses)      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance (429) (1,519) 798
Other comprehensive income (loss) before reclassifications, net of tax (170) 603 (2,556)
Amounts reclassified from accumulated other comprehensive income (loss), net of tax 200 487 239
Other comprehensive income (loss) 30 1,090 (2,317)
End of year balance (399) (429) (1,519)
Other comprehensive income (loss) before reclassifications, pre-tax (177) 612 (3,021)
Amounts reclassified from accumulated other comprehensive income (loss), pre-tax 226 566 315
Change in discount rate on long-duration insurance reserves      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance 152 219 (651)
Other comprehensive income (loss) before reclassifications, net of tax 113 (67) 870
Other comprehensive income (loss) 113 (67) 870
End of year balance 265 152 219
Other comprehensive income (loss) before reclassifications, pre-tax 146 (92) 1,126
Foreign currency translation adjustments      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance 0 0 0
Other comprehensive income (loss) before reclassifications, net of tax (4) 0 0
Other comprehensive income (loss) (4) 0 0
End of year balance (4) 0 0
Net cash flow hedges      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance 244 239 222
Other comprehensive income (loss) before reclassifications, net of tax 0 19 28
Amounts reclassified from accumulated other comprehensive income (loss), net of tax (15) (14) (11)
Other comprehensive income (loss) (15) 5 17
End of year balance 229 244 239
Other comprehensive income (loss) before reclassifications, pre-tax 0 25 38
Amounts reclassified from accumulated other comprehensive income (loss), pre-tax (20) (19) (15)
Amount expected to be reclassified 16    
Pension and other postretirement benefits      
Changes in Accumulated Other Comprehensive Income (Loss) by Component      
Beginning of year balance (264) (203) (35)
Other comprehensive income (loss) before reclassifications, net of tax 53 (61) (170)
Amounts reclassified from accumulated other comprehensive income (loss), net of tax 0 0 2
Other comprehensive income (loss) 53 (61) (168)
End of year balance (211) (264) (203)
Other comprehensive income (loss) before reclassifications, pre-tax 71 (81) (229)
Amounts reclassified from accumulated other comprehensive income (loss), pre-tax $ 0 $ 0 $ 3
v3.25.0.1
Earnings Per Share (Details) - USD ($)
$ / shares in Units, shares in Millions, $ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Numerator for earnings per share calculation:      
Net income attributable to CVS Health, basic $ 4,614 $ 8,344 $ 4,311
Net income attributable to CVS Health, diluted $ 4,614 $ 8,344 $ 4,311
Denominator for earnings per share calculation:      
Weighted average shares, basic (in shares) 1,259 1,285 1,312
Weighted average shares, diluted (in shares) 1,262 1,290 1,323
Earnings per share:      
Basic (in dollars per share) $ 3.67 $ 6.49 $ 3.29
Diluted (in dollars per share) $ 3.66 $ 6.47 $ 3.26
Stock options and SARs      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Antidilutive securities excluded from computation of EPS (in shares) 8 8 4
Denominator for earnings per share calculation:      
Effect of dilutive securities (in shares) 1 2 5
Restricted stock units and performance stock units      
Denominator for earnings per share calculation:      
Effect of dilutive securities (in shares) 2 3 6
v3.25.0.1
Reinsurance - Narrative (Details) - Subsequent Event
1 Months Ended
Jan. 31, 2025
reinsurance_agreement
Ceded Credit Risk [Line Items]  
Number of reinsurance contracts entered into 3
Term of reinsurance agreements with unrelated issuer 4 years
v3.25.0.1
Reinsurance - Reinsurance Recoverables (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables $ 1,927 $ 1,998
Hartford Life and Accident Insurance Company    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables 1,119 1,314
Lincoln Life & Annuity Company of New York    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables 444 480
Individual State Reinsurance Programs    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables 189 61
Fresenius Medical Care Reinsurance Company (Cayman) Ltd.    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables 75 54
Resolution Life Group Holdings Ltd.    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables 33 35
All Other    
Ceded Credit Risk [Line Items]    
Total reinsurance recoverables $ 67 $ 54
v3.25.0.1
Reinsurance - Effects of Reinsurance (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Net Premiums      
Direct $ 123,629 $ 99,753 $ 85,670
Assumed 471 350 432
Ceded (1,204) (911) (772)
Net premiums 122,896 99,192 85,330
Net Health Care Costs      
Direct 115,974 86,738 71,357
Assumed 431 223 379
Ceded (1,284) (714) (663)
Net health care costs $ 115,121 $ 86,247 $ 71,073
v3.25.0.1
Commitments and Contingencies (Details)
$ in Millions
1 Months Ended 6 Months Ended 37 Months Ended
Aug. 31, 2022
USD ($)
Dec. 31, 2024
USD ($)
claim
state
lease
Dec. 31, 2024
USD ($)
state
claim
lease
Dec. 31, 2023
USD ($)
Commitments and Contingencies Disclosure [Abstract]        
Guarantor obligations, maximum exposure | $   $ 300 $ 300  
Contractual obligations underlying the guaranteed benefits | $   $ 857 $ 857 $ 834
Guarantor obligations, number of leases | lease   61 61  
Settlement Framework        
Loss Contingencies [Line Items]        
Number of states that elected to join the settlement | state   45 45  
Number of states under separate settlement agreements | state   4 4  
Federal Court in Ohio Judgment | Pending Litigation        
Loss Contingencies [Line Items]        
Legal settlement awarded to other party | $ $ 651      
Legal settlement, period of payment 15 years      
Fiduciary Duty Breach, Opioid Matter        
Loss Contingencies [Line Items]        
Number of claims filed     3  
Nixon v. CVS Health Corporation, et al.        
Loss Contingencies [Line Items]        
Number of claims filed   2    
In re CVS Health Corporation Derivative Litigation        
Loss Contingencies [Line Items]        
Number of claims filed   2    
In re CVS Health Corporation Stockholder Derivative Litigation        
Loss Contingencies [Line Items]        
Number of claims filed   2    
Goff v. Lynch, et al., Brodin v. Lynch, et al., and Davidow v. Lynch, et al.        
Loss Contingencies [Line Items]        
Number of claims filed   3    
v3.25.0.1
Segment Reporting - Narrative (Details) - segment
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Segment Reporting [Abstract]      
Number of reportable segments 4    
US Federal Government | Customer Concentration Risk | Revenues      
Concentration Risk [Line Items]      
Concentration risk, percent 24.00% 19.00% 18.00%
v3.25.0.1
Segment Reporting - Reconciliation of Financial Measures of Segments to Consolidated Totals (Details)
$ in Millions
1 Months Ended 3 Months Ended 12 Months Ended
Dec. 31, 2024
USD ($)
Sep. 30, 2024
store
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Segment Reporting Information [Line Items]          
Revenues from external customers     $ 370,656 $ 356,623 $ 321,629
Net investment income (loss)     2,153 1,153 838
Total revenues     372,809 357,776 322,467
Less: Net realized capital gains (losses)     117 (497) (320)
Cost of products sold     206,287 217,098 196,892
Health care costs     115,121 86,247 71,073
Reconciliation of principal measure of segment performance to consolidated operating income:          
Amortization of intangible assets     2,025 1,905 1,785
Net realized capital losses     (117) 497 320
Acquisition-related transaction and integration costs     243 487  
Restructuring charges     1,179 507 0
Office real estate optimization charges     30 46 117
Opioid litigation charges     100 0 5,803
Loss on assets held for sale     0 349 2,533
Gain on sale of subsidiaries     0 0 (475)
Operating income     8,516 13,743 7,954
Interest expense     2,958 2,658 2,287
Gain on early extinguishment of debt     (491) 0 0
Other income     (99) (88) (169)
Income before income tax provision     6,148 11,173 5,836
Depreciation and amortization     4,597 4,366 4,224
Number of stores, planned closure | store   271      
Senior Notes          
Reconciliation of principal measure of segment performance to consolidated operating income:          
Gain on early extinguishment of debt $ (491)        
Principal amount of debt repaid $ 2,600        
Health Care Benefits          
Segment Reporting Information [Line Items]          
Revenues from external customers     129,120 104,800 90,798
Net investment income (loss)     1,473 765 476
Reconciliation of principal measure of segment performance to consolidated operating income:          
Depreciation and amortization     1,599 1,572 1,579
Health Services          
Segment Reporting Information [Line Items]          
Revenues from external customers     158,016 174,018 157,968
Net investment income (loss)     285 (1) 0
Reconciliation of principal measure of segment performance to consolidated operating income:          
Depreciation and amortization     1,059 880 519
Pharmacy & Consumer Wellness          
Segment Reporting Information [Line Items]          
Revenues from external customers     83,464 77,748 72,739
Net investment income (loss)     0 (5) (44)
Reconciliation of principal measure of segment performance to consolidated operating income:          
Depreciation and amortization     1,543 1,549 1,889
Corporate/ Other          
Segment Reporting Information [Line Items]          
Revenues from external customers     56 57 124
Net investment income (loss)     395 394 406
Reconciliation of principal measure of segment performance to consolidated operating income:          
Depreciation and amortization     396 365 237
Intersegment Eliminations          
Segment Reporting Information [Line Items]          
Net investment income (loss)     0 0 0
Total revenues     (56,412) (51,927) (47,585)
Intersegment Eliminations | Health Care Benefits          
Segment Reporting Information [Line Items]          
Total revenues     (72) (81) (76)
Intersegment Eliminations | Health Services          
Segment Reporting Information [Line Items]          
Total revenues     (15,304) (12,826) (11,608)
Intersegment Eliminations | Pharmacy & Consumer Wellness          
Segment Reporting Information [Line Items]          
Total revenues     (41,036) (39,020) (35,901)
Operating Segments and Corporate Non-Segment          
Segment Reporting Information [Line Items]          
Total revenues     429,221 409,703 370,052
Adjusted operating income (loss)     11,976 17,534 18,037
Operating Segments | Health Care Benefits          
Segment Reporting Information [Line Items]          
Net investment income (loss)     1,473 765 476
Total revenues     130,665 105,646 91,350
Less: Net realized capital gains (losses)     (97) (402) (225)
Cost of products sold     0 0 0
Health care costs     113,659 85,504 71,473
Other segment items     16,796 14,967 13,764
Adjusted operating income (loss)     307 5,577 6,338
Reconciliation of principal measure of segment performance to consolidated operating income:          
Net realized capital losses     97 402 225
Operating Segments | Health Services          
Segment Reporting Information [Line Items]          
Net investment income (loss)     285 (1) 0
Total revenues     173,605 186,843 169,576
Less: Net realized capital gains (losses)     289 0 0
Cost of products sold     160,036 175,424 160,738
Health care costs     3,407 1,607 0
Other segment items     2,630 2,500 2,057
Adjusted operating income (loss)     7,243 7,312 6,781
Reconciliation of principal measure of segment performance to consolidated operating income:          
Net realized capital losses     (289) 0 0
Copayments     11,400 13,700 12,600
Operating Segments | Pharmacy & Consumer Wellness          
Segment Reporting Information [Line Items]          
Net investment income (loss)     0 (5) (44)
Total revenues     124,500 116,763 108,596
Less: Net realized capital gains (losses)     0 (5) (44)
Cost of products sold     99,337 91,447 82,063
Health care costs     0 0 0
Other segment items     19,389 19,358 20,046
Adjusted operating income (loss)     5,774 5,963 6,531
Reconciliation of principal measure of segment performance to consolidated operating income:          
Net realized capital losses     0 5 44
Corporate/ Other | Corporate/ Other          
Segment Reporting Information [Line Items]          
Net investment income (loss)     395 394 406
Total revenues     451 451 530
Less: Net realized capital gains (losses)     (75) (90) (51)
Cost of products sold     0 1 42
Health care costs     187 210 249
Other segment items     1,687 1,648 1,903
Adjusted operating income (loss)     (1,348) (1,318) (1,613)
Reconciliation of principal measure of segment performance to consolidated operating income:          
Net realized capital losses     $ 75 $ 90 $ 51