ELEVANCE HEALTH, INC., 10-K filed on 2/20/2025
Annual Report
v3.25.0.1
Cover Page - USD ($)
12 Months Ended
Dec. 31, 2024
Feb. 01, 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 001-16751    
Entity Registrant Name ELEVANCE HEALTH, INC.    
Entity Incorporation, State or Country Code IN    
Entity Tax Identification Number 35-2145715    
Entity Address, Address Line One 220 Virginia Avenue    
Entity Address, City or Town Indianapolis    
Entity Address, State or Province IN    
Entity Address, Postal Zip Code 46204    
City Area Code (833)    
Local Phone Number 401-1577    
Title of 12(b) Security Common Stock, Par Value $0.01    
Trading Symbol ELV    
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     $ 116,687,067,115
Entity Common Stock, Shares Outstanding   227,351,871  
Documents Incorporated by Reference
Part III of this Annual Report on Form 10-K incorporates by reference information from the registrant’s Definitive Proxy Statement for the Annual Meeting of Shareholders to be held May 14, 2025.
   
Amendment Flag false    
Document Fiscal Year Focus 2024    
Document Fiscal Period Focus FY    
Entity Central Index Key 0001156039    
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Audit Information
12 Months Ended
Dec. 31, 2024
Auditor Information [Abstract]  
Auditor Firm ID 42
Auditor Name Ernst & Young LLP
Auditor Location Indianapolis, Indiana
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Consolidated Balance Sheets - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Current assets:    
Cash and cash equivalents $ 8,288 $ 6,526
Fixed maturity securities (amortized cost of $25,879 and $30,446; allowance for credit losses of $6 and $4) 25,201 29,614
Equity securities 1,192 229
Premium receivables 8,011 7,902
Self-funded receivables 5,044 4,558
Other receivables 6,016 5,405
Other current assets 4,700 5,795
Assets held for sale 490 0
Total current assets 58,942 60,029
Long-term investments:    
Fixed maturity securities (amortized cost of $1,049 and $890; allowance for credit losses of $0 and $0) 1,035 876
Other invested assets 9,749 6,107
Property and equipment, net 4,652 4,359
Goodwill 28,277 25,317
Other intangible assets 12,094 10,273
Other noncurrent assets 2,140 1,967
Total assets 116,889 108,928
Current liabilities:    
Medical claims payable 15,746 16,111
Other policyholder liabilities 4,204 5,600
Unearned income 1,508 1,402
Accounts payable and accrued expenses 6,927 6,910
Short-term borrowings 365 225
Current portion of long-term debt 1,649 1,649
Other current liabilities 10,029 9,894
Liabilities held for sale 153 0
Total current liabilities 40,581 41,791
Long-term debt, less current portion 29,218 23,246
Reserves for future policy benefits 190 778
Deferred tax liabilities, net 2,148 1,970
Other noncurrent liabilities 3,326 1,738
Total liabilities 75,463 69,523
Commitments and Contingencies—Note 14
Shareholders’ equity    
Preferred stock, without par value, shares authorized - 100,000,000; shares issued and outstanding - none 0 0
Common stock, par value $0.01, shares authorized - 900,000,000; shares issued and outstanding - 227,479,695 and 233,071,088 2 2
Additional paid-in capital 8,911 8,868
Retained earnings 33,549 31,749
Accumulated other comprehensive loss (1,147) (1,313)
Total shareholders’ equity 41,315 39,306
Noncontrolling interests 111 99
Total equity 41,426 39,405
Total liabilities and equity $ 116,889 $ 108,928
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Consolidated Balance Sheets (Parenthetical) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Statement of Financial Position [Abstract]    
Fixed maturities, amortized cost, current $ 25,879 $ 30,446
Fixed maturities, allowance for credit loss, current 6 4
Fixed maturities, amortized cost, noncurrent 1,049 890
Fixed maturities, allowance for credit Loss, noncurrent $ 0 $ 0
Preferred stock, shares authorized (in shares) 100,000,000 100,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 900,000,000 900,000,000
Common stock, shares issued (in shares) 227,479,695 233,071,088
Common stock, shares outstanding (in shares) 227,479,695 233,071,088
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Consolidated Statements of Income - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Revenues      
Premiums $ 144,166 $ 142,854 $ 133,229
Total operating revenue 175,204 170,209 155,660
Net investment income 2,051 1,825 1,485
Net losses on financial instruments (445) (694) (550)
Gain on sale of business 201 0 0
Total revenues 177,011 171,340 156,595
Expenses      
Benefit expense 127,567 124,330 116,642
Cost of products sold 19,750 17,293 13,035
Operating expense 20,025 20,087 17,700
Interest expense 1,185 1,030 851
Amortization of other intangible assets 580 885 767
Total expenses 169,107 163,625 148,995
Income before income tax expense 7,904 7,715 7,600
Income tax expense 1,933 1,724 1,712
Net income 5,971 5,991 5,888
Net loss (gain) attributable to noncontrolling interests 9 (4) 6
Shareholders’ net income $ 5,980 $ 5,987 $ 5,894
Shareholders’ earnings per share      
Basic (in dollars per share) $ 25.81 $ 25.38 $ 24.56
Diluted (in dollars per share) $ 25.68 $ 25.22 $ 24.28
Product revenue      
Revenues      
Product and service revenue $ 22,630 $ 19,452 $ 14,978
Service fees      
Revenues      
Product and service revenue $ 8,408 $ 7,903 $ 7,453
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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 $ 5,971 $ 5,991 $ 5,888
Other comprehensive income (loss), net of tax:      
Change in net unrealized gains/losses on investments 103 1,117 (2,260)
Change in non-credit component of impairment losses on investments 1 0 (3)
Change in net unrealized gains/losses on cash flow hedges 4 18 10
Change in net periodic pension and other benefit costs 60 40 (70)
Change in future policy benefits (2) (3) 32
Foreign currency translation adjustments (6) (1) (13)
Other comprehensive income (loss) 160 1,171 (2,304)
Net loss (gain) attributable to noncontrolling interests 9 (4) 6
Other comprehensive loss attributable to noncontrolling interests 6 6 11
Total shareholders’ comprehensive income $ 6,146 $ 7,164 $ 3,601
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Consolidated Statements of Cash Flows
$ in Millions
12 Months Ended
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Operating activities      
Net income $ 5,971 $ 5,991 $ 5,888
Adjustments to reconcile net income to net cash provided by operating activities:      
Net losses on financial instruments 445 694 550
Gain on sale of business (201) 0 0
Equity in net earnings (losses) of other invested assets (1) 33 (293)
Depreciation and amortization 1,393 1,745 1,675
Deferred income taxes (374) (602) (115)
Impairment of property, equipment and right-of-use assets 103 446 7
Share-based compensation 191 289 264
Changes in operating assets and liabilities:      
Receivables, net (683) (1,762) (2,510)
Other invested assets (78) (79) 11
Other assets 824 (675) 133
Policy liabilities (1,840) 147 2,411
Unearned income (113) 290 (42)
Accounts payable and other liabilities (272) 1,640 824
Income taxes 404 (103) (338)
Other, net 39 7 (66)
Net cash provided by operating activities 5,808 8,061 8,399
Investing activities      
Purchases of investments (17,986) (16,236) (24,946)
Proceeds from sale of investments 16,547 10,596 11,988
Maturities, calls and redemptions from investments 2,025 2,940 10,620
Changes in securities lending collateral 73 78 (301)
Purchases of subsidiaries, net of cash acquired (4,809) (1,552) (649)
Proceeds from sales of subsidiaries, net of cash sold 363 0 0
Purchases of property and equipment (1,256) (1,296) (1,152)
Other, net (124) (102) (120)
Net cash used in investing activities (5,167) (5,572) (4,560)
Financing activities      
Proceeds from long-term borrowings 7,710 2,574 3,071
Repayments of long-term borrowings (1,650) (1,909) (1,899)
Proceeds from short-term borrowings 275 225 1,365
Repayments of short-term borrowings (135) (265) (1,675)
Changes in securities lending payable (75) (77) 302
Changes in bank overdrafts (638) 114 933
Repurchase and retirement of common stock (2,900) (2,676) (2,316)
Cash dividends (1,508) (1,395) (1,229)
Proceeds from issuance of common stock under employee stock plans 221 152 182
Taxes paid through withholding of common stock under employee stock plans (109) (99) (93)
Other, net 2 7 41
Net cash provided by (used in) financing activities 1,193 (3,349) (1,318)
Effect of foreign exchange rates on cash and cash equivalents (6) (1) (14)
Change in cash and cash equivalents 1,828 (861) 2,507
Cash and cash equivalents at beginning of year 6,526 7,387 4,880
Less cash and cash equivalents included in assets held for sale at end of year (66) 0 0
Cash and cash equivalents at end of year $ 8,288 $ 6,526 $ 7,387
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Consolidated Statements of Shareholders’ Equity - USD ($)
shares in Millions, $ in Millions
Total
Common Stock
Additional Paid-in Capital
Retained Earnings
Accumulated Other Comprehensive (Loss) Income
Noncontrolling Interests
Beginning balance (in shares) at Dec. 31, 2021   241.8        
Beginning balance at Dec. 31, 2021 $ 36,140 $ 2 $ 9,148 $ 27,119 $ (197) $ 68
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 5,888     5,894   (6)
Other comprehensive income (loss) (2,304)       (2,293) (11)
Noncontrolling interests adjustment 36         36
Repurchase and retirement of common stock (in shares)   (4.8)        
Repurchase and retirement of common stock (2,316)   (184) (2,132)    
Dividends and dividend equivalents (1,234)     (1,234)    
Issuance of common stock under employee stock plans, net of related tax benefits (in shares)   1.0        
Issuance of common stock under employee stock plans, net of related tax benefits 352   352      
Convertible debenture repurchases and conversions (232)   (232)      
Ending balance (in shares) at Dec. 31, 2022   238.0        
Ending balance at Dec. 31, 2022 36,330 $ 2 9,084 29,647 (2,490) 87
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 5,991     5,987   4
Other comprehensive income (loss) 1,171       1,177 (6)
Noncontrolling interests adjustment $ 14         14
Repurchase and retirement of common stock (in shares) (5.8) (5.8)        
Repurchase and retirement of common stock $ (2,676)          
Repurchase and retirement of common stock, including excise tax (2,698)   (217) (2,481)    
Dividends and dividend equivalents (1,404)     (1,404)    
Issuance of common stock under employee stock plans, net of related tax benefits (in shares)   0.9        
Issuance of common stock under employee stock plans, net of related tax benefits 342   342      
Convertible debenture repurchases and conversions (341)   (341)      
Ending balance (in shares) at Dec. 31, 2023   233.1        
Ending balance at Dec. 31, 2023 39,405 $ 2 8,868 31,749 (1,313) 99
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Net income (loss) 5,971     5,980   (9)
Other comprehensive income (loss) 160       166 (6)
Noncontrolling interests adjustment $ 27         27
Repurchase and retirement of common stock (in shares) (6.7) (6.7)        
Repurchase and retirement of common stock $ (2,900)          
Repurchase and retirement of common stock, including excise tax (2,924)   (262) (2,662)    
Dividends and dividend equivalents (1,518)     (1,518)    
Issuance of common stock under employee stock plans, net of related tax benefits (in shares)   1.1        
Issuance of common stock under employee stock plans, net of related tax benefits 305   305      
Ending balance (in shares) at Dec. 31, 2024   227.5        
Ending balance at Dec. 31, 2024 $ 41,426 $ 2 $ 8,911 $ 33,549 $ (1,147) $ 111
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Organization
12 Months Ended
Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization Organization
References to the terms “we,” “our,” “us” or “Elevance Health” used throughout these Notes to Consolidated Financial Statements refer to Elevance Health, Inc., an Indiana corporation, and unless the context otherwise requires, its direct and indirect subsidiaries. References to the “states” include the District of Columbia and Puerto Rico, unless the context otherwise requires.
Elevance Health is a health company with the purpose of improving the health of humanity. We are one of the largest health insurers in the United States in terms of medical membership, serving approximately 45.7 million medical members through our affiliated health plans as of December 31, 2024. We offer a broad spectrum of network-based managed care risk-based plans to Individual, Employer Group, Medicaid and Medicare markets. In addition, we provide a broad array of managed care services to fee-based customers, including claims processing, stop loss insurance, provider network access, medical management, care management, wellness programs, actuarial services and other administrative services. We provide services to the federal government in connection with our Federal Health Products & Services business, which administers the Federal Employee Program® (“FEP®”). We provide an array of specialty services both to customers of our subsidiary health plans and to unaffiliated health plans, including pharmacy services, stop loss insurance, dental, vision and supplemental health insurance benefits, as well as integrated health services.
We are an independent licensee of the Blue Cross and Blue Shield Association (“BCBSA”), an association of independent health benefit plans. We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield (“BCBS”) licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and upstate New York), Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.) and Wisconsin. In a majority of these service areas, we do business as Anthem Blue Cross and Anthem Blue Cross and Blue Shield. We also conduct business through arrangements with other BCBS licensees as well as other strategic partners. In addition, we serve members in numerous states as Wellpoint, Carelon, MMM and/or Simply Healthcare. We are licensed to conduct insurance operations in all 50 states, the District of Columbia and Puerto Rico through our subsidiaries.
We have organized our brand portfolio into the following core go-to-market brands:
Anthem Blue Cross/Anthem Blue Cross and Blue Shield — represents our Anthem-branded and affiliated Blue Cross and/or Blue Shield licensed plans;
Wellpoint — unites select non-BCBSA licensed Medicare, Medicaid and commercial plans under the Wellpoint name; and
Carelon — this brand brings together our healthcare related services and capabilities, including our CarelonRx and Carelon Services businesses, under a single brand name.
We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other (our businesses that do not individually meet the quantitative thresholds for an operating segment, as well as corporate expenses not allocated to our other reportable segments). For additional discussion, see Note 20, “Segment Information.”
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Basis of Presentation and Significant Accounting Policies
12 Months Ended
Dec. 31, 2024
Accounting Policies [Abstract]  
Basis of Presentation and Significant Accounting Policies Basis of Presentation and Significant Accounting Policies
Basis of Presentation: The accompanying consolidated financial statements include the accounts of Elevance Health and its subsidiaries and have been prepared in conformity with U.S. generally accepted accounting principles (“GAAP”). All significant intercompany accounts and transactions have been eliminated in consolidation. Our consolidated financial
statements include the accounts of Elevance Health, Inc. and subsidiaries that we control, including variable interest entities for which we are the primary beneficiary. We are considered the primary beneficiary if we have the power to direct the variable interest entity's most significant economic activities, and we have the right to receive benefits or obligations to absorb losses that could be significant to the entity. We evaluate the following criteria: (1) the structure and purpose of the entity; (2) the risks and rewards created by and shared through the entity; and (3) our ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity.
Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income.
Reclassifications: Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates: The preparation of consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our most significant estimate relates to estimates and judgments for medical claims payable. Actual results could differ from those estimates.
Cash and Cash Equivalents: Cash and cash equivalents includes available cash and all highly liquid investments with maturities of three months or less when purchased. We control a number of bank accounts that are used exclusively to hold customer funds for the administration of customer benefits, and we have cash and cash equivalents on deposit to meet certain regulatory requirements. These amounts totaled $409 and $294 at December 31, 2024 and 2023, respectively, and are included in the cash and cash equivalents line on our consolidated balance sheets.
Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity.
If a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive loss. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive loss.
The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default.
For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income.
The changes in fair value of our marketable equity securities are recognized in our results of operations within net gains and losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations and are reported under the caption “Other invested assets” in our consolidated balance sheets.
Mortgage loans on real estate are classified as held for investment and are reported at their amortized cost basis net of loss allowance under the caption “Other invested assets” in our consolidated balance sheets. Amortized cost is the amount at which the loan is originated, adjusted for accrued interest, amortization of premium, discount and net deferred fees or costs, collection of cash and write-offs.
We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets.
We have investments in limited partnerships (“LPs”) and companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company, including unconsolidated variable interest entities. These investments are accounted for using the equity method of accounting and are reported within “Other invested assets” in our consolidated balance sheets. Our proportionate share of equity in net income for these LPs and unconsolidated investee companies is reported within “Net investment income” in our consolidated statements of income. The carrying value of these investments are written down, or impaired, to fair value when a decline in value is considered to be other-than temporary. In applying the equity method (including assessment for other-than temporary impairment), we use financial information provided by the LPs and investee companies, generally on a one-to three-month lag. We consolidate investee companies in certain other instances where it is deemed to exercise control, or is considered the primary beneficiary of a variable interest entity.
Investment income is recorded when earned. All securities sold resulting in investment realized gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold.
We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. Under Financial Accounting Standards Board (“FASB”) guidance related to accounting for transfers and servicing of financial assets and extinguishments of liabilities, we recognize the collateral as an asset, which is reported in Other current assets on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported in Other current liabilities. The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive income as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments.
Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts.
Premium receivables include the uncollected amounts from insured groups, individuals and government programs. Premium receivables are reported net of an allowance for doubtful accounts of $183 and $212 at December 31, 2024 and 2023, respectively.
Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers. Self-funded receivables are reported net of an allowance for doubtful accounts of $115 and $87 at December 31, 2024 and 2023, respectively.
Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades that have not yet settled, accrued investment income and other miscellaneous amounts due
to us. These receivables are reported net of an allowance for doubtful accounts of $1,385 and $941 at December 31, 2024 and 2023, respectively.
Income Taxes: We file a consolidated U.S. federal income tax return. Deferred income tax assets and liabilities are recognized for temporary differences between the financial statement and tax return basis of assets and liabilities based on enacted tax rates and laws and are reported net on our consolidated balance sheets. The deferred tax benefits of the deferred tax assets are recognized to the extent realization of such benefits is more likely than not. Deferred income tax expense or benefit generally represents the net change in deferred income tax assets and liabilities during the year, excluding the impact from amounts initially recorded for business combinations, if any, and amounts recorded to accumulated other comprehensive income. Current income tax expense represents the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported.
The Internal Revenue Code subjects a U.S. shareholder to tax on Global Intangible Low-Taxed Income (“GILTI”) earned by certain foreign subsidiaries. We have elected to account for GILTI tax in the year the tax is incurred.
The Inflation Reduction Act of 2022 includes a provision that imposes a new corporate alternative minimum tax (the “Corporate AMT”) that became effective for us beginning January 1, 2023. We have elected to account for the effects of the Corporate AMT on deferred tax assets and carryforwards and tax credits in the period they arise. We have also elected to disregard Corporate AMT when evaluating the need for a valuation allowance for non-Corporate AMT deferred tax assets. We do not believe the Corporate AMT will have a material impact on our consolidated financial position, results of operations, cash flows or related disclosures. Additionally, the Inflation Reduction Act of 2022 imposes an excise tax on the fair market value of net stock repurchases made after December 31, 2022. These are included as a charge to retained earnings as a component of the repurchase and retirement of common stock.
We account for income tax contingencies in accordance with FASB guidance that contains a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing a minimum recognition threshold, which all income tax positions must achieve before being recognized in the financial statements.
Property and Equipment: Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation is computed principally by the straight-line method over estimated useful lives ranging from fifteen to thirty years for buildings and improvements, three to five years for computer equipment and software, and seven years for furniture and other equipment. Leasehold improvements are depreciated over the term of the related lease. Certain costs related to the development or purchase of internal-use software are capitalized and amortized over estimated useful lives ranging from three to ten years.
Goodwill and Other Intangible Assets: FASB guidance requires business combinations to be accounted for using the acquisition method of accounting, and it also specifies the types of acquired intangible assets that are required to be recognized and reported separately from goodwill. Goodwill represents the excess of the cost of acquisition over the fair value of net assets acquired, including other intangible assets. Other intangible assets represent the values assigned to customer relationships, provider and hospital networks, Blue Cross and Blue Shield and other trademarks, licenses and other agreements, such as non-compete agreements. Goodwill and other intangible assets are allocated to reportable segments based on the relative fair value of the components of the businesses acquired.
Goodwill and other intangible assets with indefinite lives are not amortized but are tested for impairment at least annually. Goodwill and other intangible assets are allocated to reporting units for purposes of the annual goodwill impairment test. Other intangible assets with indefinite lives, such as trademarks, are tested for impairment separately. We complete our annual impairment tests of existing goodwill and other intangible assets with indefinite lives during the fourth quarter of each year. Our impairment tests require us to make assumptions and judgments regarding the estimated fair value of our reporting units, including goodwill and other intangible assets with indefinite lives. Certain interim impairment tests are also performed when potential impairment indicators exist or changes in our business or other triggering events occur.
FASB guidance allows for qualitative assessments of whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount for purposes of a goodwill impairment analysis and whether it is more likely than not that an indefinite-lived intangible asset is impaired for purposes of an indefinite-lived intangible asset impairment analysis. Estimated fair values developed based on our assumptions and judgments might be different if other reasonable assumptions and estimates were to be used. Qualitative analysis involves assessing situations and developments that could affect key
drivers used to evaluate whether the fair value of our goodwill and indefinite-lived intangible assets is impaired. Our procedures include assessing our financial performance, macroeconomic conditions, industry and market considerations, various asset specific factors, and entity specific events.
Quantitative analysis must be performed if qualitative analyses are not conclusive. Entities also have the option to bypass the assessment of qualitative factors and proceed directly to performing quantitative analyses. Fair value for purposes of a quantitative goodwill impairment test is calculated using a blend of the projected income and market valuation approaches. The projected income approach is developed using assumptions about future revenue, expenses and net income derived from our internal planning process. Our assumed discount rate is based on our industry’s weighted-average cost of capital and reflects volatility associated with the cost of equity capital. Market valuations include market comparisons to publicly traded companies in our industry and are based on observed multiples of certain measures including revenue; earnings before interest, taxes, depreciation and amortization (“EBITDA”); and book value of invested capital.
A goodwill impairment loss is recognized to the extent that the carrying amount exceeds the asset’s estimated fair value. This determination consists of a one-step test comparing the estimated fair value of a reporting unit, including goodwill, to its carrying amount. If the carrying amount of a reporting unit exceeds its estimated fair value, an impairment loss is recognized. This goodwill impairment loss is equal to the excess of the reporting unit’s carrying amount over its estimated fair value, which is recorded in the results of operations.
Fair value for purposes of a quantitative impairment test for indefinite-lived intangible assets is estimated using a projected income approach. We recognize an impairment loss when the estimated fair value of indefinite-lived intangible assets is less than the carrying value, which is recorded in the results of operations. If significant impairment indicators are noted relative to other intangible assets subject to amortization, we may be required to record impairment losses against future income.
Derivative Financial Instruments: We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, collars, swaptions, embedded derivatives and warrants. Derivatives embedded within non-derivative instruments, such as options embedded in convertible fixed maturity securities, are bifurcated from the host instrument when the embedded derivative is not clearly and closely related to the host instrument. Our use of derivatives is limited by statutes and regulations promulgated by the various regulatory bodies to which we are subject, and by our own derivative policy. Our derivative use is generally limited to hedging purposes, on an economic basis, and we generally do not use derivative instruments for speculative purposes.
We have exposure to economic losses due to interest rate risk arising from changes in the level or volatility of interest rates. We attempt to mitigate our exposure to interest rate risk through active portfolio management, including rebalancing our existing portfolios of assets and liabilities, as well as changing the characteristics of investments to be purchased or sold in the future. In addition, derivative financial instruments are used to modify the interest rate exposure of certain liabilities or forecasted transactions. These strategies include the use of interest rate swaps and forward contracts, which are used to lock-in interest rates or to hedge, on an economic basis, interest rate risks associated with variable rate debt. We have used these types of instruments as designated hedges against specific liabilities.
All investments in derivatives are recorded as assets or liabilities at fair value, except certain put and call options on large blocks of equity securities. Put and call options on large blocks of equity securities are initially recorded at fair value; however, they are not subsequently marked to market. If certain correlation, hedge effectiveness and risk reduction criteria are met, a derivative may be specifically designated as a hedge of exposure to changes in fair value or cash flow. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the nature of any hedge designation thereon. Amounts excluded from the assessment of hedge effectiveness, if any, are reported in results of operations immediately. If the derivative is not designated as a hedge, the gain or loss resulting from the change in the fair value of the derivative is recognized in results of operations in the period of change. Cash flows associated with the settlement of non-designated derivatives are shown on a net basis in investing activity in our consolidated statements of cash flow.
From time to time, we may also purchase derivatives to hedge, on an economic basis, our exposure to foreign currency exchange fluctuations associated with the operations of certain of our subsidiaries. We generally use futures or forward
contracts for these transactions. We generally do not designate these contracts as hedges and, accordingly, the changes in fair value of these derivatives are recognized in results of operations immediately.
As part of our international operations, we conduct transactions in foreign currencies, which exposes us to risks associated with fluctuations in foreign currency exchange rates. To manage this exposure, we utilize forward contracts to hedge expenses that are denominated in currencies other than the U.S. dollar. These forward contracts are designated as cash flow hedges and qualify for hedge accounting treatment under the applicable accounting standards.
Credit exposure associated with non-performance by the counterparties to derivative instruments is generally limited to the uncollateralized fair value of the asset related to instruments recognized in the consolidated balance sheets. We attempt to mitigate the risk of non-performance by selecting counterparties with high credit ratings and monitoring their creditworthiness and by diversifying derivatives among multiple counterparties. At December 31, 2024, we believe there were no material concentrations of credit risk with any individual counterparty.
We generally enter into master netting agreements, which reduce credit risk by permitting net settlement of transactions with the same counterparty. Certain of our derivative agreements also contain credit support provisions that require us or the counterparty to post collateral if there are declines in the derivative fair value or our credit rating. The derivative assets and derivative liabilities are reported at their fair values net of collateral and netting by the counterparty.
Retirement Benefits: We recognize the funded status of pension and other postretirement benefit plans on the consolidated balance sheets based on fiscal-year-end measurements of plan assets and benefit obligations. Prepaid pension benefits represent prepaid costs related to defined benefit pension plans and are reported with other noncurrent assets. Prepaid postretirement benefits represent prepaid costs related to retiree medical, life, vision and dental benefits and are reported with other noncurrent assets.
We determine the expected return on plan assets using the calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over three years. We apply a corridor approach to amortize unrecognized actuarial gains or losses. Under this approach, only accumulated net actuarial gains or losses in excess of 10% of the greater of the projected benefit obligation or the fair value of plan assets are amortized over the average remaining service or lifetime of the workforce as a component of net periodic benefit cost.
The discount rate reflects the current rate at which the pension liabilities could be effectively settled at the end of the year based on our most recent measurement date. We use the annual spot rate approach for setting our discount rate. Under the spot rate approach, individual spot rates from a full yield curve of published rates are used to discount each plan’s cash flows to determine the plan’s obligations.
The assumed healthcare cost trend rates used to measure the expected cost of other postretirement benefits are based on an initial assumed healthcare cost trend rate declining to an ultimate healthcare cost trend rate over a select number of years.
Medical Claims Payable: Liabilities for medical claims payable include estimated provisions for incurred but not paid claims on an undiscounted basis, as well as estimated provisions for expenses related to the processing of claims. Incurred but not paid claims include (1) an estimate for claims that are incurred but not reported; (2) claims reported to us but not yet processed through our systems; and (3) claims reported to us and processed through our systems but not yet paid.
Liabilities for claims incurred but not reported and reported but not yet processed through our systems are determined in the aggregate, employing actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. Our reserving practice for claim liabilities is to consistently recognize the appropriate amount of reserve within a level of confidence required by Actuarial Standards of Practice. We determine the amount of the liability for incurred but not yet reported or processed claims by following a detailed actuarial process that uses both historical claim payment patterns as well as emerging medical cost trends to project our best estimate of claim liabilities. Under this process, historical paid claims data is formatted into “claim triangles,” which compare claim incurred dates to the dates of claim payments. This information is analyzed to create “completion factors” that represent the average percentage of total incurred claims that have been paid through a given date after being incurred. Completion factors are applied to claims paid through the period-end date to estimate the ultimate claim expense incurred for the period. Actuarial estimates of incurred but not paid claim liabilities are then determined by subtracting the actual paid claims from the estimate of the ultimate incurred claims.
For the most recent incurred months (typically the most recent two months), the percentage of claims paid for claims incurred in those months is generally low. This makes the completion factor methodology less reliable for such months. Therefore, incurred claims for recent months are not projected from historical completion and payment patterns; rather, they are projected by estimating the claims expense for those months based on recent claims expense levels and healthcare trend levels (“trend factors”).
On a regular basis, we review cost trends and utilization assumptions set upon initial establishment of claim liabilities. We utilize subsequent paid claims activity to monitor and continuously adjust the claims liability and benefit expense. If actual results are determined to be materially different than assumptions regarding cost trends and utilization, future periods of our income statement and overall financial position could be impacted.
Premium deficiencies are recognized when it is probable that expected claims plus administrative expenses will exceed future premiums on existing medical insurance contracts without consideration of investment income. For purposes of evaluating premium deficiencies, contracts are deemed to be either short or long duration and are grouped in a manner consistent with our method of acquiring, servicing and measuring the profitability of such contracts. Once established, reserves for premium deficiencies are released commensurate with actual claims experience over the remaining life of the contract. No reserves for premium deficiencies were established at December 31, 2024 or 2023.
Benefit expense includes incurred medical claims as well as quality improvement expenses for our risk-based members. Quality improvement activities are those designed to improve member health outcomes, prevent hospital readmissions and improve patient safety. They also include expenses for wellness and health promotion provided to our members.
 Other Policyholder Liabilities: Other policyholder liabilities include rate stabilization reserves associated with retrospectively rated insurance contracts and certain case-specific reserves. Rate stabilization reserves represent accumulated premiums that exceed what customers owe us based on actual claim experience. The timing of payment of these retrospectively rated refunds is based on the contractual terms with our customers and can vary from period to period based on the specific contractual requirements.
Other policyholder liabilities also include liabilities for premium refunds based upon the minimum medical loss ratio (“MLR”). We are required to meet certain minimum MLR thresholds prescribed by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”). If we do not meet or exceed the minimum MLR thresholds specified by the ACA, we are required to pay rebates to certain customers. Minimum MLR rebates are calculated by subsidiary, state and applicable line of business in accordance with regulations issued by the US Department of Health and Human Services (“HHS”). Such calculations are made using estimated calendar year medical loss expense and premiums, as defined by HHS.
We follow HHS guidelines for determining the types of expenses that may be included in our minimum MLR rebate calculations, which differ from benefit expense and premiums as reported in our consolidated financial statements prepared in conformity with GAAP. Certain amounts reported as expense in our consolidated GAAP financial statements may be reported as a reduction of premiums in accordance with HHS regulations. In addition, profit amounts included in our payments to third-party administrative service providers are recorded as benefit expense in our consolidated GAAP financial statements, while HHS does not allow for the inclusion of these expenses within the medical loss expense for purposes of calculating minimum MLR.
Also included are our risk-adjustment payables for certain risk-adjustment programs. The risk-adjustment programs reallocate funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our payable based on the risk of our customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and HHS. Payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.
Reserves for Future Policy Benefits: Future policy benefits include liabilities for insurance policies for which some of the premiums received in earlier years are intended to pay anticipated benefits to be incurred in future years. Future policy benefits are continually monitored and reviewed, and when reserves are adjusted, differences are reflected in benefit expense.
We believe that our liabilities for future policy benefits, along with future premiums received, are adequate to satisfy our ultimate benefit liability; however, these estimates are inherently subject to a number of variable circumstances. Consequently, the actual results could differ materially from the amounts recorded in our consolidated financial statements.
Revenue Recognition: Premiums for risk-based contracts are recognized as revenue over the period insurance coverage is provided, and, if applicable, net of amounts recognized for MLR rebates, risk adjustment, reinsurance and risk corridor under contractual premium stabilization arrangements, the ACA or other regulatory requirements. Premiums may also include performance incentives and penalties, which are recognized based on contractual terms. We estimate amounts receivable and payable under these contractual terms, and to the extent that such estimated amounts vary from the final amounts paid, the adjustments are included in earnings in the period of final settlement. Premium payments from contracted government agencies are based on eligibility lists produced by the government agencies. Premium payments related to the unexpired contractual coverage periods are reflected in the accompanying consolidated balance sheets as Unearned income. Premiums include revenue adjustments for retrospectively rated contracts where revenue is based on the estimated loss experience of the contract. Premium rates for certain lines of business are subject to approval by the Department of Insurance of each respective state. Additionally, delays in annual premium rate changes from contracted government agencies require that we defer the recognition of any increases to the period in which the premium rates become final. The value of the impact can be significant in the period in which it is recognized depending on the magnitude of the premium rate increase, the membership to which it applies and the length of the delay between the effective date of the rate increase and the final contract date. Premium rate decreases are recognized in the period the change in premium rate becomes effective and the change in the rate is known, which may be prior to the period when the contract amendment affecting the rate is finalized.
Service fees include revenue from certain group contracts that provide for the group to be at risk for all, or with supplemental insurance arrangements, a portion, of their claims experience. We charge these fee-based groups an administrative fee, which is based on the number of members in a group and the group’s claim experience. In addition, service fees include amounts received for the administration of Medicare, certain other government programs, and administrative services arrangements of our Carelon subsidiaries. Generally, each fee-based arrangement includes services which constitute a single suite of services provided and for which consideration is based upon an agreed-upon rate, regardless of the amount of services provided in a given period. As with premiums, each fee-based arrangement may include terms with retroactive rate or membership adjustments, performance incentives and penalties, each of which is a form of variable consideration within the transaction price. As such, each fee-based arrangement contains a single performance obligation that constitutes a series, and revenue is recognized over time as the services are performed. All benefit payments under these programs are excluded from benefit expense.
The determination of whether services are distinct performance obligations that should be accounted for separately or combined as one unit of accounting may require significant judgment. The estimation of variable consideration to be recognized requires significant judgment in the determination of the level of achievement of performance incentives, service level achievements subject to performance penalties, and the completion level of tasks subject to implementation fees.
Product revenue represents services performed by CarelonRx for unaffiliated pharmacy customers and includes ingredient costs (net of any rebates or discounts), including co-payments made by or on behalf of the customer, and service fees. Unaffiliated pharmacy customers include our fee-based groups that have contracted with CarelonRx for pharmacy services and third-party health plans. Product revenues and costs of goods sold for our affiliated health plans are eliminated in consolidation, excluding co-payments and subsidies made by or on behalf of affiliated customers. Product revenue for pharmacy services is recognized using the gross method at the negotiated contract price when CarelonRx has concluded that it is the principal, and it controls the services before prescription drugs are transferred to the customer. CarelonRx determined it is the principal due to its contractual rights to design and develop a listing of prescription drugs offered to the customer (formulary management); its control over establishing the pharmacy network available to the customer to have its prescription fulfilled (network management); and its discretion over establishing the pricing for prescription drugs. Overall, control over these activities indicate CarelonRx is primarily responsible for fulfilling the promise to provide pharmacy services. CarelonRx recognizes revenue when control of the prescription drugs is transferred to customers, in an amount it expects to be entitled to in exchange for the products or services provided.
For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheets at December 31, 2024 and 2023. Revenue recognized in 2024 and 2023 from performance obligations related to prior years, such as due to changes in transaction price, was not material. For contracts that
have an original expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material.
Cost of Products Sold: CarelonRx’s cost of products sold includes the cost of prescription drugs dispensed to unaffiliated pharmacy customers (net of rebates or discounts). Cost of products sold includes per-claim administrative fees for prescription fulfillment by its vendor and certain CarelonRx direct costs related to sales and administration of customer contracts.
Share-Based Compensation: Our current compensation philosophy provides for share-based compensation, including stock options, restricted stock awards and an employee stock purchase plan. Stock options are granted for a fixed number of shares with an exercise price at least equal to the fair value of the shares at the date of the grant. Restricted stock awards are issued at the fair value of the stock on the grant date. The employee stock purchase plan allows for a purchase price per share which is 90% of the fair value of a share of common stock on the lower of the first or last trading day of the plan quarter. The employee stock purchase plan discount is recognized as compensation expense based on GAAP guidance. All other share-based payments to employees are recognized as compensation expense in our consolidated statements of income based on their fair values. Additionally, excess tax benefits, which result from actual tax benefits realized when awards vest or options are exercised exceeding deferred tax benefits previously recognized based on grant date fair value, are recognized as tax benefits in the consolidated statements of income.
Advertising and Marketing Costs: We use print, broadcast and other advertising to promote our products and to develop our corporate image. We market our products through direct marketing activities and an extensive network of independent agents, brokers and retail partnerships for Individual and Medicare customers, and for certain Employer Group risk-based customers with a smaller employee base. Products for our Employer Group risk-based customers with a larger employee base are generally sold through independent brokers or consultants retained by the customer who work with industry specialists from our in-house sales force. In the Individual and Group markets, we offer products through state or federally facilitated marketplaces, or Public Exchanges, and off-exchange products. The cost of advertising and marketing for product promotion is expensed as incurred, while advertising and marketing costs associated with our corporate image are expensed when first aired. Total advertising and marketing expense was $540, $599 and $511 for the years ended December 31, 2024, 2023 and 2022, respectively.
Leases: We lease office space and certain computer and related equipment under noncancelable operating leases. We determine whether an arrangement is or contains a lease at its inception. We recognize lease liabilities based on the present value of the minimum lease payments not yet paid by using the lease term, any amounts probable of being owed under any residual value guarantees and the discount rate determined at lease commencement. As our leases do not generally provide an implicit rate, we use our incremental secured borrowing rate commensurate with the underlying lease terms to determine the present value of our lease payments. Our lease liabilities may include amounts for options to extend or terminate a lease when it is reasonably certain that we will exercise that option. We recognize operating right-of-use (“ROU”) assets at an amount equal to the lease liability adjusted for prepaid or accrued rent, the remaining balance of any lease incentives and unamortized initial direct costs.
The operating lease liabilities are reported in Other current liabilities and Other noncurrent liabilities and the related ROU assets are reported in Other noncurrent assets on our consolidated balance sheets. Lease expense for our operating leases is calculated on a straight-line basis over the lease term and is reported in operating expense on our consolidated statements of income. For our office space leases, we account for the lease and non-lease components (such as common area maintenance) as a single lease component. We also do not recognize a lease liability or ROU asset for our office space leases whose lease terms, at commencement, are twelve months or less and that do not include a purchase option or option to extend that we are reasonably certain to exercise.
We assess our ROU assets for impairment when there are indicators of impairment and compare the carrying amount of the ROU asset to its estimated undiscounted future cash flows. If the estimated undiscounted future cash flows are less than the carrying amount of the ROU asset, an impairment calculation is performed. An impairment loss is recorded for the difference of the ROU asset’s carrying value that exceeds its estimated discounted cash flows. During the years ended December 31, 2024, 2023 and 2022, we recorded $17, $23 and $34, respectively, for impairment and abandonment of ROU assets. See Note 18, “Leases,” for additional information about the ROU asset impairment and abandonment charges.
Shareholders Earnings per Share: Earnings per share amounts, on a basic and diluted basis, have been calculated based upon the weighted-average common shares outstanding for the period.
Basic shareholders’ earnings per share excludes dilution and is computed by dividing income available to common shareholders by the weighted-average number of common shares outstanding for the period. Diluted shareholders’ earnings per share may include the dilutive effect of stock options, restricted stock and convertible debentures, using the treasury stock method. The treasury stock method assumes exercise of stock options and vesting of restricted stock, with the assumed proceeds used to purchase common stock at the average market price for the period. The difference between the number of shares assumed issued and the number of shares assumed purchased represents the dilutive shares.
Recently Adopted Accounting Guidance: In November 2023, the FASB issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”). The amendments in ASU 2023-07 are intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for our fiscal year beginning after December 15, 2023, and interim periods within our fiscal year beginning after December 15, 2024. The amendments are to be applied retrospectively to all prior periods presented in the financial statements, and upon transition, the significant segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. The adoption of ASU 2023-07 did not have an impact on our results of operations or our consolidated cash flows.
In November 2020, the FASB issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 changed the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts, which was issued in November 2018. The amendments in ASU 2020-11 extended the original effective date by one year to our interim and annual reporting periods beginning after December 15, 2022. This standard requires us to review cash flow assumptions for our long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires us to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other comprehensive income. The rate used to discount our reserves for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of our liabilities. In addition, this standard changes the amortization method for deferred acquisition costs. We adopted these amendments on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and deferred acquisition costs as of the transition date, January 1, 2021. While the adoption did not have an overall material impact, our prior period financial statements presented in this Annual Report on Form 10-K have been restated to reflect the impacts of our adoption as required by the new standard. An adjustment of $(131) was made to shareholders’ net income for the year ended December 31, 2022, which include an adjustment to benefit expense of $155. In addition, the following balance sheet adjustments were made for the year ended December 31, 2022: $(17) to total assets; $47 to total liabilities; $13 to accumulated other comprehensive loss; and $(64) to shareholders’ equity and total equity.
Recent Accounting Guidance Not Yet Adopted: In November 2024, the FASB issued Accounting Standards Update No. 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses (“ASU 2024-03”). This standard requires additional expense breakdowns in the footnotes for items such as inventory purchases, employee compensation, depreciation, and intangible asset amortization. Public companies must also provide a qualitative description of remaining expense amounts not separately disclosed, as well as the definition and total amount of selling expenses. ASU 2024-03 is effective for our fiscal year beginning after December 15, 2026, and interim periods within our fiscal year beginning after December 15, 2027. The amendments are to be applied either prospectively to financial statements issued for reporting periods after the effective date of the update, or retrospectively to all prior periods presented in the financial statements. We are currently evaluating the effects the adoption of ASU 2024-03 will have on our consolidated financial statements and related disclosures.
In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740) (“ASU 2023-09”). The amendments in ASU 2023-09 are intended to improve income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for our fiscal year beginning after December 15, 2024. The amendments are to be applied on a prospective basis, although retrospective adoption is permitted. We do not believe the adoption of ASU 2023-09 will have a material impact on our consolidated financial statements or disclosures.
In August 2023, the FASB issued Accounting Standards Update No. 2023-05, Business Combinations—Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement (“ASU 2023-05”). ASU 2023-05 clarifies existing guidance to reduce diversity in practice and is requiring a joint venture to recognize and initially measure its assets and liabilities using a new basis of accounting, at fair value, upon formation. These amendments are effective prospectively for all joint venture formations with a formation date on or after January 1, 2025. We do not believe the adoption of ASU 2023-05 will have a material impact on our consolidated financial statements and disclosures.
There were no other new accounting pronouncements that were issued or became effective during the year ended December 31, 2024 that had, or are expected to have, a material impact on our financial position, results of operations, cash flows or financial statement disclosures.
v3.25.0.1
Business Acquisitions and Divestitures
12 Months Ended
Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Business Acquisitions and Divestitures Business Acquisitions and Divestitures
Completed Acquisitions
On December 31, 2024, we completed our acquisition of Centers Plan for Healthy Living LLC and Centers for Specialty Care Group IPA, LLC (“Centers”). Centers is a managed long-term care plan that serves New York state Medicaid and dual-eligible Medicaid/Medicare members, enabling adults with long-term care needs and disabilities to live safely and independently in their own home. This acquisition aligns with our strategic plan to grow the Health Benefits segment and leverage industry-leading expertise while serving Medicaid and dual-eligible populations. As of December 31, 2024, the purchase price was allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values, of which $152 has been allocated to finite-lived intangible assets, $426 to indefinite-lived intangible assets and $450 to goodwill. The majority of the goodwill is not deductible for income tax purposes. As of December 31, 2024, the initial accounting for the acquisition has not been finalized. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations.
On December 10, 2024, we completed our acquisition of RSV QOZB LTSS, Inc. and certain affiliated entities (“CareBridge”), a value-based healthcare company that manages home and community-based services for Medicaid and dual-eligible members receiving long-term services and support. This acquisition aligns with Carelon Services’ care at home strategy, and our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. As of December 31, 2024, the purchase price was allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values, of which $995 has been allocated to finite-lived intangible assets and $1,631 to goodwill. The majority of the goodwill is not deductible for income tax purposes. As of December 31, 2024, the initial accounting for the acquisition has not been finalized. The proforma effects of this acquisition for prior periods were not material to our consolidated results of operations.
On March 11, 2024, we completed our acquisition of Paragon Healthcare, Inc. (“Paragon”). Paragon, which operates as part of CarelonRx, provides infusion services and injectable therapies through its omnichannel model of ambulatory infusion centers, home infusion pharmacies, and other specialty pharmacy services. This acquisition aligns with our vision to be an innovative, valuable and inclusive healthcare partner by providing care management programs that improve the lives of the people we serve. As of December 31, 2024, the purchase price was allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values, of which $411 has been allocated to finite-lived intangible assets and $747 to goodwill. The majority of the goodwill is not deductible for income tax purposes. As of December 31, 2024, the initial accounting for the acquisition has not been finalized. The proforma effects of this acquisition for prior periods were not
material to our consolidated results of operations.
During the year ended December 31, 2024, in total, we completed business combinations for total cash consideration of approximately $5,128. The purchase prices for all business combinations were preliminarily allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values. Tangible net assets acquired were $(236), and intangible assets were $5,364, of which $1,872 was allocated to finite-lived intangible assets, $426 to indefinite-lived intangible assets, and $3,066 to goodwill. Of these amounts, $2,641 was allocated to our Carelon Services reportable segment, $1,594 was allocated to our CarelonRx reportable segment and $1,129 to our Health Benefits reportable segment. The majority of goodwill is not deductible for income tax purposes. As of December 31, 2024, the initial accounting for the acquisitions had not been finalized. Any subsequent adjustments made to the assets acquired or liabilities assumed during the measurement period may result from a purchase price adjustment, or will be recorded as an adjustment to goodwill and/or intangible assets acquired. The proforma effects of these acquisitions for prior periods were not material to our consolidated results of operations.
During the year ended December 31, 2023, in total, we completed business combinations for total cash consideration of approximately $1,655. These acquisitions included BioPlus Parent, LLC and its subsidiaries (“BioPlus”), which were acquired in February 2023. The purchase prices for all business combinations were preliminarily allocated to the tangible and intangible net assets acquired based on management's initial estimates of their fair values, of which $820 was allocated to finite-lived intangible assets and $923 to goodwill. Of these amounts, $1,723 was allocated to our CarelonRx reportable segment and $20 to our Carelon Services reportable segment. The majority of goodwill is not deductible for income tax purposes. As of December 31, 2024, the accounting for the acquisitions was finalized. The proforma effects of these acquisitions for prior periods were not material to our consolidated results of operations.
Acquired tangible assets (liabilities) at the acquisition date were:
20242023
Cash, cash equivalents and short-term investments$484 $
Accounts receivable and other current assets847 241 
Property, equipment and other long-term assets309 18 
Medical claims and other policyholder liabilities payable(154)— 
Accounts payable and other current liabilities(1,005)(169)
Other long-term liabilities(242)(1)
Deferred tax liabilities(475)(183)
Total net tangible assets (liabilities)
$(236)$(88)
The preliminary purchase price allocations for the various 2024 business combinations are subject to adjustment as valuation analyses, primarily related to intangible assets and contingent and tax liabilities, are finalized.
Acquisition date fair values and weighted-average useful lives assigned to intangible assets include:
20242023
Fair ValueWeighted Average Useful LifeFair ValueWeighted Average Useful Life
Customer-related$1,621 20 years$796 25 years
Provider and hospital relationships70 10 years— 0
Other 181 8 years24 5 years
State Medicaid licenses 426 — — — 
Total intangible assets$2,298 $820 
The results of operations and financial condition of acquired entities have been included in our consolidated results and the results of the corresponding operating segment as of the date of acquisition. Through December 31, 2024, the impact of
the acquired entities on revenue and net earnings was not material. Unaudited pro-forma revenues for the years ended December 31, 2024, 2023 and 2022, as if the acquisitions had occurred on January 1, 2022, were immaterial.
Divestitures
On April 1, 2024, we completed the sale of our life and disability businesses to StanCorp Financial Group, Inc. (“The Standard”), a provider of financial protection products and services for employers and individuals, which resulted in a gain on sale of business of $201 in the year ended December 31, 2024. Upon closing, we and The Standard entered into a product distribution partnership. The related net assets held for sale for the life and disability businesses divested as of December 31, 2023 and results of operations for the year ended December 31, 2024 were not material.
v3.25.0.1
Business Optimization Initiatives
12 Months Ended
Dec. 31, 2024
Restructuring and Related Activities [Abstract]  
Business Optimization Initiatives Business Optimization Initiatives
2023-2024 Business Efficiency Program
During the third quarter of 2023, based on a strategic review of our operations, assets and investments, management implemented the “2023-2024 Business Efficiency Program” to enhance operating efficiency, refine the focus of our investments and optimize our physical footprint. The 2023-2024 Business Efficiency Program included the write-off of certain information technology assets and contract exit costs, a reduction in staff including the relocation of certain job functions, and the impairment of assets associated with the closure or partial closure of data centers and offices. The 2023-2024 Business Efficiency Program was finalized as of December 31, 2024. Cash outlays associated with this program, which primarily relate to the personnel-related costs, are expected to be paid through 2025.
In 2024, we incurred $268 of costs towards the 2023-2024 Business Efficiency Program. This included primarily $72 of pre-tax charges for information technology asset write-offs, $165 of pre-tax personnel-related charges for the reduction and/or relocation of staff, which includes severance and related costs primarily determined under our existing severance plans, and $31 of pre-tax charges from asset impairments related to the closure or partial closure of offices, including operating lease-related ROU assets and other property and equipment.
In 2023, we incurred $752 of expense, which included $468 of pre-tax charges for information technology assets and contract write-offs related to projects that have been de-prioritized and stopped, $230 of pre-tax personnel-related charges for the reduction and/or relocation of workforce, which includes severance and related costs primarily determined under our existing severance plans, and $54 of pre-tax charges from asset impairments related to the closure or partial closure of data centers and offices, including operating lease-related ROU assets and other property and equipment.
These charges in both years were recognized in operating expense in the Corporate & Other segment; see Note 20, “Segment Information.”
During the year ended December 31, 2024, there were $165 in charges related to employee termination costs under the 2023-2024 Business Efficiency Program, and payments were $132. During the year ended December 31, 2023, there were $230 in charges related to employee termination costs under the 2023-2024 Business Efficiency Program, and payments were $39.
v3.25.0.1
Investments
12 Months Ended
Dec. 31, 2024
Investments [Abstract]  
Investments Investments
A summary of current and long-term fixed maturity securities, available-for-sale, at December 31, 2024 and 2023 is as follows:
Cost or
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Allowance For Credit LossesEstimated
Fair Value
 
December 31, 2024
Fixed maturity securities:
United States Government securities$1,907 $$(85)$— $1,824 
Government sponsored securities156 — (5)— 151 
Foreign government securities19 — (2)— 17 
States, municipalities and political subdivisions, tax-exempt3,142 33 (123)— 3,052 
Corporate securities14,095 192 (367)(4)13,916 
Residential mortgage-backed securities3,274 13 (236)— 3,051 
Commercial mortgage-backed securities
1,801 (60)(1)1,748 
 Other asset-backed securities2,534 36 (92)(1)2,477 
Total fixed maturity securities$26,928 $284 $(970)$(6)$26,236 
December 31, 2023
Fixed maturity securities:
United States Government securities$1,873 $25 $(54)$— $1,844 
Government sponsored securities112 (3)— 110 
Foreign government securities(2)— 
States, municipalities and political subdivisions, tax-exempt
3,985 69 (152)— 3,902 
Corporate securities14,838 322 (580)(2)14,578 
Residential mortgage-backed securities4,071 40 (279)— 3,832 
Commercial mortgage-backed securities
2,174 13 (138)(2)2,047 
Other asset-backed securities4,278 25 (130)— 4,173 
Total fixed maturity securities$31,336 $496 $(1,338)$(4)$30,490 
Other asset-backed securities primarily consist of collateralized loan obligations and other debt securities.
For fixed maturity securities in an unrealized loss position at December 31, 2024 and 2023, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position.
 Less than 12 Months12 Months or Greater
 Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
(Securities are whole amounts)      
December 31, 2024
Fixed maturity securities:
United States Government securities40$1,240 $(52)25$330 $(33)
Government sponsored securities1089 (2)3642 (3)
Foreign government securities215 (1)2(1)
States, municipalities and political subdivisions, tax-exempt
5271,092 (22)661943 (101)
Corporate securities1,4154,717 (92)1,3172,645 (275)
Residential mortgage-backed securities3061,097 (25)1,3121,291 (211)
Commercial mortgage-backed securities136670 (15)297661 (45)
Other asset-backed securities123293 (9)236735 (83)
Total fixed maturity securities2,559$9,213 $(218)3,886$6,649 $(752)
December 31, 2023
Fixed maturity securities:
United States Government securities
35 $552 $(9)44 $370 $(45)
Government sponsored securities
— — — 40 52 (3)
Foreign government securities— — — (2)
States, municipalities and political subdivisions, tax-exempt
203 354 (2)1,034 1,811 (150)
Corporate securities
389 608 (15)2,624 6,871 (565)
Residential mortgage-backed securities
183 438 (5)1,620 2,075 (274)
Commercial mortgage-backed securities
112 353 (6)534 1,317 (132)
Other asset-backed securities110 394 (18)761 2,342 (112)
Total fixed maturity securities1,032 $2,699 $(55)6,659 $14,842 $(1,283)
Unrealized losses on our securities shown in the table above have not been recognized into income because, as of December 31, 2024, we do not intend to sell these investments, and it is likely that we will not be required to sell these investments prior to their anticipated recovery. The declines in fair values are largely due to increasing interest rates driven by the higher rate of inflation and other market conditions.
Allowances for credit losses have been recorded in the amounts of $6 and $4 at December 31, 2024 and 2023, respectively, for declines in fair value due to unfavorable changes in the credit quality characteristics that impact our assessment of collectability of principal and interest.
The amortized cost and fair value of fixed maturity securities at December 31, 2024, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations.
Amortized
Cost
Estimated
Fair Value
Due in one year or less$198 $196 
Due after one year through five years4,827 4,772 
Due after five years through ten years10,550 10,378 
Due after ten years6,278 6,090 
Mortgage-backed securities5,075 4,800 
Total fixed maturity securities$26,928 $26,236 
Equity Securities
A summary of current equity securities at December 31, 2024 and 2023 is as follows:
December 31, 2024December 31, 2023
Equity Securities:
Exchange traded funds$1,002 $106 
Common equity securities118 45 
Private equity securities72 78 
Total$1,192 $229 
Other Invested Assets
Other invested assets include non-controlled joint ventures, including our minority interest ownership of approximately 35% of Augusta Topco Holdings, L.P. (“Mosaic Health”) and our 40% minority interest ownership of Project Freedom Holdings, LLC, which is the ultimate parent of LIBERTY Dental Plan Corporation (“Liberty Dental”).
On August 6, 2024, we made an equity investment in Mosaic Health of $2,580, consisting of cash and the net put option discussed in Note 6 “Derivative Financial Instruments”, Mosaic Health is a joint venture with Clayton, Dubilier & Rice (“CD&R”) that is designed to accelerate innovation in care delivery across multiple regions in the United States by bringing together certain care delivery and enablement assets of Carelon Management Services, LLC (“CMSI Assets”), a Carelon Health business, and two CD&R portfolio businesses, apree health and Millennium Physician Group. The investment is accounted for as an equity method investment. Our additional contribution of the CMSI Assets to Mosaic Health was completed on January 1, 2025, for which we received an additional $300 of equity (approximately 5% ownership) in Mosaic Health. The CMSI Assets are included under the captions “Assets held for sale” and “Liabilities held for sale” in our consolidated balance sheets as of December 31, 2024.
In connection with our equity method investment in Mosaic Health, we entered into a financing agreement to provide a term loan of $200 and a line of credit up to $500 to Mosaic Health. Net amounts receivable under these arrangements were $188 at December 31, 2024, which is included under the caption “Other invested assets” in our consolidated balance sheets as of December 31, 2024. During the year ended December 31, 2024, we recognized $7 in interest income from the financing arrangement with Mosaic Health. In addition to the term loan and line of credit, we committed to providing $70 of funding with no additional equity interest in Mosaic Health to meet any shortfall in operating cash flow and regulatory capital requirements of the CMSI Assets through December 31, 2026, and to fund any remaining shortfalls as necessary for which we would receive additional equity interests in Mosaic Health.
In January 2023, we made an equity investment in Liberty Dental, a joint venture with Welsh, Carson, Anderson & Stowe which engages in dental insurance and dental health care administration. The investment is accounted for as an equity method investment. In connection with our equity method investment in Liberty Dental, in December 2024 we entered into a commitment to provide funding in the form of mandatorily redeemable preferred equity shares in Liberty Dental of up to $250 of which $87 was disbursed in 2024. The mandatorily redeemable preferred equity in Liberty Dental is included in the caption “Other invested assets” in our consolidated balance sheets at December 31, 2024. Dividend income recognized from the financing arrangement during the year ended December 31, 2024 was not material.
Investment Income
The major categories of net investment income for the years ended December 31, 2024, 2023 and 2022 are as follows:
202420232022
Fixed maturity securities$1,539 $1,387 $971 
Equity securities40 18 48 
Cash equivalents235 305 77 
Other invested assets274 157 432 
Investment income2,088 1,867 1,528 
Investment expenses(37)(42)(43)
Net investment income$2,051 $1,825 $1,485 
Investment (Losses) Gains
Net investment (losses) gains for the years ended December 31, 2024, 2023 and 2022 are as follows:
202420232022
Net gains (losses):
Fixed maturity securities:
Gross realized gains from sales$158 $47 $52 
Gross realized losses from sales(479)(488)(469)
Impairment losses recognized in income
(17)(15)(31)
Net realized losses on fixed maturity securities
(338)(456)(448)
Equity securities:
Unrealized losses recognized on equity securities still held
(6)(1)(78)
Net realized (losses) gains recognized on equity securities sold(9)(102)
Net (losses) gains on equity securities(15)(180)
Other investments:
Gross gains49 103 96 
Gross losses(25)(63)(64)
Impairment losses recognized in income(126)(291)(34)
Net losses on other investments
(102)(251)(2)
Net losses on investments
$(455)$(702)$(630)
A primary objective in the management of our fixed maturity and equity portfolios is to maximize total return relative to underlying liabilities and respective liquidity needs. In achieving this goal, assets may be sold to take advantage of market conditions or other investment opportunities as well as tax considerations. Sales will generally produce realized gains and losses. In the ordinary course of business, we may sell securities at a loss for a number of reasons, including, but not limited
to: (i) changes in the investment environment; (ii) expectations that the fair value could deteriorate further; (iii) desire to reduce exposure to an issuer or an industry; (iv) changes in credit quality; or (v) changes in expected cash flow.
Total proceeds from sales, maturities, calls or redemptions of fixed maturity securities were $16,334, $12,289 and $22,048 for the years ended December 31, 2024, 2023 and 2022, respectively.
A significant judgment in the valuation of investments is the determination of when a credit loss has occurred. We follow a consistent and systematic process for recognizing impairments on securities that sustain credit declines in value. We have established a committee responsible for the impairment review process. The decision to impair a security incorporates both quantitative criteria and qualitative information. The impairment review process considers a number of factors including, but not limited to: (i) the extent to which the fair value is less than book value, (ii) the financial condition and near term prospects of the issuer, (iii) our intent and ability to retain impaired investments for a period of time sufficient to allow for any anticipated recovery in fair value, (iv) our intent to sell or the likelihood that we will need to sell a fixed maturity security before recovery of its amortized cost basis, (v) whether the debtor is current on interest and principal payments, (vi) the reasons for the decline in value (i.e., credit event compared to liquidity, general credit spread widening, currency exchange rate or interest rate factors) and (vii) general market conditions and industry or sector specific factors. When a decision has been made to sell an impaired security or it is more likely than not that the impaired security will be required to be disposed of prior to recovery of its cost basis, the security is written down to fair value at the reporting date. For all other impaired securities, if the impairment is deemed to be credit related, an allowance is created.
Investment securities are exposed to various risks, such as interest rate, market and credit. Due to the level of risk associated with certain investment securities and the level of uncertainty related to changes in the value of investment securities, it is possible that changes in these risk factors in the near term could have a material adverse impact on our results of operations or shareholders’ equity.
At December 31, 2024 and 2023, there were no individual investments that exceeded 10% of shareholders’ equity.
At December 31, 2024 and 2023, there were nine and eleven, respectively, fixed maturity investments that did not produce income during the years then ended.
We had unfunded loan commitments to certain equity investees of $1,442 and $1,321 at December 31, 2024 and 2023, respectively. We do not believe such obligations will materially affect its financial position, results of operations, or cash flows.
As of December 31, 2024 and 2023, we had committed approximately $423 and $497, respectively, to future investments in rated notes.
At December 31, 2024 and 2023, securities with carrying values of approximately $1,035 and $876, respectively, were deposited by our insurance subsidiaries under requirements of regulatory authorities.
Accrued Investment Income
Accrued investment income totaled $287 and $301 at December 31, 2024 and 2023, respectively. We recognize accrued investment income under the caption “Other receivables” on our consolidated balance sheets.
Securities Lending Programs
The fair value of the cash and securities received as collateral for securities loaned at December 31, 2024 and 2023 was $2,305 and $2,380, respectively. The collateral received was 102% of the market value of the loaned securities at each of December 31, 2024 and 2023.
We recognize the collateral as an asset under the caption “Other current assets” in our consolidated balance sheets, and we recognize a corresponding liability for the obligation to return the collateral to the borrower under the caption “Other current liabilities.” The securities on loan are reported in the applicable investment category on our consolidated balance sheets.
At December 31, 2024 and 2023, the remaining contractual maturities of our securities lending transactions included overnight and continuous transactions of cash for $2,115 and $2,255, respectively, United States Government securities for $176 and $99, respectively, and residential mortgage-backed securities for $14 and $26, respectively.
v3.25.0.1
Derivative Financial Instruments
12 Months Ended
Dec. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]  
Derivative Financial Instruments Derivative Financial Instruments
We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, collars, swaptions, embedded derivatives and warrants. We also enter into master netting agreements which reduce credit risk by permitting net settlement of transactions. At December 31, 2024 and 2023, we had posted collateral of $142 and $35, respectively, related to our derivative financial instruments.
A summary of the aggregate contractual or notional amounts and carrying values related to derivative financial instruments at December 31, 2024 and 2023 is as follows:
 Contractual/
Notional
Amount
Balance Sheet Location
Carrying Value
Asset(Liability)
December 31, 2024
Hedging instruments
Interest rate swaps - fixed to floating$6,475 Other assets/other liabilities$$(150)
Foreign currency forwards
322 
Other liabilities
— (6)
Subtotal hedging
6,797 (156)
Non-hedging instruments
Interest rate swaps— — 
Options2,453 
Other liabilities
— (1,415)
Futures/Forwards
124 
Equity securities/other assets
— 
Subtotal non-hedging2,582 Subtotal non-hedging(1,415)
Total derivatives$9,379 Total derivatives11 (1,571)
Amounts netted(6)
Net derivatives$$(1,565)
December 31, 2023
Hedging instruments
Interest rate swaps - fixed to floating$1,475 Other assets/other liabilities$15 $(52)
Non-hedging instruments
Derivatives embedded in convertible securities
15 
Fixed maturity securities
— 
Interest rate swaps— — 
Options161 
Other liabilities
— (85)
Collars19 Equity securities14 (3)
Futures/Forwards
151 
Equity securities/other assets
— 
Subtotal non-hedging351 Subtotal non-hedging22 (88)
Total derivatives$1,826 Total derivatives37 (140)
Amounts netted(15)15 
Net derivatives$22 $(125)
Fair Value Hedges
We have entered into various interest rate swap contracts to convert a portion of our interest rate exposure on our long-term debt from fixed rates to floating rates. The floating rates payable on all of our fair value hedges are benchmarked to the Secured Overnight Financing Rate. A summary of our outstanding fair value hedges at December 31, 2024 and 2023 is as follows:
Type of Fair Value HedgesYear
Entered
Into
Outstanding Notional AmountInterest Rate
Received
Expiration Date
20242023
Interest rate swap2024$200 $— 5.500 %April 15, 2032
Interest rate swap20241,000 — 4.750 August 15, 2032
Interest rate swap2024600 — 5.150 December 15, 2028
Interest rate swap20241,000 — 5.375 December 15, 2033
Interest rate swap2024750 — 4.750 August 15, 2029
Interest rate swap2024750 — 4.950 May 1, 2031
Interest rate swap20241,200 — 5.200 August 15, 2034
Interest rate swap2023300 300 5.000 April 15, 2032
Interest rate swap2023150 150 2.550 September 15, 2030
Interest rate swap2023— 500 4.900 February 8, 2026
Interest rate swap2023125 125 4.101 September 1, 2027
Interest rate swap2023100 100 2.250 November 15, 2029
Interest rate swap2022150 150 5.500 April 15, 2032
Interest rate swap202275 75 4.101 September 1, 2027
Interest rate swap202275 75 2.250 November 15, 2029
Total notional amount outstanding
$6,475 $1,475 
The following amounts were recorded on our consolidated balance sheets related to cumulative basis adjustments for fair value hedges at December 31, 2024 and 2023:
Balance Sheet Classification in Which Hedged Item is IncludedCarrying Amount of Hedged LiabilityCumulative Amount of Fair Value Hedging Adjustment Included in the Carrying Amount of the Hedged Liability
2024202320242023
Long-term debt$29,218 $23,246 $(142)$(37)
Cash Flow Hedges
We have entered into a series of forward starting pay fixed interest rate swaps with the objective of eliminating the variability of cash flows in the interest payments on future financings that were anticipated at the time of entering into the swaps. During 2024 and 2023, swaps in the notional amount of $900 and $550, respectively, were terminated.
The unrecognized loss for all expired and terminated cash flow hedges included in accumulated other comprehensive loss, net of tax, was $201 and $211 at December 31, 2024 and 2023, respectively. As of December 31, 2024, the total amount of amortization over the next twelve months for all cash flow hedges is estimated to increase interest expense by approximately $13. No amounts were excluded from effectiveness testing.
Non-Hedging Derivatives
A summary of the effect of non-hedging derivatives on our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
Type of Non-hedging DerivativesIncome Statement Location of
Gain (Loss) Recognized
Derivative
(Loss) Gain
Recognized
Year ended December 31, 2024
Options (including swaptions)
Net losses on financial instruments
$(1)
Collars
Net losses on financial instruments
14 
Futures
Net losses on financial instruments
(3)
Total$10 
Year ended December 31, 2023
Derivatives embedded in convertible securities
Net losses on financial instruments
$(2)
Options (including swaptions)
Net losses on financial instruments
Collars
Net losses on financial instruments
(3)
Futures
Net losses on financial instruments
10 
Total$
Year ended December 31, 2022
Derivatives embedded in convertible securities
Net losses on financial instruments
$(3)
Interest rate swaps
Net losses on financial instruments
(4)
Options (including swaptions)
Net losses on financial instruments
13 
Collars
Net losses on financial instruments
10 
Futures64 
Total$80 
In connection with our equity investment in Mosaic Health (see Note 5, “Investments”), we entered into a limited partnership and related agreements with the majority owners that provides for certain rights and obligations of each party, including certain put, call, and purchase price true-up options. These options, if exercised, will result in our purchase of the units held by the majority owners as early as 2028 but no later than 2030 at a price based on certain multiples of revenue and earnings of Mosaic Health businesses, subject to various adjustments and qualifications. We have calculated the fair value of the net put option, which is a Level III measurement (see Note 7, “Fair Value”), using a Monte Carlo simulation, which relies on assumptions including cash flow projections, risk-free rates, volatility and details specific to the options. Significant changes in assumptions could result in significantly lower or higher fair value measurements. The net put option’s fair value liability of $1,330, which is a non-cash item measured at the date of our initial investment, is included under the caption “Other noncurrent liabilities” in our consolidated balance sheets as of December 31, 2024. We have elected to not mark the net put option to market, as it is an option on large blocks of equity securities, and the carrying value of the net put option will remain on the consolidated balance sheets until it is exercised or expires.
As discussed in Note 5, “Investments,” in January 2023, we made an equity investment that resulted in our minority interest ownership of Liberty Dental. As part of the Liberty Dental transaction, we entered into a shareholders’ agreement with the majority owners that provides for certain rights and obligations of each party, including certain put and call options. These options could result in our purchase of the units held by the majority owners in 2026 and 2027. We have calculated the fair value of the net put option, which is a Level III measurement (see Note 7, “Fair Value”), using a Monte Carlo simulation, which relies on assumptions, including cash flow projections, risk-free rates, volatility and details specific to the put and call options. Significant changes in assumptions could result in significantly lower or higher fair value measurements. The net put option’s fair value liability of $85 determined as of December 31, 2023 is included under the caption “Other noncurrent liabilities” in our consolidated balance sheets as of December 31, 2024 and 2023. We have elected to not mark the net put option to market, and the carrying value of the net put option will remain on the consolidated balance sheets until it is exercised or expires.
v3.25.0.1
Fair Value
12 Months Ended
Dec. 31, 2024
Fair Value Disclosures [Abstract]  
Fair Value Fair Value
Assets and liabilities recorded at fair value in the consolidated balance sheets are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Level inputs, as defined by FASB guidance for fair value measurements and disclosures, are as follows:
Level Input: Input Definition:
Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date.
Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date.
Level III Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date.
The following methods, assumptions and inputs were used to determine the fair value of each class of the following assets and liabilities recorded at fair value in the consolidated balance sheets:
Cash equivalents: Cash equivalents primarily consist of highly rated money market funds with maturities of three months or less and are purchased daily at par value with specified yield rates. Due to the short-term nature of the funds, we designate all cash equivalents as Level I.
Fixed maturity securities, available-for-sale: Fair values of available-for-sale fixed maturity securities are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value to facilitate fair value measurements and disclosures. Level II securities primarily include corporate securities, securities from states, municipalities and political subdivisions, mortgage-backed securities, United States Government securities, foreign government securities, and certain other asset-backed securities. For securities not actively traded, the pricing services may use quoted market prices of comparable instruments or discounted cash flow analyses, incorporating inputs that are currently observable in the markets for similar securities. We have controls in place to review the pricing services’ qualifications and procedures used to determine fair values. In addition, we periodically review the pricing services’ pricing methodologies, data sources and pricing inputs to ensure the fair values obtained are reasonable. Inputs that are often used in the valuation methodologies include, but are not limited to, broker quotes, benchmark yields, credit spreads, default rates and prepayment speeds. We also have certain fixed maturity securities, primarily collateralized loan obligation securities, rated note securities and corporate debt securities, that are designated Level III securities. For these securities, the valuation methodologies may incorporate broker quotes, net asset value of underlying loans or discounted cash flow analyses using assumptions for inputs such as expected cash flows, benchmark yields, credit spreads, default rates and prepayment speeds that are not observable in the markets.
Equity securities: Fair values of equity securities are generally designated as Level I and are based on quoted market prices. For certain equity securities, quoted market prices for the identical security are not always available, and the fair value is estimated by reference to similar securities for which quoted prices are available. These securities are designated Level II. We also have certain equity securities, including private equity securities, for which the fair value is estimated based on each security’s current condition and future cash flow projections. Such securities are designated Level III. The fair values of these private equity securities are generally based on either broker quotes or discounted cash flow projections using assumptions for inputs such as the weighted-average cost of capital, long-term revenue growth rates and earnings before interest, taxes, depreciation and amortization, and/or revenue multiples that are not observable in the markets.
Securities lending collateral: Fair values of securities lending collateral are based on quoted market prices, where available. These fair values are obtained primarily from third-party pricing services, which generally use Level I or Level II inputs for the determination of fair value, to facilitate fair value measurements and disclosures.
Derivatives: Fair values are generally based on the quoted market prices by the financial institution that is the counterparty to the derivative transaction. We independently verify prices provided by the counterparties using valuation models that incorporate market observable inputs for similar derivative transactions. These derivatives are designated as Level II securities. Fair values of certain derivatives where market observable inputs are not available are estimated using
assumptions such as cash flow projections, risk-free rates, volatility and details specific to the derivative contract. These derivatives are designated as Level III securities.
In addition, the following methods and assumptions were used to determine the fair value of each class of pension benefit plan assets and other benefit plan assets not defined above (see Note 11, “Retirement Benefits,” for fair values of benefit plan assets):
Mutual funds: Fair values are based on quoted market prices, which represent the net asset value (“NAV”) of shares held.
Partnership investments: Fair values are estimated based on the plan’s ownership share of the partnerships’ net assets, as reported in their periodic capital statements, and are valued using NAV as a practical expedient. The partnerships primarily consist of a real estate investment fund which acquires investments in real estate entities, and an energy fund which invests in public and private oil and gas companies principally through privately issued securities.

Collective investment trusts (“CITs”): Fair values are based on the NAV of the units held by the plan at year end and are valued using NAV as a practical expedient. The CITs are passive index funds that seek investment results that generally correspond to the performance of the Bloomberg U.S. Intermediate Treasury Index.
Commingled fund: Fair value is based on NAV per fund share and is valued using NAV as a practical expedient. The fund primarily invests in publicly traded equity securities of issuers within the fund’s benchmark. The objective of the fund is to produce returns in excess of the relevant benchmark over rolling five-year periods.
Insurance company contracts: Fair value is based on the fair value of the underlying investments of the account as determined by the insurance company.
Investment in DOL 103-12 trust: Fair value is based on the plan’s proportionate share of the fair value of investments held by the trust, qualified as a Department of Labor Regulation 2520.103-12 entity (“DOL 103-12 trust”) as reported in the audited financial statements of the trust, where the trustee applies fair value measurements to the underlying investments of the trust.
Life insurance contracts: Fair value is based on the cash surrender value of the policies as reported by the insurance carriers.
A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at December 31, 2024 and 2023 is as follows:
Level ILevel IILevel IIITotal
December 31, 2024
Assets:
Cash equivalents$3,199 $— $— $3,199 
Fixed maturity securities, available-for-sale:
United States Government securities— 1,824 — 1,824 
Government sponsored securities— 151 — 151 
Foreign government securities— 17 — 17 
States, municipalities and political subdivisions, tax-exempt— 3,052 — 3,052 
Corporate securities— 13,873 43 13,916 
Residential mortgage-backed securities— 3,041 10 3,051 
Commercial mortgage-backed securities— 1,748 — 1,748 
Other asset-backed securities— 1,730 747 2,477 
Total fixed maturity securities, available-for-sale— 25,436 800 26,236 
Equity securities:
Exchange traded funds1,002 — — 1,002 
Common equity securities87 31 — 118 
Private equity securities— — 72 72 
Total equity securities1,089 31 72 1,192 
Other invested assets - common equity securities18 — — 18 
Securities lending collateral— 2,306 — 2,306 
Derivatives - other assets— — 
Total assets$4,306 $27,778 $872 $32,956 
Liabilities:
Derivatives - other liabilities$— $(150)$— $(150)
Total liabilities$— $(150)$— $(150)
December 31, 2023
Assets:
Cash equivalents$2,210 $— $— $2,210 
Fixed maturity securities, available-for-sale:
United States Government securities— 1,844 — 1,844 
Government sponsored securities— 110 — 110 
Foreign government securities— — 
States, municipalities and political subdivisions, tax-exempt— 3,902 — 3,902 
Corporate securities— 14,532 46 14,578 
Residential mortgage-backed securities— 3,830 3,832 
Commercial mortgage-backed securities— 2,047 — 2,047 
Other asset-backed securities— 3,634 539 4,173 
Total fixed maturity securities, available-for-sale— 29,903 587 30,490 
Equity securities:
Exchange traded funds106 — — 106 
Common equity securities12 33 — 45 
Private equity securities— — 78 78 
Total equity securities118 33 78 229 
Other invested assets - common equity securities111 — — 111 
Securities lending collateral— 2,382 — 2,382 
Derivatives - other assets— 10 — 10 
Total assets$2,439 $32,328 $665 $35,432 
Liabilities:
Derivatives - other liabilities$— $(40)$— $(40)
Total liabilities$— $(40)$— $(40)
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using Level III inputs for the years ended December 31, 2024, 2023 and 2022 is as follows:
Corporate
Securities
Residential
Mortgage-
backed
Securities
Other Asset-Backed SecuritiesEquity
Securities
Total
Year ended December 31, 2024
Beginning balance at January 1, 2024$46 $$539 $78 $665 
Total gains (losses):
Recognized in net income— — (6)(5)
Recognized in accumulated other comprehensive income— — 12 — 12 
Purchases26 10 118 17 171 
Sales(5)(2)(10)(17)(34)
Settlements(4)— (1)— (5)
Transfers into Level III— — 92 — 92 
Transfers out of Level III(21)— (3)— (24)
Ending balance at December 31, 2024$43 $10 $747 $72 $872 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2024$— $— $— $(5)$(5)
Year ended December 31, 2023
Beginning balance at January 1, 2023$137 $— $356 $88 $581 
Total gains (losses):
Recognized in net income(10)— — (4)(14)
Recognized in accumulated other comprehensive income— — 
Purchases38 — 191 15 244 
Sales(88)— (17)(21)(126)
Settlements(21)— — — (21)
Transfers into Level III— 14 
Transfers out of Level III(22)— — — (22)
Ending balance at December 31, 2023$46 $$539 $78 $665 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2023$— $— $— $(6)$(6)
Year ended December 31, 2022
Beginning balance at January 1, 2022$336 $$19 $89 $449 
Total gains (losses):
Recognized in net income— — (1)— (1)
Recognized in accumulated other comprehensive income(1)— (16)— (17)
Purchases56 — 370 17 443 
Sales(210)— (14)(18)(242)
Settlements(41)— — — (41)
Transfers into Level III— — — 
Transfers out of Level III(12)(5)(2)— (19)
Ending balance at December 31, 2022$137 $— $356 $88 $581 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2022$— $— $— $— $— 
There were no individually material transfers into or out of Level III during the years ended December 31, 2024, 2023 or 2022.
Certain assets and liabilities are measured at fair value on a nonrecurring basis; that is, the instruments are not measured at fair value on an ongoing basis but are subject to fair value adjustments only in certain circumstances. As disclosed in Note 3, “Business Acquisitions and Divestitures,” we completed our acquisitions of Centers, CareBridge and Paragon in 2024 and BioPlus in 2023. The net assets acquired in these acquisitions and resulting goodwill and other intangible assets were recorded at fair value primarily using Level III inputs. The majority of assets acquired and liabilities assumed were recorded at their carrying values as of the respective date of acquisition, as their carrying values approximated their fair values due to
their short-term nature. The fair values of goodwill and other intangible assets acquired in our acquisitions of Centers, CareBridge, Paragon and BioPlus were estimated based on the income approach. The income approach estimates fair value based on the present value of the cash flows that the assets could be expected to generate in the future. We developed internal estimates for the expected cash flows and discount rate in the present value calculation.
Also, we entered into agreements which included certain put and call options associated with our minority interest ownership of Mosaic Health in 2024 and Liberty Dental in 2023. The resulting net put option liabilities were recorded at their fair values measured at the dates of acquisition using Level III inputs with an election not to mark the derivative to market, which is further discussed and disclosed in Note 6, “Derivatives”. The net put option carrying value for Mosaic Health was $1,330 at December 31, 2024. The net put option fair value for Liberty Dental was $543 and $85 at December 31, 2024 and 2023, respectively.
Other than the assets acquired and liabilities assumed in our acquisitions of CareBridge, Centers, Paragon and BioPlus and the net put options on Mosaic Health and Liberty Dental described above, there were no material assets or liabilities measured at fair value on a nonrecurring basis during the years ended December 31, 2024 or 2023.
Our valuation policy is determined by members of our treasury and accounting departments. Whenever possible, our policy is to obtain quoted market prices in active markets to estimate fair values for recognition and disclosure purposes. Where quoted market prices in active markets are not available, fair values are estimated using discounted cash flow analyses, broker quotes, unobservable inputs or other valuation techniques. These techniques are significantly affected by our assumptions, including discount rates and estimates of future cash flows. The use of assumptions for unobservable inputs for the determination of fair value involves a level of judgment and uncertainty. Changes in assumptions that reasonably could have been different at the reporting date may result in a higher or lower determination of fair value. Changes in fair value measurements, if significant, may affect performance of cash flows.
Potential taxes and other transaction costs are not considered in estimating fair values. Our valuation policy is generally to obtain quoted prices for each security from third-party pricing services, which are derived through recently reported trades for identical or similar securities, making adjustments through the reporting date based upon available market observable information. As we are responsible for the determination of fair value, we perform analysis on the prices received from the pricing services to determine whether the prices are reasonable estimates of fair value. This analysis is performed by our internal treasury personnel who are familiar with our investment portfolios, the pricing services engaged and the valuation techniques and inputs used. Our analysis includes procedures such as a review of month-to-month price fluctuations and price comparisons to secondary pricing services. There were no adjustments to quoted market prices obtained from the pricing services during the years ended December 31, 2024, 2023 or 2022.
In addition to the preceding disclosures on assets recorded at fair value in the consolidated balance sheets, FASB guidance also requires the disclosure of fair values for certain other financial instruments for which it is practicable to estimate fair value, whether or not such values are recognized in the consolidated balance sheets.
Non-financial instruments such as property and equipment, other current assets, deferred income taxes, intangible assets and certain financial instruments, such as limited partnerships, joint ventures, other non-controlled corporations, corporate-owned life insurance policies, and policy liabilities, are excluded from the fair value disclosures. Therefore, the fair value amounts cannot be aggregated to determine our underlying economic value.
The carrying amounts reported in the consolidated balance sheets for cash, premium receivables, self-funded receivables, other receivables, unearned income, accounts payable and accrued expenses, and certain other current liabilities approximate fair value because of the short-term nature of these items. These assets and liabilities are not listed in the table below.
The following methods and assumptions were used to estimate the fair value of each class of financial instrument that is recorded at its carrying value on the consolidated balance sheets:
Other invested assets: Other invested assets primarily include our mortgage loans and notes receivables. Mortgage loans are carried at amortized cost net of loss allowance. The fair value of mortgage loans is measured using discounted cash flows benchmarked against the 10-year U.S. Treasury yield plus a market rate spread. The notes receivables are measured at their amortized cost. The fair value of notes receivables is the present value of discounted future cash flows.
Short-term borrowings: The fair value of our short-term borrowings is based on quoted market prices for the same or similar debt, or if no quoted market prices were available, on the current market interest rates estimated to be available to us for debt of similar terms and remaining maturities.
Long-term debt—senior unsecured notes and surplus notes: The fair values of our notes are based on quoted market prices in active markets for the same or similar debt, or, if no quoted market prices are available, on the current market observable rates estimated to be available to us for debt of similar terms and remaining maturities.
Options: The options consist of put, call and purchase price true-up options associated with our equity investment in the Mosaic Health joint venture and the put and call options associated with our equity investment in Liberty Dental. The fair value of the net put option associated with Mosaic Health is based on a Monte Carlo simulation, which relies on assumptions including cash flow projections, risk-free rates, volatility and details specific to the options. The fair value of the net put option associated with Liberty Dental is based on the discounted present value of estimated future option exercise prices.
A summary of the estimated fair values by level of each class of financial instrument that is recorded at its carrying value on our consolidated balance sheets at December 31, 2024 and 2023 is as follows:
 Carrying
Value
Estimated Fair Value
 Level ILevel IILevel IIITotal
December 31, 2024
Assets:
Other invested assets$642 $— $— $610 $610 
Liabilities:
Debt:
Short-term borrowings365 — 365 — 365 
Notes30,867 — 28,460 — 28,460 
Options
1,415 — — 1,873 1,873 
December 31, 2023
Assets:
Other invested assets$302 $— $— $278 $278 
Liabilities:
Debt:
Short-term borrowings225 — 225 — 225 
Notes24,895 — 23,569 — 23,569 
Options
85 — — 85 85 
v3.25.0.1
Income Taxes
12 Months Ended
Dec. 31, 2024
Income Tax Disclosure [Abstract]  
Income Taxes Income Taxes
The components of deferred income taxes at December 31, 2024 and 2023 are as follows:
20242023
Deferred income tax assets:
Accrued expenses$826 $595 
Bad debt reserves434 415 
Insurance reserves192 178 
Lease liabilities170 172 
Retirement liabilities126 132 
Deferred compensation45 44 
Federal and state carryforwards
428 368 
Foreign (including Puerto Rico) carryforwards90 87 
Other100 166 
Subtotal2,411 2,157 
Less: valuation allowance(294)(271)
Total deferred income tax assets2,117 1,886 
Deferred income tax liabilities:
U.S. federal and state intangible assets2,584 2,043 
Foreign (including Puerto Rico) intangible assets194 330 
Capitalized software513 485 
Depreciation and amortization38 81 
Investment basis11 11 
Retirement assets330 319 
Lease right-of-use assets
114 110 
Prepaid expenses275 249 
Total deferred income tax liabilities4,059 3,628 
Net deferred income tax liabilities$1,942 $1,742 
We recognized $206 and $228 of deferred tax asset under the caption “Other noncurrent assets” at December 31, 2024 and 2023, respectively. We recognized $2,148 and $1,970 of deferred tax liability under the caption “Deferred tax liabilities, net” at December 31, 2024 and 2023, respectively.
As of December 31, 2024, we have established U.S. deferred taxes for undistributed earnings from certain non-U.S. subsidiaries, which are included in the Investment basis component above, consistent with prior years.
Significant components of the provision for income taxes for the years ended December 31, 2024, 2023 and 2022 consist of the following:
202420232022
Current tax expense:
Federal$1,753 $1,899 $1,455 
Foreign (including Puerto Rico)93 95 98 
State and local448 420 244 
Total current tax expense2,294 2,414 1,797 
Deferred tax benefit
(361)(690)(85)
Total income tax expense$1,933 $1,724 $1,712 
State and local current tax expense is reported gross of federal benefit in the preceding table, and includes amounts related to audit settlements, uncertain tax positions, state tax credits and true up of prior years’ tax. Such items are included on a net of federal tax basis in multiple lines in the following rate reconciliation table.
A reconciliation of income tax expense recorded in the consolidated statements of income and amounts computed at the statutory federal income tax rate for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
 AmountPercentAmountPercentAmountPercent
Amount at statutory rate$1,660 21.0 %$1,620 21.0 %$1,596 21.0 %
State and local income taxes net of federal tax expense/benefit
216 2.7 124 1.6 190 2.5 
Tax exempt interest and dividends received deduction
(12)(0.1)(15)(0.2)(19)(0.3)
Change in valuation allowance
43 0.6 84 1.1 51 0.7 
Other, net26 0.3 (89)(1.2)(106)(1.4)
Total income tax expense$1,933 24.5 %$1,724 22.3 %$1,712 22.5 %
During the year ended December 31, 2024, we recognized income tax expense of $1,933, or $8.30 per diluted share. The increase in effective income tax rate for 2024 compared to 2023 was primarily due to the impact of geographic changes in the mix of 2024 earnings.
During the year ended December 31, 2023, we recognized income tax expense of $1,724, or $7.26 per diluted share. The decrease in effective income tax rate for 2023 compared to 2022 was primarily due to the impact of geographic changes in the mix of 2023 earnings.
During the year ended December 31, 2022, we recognized income tax expense of $1,712, or $7.05 per diluted share.
The change in the carrying amount of gross unrecognized tax benefits from uncertain tax positions for the years ended December 31, 2024 and 2023 is as follows:
20242023
Balance at January 1$468 $349 
Additions based on:
Tax positions related to current year146 19 
Tax positions related to prior years216 119 
Reductions based on:
Tax positions related to prior years(55)(19)
Balance at December 31$775 $468 
The table above excludes interest, net of related tax benefits, which is treated as income tax expense (benefit) under our accounting policy. The interest is included in the amounts described in the following paragraph.
The amount of unrecognized tax benefits that would impact our effective tax rate in future periods, if recognized, was $804 and $450 at December 31, 2024 and 2023, respectively. Also included in the table above, at December 31, 2024, is $2 that would be recognized as an adjustment to additional paid-in capital, which would not affect our effective tax rate.
For the years ended December 31, 2024, 2023 and 2022, we recognized net interest expense of $57, $24 and $13, respectively. We had accrued approximately $165 and $79 for the payment of interest at December 31, 2024 and 2023, respectively. For the years ended December 31, 2024, 2023 and 2022 we recognized net penalty expense of $7, $17 and $0, respectively. We had accrued approximately $85 and $60 for the payment of penalties at December 31, 2024 and 2023, respectively.
As of December 31, 2024, as further described below, certain tax years remain open to examination by the Internal Revenue Service (“IRS”) and various state, local and foreign authorities. As a result of these examinations and discussions with taxing agencies, we have recorded amounts for uncertain tax positions. It is anticipated that the amount of unrecognized tax benefits will change in the next twelve months due to possible settlements of audits and changes in temporary items. However, the ultimate resolution of these items is dependent on the completion of negotiations with various taxing authorities. While it is difficult to determine when other tax settlements will actually occur, it is reasonably possible that one could occur in the next twelve months and our unrecognized tax benefits could be reduced within a range of approximately $137 to $475.
We are a member of the IRS Compliance Assurance Process (“CAP”). The objective of CAP is to reduce taxpayer burden and uncertainty while assuring the IRS of the accuracy of tax returns prior to filing, thereby reducing or eliminating the need for post-filing examinations. As of December 31, 2024, the IRS examination of our 2024, 2023 and 2022 tax years continues to be in process.
In certain states, we pay premium taxes in lieu of state income taxes. Premium taxes are reported in operating expense.
At December 31, 2024, we had federal net operating loss carryforwards of $54, of which $33 will expire beginning 2032 through 2044 and $21 have an indefinite carryforward period. State and local net operating loss carryforwards of $256, of which $194 will expire beginning 2025 through 2044, and $62 have an indefinite carryforward period. Foreign net operating loss carryforward of $90 will expire beginning 2033.
Income taxes receivable totaled $138 and $543 at December 31, 2024 and 2023, respectively. We recognized the income tax receivable of $213 and $543 as an asset under the caption “Other current assets” and the income tax payable of $75 and $0 as a liability under the caption “Other current liabilities” in our consolidated balance sheets as of December 31, 2024 and December 31, 2023, respectively.
During 2024, 2023 and 2022, federal income taxes paid totaled $1,303, $1,936 and $1,594, respectively.
v3.25.0.1
Property and Equipment
12 Months Ended
Dec. 31, 2024
Property, Plant and Equipment [Abstract]  
Property and Equipment Property and Equipment
A summary of property and equipment at December 31, 2024 and 2023 is as follows:
20242023
Computer software, purchased and internally developed$6,617 $6,195 
Computer equipment, furniture and other equipment940 955 
Leasehold improvements744 715 
Building and improvements27 37 
Land and improvements
Property and equipment, gross8,329 7,903 
Accumulated depreciation and amortization(3,677)(3,544)
Property and equipment, net$4,652 $4,359 
Depreciation expense for 2024, 2023 and 2022 was $105, $107 and $123, respectively. Amortization expense on computer software and leasehold improvements for 2024, 2023 and 2022 was $809, $765 and $661, respectively, which includes amortization expense on computer software, both purchased and internally developed, for 2024, 2023 and 2022 of $734, $685 and $599, respectively. Capitalized costs related to the internal development of software of $6,363 and $5,870 at December 31, 2024 and 2023, respectively, are reported with computer software.
Impairment of property and equipment for the years ended December 31, 2024, 2023 and 2022 was $72, $446, and $7, respectively, which is included in Operating expenses and primarily related to our activities disclosed in Note 4, “Business Optimization Initiatives.”
v3.25.0.1
Goodwill and Other Intangible Assets
12 Months Ended
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets
A summary of the change in the carrying amount of goodwill for our segments (see Note 20, “Segment Information”) for 2024 and 2023 is as follows:
Health BenefitsCarelonRxCarelon ServicesTotal
Balance as of January 1, 2023$22,088 $59 $2,236 $24,383 
Acquisitions and adjustments16 898 20 934 
Balance as of December 31, 202322,104 957 2,256 25,317 
Acquisitions and adjustments460 958 1,542 2,960 
Balance as of December 31, 2024$22,564 $1,915 $3,798 $28,277 
Accumulated impairment as of December 31, 2024
$— $— $(106)$(106)
As required by FASB guidance, we completed annual impairment tests of existing goodwill and other intangible assets with indefinite lives during 2024, 2023 and 2022. We perform these annual impairment tests during the fourth quarter. FASB guidance also requires interim impairment testing to be performed when potential impairment indicators exist. These tests involve the use of estimates related to the estimated fair value of goodwill and intangible assets with indefinite lives and require a significant degree of management judgment and the use of subjective assumptions. Qualitative testing procedures include assessing our financial performance, macroeconomic conditions, industry and market considerations, various asset specific factors and entity specific events. For quantitative testing, the fair values are estimated using the projected income and market valuation approaches, incorporating Level III internal estimates for inputs, including, but not limited to, revenue projections, income projections, cash flows and discount rates. 
In 2024, we incurred goodwill impairment losses of $106 in our Carelon Services reporting segment specific to the fair valuation of the CMSI assets included in assets and liabilities held for sale as discussed in Note 5, “Investments.” Otherwise, the estimated fair values of our reporting units were substantially in excess of their carrying values.
We did not incur any impairment losses in 2023 or 2022, as the estimated fair values of our reporting units were substantially in excess of their carrying values.
The components of other intangible assets as of December 31, 2024 and 2023 are as follows:
 20242023
Gross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Gross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Intangible assets with finite lives:
Customer relationships$7,866 $(4,233)$3,633 $6,263 $(3,817)$2,446 
Provider and hospital relationships377 (165)212 326 (164)162 
Other423 (67)356 242 (44)198 
Total8,666 (4,465)4,201 6,831 (4,025)2,806 
Intangible assets with indefinite lives:
Blue Cross and Blue Shield and other trademarks5,991 — 5,991 5,991 — 5,991 
State Medicaid licenses1,902 — 1,902 1,476 — 1,476 
Total7,893 — 7,893 7,467 — 7,467 
Other intangible assets$16,559 $(4,465)$12,094 $14,298 $(4,025)$10,273 
In 2024, additions to the gross carrying amount of customer relationships primarily relate to the acquisitions of Centers, CareBridge and Paragon.
Intangible assets with finite lives, along with the related accumulated amortization, are removed from the table above at the end of the fiscal year in which they become fully amortized.
As of December 31, 2024, the estimated amortization expense for each of the five succeeding years is as follows: 2025, $671; 2026, $474; 2027, $428; 2028, $377; and 2029, $317.
v3.25.0.1
Retirement Benefits
12 Months Ended
Dec. 31, 2024
Retirement Benefits [Abstract]  
Retirement Benefits Retirement Benefits
We sponsor various non-contributory employee defined benefit plans through certain subsidiaries. Future benefit accruals for these plans are frozen, but participants continue to earn interest on existing account balances. We also have a post-retirement health and welfare plan that primarily provides healthcare benefits to certain eligible employees. The majority of the pension and post-retirement plans are over funded. We fund our qualified pension plans at least sufficient to meet minimum amounts required by law. Pension and post-retirement healthcare plan expenses and valuations are dependent on assumptions used by third-party actuaries in calculating those amounts. These assumptions include discount rates, healthcare cost trends, long-term return on plan assets, retirement rates, mortality rates and other factors.
The reconciliation of the benefit obligations for the plans is as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Benefit obligation at beginning of year$1,393 $1,415 $255 $277 
Interest cost63 68 12 14 
Plan participant contributions— — 16 16 
Actuarial (gain) loss(61)40 (10)(12)
Settlements(27)(27)— — 
Benefits paid(105)(103)(35)(40)
Benefit obligation at end of year$1,263 $1,393 $238 $255 
The changes in the fair value of plan assets are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Fair value of plan assets at beginning of year$1,807 $1,734 $313 $299 
Actual return on plan assets83 199 29 42 
Employer contributions— — 
Plan participant contributions— — 16 16 
Settlements(27)(27)— 
Benefits paid(105)(103)(37)(44)
Fair value of plan assets at end of year$1,764 $1,807 $325 $313 
 The amounts included in the consolidated balance sheets are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Noncurrent assets$539 $459 $87 $58 
Current liabilities(4)(7)— — 
Noncurrent liabilities(34)(38)— — 
Net amount at end of year
$501 $414 $87 $58 
Our estimated future payments for pension benefits and other benefits are as follows:
Pension
Benefits
Other
Benefits
2025$128 $26 
2026112 26 
2027109 25 
2028106 24 
2029103 24 
2030 - 2034472 99 
The components of net periodic benefit credit included in the consolidated statements of income are as follows:
202420232022
Pension Benefits
Interest cost$63 $68 $52 
Expected return on assets(117)(127)(101)
Recognized actuarial loss14 16 
Settlement loss28 
Net periodic benefit credit$(34)$(43)$(5)
Other Benefits
Interest Cost
$12 $14 $
Expected return on assets
(22)(21)(26)
Amortization of prior service credit
(1)(2)(4)
Recognized actuarial gain
(1)— — 
Net periodic benefit credit$(12)$(9)$(23)
The net amounts included in accumulated other comprehensive income (loss) that have not been recognized as components of net periodic benefit costs are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Net actuarial gain (loss)
$(580)$(625)$55 $38 
Prior service credit— — — 
Net amount before tax at end of year
$(580)$(625)$55 $40 
The pre-tax amounts recognized in other comprehensive loss are as follows:
202420232022
Pension Benefits
Net actuarial gain (loss)
$25 $31 $(91)
Recognized actuarial loss
14 16 
Settlement loss
28 
Total pre-tax other comprehensive income (loss)
$45 $47 $(47)
Other Benefits
Net actuarial gain (loss)
$17 $34 $(32)
Recognized actuarial gain
(1)— — 
Prior service credit
(1)(2)(5)
Total pre-tax other comprehensive income (loss)
$15 $32 $(37)
The accumulated benefit obligation for the defined benefit pension plans was $1,262 and $1,391 at December 31, 2024 and 2023, respectively. 
As of December 31, 2024, certain pension plans had accumulated benefit obligations in excess of plan assets. Such plans had accumulated benefit obligation and fair value of plan assets of $38 and $0, respectively. In addition, certain plans had projected benefit obligations in excess of plan assets. Such plans had projected benefit obligation and fair value of plan assets of $38 and $0, respectively.
The following table represents the significant weighted-average actuarial assumptions for all plans:
 Pension BenefitsOther Benefits
 2024202320242023
Benefit Obligation
Discount rate
5.47 %4.91 %5.34 %4.83 %
Interest Crediting rate
4.50 %4.50 %4.36 %4.50 %
The following table represents the significant weighted-average actuarial assumptions for all plans:
202420232022
Net Periodic Benefit Cost
Pension Benefits
Discount rate4.91 %5.18 %2.70 %
Expected rate of return on plan assets6.47 %6.58 %5.02 %
Interest crediting rate4.50 %4.25 %3.82 %
Other Benefits
Discount rate4.83 %5.12 %2.49 %
Expected rate of return on plan assets6.64 %6.57 %6.43 %
Interest crediting rate4.50 %3.89 %1.56 %
    
The assumed healthcare cost trend rates used to measure the expected cost of pre-Medicare (those who are not currently eligible for Medicare benefits) benefits at December 31, 2024 was 8.00% for 2025, with a gradual decline to 4.50% by the year 2035. The assumed healthcare cost trend rates used to measure the expected medical and pharmacy cost of post-Medicare (those who are currently eligible for Medicare benefits) benefits at December 31, 2024 was 5.50% and 10.00% for 2025, respectively, both with a gradual decline to 4.50% by the year 2035. These estimated trend rates are subject to change in the future.
Plan assets include a diversified mix of equity securities, investment grade fixed maturity securities and other types of investments across a range of sectors and levels of capitalization to maximize long-term return for a prudent level of risk. The weighted-average target allocation for pension benefit plan assets is 35% equity securities, 63% fixed maturity securities, and 2% to all other types of investments. Equity securities primarily include a mix of domestic securities, foreign securities and mutual funds invested in equities. Fixed maturity securities primarily include corporate bonds, treasury securities and asset-backed investments issued by corporations and the U.S. government. Other types of investments include insurance contracts designed specifically for employee benefit plans, an investment in a DOL 103-12 trust and certain alternative investments.
As of December 31, 2024, there were no significant concentrations of investments in the pension benefit assets or other benefit assets. No plan assets were invested in Elevance Health common stock.
Pension benefit assets and other benefit assets recorded at fair value are categorized based upon the level of judgment associated with the inputs used to measure their fair value. In accordance with FASB guidance, certain alternative investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been classified in the fair value hierarchy. The fair value amounts presented are intended to permit reconciliation of the fair value hierarchy to the total plan assets.
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2024, excluding cash, investment income receivable and amounts due to/from brokers of $30, and excluding estimated claims settlements to be paid from other benefit assets of $(19), are as follows (see Note 7, “Fair Value,” for additional information regarding the definition of level inputs):
Level ILevel IILevel IIITotal
December 31, 2024
Pension Benefit Assets:
Cash equivalents
$$— $— $
Equity securities:
U.S. securities307 — — 307 
Foreign securities71 — — 71 
Mutual funds44 — — 44 
Fixed maturity securities:
Government securities— 78 — 78 
Corporate securities— 539 — 539 
Asset-backed securities— — 
Other types of investments:
Insurance company contracts— — 143 143 
Total pension benefit assets at fair value$428 $620 $143 1,191 
Alternative investments
543 
Total pension benefit assets$1,734 
Other Benefit Assets:
Equity securities:
U.S. securities$$— $— $
Foreign securities— — 
Mutual funds16 — — 16 
Other types of investments:
Life insurance contracts— — 301 301 
Investment in DOL 103-12 trust— — 
Total other benefit assets at fair value
$25 $$301 335 
Alternative investments
Total other benefit assets
$344 
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2023, excluding cash, investment income receivable and amounts due to/from brokers of $43, and excluding estimated claims settlements to be paid from other benefit assets of $(23), are as follows:
Level ILevel IILevel IIITotal
December 31, 2023
Pension Benefit Assets:
Cash equivalents
$$— $— $
Equity securities:
U.S. securities390 — — $390 
Foreign securities94 — — 94 
Mutual funds42 — — 42 
Fixed maturity securities:
Government securities— 70 — 70 
Corporate securities— 522 — 522 
Asset-backed securities— — 
Other types of investments:
Insurance company contracts— — 143 143 
Total pension benefit assets at fair value$528 $594 $143 1,265 
Alternative investments
500 
Total pension benefit assets$1,765 
Other Benefit Assets:
Equity securities:
U.S. securities$$— $— $
Foreign securities— — 
Mutual funds17 — — 17 
Other types of investments:
Life insurance contracts— — 289 289 
Investment in DOL 103-12 trust— — 
Total other benefit assets at fair value
$26 $$289 324 
Alternative investments
11 
Total other benefit assets
$335 
The following table provides additional information on the alternative investments that are measured using NAV as a practical expedient:
Fair Value as of December 31Unfunded Commitments as of December 31, 2024Redemption Frequency (if applicable)Redemption Notice Period
20242023
Collective investment trusts:
Pension benefit assets
$413 $346 
Other benefit assets
Total CITs
421 355 $— 
Daily
2 days
Commingled fund:
Pension benefit assets
69 84 
Other benefit assets
Total commingled fund
70 86 — 
1st & 15th of the month
7 business days
Partnership investments61 70 
Not Applicable
Not Applicable
Total alternative investments$552 $511 $
A reconciliation of the beginning and ending balances of plan assets measured at fair value using Level III inputs for the years ended December 31, 2024, 2023 and 2022 is as follows:
Insurance
Company
Contracts
Life
Insurance
Contracts
Total
Year ended December 31, 2024
Beginning balance at January 1, 2024$143 $289 $432 
Actual return on plan assets relating to assets still held at the reporting date
28 31 
Purchases— 
Sales(9)(16)(25)
Ending balance at December 31, 2024$143 $301 $444 
Year ended December 31, 2023
Beginning balance at January 1, 2023$154 $270 $424 
Actual return on plan assets relating to assets still held at the reporting date
37 40 
Purchases— 
Sales(20)(18)(38)
Ending balance at December 31, 2023$143 $289 $432 
Year ended December 31, 2022
Beginning balance at January 1, 2022$179 $338 $517 
Actual return on plan assets relating to assets still held at the reporting date
(22)(53)(75)
Purchases— 
Sales(12)(15)(27)
Ending balance at December 31, 2022$154 $270 $424 
There were no transfers into or out of Level III during the years ended December 31, 2024, 2023 or 2022.
In addition to the defined benefit plans, we maintain the Elevance Health 401(k) Plan, which is a qualified defined contribution plan covering substantially all employees. Voluntary employee contributions are matched by us subject to certain limitations. Contributions made by us totaled $314, $316 and $275 during 2024, 2023 and 2022, respectively.
v3.25.0.1
Medical Claims Payable
12 Months Ended
Dec. 31, 2024
Insurance [Abstract]  
Medical Claims Payable Medical Claims Payable
A reconciliation of the beginning and ending balances for medical claims payable for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Gross medical claims payable, beginning of year$15,865 $15,348 $13,282 
Ceded medical claims payable, beginning of year(7)(6)(21)
Net medical claims payable, beginning of year15,858 15,342 13,261 
Business combinations and purchase adjustments143 — 133 
Net incurred medical claims:
Current year125,370 121,798 113,414 
Prior years redundancies(1,731)(1,571)(869)
Total net incurred medical claims123,639 120,227 112,545 
Net payments attributable to:
Current year medical claims110,930 107,146 98,997 
Prior years medical claims13,143 12,565 11,600 
Total net payments124,073 119,711 110,597 
Net medical claims payable, end of year15,567 15,858 15,342 
Ceded medical claims payable, end of year13 
Gross medical claims payable, end of year$15,580 $15,865 $15,348 
Amounts incurred related to prior years vary from previously estimated liabilities as the claims are ultimately settled. Liabilities at any period-end are continually reviewed and re-estimated as information regarding actual claims payments, or run out, becomes known. This information is compared to the originally established year end liability. Negative amounts reported for incurred medical claims related to prior years result from claims being settled for amounts less than originally estimated. The prior year redundancy of $1,731 shown above for the year ended December 31, 2024, represents an estimate based on paid claim activity from January 1, 2024 to December 31, 2024. Medical claim liabilities are usually described as having a “short tail,” which means that they are generally paid within twelve months of the member receiving service from the provider. Accordingly, the majority of the $1,731 redundancy relates to claims incurred in calendar year 2023.
The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the years ended December 31, 2024, 2023 and 2022, which are the completion and trend factors. These vital assumptions can be affected by variables such as utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing and submission patterns, and operational changes resulting from business combinations.
 Favorable Developments
by Changes in Key Assumptions
 202420232022
Assumed trend factors$(688)$(895)$(859)
Assumed completion factors(1,043)(676)(10)
Total$(1,731)$(1,571)$(869)
The favorable development recognized in 2024 resulted primarily from completion factors developing more favorably than originally expected as well as a smaller but significant contribution from trend factors in late 2023.
The favorable development recognized in 2023 resulted primarily from trend factors in late 2022 developing more favorably than originally expected. Favorable development in the completion factors in late 2022 also contributed to the favorable development in 2023.
The favorable development recognized in 2022 resulted primarily from trend factors in late 2021 developing more favorably than originally expected as well as a smaller contribution from completion factor development.
The reconciliation of net incurred medical claims to benefit expense included in the consolidated statements of income is as follows:
Years Ended December 31
202420232022
Total net incurred medical claims$123,639 $120,227 $112,545 
Quality improvement and other claims expense3,928 4,103 4,097 
Benefit expense$127,567 $124,330 $116,642 
Incurred claims development, net of reinsurance, for the years ended December 31, 2024, 2023 and 2022 is as follows:
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202220232024
Claim Years(Unaudited)(Unaudited)
2022 & Prior$125,938 $124,367 $124,041 
2023121,798 120,393 
2024125,513 
Total$369,947 
Paid claims development, net of reinsurance, for the years ended December 31, 2024, 2023 and 2022 is as follows:
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202220232024
Claim Years(Unaudited)(Unaudited)
2022 & Prior$110,597 $123,162 $123,849 
2023107,146 119,601 
2024110,930 
Total$354,380 
At December 31, 2024, the total of incurred but not reported liabilities plus expected development on reported claims was $192, $792 and $14,583 for the claim years 2022 and prior, 2023 and 2024, respectively.
At December 31, 2024, the cumulative number of reported claims was 507, 497 and 454 for the claim years 2022 and prior, 2023 and 2024, respectively.
The information about incurred claims development, paid claims development and cumulative number of reported claims for the years ended December 31, 2022 and 2023 is unaudited and presented as supplementary information.
The cumulative number of reported claims for each claim year has been developed using historical data captured by our claim payment systems. The provided claim amounts are not a precise tool for understanding utilization of medical services. They could be impacted by a variety of factors, including changes in provider billing practices, provider reimbursement arrangements, mix of services, benefit design or processing systems. The cumulative number of reported claims has been provided to comply with FASB accounting standards and is not used by management in its claims analysis. Our cumulative number of reported claims may not be comparable to similar measures reported by other health benefits companies.
The reconciliation of incurred and paid claims development information for the three years ended December 31, 2024, reflected in the tables above, to the consolidated ending balance for medical claims payable included in the consolidated balance sheets, as of December 31, 2024, is as follows:
Total
Cumulative incurred claims and allocated claim adjustment expenses, net of reinsurance$369,947 
Less: Cumulative paid claims and allocated claim adjustment expenses, net of reinsurance354,380 
Net medical claims payable, end of year15,567 
Ceded medical claims payable, end of year13 
Insurance lines other than short duration256 
Liabilities held for sale
(90)
Gross medical claims payable, end of year$15,746 
v3.25.0.1
Debt
12 Months Ended
Dec. 31, 2024
Debt Disclosure [Abstract]  
Debt Debt
Short-term Borrowings
We are a member, through certain subsidiaries, of the Federal Home Loan Bank of Indianapolis, the Federal Home Loan Bank of Cincinnati, the Federal Home Loan Bank of Atlanta and the Federal Home Loan Bank of New York (collectively, the “FHLBs”). As a member we have the ability to obtain short-term cash advances, subject to certain minimum collateral requirements. At December 31, 2024 and 2023, $365 and $225, respectively, were outstanding under our short-term FHLB borrowings. Outstanding short-term FHLB borrowings at December 31, 2024 had fixed interest rates of 4.43%.
We have a senior revolving credit facility (the “5-Year Facility”) with a group of lenders for general corporate purposes. The 5-Year Facility provides credit of up to $4,000 and matures in April 2027. Our ability to borrow under the 5-Year Facility is subject to compliance with certain covenants, including covenants requiring us to maintain a defined debt-to-capital ratio of not more than 60%, subject to increase in certain circumstances set forth in the credit agreement for the 5-Year Facility. As of December 31, 2024, our debt-to-capital ratio, as defined and calculated under the 5-Year Facility, was 43.0%. We do not believe the restrictions contained in our 5-Year Facility covenants materially affect our financial or operating flexibility. As of December 31, 2024, we were in compliance with all of our debt covenants under the 5-Year Facility. There were no amounts outstanding under the 5-Year Facility at any time during the years ended December 31, 2024 or 2023.
We have an authorized commercial paper program of up to $4,000, the proceeds of which may be used for general corporate purposes. At December 31, 2024 and 2023, we had $0 outstanding under our commercial paper program. Beginning in 2023, we reclassified our commercial paper balances from long-term debt to short-term debt as our intent is to not replace short-term commercial paper outstanding at expiration with additional short-term commercial paper for an uninterrupted period extending for more than one year.
Long-term Debt
The carrying value of our long-term debt at December 31, 2024 and 2023 consists of the following:
20242023
Senior unsecured notes:
3.350%, due 2024
$— $850 
3.500%, due 2024
— 799 
2.375%, due 2025
1,250 1,251 
5.350%, due 2025
399 399 
1.500%, due 2026
749 747 
4.500%, due 2026
349 — 
4.900%, due 2026
499 496 
3.650%, due 2027
1,596 1,595 
4.101%, due 2028
1,238 1,236 
2.875%, due 2029
822 821 
5.150%, due 2029
601 — 
2.250%, due 2030
1,075 1,075 
4.750%, due 2030
731 — 
2.550%, due 2031
971 972 
4.950%, due 2031
726 — 
4.100%, due 2032
596 595 
5.500%, due 2032
635 658 
4.750%, due 2033
973 992 
5.375%, due 2034
992 — 
5.950%, due 2034
335 335 
5.200%, due 2035
1,151 — 
5.850%, due 2036
397 397 
6.375%, due 2037
364 364 
5.800%, due 2040
115 114 
4.625%, due 2042
860 860 
4.650%, due 2043
975 975 
4.650%, due 2044
768 768 
5.100%, due 2044
548 548 
4.375%, due 2047
1,389 1,388 
4.550%, due 2048
840 840 
3.700%, due 2049
813 813 
3.125%, due 2050
988 988 
3.600%, due 2051
1,234 1,233 
4.550% due 2052
689 689 
6.100%, due 2052
742 742 
5.125%, due 2053
1,084 1,083 
4.850%, due 2054
247 247 
5.650%, due 2054
985 — 
5.700%, due 2055
1,327 — 
5.850% due 2064
789 — 
Surplus note:
9.000%, due 2027
25 25 
Total Long-Term Debt
30,867 24,895 
Current portion of long-term debt
(1,649)(1,649)
Long-term debt, less current portion
$29,218 $23,246 
All debt is a direct obligation of Elevance Health, Inc., except for the surplus note and the FHLB borrowings.
We generally issue senior unsecured notes (“Notes”) for long-term borrowing purposes. Certain of these Notes may have a call feature that allows us to redeem the Notes at any time at our option and/or a put feature that allows a Note holder to
redeem the Notes upon the occurrence of both a change in control event and a downgrade of the Notes below an investment grade rating.
On January 15, 2025, we repaid, at maturity, the $1,250 outstanding balance of our 2.375% senior unsecured notes.
On December 1, 2024, we repaid, at maturity, the $850 outstanding balance of our 3.35% senior unsecured notes.
On October 31, 2024, we issued $350 aggregate principal amount of 4.500% Notes due 2026 (the “New 2026 Notes”), $750 aggregate principal amount of 4.750% Notes due 2030 (the “2030 Notes”), $750 aggregate principal amount of 4.950% Notes due 2031 (the “2031 Notes”), $1,200 aggregate principal amount of 5.200% Notes due 2035 (the “2035 Notes”), $1,350 aggregate principal amount of 5.700% Notes due 2055 (the “2055 Notes”) and $800 aggregate principal amount of 5.850% Notes due 2064 (the “2064 Notes”) under our shelf registration statement. Interest on the New 2026 Notes is payable semi-annually in arrears on April 30 and October 30 of each year, commencing April 30, 2025. Interest on the 2030 Notes, 2035 Notes and 2055 Notes are payable semi-annually in arrears on February 15 and August 15 of each year, commencing February 1, 2025. Interest on the 2031 Notes and 2064 Notes are payable semi-annually in arrears on May 1 and November 1 of each year, commencing May 1, 2025. We used the net proceeds for working capital and general corporate purposes, including, but not limited to, the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
On August 15, 2024, we repaid, at maturity, the $799 outstanding balance of our 3.500% senior unsecured notes.
On May 30, 2024, we issued $600 aggregate principal amount of 5.150% Notes due 2029 (the “2029 Notes”), $1,000 aggregate principal amount of 5.375% Notes due 2034 (the “2034 Notes”) and $1,000 aggregate principal amount of 5.650% Notes due 2054 (the “2054 Notes”, and, together with the 2029 Notes and the 2034 Notes, the “Notes”) under our shelf registration statement. Interest on the Notes is payable semi-annually in arrears on June 15 and December 15 of each year, commencing December 15, 2024. We used the net proceeds for working capital and general corporate purposes, including, but not limited to, the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
On February 8, 2023, we issued $500 aggregate principal amount of 4.900% Notes due 2026 (the “2026 Notes”), $1,000 aggregate principal amount of 4.750% Notes due 2033 (the “2033 Notes”) and $1,100 aggregate principal amount of 5.125% Notes due 2053 (the “2053 Notes”) under our shelf registration statement. Interest on the 2026 Notes is payable semi-annually in arrears on February 8 and August 8 of each year, commencing August 8, 2023. Interest on the 2033 Notes and 2053 Notes is payable semi-annually in arrears on February 15 and August 15 of each year, commencing August 15, 2023. We used the net proceeds for working capital and general corporate purposes, including, but not limited to, the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
On January 17, 2023, we repaid, at maturity, the $1,000 outstanding balance of our 3.300% senior unsecured notes. On March 15, 2023, we repaid, at maturity, the $500 outstanding balance of our 0.450% senior unsecured notes.
On December 1, 2022, we repaid, at maturity, the $750 outstanding balance of our 2.950% senior unsecured notes.
On November 4, 2022, we issued $400 aggregate principal amount of 5.350% Notes due 2025, $650 aggregate principal amount of 5.500% Notes due 2032 and $750 aggregate principal amount of 6.100% Notes due 2052 under our shelf registration statement. Interest on these notes is payable semi-annually in arrears on April 15 and October 15 of each year, commencing April 15, 2023. We used the net proceeds for working capital and general corporate purposes, such as the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
On May 16, 2022, we repaid, at maturity, the $850 outstanding balance of our 3.125% senior unsecured notes.
On April 29, 2022, we issued $600 aggregate principal amount of 4.100% Notes due 2032 and $700 aggregate principal amount of 4.550% Notes due 2052 under our shelf registration statement. Interest on these notes is payable semi-annually in arrears on May 15 and November 15 of each year, commencing November 15, 2022. We used the net proceeds for working
capital and general corporate purposes, such as the funding of acquisitions, repayment of short-term and long-term debt and the repurchase of our common stock pursuant to our share repurchase program.
Convertible Debentures
On March 15, 2023, we redeemed all of our outstanding senior unsecured convertible debentures due 2042 (the “Debentures”), pursuant to the indenture dated as of October 9, 2012 (the “Indenture”) between us and The Bank of New York Mellon Trust Company, N.A., as trustee. The Debentures were redeemed at a redemption price equal to 100% of the principal amount of the Debentures plus accrued and unpaid interest to, but excluding, the date of redemption for cash totaling $5. During the three months ended March 31, 2023, $59 of aggregate principal amount of the Debentures was surrendered for conversion by certain holders in accordance with the terms and conditions of the Indenture. We elected to settle the excess of the principal amount of the conversions with cash for total payments during the three months ended March 31, 2023 of $404.
During the year ended December 31, 2022, $41 aggregate principal amount of the Debentures was surrendered for conversion by certain holders in accordance with the terms and provisions of the Indenture. We elected to settle the excess of the principal amount of the conversion with cash for total payments of $299. We recognized $2 of interest expense related to the Debentures during 2022.
Interest paid on our total outstanding debt during 2024, 2023 and 2022 was $1,239, $1,032, and $878, respectively. 
We were in compliance with all applicable covenants under all of our outstanding debt agreements at December 31, 2024 and 2023.
Future maturities of all long-term debt outstanding at December 31, 2024 are as follows: 2025, $1,649; 2026, $1,596; 2027, $1,621; 2028, $1,237; 2029, $1,423 and thereafter, $23,341.
v3.25.0.1
Commitments and Contingencies
12 Months Ended
Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies Commitments and Contingencies
Litigation and Regulatory Proceedings
We are defendants in, or parties to, a number of pending or threatened legal actions or proceedings. To the extent a plaintiff or plaintiffs in the following cases have specified in their complaint or in other court filings the amount of damages being sought, we have noted those alleged damages in the descriptions below.
Where available information indicates that it is probable that a loss has been incurred as of the date of the consolidated financial statements and we can reasonably estimate the amount of that loss, we accrue the estimated loss by a charge to income. In many proceedings, however, it is difficult to determine whether any loss is probable or reasonably possible. In addition, even where loss is possible or probable or an exposure to loss exists in excess of the liability already accrued with respect to a previously identified loss contingency, it is not always possible to reasonably estimate the amount of the possible or probable loss or range of losses in excess of the amount, if any, accrued, for various reasons, including but not limited to some or all of the following: (i) there are novel or unsettled legal issues presented, (ii) the proceedings are in early stages, (iii) there is uncertainty as to the likelihood of a class being certified or decertified or the ultimate size and scope of the class, (iv) there is uncertainty as to the outcome of pending appeals or motions, (v) there are significant factual issues to be resolved, and/or (vi) in many cases, the plaintiffs have not specified damages in their complaint or in court filings.
With respect to the cases described below, we contest liability and/or the amount of damages in each matter, and we believe we have meritorious defenses. We do not believe the outcome of any known pending or threatened legal actions or proceedings will, in the aggregate, have a material impact on our financial position. However, unanticipated outcomes do sometimes occur, which could result in liabilities in excess of our accruals and could have a material adverse effect on our consolidated financial position or results of operations.
In addition to the lawsuits described below, we are also involved in other pending and threatened litigation of the character incidental to our business and are from time to time involved as a party in various governmental investigations, audits, reviews and administrative proceedings (“government actions”). These government actions include routine and special inquiries by and disclosures to state insurance departments, state attorneys general, U.S. Regulatory Agencies, the U.S.
Attorney General and subcommittees of the U.S. Congress. Such government actions could result in the imposition of civil or criminal fines, penalties, other sanctions and additional rules, regulations or other restrictions on our business operations. Any liability that may result from any one of these government actions individually, or in the aggregate, could have a material adverse effect on our consolidated financial position or results of operations.
Blue Cross Blue Shield Antitrust Litigation
We are a defendant in multiple lawsuits that were initially filed in 2012 against the BCBSA and Blue Cross and/or Blue Shield licensees (the “Blue plans”) across the country. Cases filed in twenty-eight states were consolidated into a single, multi-district proceeding captioned In re Blue Cross Blue Shield Antitrust Litigation that is pending in the U.S. District Court for the Northern District of Alabama (the “Court”). Generally, the suits allege that the BCBSA and the Blue plans have conspired to horizontally allocate geographic markets through license agreements, best efforts rules that limit the percentage of non-Blue revenue of each plan, restrictions on acquisitions, rules governing the BlueCard® and National Accounts programs and other arrangements in violation of the Sherman Antitrust Act and related state laws. The cases were brought by two putative nationwide classes of plaintiffs, health plan subscribers and providers.
The BCBSA and Blue plans approved a settlement agreement and release with the subscriber plaintiffs (the “Subscriber Settlement Agreement”), which agreement required the Court’s approval to become effective. The Subscriber Settlement Agreement requires the defendants to make a monetary settlement payment and contains certain terms imposing non-monetary obligations including (i) eliminating the “national best efforts” rule in the BCBSA license agreements (which rule limits the percentage of non-Blue revenue permitted for each Blue plan) and (ii) allowing for some large national employers with self-funded benefit plans to request a bid for insurance coverage from a second Blue plan in addition to the local Blue plan.
In November 2020, the Court issued an order preliminarily approving the Subscriber Settlement Agreement, following which members of the subscriber class were provided notice of the Subscriber Settlement Agreement and an opportunity to opt out of the class. A small number of subscribers submitted valid opt-outs by the opt-out deadline.
In August 2022, the Court issued a final order approving the Subscriber Settlement Agreement (the “Final Approval Order”). The Court amended its Final Approval Order in September 2022, further clarifying the injunctive relief that may be available to subscribers who submitted valid opt-outs. The ultimate amount paid by us under the Subscriber Settlement Agreement was $604.
Four notices of appeal of the Final Approval Order were heard by a panel of the United States Court of Appeals for the Eleventh Circuit (the “Eleventh Circuit”) in September 2023, and the Eleventh Circuit affirmed the Court’s Final Approval Order approving the Subscriber Settlement Agreement in October 2023. Petitions for rehearing were filed by certain appellants in November 2023 and December 2023 and were denied in January 2024. As a result, the Eleventh Circuit issued a mandate terminating the jurisdiction of the Eleventh Circuit in February 2024. In March 2024, Home Depot, one of the appellants, filed a petition for certiorari to the United States Supreme Court (the “Supreme Court”). On the respondents' request, the Supreme Court granted an extension to respond until May 2024. In April 2024, David Behenna, another appellant, filed a petition for certiorari to the Supreme Court, and the defendants and the subscriber plaintiffs filed briefs in opposition in May 2024. In June 2024, the Supreme Court declined to grant certiorari, exhausting all appellate rights. The Subscriber Settlement Agreement and the defendants' payment and non-monetary obligations under the Subscriber Settlement Agreement became effective in June 2024, with the request for second Blue plan bid provisions effective in September 2024. The funds held in escrow will be distributed in accordance with the Subscriber Settlement Agreement.
A number of follow-on cases involving entities that opted out of the Subscriber Settlement Agreement have been filed. Those actions are: Alaska Air Group, Inc., et al. v. Anthem, Inc., et al., No. 2:21-cv-01209-AMM (N.D. Ala.) (“Alaska Air”); JetBlue Airways Corp., et al. v. Anthem, Inc., et al., No. 2:22-cv-00558-GMB (N.D. Ala.) (“Jet Blue”); Metropolitan Transportation Authority v. Blue Cross and Blue Shield of Alabama et al., No. 2:22-cv-00265-RDP (N.D. Ala.) (dismissed without prejudice in June 2023); Bed Bath & Beyond Inc. v. Anthem, Inc., No. 2:22-cv-01256-SGC (N.D. Ala.); Hoover, et al. v. Blue Cross Blue Shield Association, et al., No. 2:22-cv-00261-RDP (N.D. Ala.); and VHS Liquidating Trust v. Blue Cross of California, et al., No. RG21106600 (Cal. Super.) (“VHS”). In February 2023, the Court denied the defendants’ motion to dismiss based on a statute of limitations defense in Alaska Air and Jet Blue. In September 2023, the California court presiding over the VHS case, upheld its prior order granting in part defendants’ motion to strike based on the statute of
limitations. We intend to continue to vigorously defend these follow-on cases, which we believe are without merit; however, their ultimate outcome cannot be presently determined.
In October 2020, after the Court lifted the stay as to the provider litigation, provider plaintiffs filed a renewed motion for class certification, which defendants opposed. In March 2021, the Court issued an order terminating the pending motion for class certification until the Court determined the standard of review applicable to the providers’ claims. In response to that order, the parties filed renewed standard of review motions, and in June 2021, the parties filed summary judgment motions not critically dependent on class certification. In February 2022, the Court issued orders (i) granting certain defendants’ motion for partial summary judgment against the provider plaintiffs who had previously released claims against such defendants, and (ii) granting the provider plaintiffs’ motion for partial summary judgment, determining that Ohio v. American Express Co. does not affect the standard of review in this case. In August 2022, the Court issued orders (i) granting in part the defendants’ motion regarding the antitrust standard of review, holding that for the period of time after the elimination of the “national best efforts” rule, the rule of reason applies to the provider plaintiffs’ market allocation conspiracy claims, and (ii) denying the provider plaintiffs’ motion for partial summary judgment on the standard of review, reaffirming its prior holding that the provider groups’ boycott claims are subject to the rule of reason. In December 2023, the Court denied defendants’ motion for summary judgment on providers’ damage claims as time-barred and speculative and provider plaintiffs’ motion for partial summary judgment on the defendants’ single entity defense due to the existence of genuine issues of material fact. In January 2024, the Court issued orders (i) denying defendants’ motion for summary judgment on (a) all claims by certain hospital providers and (b) any claims based on the Blue system's rules other than exclusive serviced areas or BlueCard and (ii) denying provider plaintiffs’ motion for partial summary judgment on defendants’ common law trademark claims.
In the third quarter of 2024, the BCBSA, along with the individually named Blue plans approved a settlement agreement and release (the “Provider Settlement Agreement”) with the provider plaintiffs, and in October 2024 the provider plaintiffs filed a motion for preliminary approval with the Court. The Court granted preliminary approval of the provider settlement on December 4, 2024. If finally approved by the Court, the Provider Settlement Agreement will require the defendants to make a monetary settlement payment, our portion of which is estimated to be $666, and will contain certain non-monetary terms including (i) expansion of certain opportunities to contract with providers in contiguous service areas, (ii) certain prompt pay commitments, and (iii) various technological enhancements to the BlueCard program. We recognized our estimated payment obligation under the Provider Settlement Agreement of $666 in September 2024. We recognized this estimated payment obligation as operating expense in the Corporate & Other segment (see Note 20, “Segment Information”).
Express Scripts, Inc. Pharmacy Benefit Management Litigation
In March 2016, we filed a lawsuit against Express Scripts, Inc. (“Express Scripts”), our vendor at the time for pharmacy benefit management services, captioned Anthem, Inc. v. Express Scripts, Inc., in the U.S. District Court for the Southern District of New York (the “District Court”). The lawsuit sought to recover over $14,800 in damages for pharmacy pricing that is higher than competitive benchmark pricing under the agreement between the parties (the “ESI Agreement”), over $158 in damages related to operational breaches, as well as various declarations under the ESI Agreement, including that Express Scripts: (i) breached its obligation to negotiate in good faith and to agree in writing to new pricing terms (the “Pricing Claim”); (ii) was required to provide competitive benchmark pricing to us through the term of the ESI Agreement; (iii) has breached the ESI Agreement; and (iv) is required under the ESI Agreement to provide post-termination services, at competitive benchmark pricing, for one year following any termination.
Express Scripts disputed our contractual claims and it sought declaratory judgments: (i) regarding the timing of the periodic pricing review under the ESI Agreement, and (ii) that it has no obligation to ensure that we receive any specific level of pricing, that we have no contractual right to any change in pricing under the ESI Agreement and that its sole obligation is to negotiate proposed pricing terms in good faith. In the alternative, Express Scripts claimed that we have been unjustly enriched by its payment of $4,675 at the time we entered into the ESI Agreement. In March 2017, the District Court granted our motion to dismiss Express Scripts’ counterclaims for (i) breach of the implied covenant of good faith and fair dealing, and (ii) unjust enrichment with prejudice. After such ruling, Express Scripts’ only remaining claims were for breach of contract and declaratory relief. In August 2021, Express Scripts filed a motion for summary judgment, which we opposed. In March 2022, the District Court granted in part and denied in part Express Scripts’ motion for summary judgment. The District Court dismissed our declaratory judgment claim, our breach of contract claim for failure to prove damages and most of our operational breach claims. As a result of the summary judgment decision, only two claims remained. Express Scripts filed a second motion for summary judgment in June 2022, challenging our remaining operational breach claims, which the
District Court denied in March 2023. In November 2023, the District Court issued a final judgment ending the lawsuit in the District Court after the parties settled and stipulated to dismiss the only remaining claim that had not been disposed of by the court order or stipulation. In December 2023, we filed a notice of appeal with the United States Court of Appeals for the Second Circuit (the “Second Circuit”), regarding the Pricing Claim. Mediation ordered by the Second Circuit occurred in March 2024 and was unsuccessful. Oral argument before the Second Circuit was held in October 2024. In November 2024, the Court affirmed the trial court's decision dismissing the case. A motion for rehearing was submitted which was denied. The matter is now closed.
Medicare Risk Adjustment Litigation
In March 2020, the U.S. Department of Justice (“DOJ”) filed a civil lawsuit against Elevance Health, Inc. in the District Court in a case captioned United States v. Anthem, Inc. The DOJ’s suit alleges, among other things, that we falsely certified the accuracy of the diagnosis data we submitted to the Centers for Medicare and Medicaid Services (“CMS”) for risk-adjustment purposes under Medicare Part C and knowingly failed to delete inaccurate diagnosis codes. The DOJ further alleges that, as a result of these purported acts, we caused CMS to calculate the risk-adjustment payments based on inaccurate diagnosis information, which enabled us to obtain unspecified amounts of payments in Medicare funds in violation of the False Claims Act. The DOJ filed an amended complaint in July 2020, alleging the same causes of action but revising some of its factual allegations. In September 2020, we filed a motion to transfer the lawsuit to the Southern District of Ohio, a motion to dismiss part of the lawsuit, and a motion to strike certain allegations in the amended complaint, all of which the District Court denied in October 2022. In November 2022, we filed an answer. In March 2023, discovery commenced, and an initial case management conference was held in April 2023. Fact discovery is ongoing. In December 2024, the District Court issued a scheduling order setting the deadlines for the completion of fact discovery in August 2025 and April 2026 for the completion of expert discovery. We intend to continue to vigorously defend this suit, which we believe is without merit; however, the ultimate outcome cannot be presently determined.
Other Contingencies
From time to time, we and certain of our subsidiaries are parties to various legal proceedings, many of which involve claims for coverage encountered in the ordinary course of business. We, like Health Maintenance Organizations (“HMOs”) and health insurers generally, exclude certain healthcare and other services from coverage under our HMO, Preferred Provider Organizations and other plans. We are, in the ordinary course of business, subject to the claims of our enrollees arising out of decisions to restrict or deny reimbursement for uncovered services. The loss of even one such claim, if it results in a significant punitive damage award, could have a material adverse effect on us. In addition, the risk of potential liability under punitive damage theories may increase significantly the difficulty of obtaining reasonable reimbursement of coverage claims.
Contractual Obligations and Commitments
In September 2024, we extended our agreement with a vendor for information technology infrastructure and related management and support services through June 2029. Our remaining commitment under this agreement is approximately $2,065. We have the ability to terminate the agreement upon the occurrence of certain events, subject to early termination fees.
CarelonRx markets and offers pharmacy services to our affiliated health plan customers throughout the country, as well as to customers outside of the health plans we own. The comprehensive pharmacy services portfolio includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services. CarelonRx delegates certain core pharmacy services to CVS, pursuant to the CVS Agreement, with the current contractual term extending through December 31, 2027. We can elect to have CVS continue to provide services to us for a three-year extension period on the same terms and conditions as in the current CVS Agreement in the event of a termination or non-renewal by either party.
We have financial guarantees related to standby letters of credit and surety bonds related to certain contractual commitments which totaled $912 as of December 31, 2024. We do not believe such obligations will materially affect its financial position, results of operations, or cash flows.
The Company has unfunded loan commitments to certain equity investees of $501 at December 31, 2024. The Company does not believe such obligations will materially affect its financial position, results of operations, or cash flows.
Vulnerability from Concentrations
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash equivalents, investment securities, premium receivables and instruments held through hedging activities. All investment securities are managed by professional investment managers within policies authorized by our Board of Directors. Such policies limit the amounts that may be invested in any one issuer and prescribe certain investee company criteria. Concentrations of credit risk with respect to premium receivables are limited due to the large number of employer groups that constitute our customer base in the states in which we conduct business. As of December 31, 2024, there were no significant concentrations of financial instruments in a single investee, industry or geographic location.
v3.25.0.1
Capital Stock
12 Months Ended
Dec. 31, 2024
Class of Stock Disclosures [Abstract]  
Capital Stock Capital Stock
Stock Incentive Plans
Our Board of Directors has adopted the 2017 Elevance Health Incentive Compensation Plan (the “2017 Incentive Plan”) which has been approved by our shareholders. The term of the 2017 Incentive Plan is such that no awards may be granted on or after May 18, 2027. The 2017 Incentive Plan gives authority to the Compensation and Talent Committee of the Board of Directors to make incentive awards to our non-employee directors, employees and consultants, consisting of stock options, stock, restricted stock, restricted stock units, cash-based awards, stock appreciation rights, performance shares and performance units. The 2017 Incentive Plan limits the number of available shares for issuance to 37.5 shares, subject to adjustment as set forth in the 2017 Incentive Plan.
Stock options are granted for a fixed number of shares with an exercise price at least equal to the fair value of the shares at the grant date. Stock options vest over three years in equal annual installments and generally have a term of ten years from the grant date.
Certain option grants contain provisions whereby the employee continues to vest in the award subsequent to termination due to retirement. Our attribution method for newly granted awards considers all vesting and other provisions, including retirement eligibility, in determining the requisite service period over which the fair value of the awards will be recognized.
Awards of restricted stock or restricted stock units are issued at the fair value of the stock on the grant date and may also include one or more performance measures that must be met for the award to vest. For restricted stock or restricted stock units without performance measures, the restrictions lapse in three equal annual installments. Restricted stock or restricted stock units with performance measures vest in three-year installments. Performance units issued in 2024 will vest in 2027, based on certain revenue and earnings targets over the three-year period of 2024 to 2026. Performance units issued in 2023 will vest in 2026, based on certain revenue and earnings targets over the three-year period of 2023 to 2025. Performance units issued in 2022 will vest in 2025, based on certain revenue and earnings targets over the three-year period of 2022 to 2024.
For the years ended December 31, 2024, 2023 and 2022, we recognized share-based compensation expense of $191, $289 and $264, respectively, as well as related tax benefits of $47, $73 and $66, respectively.
A summary of stock option activity for the year ended December 31, 2024 is as follows:
Number of
Shares
Weighted-Average
Option Price
per Share
Weighted-Average
Remaining
Contractual Life
(Years)
Aggregate
Intrinsic
Value
Outstanding at January 1, 20243.0 $327.14 
Granted0.5 499.52 
Exercised(0.5)286.33 
Forfeited or expired(0.1)459.14 
Outstanding at December 31, 20242.9 361.36 5.58$166 
Exercisable at December 31, 20241.9 300.24 4.41$166 
The intrinsic value of options exercised during the years ended December 31, 2024, 2023 and 2022 amounted to $123, $69 and $120, respectively. We recognized tax benefits of $21, $18 and $31 during the years ended December 31, 2024, 2023 and 2022, respectively, from option exercises and disqualifying dispositions. During the years ended December 31, 2024, 2023 and 2022, we received cash of $154, $87 and $120, respectively, from exercises of stock options.
The total fair value of restricted stock awards that vested during the years ended December 31, 2024, 2023 and 2022 was $298, $285 and $261, respectively.
A summary of the status of nonvested restricted stock activity, including restricted stock units and performance units, for the year ended December 31, 2024 is as follows:
Restricted
Stock Shares
and Units
Weighted-Average
Grant Date
Fair Value
per Share
Nonvested at January 1, 20241.1 $423.94 
Granted0.6 501.78 
Vested(0.6)358.21 
Forfeited(0.1)479.40 
Nonvested at December 31, 20241.0 478.70 
During the year ended December 31, 2024, we granted approximately 0.2 restricted stock units that are contingent upon us achieving certain revenue and earnings targets over the three-year period of 2024 to 2026. These grants have been included in the activity shown above, but will be subject to adjustment at the end of 2026, based on results in the three-year period.
As of December 31, 2024, the total remaining unrecognized compensation expense related to nonvested stock options and restricted stock, including restricted stock units and performance units, amounted to $37 and $203, respectively, which will be amortized over the weighted-average remaining requisite service periods of 9 months and 13 months, respectively.
As of December 31, 2024, there were approximately 10.2 shares of common stock available for future grants under the 2017 Incentive Plan.
 Fair Value
We use a binomial lattice valuation model to estimate the fair value of all stock options granted. Expected volatility assumptions used in the binomial lattice model are based on an analysis of implied volatility of publicly traded options on our stock and historical volatility of our stock price. The risk-free interest rate is derived from the U.S. Treasury strip rates at the time of the grant. The expected term of the options was derived from the outputs of the binomial lattice model, which incorporates post-vesting forfeiture assumptions based on an analysis of historical data. The dividend yield was based on our estimate of future dividend yields. Similar groups of employees that have dissimilar exercise behavior are considered separately for valuation purposes. We utilize the multiple-grant approach for recognizing compensation expense associated with each separately vesting portion of the share-based award.
The following weighted-average assumptions were used to estimate the fair values of options granted during the years ended December 31, 2024, 2023 and 2022:
202420232022
Risk-free interest rate4.28 %3.95 %1.97 %
Volatility factor28.00 %29.00 %29.00 %
Dividend yield (annual)1.31 %1.30 %1.10 %
Weighted-average expected life (years)4.404.405.10
The following weighted-average fair values per share were determined for the years ended December 31, 2024, 2023 and 2022:
202420232022
Options granted during the year$134.61 $126.90 $116.92 
Restricted stock awards granted during the year501.78 467.79 453.70 
The binomial lattice option-pricing model requires the input of subjective assumptions including the expected stock price volatility. Because our stock option grants have characteristics significantly different from those of traded options, and because changes in the subjective input assumptions can materially affect the fair value estimate, in our opinion, existing models do not necessarily provide a reliable single measure of the fair value of our stock option grants.
Employee Stock Purchase Plan
We have registered 14.0 shares of common stock for the Employee Stock Purchase Plan (the “Stock Purchase Plan”), which is intended to provide a means to encourage and assist employees in acquiring a stock ownership interest in Elevance Health. Pursuant to the terms of the Stock Purchase Plan, an eligible employee is permitted to purchase no more than $25,000 (actual dollars) worth of stock in any calendar year, based on the fair value of the stock at the end of each plan quarter. Employees become participants by electing payroll deductions from 1% to 15% of gross compensation. Once purchased, the stock is accumulated in the employee’s investment account. The Stock Purchase Plan allows participants to purchase shares of our common stock at a discounted price per share of 90% of the fair value of a share of common stock on the lower of the first or last trading day of the plan quarter purchase period. The Stock Purchase Plan discount was recognized as compensation expense for the year ended December 31, 2024, based on GAAP guidance. During the years ended December 31, 2024, 2023 and 2022, we issued 0.2, 0.1 and 0.1 shares, respectively, under the Stock Purchase Plan, and we received cash of $65, $65 and $62, respectively, for such shares. As of December 31, 2024, 4.0 shares were available for issuance under the Stock Purchase Plan.
Use of Capital and Stock Repurchase Program
We regularly review the appropriate use of capital, including acquisitions, common stock and debt security repurchases and dividends to shareholders. The declaration and payment of any dividends or repurchases of our common stock or debt is at the discretion of our Board of Directors and depends upon our financial condition, results of operations, future liquidity needs, regulatory and capital requirements and other factors deemed relevant by our Board of Directors.
A summary of the cash dividend activity for the years ended December 31, 2024 and 2023 is as follows:
Declaration DateRecord DatePayment DateCash Dividend
per Share
Total
Year ended December 31, 2024
January 23, 2024March 8, 2024March 22, 2024$1.63 $379 
April 16, 2024June 10, 2024June 25, 20241.63 378 
July 16, 2024September 10, 2024September 25, 20241.63 378 
October 15, 2024December 5, 2024December 20, 20241.63 373 
Year ended December 31, 2023
January 24, 2023March 10, 2023March 24, 2023$1.48 $351 
April 18, 2023June 9, 2023June 23, 20231.48 350 
July 18, 2023September 8, 2023September 22, 20231.48 348 
October 17, 2023December 6, 2023December 21, 20231.48 346 
On January 22, 2025, our Audit Committee declared a quarterly cash dividend to shareholders of $1.71 per share on the outstanding shares of our common stock. This quarterly dividend is payable on March 25, 2025 to the shareholders of record as of March 10, 2025.
Under our Board of Directors’ authorization, we maintain a common stock repurchase program. On October 15, 2024, our Audit Committee, pursuant to authorization granted by the Board of Directors, authorized an $8,000 increase to the common stock repurchase program. No duration has been placed on our common stock repurchase program, and we reserve the right to discontinue the program at any time. We intend to utilize this authorization over a multi-year period, subject to market and industry conditions. Repurchases may be made from time to time at prevailing market prices, subject to certain restrictions on volume, pricing and timing. The repurchases are affected from time to time in the open market, through negotiated transactions, including accelerated share repurchase agreements, and through plans designed to comply with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. Our stock repurchase program is discretionary, as we are under no obligation to repurchase shares. We repurchase shares under the program when we believe it is a prudent use of capital. The excess cost of the repurchased shares over par value is charged on a pro rata basis to additional paid-in capital and retained earnings.
A summary of common stock repurchases for the years ended December 31, 2024 and 2023 is as follows:
Years Ended December 31
 20242023
Shares repurchased6.7 5.8 
Average price per share$435.32 $463.53 
Aggregate cost$2,900 $2,676 
Authorization remaining at end of year$9,300 $4,200 
We expect to utilize the remaining authorized amount over a multi-year period, subject to market and industry conditions.
For additional information regarding the use of capital for debt security repurchases, see Note 13, “Debt.”
v3.25.0.1
Accumulated Other Comprehensive (Loss) Income
12 Months Ended
Dec. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Accumulated Other Comprehensive (Loss) Income Accumulated Other Comprehensive (Loss) Income
A reconciliation of the components of accumulated other comprehensive (loss) income at December 31, 2024, 2023, and 2022 is as follows:
202420232022
Net unrealized investment gains:
Beginning of year balance$(632)$(1,755)$494 
Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $44, $(218), and $926, respectively
(153)760 (2,614)
Amounts reclassified from accumulated other comprehensive income, net of tax expense of $(82), $(113), and $(94), respectively
256 357 354 
Other comprehensive income (loss)
103 1,117 (2,260)
Other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively
11 
End of year balance(523)(632)(1,755)
Non-credit components of impairments on investments:
Beginning of year balance(3)(3)— 
Other comprehensive income (loss), net of tax expense of $(1), $0, and $0, respectively
— (3)
End of year balance(2)(3)(3)
Net cash flow hedges:
Beginning of year balance(211)(229)(239)
Other comprehensive income, net of tax benefit (expense) of $(4), $6, and $(6), respectively
18 10 
End of year balance(207)(211)(229)
Pension and other benefits:
Beginning of year balance(459)(499)(429)
Other comprehensive income (loss), net of tax expense of $0, $(39), and $(23), respectively
60 40 (70)
End of year balance(399)(459)(499)
Future policy benefits:
Beginning of year balance10 13 (19)
Other comprehensive (loss) income, net of tax benefit (expense) of $1, $1, and $(10), respectively
(2)(3)32 
End of year balance10 13 
Foreign currency translation adjustments:
Beginning of year balance(18)(17)(4)
Other comprehensive loss, net of tax benefit of $0, $1, and $6
(6)(1)(13)
End of year balance(24)(18)(17)
Total:
Total beginning of year accumulated other comprehensive loss
(1,313)(2,490)(197)
Total other comprehensive income (loss), net of tax benefit (expense) of $(42), $(362), and $799, respectively
160 1,171 (2,304)
Total other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively
11 
Total end of year accumulated other comprehensive loss
$(1,147)$(1,313)$(2,490)
v3.25.0.1
Reinsurance
12 Months Ended
Dec. 31, 2024
Reinsurance Disclosures [Abstract]  
Reinsurance Reinsurance
We reinsure certain risks with other companies and assume risk from other companies. We remain primarily liable to policyholders under ceded insurance contracts and are contingently liable for amounts recoverable from reinsurers in the event that such reinsurers do not meet their contractual obligations.
A summary of direct, assumed and ceded premiums earned for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
Direct$139,479$136,927$127,788
Assumed4,7535,9885,505
Ceded(66)(61)(64)
Net premiums$144,166$142,854$133,229
Percentage—assumed to net premiums
3.3 %4.2 %4.1 %
The difference between written premiums and earned premiums is immaterial in each of the years presented above.
A summary of net premiums earned by segment (see Note 20, “Segment Information”) for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
Reportable segments:
Health Benefits$142,668 $141,515 $131,964 
Carelon Services2,630 1,679 1,499 
Eliminations(1,132)(340)(234)
Net premiums$144,166 $142,854 $133,229 
The effect of reinsurance on benefit expense for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Direct$123,602 $119,409 $112,061 
Assumed4,021 4,984 4,633 
Ceded(56)(63)(52)
Net benefit expense$127,567 $124,330 $116,642 
v3.25.0.1
Leases
12 Months Ended
Dec. 31, 2024
Leases [Abstract]  
Leases Leases
We lease office space and certain computer and related equipment using noncancelable operating leases. Our leases have remaining lease terms of 1 year to 11 years.
The information related to our leases is as follows:
Balance Sheet LocationDecember 31, 2024December 31, 2023
Operating Leases
ROU assetsOther noncurrent assets$567 $584 
Lease liabilities, currentOther current liabilities153 164 
Lease liabilities, noncurrentOther noncurrent liabilities658 685 
Years Ended December 31
202420232022
Lease Expense
Operating lease expense$147$155$143 
Short-term and variable lease expense474335 
Sublease income(6)(5)(3)
Total lease expense$188$193 $175 
Our activities as disclosed in Note 4, “Business Optimization Initiatives,” include reducing our office space footprint. As a result, we performed an interim impairment test during the years ended December 31, 2024, 2023 and 2022, and recorded impairment charges of $17, $23 and $34, respectively, for impairment and abandonment of ROU assets which are included in the operating lease expense shown above.
Years Ended December 31
20242023
Other information
Operating cash paid for amounts included in the measurement of lease liabilities, operating leases$202$206
ROU assets obtained in exchange for new lease liabilities, operating leases$44$59
Weighted average remaining lease term in years, operating leases66
Weighted average discount rate, operating leases3.96 %3.66 %
At December 31, 2024, future lease payments for noncancelable operating leases with initial or remaining terms of one year or more are as follows:
2025$184 
2026154 
2027127 
2028112 
2029100 
Thereafter209 
Total future minimum payments 886 
Less imputed interest(75)
Total lease liabilities$811 
v3.25.0.1
Shareholders’ Earnings per Share
12 Months Ended
Dec. 31, 2024
Earnings Per Share [Abstract]  
Shareholders’ Earnings per Share Shareholders Earnings per Share
The denominator for basic and diluted shareholders’ earnings per share at December 31, 2024, 2023 and 2022 is as follows:
202420232022
Denominator for basic shareholders’ earnings per share—weighted-average shares
231.7 235.9 240.0 
Effect of dilutive securities—employee stock options, non-vested restricted stock awards and convertible debentures
1.2 1.5 2.8 
Denominator for diluted shareholders’ earnings per share
232.9 237.4 242.8 
During the years ended December 31, 2024, 2023 and 2022, weighted-average shares related to certain stock options of 0.7, 0.8 and 0.4, respectively, were excluded from the denominator for diluted shareholders’ earnings per share because the stock options were anti-dilutive.
During each of the years ended December 31, 2024, 2023 and 2022, we issued approximately 0.2 restricted stock units, of which vesting was contingent upon us meeting certain earnings targets. Contingent restricted stock units are excluded from the denominator for diluted shareholders’ earnings per share and are included only if and when the contingency is met. The 2024 contingent restricted stock units are being measured over the three-year period of 2024 through 2026, the 2023 contingent restricted stock units are being measured over the three-year period of 2023 through 2025 and the 2022 contingent restricted stock units are being measured over the three year period of 2022 through 2024. Contingent restricted stock units generally vest in March of the year following each measurement period.
v3.25.0.1
Segment Information
12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Segment Information Segment Information
We report our results of operations in the following four reportable segments: Health Benefits, CarelonRx, Carelon Services and Corporate & Other. An immaterial amount of our total consolidated revenues is derived from activities outside of the U.S. and Puerto Rico.
Our Health Benefits segment offers a comprehensive suite of health plans and services to our Individual, Employer Group risk-based, Employer Group fee-based, BlueCard®, Medicare, Medicaid and FEP® members. The Health Benefits segment offers health products on a full-risk basis; provides a broad array of administrative managed care services to our fee-based customers; and provides a variety of specialty and other insurance products and services such as stop loss, dental, vision and supplemental health insurance benefits.
Our CarelonRx segment includes our pharmacy services business. CarelonRx markets and offers pharmacy services to our affiliated health plan customers, as well as to external customers outside of the health plans we own. CarelonRx offers a comprehensive pharmacy services portfolio, which includes all core pharmacy services, such as home delivery and specialty pharmacies, claims adjudication, formulary management, pharmacy networks, rebate administration, a prescription drug database and member services, as well as infusion services and injectable therapies.
Our Carelon Services segment integrates physical, behavioral, pharmacy, and social services with the aim of delivering whole health affordably by offering a broad array of healthcare related services and capabilities to internal and external customers through our Carelon Health and Carelon Insights businesses. Carelon promotes affordability by managing complex areas of the healthcare system, leveraging data and insights to ensure members receive safe, appropriate, high-quality care and providers are reimbursed accurately and timely. Our approach to cost management relies on capabilities including provider enablement, value-based networks, member engagement, and utilization management. Our care delivery services primarily target serving chronic and complex populations by providing personalized care in the home and virtually. As a part of Carelon Health, we completed our acquisition of CareBridge at the end of 2024, which provides virtual care to complex Medicaid and Medicare patients and supports plans in managing home and community-based services.
Our Corporate & Other segment includes our businesses that do not individually meet the quantitative threshold for an operating segment, as well as corporate expenses not allocated to our other reportable segments.
We define operating revenues to include premiums, product revenue and service fees. Operating revenues are derived from premiums and fees received, primarily from the sale and administration of health benefits and pharmacy products and services. Operating gain is calculated as total operating revenue less benefit expense, cost of products sold and operating expense.
Affiliated operating revenues represent revenues or costs for services provided to our subsidiaries by CarelonRx and Carelon Services, in addition to certain administrative and other services provided by our international businesses, which are recorded at cost or management’s estimate of fair market value. These affiliated operating revenues are eliminated in our consolidated financial statements. For segment reporting, we present all capitation risk arrangements on a gross basis; therefore, eliminations also include adjustments for capitated risk arrangements that are recognized on a net basis under GAAP.
Through our participation in various federal government programs, we generated approximately 31%, 29% and 28% of our total consolidated revenues from agencies of the U.S. government for the year ended December 31, 2024, 2023 and 2022, respectively. The majority of these revenues are contained in our Health Benefits segment.
The accounting policies of the segments are consistent with those described in the summary of significant accounting policies in Note 2, “Basis of Presentation and Significant Accounting Policies,” except that all capitation risk arrangements are reported on a gross basis with an adjustment included in eliminations for capitated risk arrangements that are presented on a net basis under GAAP.
Our chief operating decision maker (the “CODM”) is our Chief Executive Officer. The CODM assesses the performance of our reportable segments based on operating gain or loss as defined above. The CODM evaluates net investment income, net gains (losses) on financial instruments, interest expense, depreciation and amortization expense, income taxes and assets, liabilities and equity on a consolidated basis, as these items are managed in a corporate shared service environment and are not the responsibility of segment operating management.
The CODM uses operating gain or loss, developed during the annual budget process, and updated during the periodic forecasting process, as a basis to assess performance and allocate operating and capital resources to each segment.
Financial data by reportable segment for the years ended December 31, 2024, 2023 and 2022 is as follows:
Carelon
Health
Benefits
CarelonRxCarelon
Services
TotalCorporate
& Other
EliminationsTotal
Year Ended December 31, 2024
Premiums$142,668 $— $2,630 $2,630 $— $(1,132)$144,166 
Product revenue— 22,630 — 22,630 — — 22,630 
Service fees7,607 790 795 — 8,408 
Operating revenue - unaffiliated150,275 22,635 3,420 26,055 (1,132)175,204 
Operating revenue - affiliated— 13,326 14,541 27,867 303 (28,170)— 
Operating revenue - total$150,275 $35,961 $17,961 $53,922 $309 $(29,302)$175,204 
Benefit expense
$126,703 $— $14,388 $14,388 $19 $(13,543)$127,567 
Cost of products sold
— 32,978 — 32,978 — (13,228)19,750 
Operating expense
17,329 811 2,856 3,667 1,560 (2,531)20,025 
Operating gain (loss)$6,243 $2,172 $717 $2,889 $(1,270)$— $7,862 
Year Ended December 31, 2023
Premiums$141,515 $— $1,679 $1,679 $— $(340)$142,854 
Product revenue— 19,452 — 19,452 — — 19,452 
Service fees7,056 813 819 28 — 7,903 
Operating revenue - unaffiliated148,571 19,458 2,492 21,950 28 (340)170,209 
Operating revenue - affiliated— 14,377 11,655 26,032 451 (26,483)— 
Operating revenue - total$148,571 $33,835 $14,147 $47,982 $479 $(26,823)$170,209 
Benefit expense
$123,705 $— $10,610 $10,610 $35 $(10,020)$124,330 
Cost of products sold
— 31,588 — 31,588 — (14,295)17,293 
Operating expense
17,9782722,8573,1291,488(2,508)20,087
Operating gain (loss)$6,888 $1,975 $680 $2,655 $(1,044)$— $8,499 
Year Ended December 31, 2022
Premiums$131,964 $— $1,499 $1,499 $— $(234)$133,229 
Product revenue— 14,978 — 14,978 — — 14,978 
Service fees6,520 — 889 889 44 — 7,453 
Operating revenue - unaffiliated138,484 14,978 2,388 17,366 44 (234)155,660 
Operating revenue - affiliated— 13,548 10,472 24,020 355 (24,375)— 
Operating revenue - total$138,484 $28,526 $12,860 $41,386 $399 $(24,609)$155,660 
Benefit expense
$115,869 $— $9,667 $9,667 $39 $(8,933)$116,642 
Cost of products sold
— 26,544 — 26,544 — (13,509)13,035 
Operating expense
16,5931142,6582,772502(2,167)17,700
Operating gain (loss)$6,022 $1,868 $535 $2,403 $(142)$— $8,283 
 
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Reportable segments’ operating revenues$175,204 $170,209 $155,660 
Net investment income2,051 1,825 1,485 
Net losses on financial instruments
(445)(694)(550)
Gain on sale of business
201 — — 
Total revenues$177,011 $171,340 $156,595 
A reconciliation of reportable segments’ operating gain to income before income tax expense included in our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Income before income tax expense$7,904 $7,715 $7,600 
Net investment income(2,051)(1,825)(1,485)
Net losses on financial instruments
445 694 550 
Gain on sale of business
(201)— — 
Interest expense1,185 1,030 851 
Amortization of other intangible assets580 885 767 
Reportable segments’ operating gain$7,862 $8,499 $8,283 
v3.25.0.1
Related Party Transactions
12 Months Ended
Dec. 31, 2024
Related Party Transactions [Abstract]  
Related Party Transactions Related Party Transactions
We have an equity investment in APC Passe, LLC, which offers Medicaid products in Arkansas. During the years ended December 31, 2024, 2023 and 2022, in the normal course of business, we assumed premiums of $490, $481 and $501, respectively, from APC Passe, LLC, which is included in our total assumed premiums (see Note 17, “Reinsurance”).
In January 2023, we made an equity investment that resulted in our minority interest ownership of Liberty Dental. During the years ended December 31, 2024 and 2023, in the normal course of business, Liberty Dental provided administrative services to our Medicare Advantage members under a capitated arrangement amounting to $519 and $426, respectively, reported in benefit expense.
v3.25.0.1
Statutory Information
12 Months Ended
Dec. 31, 2024
Insurance [Abstract]  
Statutory Information Statutory Information
The majority of our insurance and HMO subsidiaries report their accounts in conformity with accounting practices prescribed or permitted by state insurance regulatory authorities, commonly referred to as statutory accounting, which vary in certain respects from GAAP. However, certain of our insurance and HMO subsidiaries, including Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Carelon Behavioral Health of California, Inc. and Carelon Health of California, Inc. are regulated by the California Department of Managed Health Care (“DMHC”) and report their accounts in conformity with GAAP (these entities are collectively referred to as the “DMHC regulated entities”). Typical differences of GAAP reporting as compared to statutory reporting are the recognition of all assets including those that are non-admitted for statutory purposes and recognition of all deferred tax assets without regard to statutory limits. The National Association of Insurance Commissioners (the “NAIC”) developed a codified version of the statutory accounting principles, designed to foster more consistency among the states for accounting guidelines and reporting. Prescribed statutory accounting practices are set forth in a variety of publications of the NAIC as well as state laws, regulations and general administrative rules.
Our statutory basis insurance and HMO subsidiaries are subject to risk-based capital (“RBC”) requirements. RBC is a method developed by the NAIC to determine the minimum amount of statutory capital appropriate for an insurance company or HMO to support its overall business operations in consideration of its size and risk profile. The formula for determining the amount of RBC specifies various factors, weighted based on the perceived degree of risk, which are applied to certain financial balances and financial activity. Below minimum RBC requirements are classified within certain levels, each of
which requires specified corrective action. Additionally, the DMHC regulated entities are subject to capital and solvency requirements as prescribed by the DMHC. As of December 31, 2024 and 2023, all of our regulated subsidiaries exceeded the minimum applicable mandatory RBC requirements and/or capital and solvency requirements of their applicable governmental regulator.
The statutory RBC necessary to satisfy regulatory requirements of our statutory basis insurance and HMO subsidiaries was approximately $8,100 and $7,800 as of December 31, 2024 and 2023, respectively. The tangible net equity required for the DMHC regulated entities was approximately $970 and $950 as of December 31, 2024 and 2023, respectively. Statutory-basis capital and surplus of our insurance and HMO subsidiaries and capital and surplus of our other regulated subsidiaries, excluding the DMHC regulated entities, was $18,668 and $19,808 at December 31, 2024 and 2023, respectively. GAAP equity of the DMHC regulated entities was $3,817 and $3,975 at December 31, 2024 and 2023, respectively.
Our ability to pay dividends and credit obligations is significantly dependent on receipt of dividends from our subsidiaries. The payment of dividends to us by our insurance and HMO subsidiaries without prior approval of the insurance departments of each subsidiary’s domiciliary jurisdiction is limited by formula. Dividends in excess of these amounts are subject to prior approval by the respective state insurance departments or the DMHC. During 2024, our insurance and HMO subsidiaries paid aggregate cash dividends of $6,322 to the parent company, including cash dividends which required prior approval from regulatory authorities. We currently estimate that approximately $2,700 of dividends will be paid to the parent company in 2025.
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant
12 Months Ended
Dec. 31, 2024
Condensed Financial Information Disclosure [Abstract]  
Schedule II-Condensed Financial Information of Registrant
Elevance Health, Inc. (Parent Company Only)
Balance Sheets
(In millions, except share data)December 31,
2024
December 31,
2023
Assets
Current assets:
Cash and cash equivalents$1,870 $1,483 
Equity securities487 80 
Other receivables49 58 
Net due from subsidiaries4,697 — 
Other current assets705 959 
Total current assets7,808 2,580 
Other invested assets3,636 822 
Property and equipment, net159 178 
Deferred tax assets, net— 199 
Investments in subsidiaries63,173 63,426 
Other noncurrent assets584 217 
Total assets$75,360 $67,422 
Liabilities and shareholders’ equity
Liabilities
Current liabilities:
Accounts payable and accrued expenses$737 $1,709 
Net due to subsidiaries— 734 
Current portion of long-term debt1,649 1,649 
Other current liabilities610 413 
Total current liabilities2,996 4,505 
Long-term debt, less current portion29,193 23,221 
Deferred tax liabilities, net55 — 
Other noncurrent liabilities1,801 390 
Total liabilities34,045 28,116 
Commitments and contingencies—Note 5
Shareholders’ equity
Preferred stock, without par value, shares authorized - 100,000,000; shares issued and outstanding - none
— — 
Common stock, par value $0.01, shares authorized - 900,000,000; shares issued and outstanding - 227,479,695 and 233,071,088
Additional paid-in capital8,911 8,868 
Retained earnings33,549 31,749 
Accumulated other comprehensive loss(1,147)(1,313)
Total shareholders’ equity41,315 39,306 
Total liabilities and shareholders’ equity$75,360 $67,422 
 
See accompanying notes.
Elevance Health, Inc. (Parent Company Only)
Statements of Income
Years ended December 31
(In millions)202420232022
Revenues
Net investment income$110 $25 $
Net (losses) gains on financial instruments
(23)(100)
Service fees
Total revenues (losses)
96 (67)13 
Expenses
Operating expense279 352 188 
Interest expense1,172 1,017 845 
Total expenses1,451 1,369 1,033 
Loss before income tax credits and equity in net income of subsidiaries(1,355)(1,436)(1,020)
Income tax credits(477)(214)(461)
Equity in net income of subsidiaries6,858 7,209 6,453 
Shareholders’ net income$5,980 $5,987 $5,894 































See accompanying notes.
Elevance Health, Inc. (Parent Company Only)
Statements of Comprehensive Income
Years ended December 31
(in millions)202420232022
Shareholders’ net income
$5,980 $5,987 $5,894 
Other comprehensive income (loss), net of tax:
Change in net unrealized gains/losses on investments
109 1,123 (2,249)
Change in non-credit component of impairment losses on investments— (3)
Change in net unrealized gains/losses on cash flow hedges18 10 
Change in net periodic pension and other benefit costs
60 40 (70)
Change in future policy benefits(2)(3)32 
Foreign currency translation adjustments(6)(1)(13)
Other comprehensive income (loss)
166 1,177 (2,293)
Total shareholders’ comprehensive income$6,146 $7,164 $3,601 
 
































See accompanying notes.
Elevance Health, Inc. (Parent Company Only)
Statements of Cash Flows
Years ended December 31
(In millions)202420232022
Net cash provided by operating activities$1,451 $4,113 $1,447 
Investing activities
Purchases of investments(3,240)(95)(367)
Proceeds from sales, maturities, calls and redemptions of investments1,567 212 618 
Repayment of note to subsidiary
— — 1,500 
Capitalization of subsidiaries(324)(363)(411)
Changes in securities lending collateral(16)42 36 
Purchases of property and equipment, net of sales(36)(55)(47)
Net cash (used in) provided by investing activities
(2,049)(259)1,329 
Financing activities
Net repayments of short-term borrowings
— — (300)
Proceeds from long-term borrowings7,710 2,574 3,071 
Repayments of long-term borrowings(1,650)(1,909)(1,899)
Changes in securities lending payable16 (42)(36)
Repurchase and retirement of common stock(2,900)(2,676)(2,316)
Cash dividends(1,586)(1,466)(1,290)
Proceeds from issuance of common stock under employee stock plans221 152 182 
Taxes paid through withholding of common stock under employee stock plans(109)(99)(93)
Other, net(717)153 217 
Net cash provided by (used in) financing activities
985 (3,313)(2,464)
Change in cash and cash equivalents387 541 312 
Cash and cash equivalents at beginning of year1,483 942 630 
Cash and cash equivalents at end of year$1,870 $1,483 $942 











See accompanying notes.
1. Basis of Presentation and Significant Accounting Policies
In the parent company only financial statements of Elevance Health, Inc. (“Elevance Health”), Elevance Health’s investment in subsidiaries is stated at cost plus equity in undistributed earnings of the subsidiaries. Elevance Health’s share of net income of its unconsolidated subsidiaries is included in income using the equity method of accounting.
Certain amounts presented in the parent company only financial statements are eliminated in the consolidated financial statements of Elevance Health.
Elevance Health’s parent company only financial statements should be read in conjunction with Elevance Health’s audited consolidated financial statements and the accompanying notes included in Part II, Item 8 of this Annual Report on Form 10-K.
2. Subsidiary Transactions
Dividends from Subsidiaries
Elevance Health received cash dividends from subsidiaries of $6,322, $4,909 and $3,097 during 2024, 2023 and 2022, respectively.
Dividends to Subsidiaries
Certain subsidiaries of Elevance Health own shares of Elevance Health common stock. Elevance Health paid cash dividends to subsidiaries related to these shares of common stock in the amount of $78, $71 and $61 during 2024, 2023 and 2022, respectively.
Investments in Subsidiaries
Capital contributions to subsidiaries were $324, $363 and $411 during 2024, 2023 and 2022, respectively.
Amounts Due From and To Subsidiaries
At December 31, 2024 and 2023, Elevance Health reported amounts due from and (to) subsidiaries of $4,697 and $(734), respectively. The amounts due from and (to) subsidiaries primarily include amounts for allocated operating expenses or daily cash management activities. These items are routinely settled, and as such, are classified as current liabilities or assets.
In June 2021 Elevance Health entered into a short-term loan agreement with a subsidiary for the amount of $1,500. This loan was repaid in February 2022.
Guarantees on Behalf of Subsidiaries
Elevance Health guarantees contractual or financial obligations or solvency requirements for certain of its subsidiaries. These guarantees approximated $912 at December 31, 2024. There were no payments made on these guarantees in 2024.
3. Derivative Financial Instruments
The information regarding derivative financial instruments contained in Note 6, “Derivative Financial Instruments,” of the Notes to Consolidated Financial Statements of Elevance Health and its subsidiaries, included in Part II, Item 8 of this Annual Report on Form 10-K, is incorporated herein by reference.
4. Long-Term Debt
The information regarding long-term debt contained in Note 13, “Debt,” of the Notes to Consolidated Financial Statements of Elevance Health and its subsidiaries, included in Part II, Item 8 of this Annual Report on Form 10-K, is incorporated herein by reference.
5. Commitments and Contingencies
The information regarding commitments and contingencies contained in Note 14, “Commitments and Contingencies,” of the Notes to Consolidated Financial Statements of Elevance Health and its subsidiaries, included in Part II, Item 8 of this Annual Report on Form 10-K, is incorporated herein by reference.
6. Capital Stock
The information regarding capital stock contained in Note 15, “Capital Stock,” of the Notes to Consolidated Financial Statements of Elevance Health and its subsidiaries, included in Part II, Item 8 of this Annual Report on Form 10-K, is incorporated herein by reference.
v3.25.0.1
Pay vs Performance Disclosure - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pay vs Performance Disclosure      
Shareholders' net income $ 5,980 $ 5,987 $ 5,894
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]
Our cybersecurity and risk management programs are part of our continuously evolving enterprise-wide risk management practices. Aligned and measured against the National Institute of Standards and Technology (NIST) Cybersecurity Framework, recognized best practices and standards for cybersecurity and information technology, industry and government standards and other guidelines, our cybersecurity and risk management programs utilize policies, processes, and technologies to identify, assess, manage and mitigate cybersecurity risks and threats we face. We also conduct periodic reviews and updates to uphold our security standards, including implementation of tabletop crises exercises. Our management implements ongoing and annual risk assessment processes to identify and manage risks that could affect our ability to safeguard sensitive data or provide reliable transaction processing and to minimize financial risk exposure. These risks include, but are not limited to, regulatory compliance; third-party management, including risks from business partners and software providers; mergers and acquisitions; system availability and disruption of business operations; data use and security; vulnerability and configuration management; fraud and extortion; and reputation risk.
The steps we take to reduce vulnerability to cyber-attacks and to mitigate and remediate the impact of cybersecurity incidents in a timely and coordinated manner include, but are not limited to: establishing information security policies and standards, implementing information protection processes, tools and technologies, monitoring information technology systems for cybersecurity threats, coordinating internal reporting, 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.
In addition to our internal Information Security teams, we also utilize trusted third-party auditors and recognized cybersecurity consultants and certified assessors, to assess cybersecurity risks, related controls, and alignment to relevant regulatory and legal requirements. A third party evaluates our information security policies, standards and control environment at least annually. Assessments and testing protocols are performed against industry best practices and widely recognized security frameworks.
We face many cybersecurity risks in connection with our business. As of December 31, 2024, no known cybersecurity threats have materially affected, or are reasonably likely to materially affect, the Company, including our business strategy, cash flows, financial condition or results of operations; however, future cybersecurity incidents or threats may materially affect us, including by affecting our business strategy, results of operations or financial conditions. See Part I, 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] Our cybersecurity and risk management programs are part of our continuously evolving enterprise-wide risk management practices. Aligned and measured against the National Institute of Standards and Technology (NIST) Cybersecurity Framework, recognized best practices and standards for cybersecurity and information technology, industry and government standards and other guidelines, our cybersecurity and risk management programs utilize policies, processes, and technologies to identify, assess, manage and mitigate cybersecurity risks and threats we face. We also conduct periodic reviews and updates to uphold our security standards, including implementation of tabletop crises exercises. Our management implements ongoing and annual risk assessment processes to identify and manage risks that could affect our ability to safeguard sensitive data or provide reliable transaction processing and to minimize financial risk exposure. These risks include, but are not limited to, regulatory compliance; third-party management, including risks from business partners and software providers; mergers and acquisitions; system availability and disruption of business operations; data use and security; vulnerability and configuration management; fraud and extortion; and reputation risk.
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]
Our Board oversees and guides our business and oversees our exposure to major risks, including steps taken by management to monitor and mitigate cybersecurity risks. The Board receives and reviews periodic reports from management on various risks, and delegates to its Audit Committee certain oversight responsibilities. The Board monitors cybersecurity risks and receives a report at least quarterly from our CISO regarding our Information Security Program. In addition, certain cybersecurity incidents are escalated to the Board in accordance with our Plan as described above. Periodically, the Board also receives third party assessments of our information security. The Audit Committee receives regular updates on both information security and data privacy matters, and oversees data privacy, integrity, incident and breach risks.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]
To manage our cybersecurity risk, we employ a cross-organizational steering committee, the Information Security Steering Committee (“ISSC”), that supports the direction and governance of our enterprise-wide Information Security Program. The ISSC is chaired by our Chief Information Security Officer (“CISO”) and is comprised of accountable senior business leaders including our Chief Compliance Officer (“CCO”), Chief Risk Officer (“CRO”), legal counsel, and human resources, procurement and business segment leaders.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block] The Board receives and reviews periodic reports from management on various risks, and delegates to its Audit Committee certain oversight responsibilities. The Board monitors cybersecurity risks and receives a report at least quarterly from our CISO regarding our Information Security Program. In addition, certain cybersecurity incidents are escalated to the Board in accordance with our Plan as described above. Periodically, the Board also receives third party assessments of our information security. The Audit Committee receives regular updates on both information security and data privacy matters, and oversees data privacy, integrity, incident and breach risks.
Cybersecurity Risk Role of Management [Text Block]
To manage our cybersecurity risk, we employ a cross-organizational steering committee, the Information Security Steering Committee (“ISSC”), that supports the direction and governance of our enterprise-wide Information Security Program. The ISSC is chaired by our Chief Information Security Officer (“CISO”) and is comprised of accountable senior business leaders including our Chief Compliance Officer (“CCO”), Chief Risk Officer (“CRO”), legal counsel, and human resources, procurement and business segment leaders.
In addition to the ISSC, we have defined risk functions to cover overall enterprise risks and information technology and cybersecurity risks within our enterprise risk management framework, including, but not limited to: our IT Risk Management program, led by our CISO; our Responsible Artificial Intelligence (“RAI”) Program, led by our Chief Digital Information Officer; Compliance, led by our CCO; Internal Audit, led by our Chief Audit Executive (“CAE”); Enterprise Risk Management programs led by our CRO; Third-Party Risk Management, comprised of business and information security leaders; IT due diligence processes, led by business, technology and information security leaders; and our Corporate Insurance Program, including cybersecurity insurance, led by our Treasurer.
To evaluate cybersecurity and privacy incidents and enable us to comply with public disclosure requirements, we have a Privacy and Security Incident Response and Reporting Policy and Procedure (the “Policy”) with defined escalation criteria (the “Plan”) in support of our incident response processes. The Plan provides a framework to our Cyber Incident Response Taskforce, comprised of our Chief Privacy Officer (“CPO”), CISO and applicable legal counsel and business and corporate services leaders, for responding to cybersecurity incidents. The Policy, together with the Plan, identifies applicable requirements for incident disclosure and reporting and also provides protocols for incident evaluation based on facts and circumstances of each incident, including the use of third-party service providers and partners, processes for notification and internal escalation of information to our senior management, including to our chief legal officer and CEO, a subcommittee of our SEC disclosure committee, and ultimately, our Board of Directors and appropriate Board committees. The Policy also addresses requirements for our external reporting obligations. The Policy is reviewed and updated, as necessary, under the leadership of our CISO and CPO.
Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]
To manage our cybersecurity risk, we employ a cross-organizational steering committee, the Information Security Steering Committee (“ISSC”), that supports the direction and governance of our enterprise-wide Information Security Program. The ISSC is chaired by our Chief Information Security Officer (“CISO”) and is comprised of accountable senior business leaders including our Chief Compliance Officer (“CCO”), Chief Risk Officer (“CRO”), legal counsel, and human resources, procurement and business segment leaders.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] Our current CISO has over 30 years of experience in information security and technology and has held a wide variety of technical and strategic leadership positions. He holds advanced certifications including Certified Information Systems Security Professional and Certified Secure Software Lifecycle Professional.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block] The Board receives and reviews periodic reports from management on various risks, and delegates to its Audit Committee certain oversight responsibilities. The Board monitors cybersecurity risks and receives a report at least quarterly from our CISO regarding our Information Security Program. In addition, certain cybersecurity incidents are escalated to the Board in accordance with our Plan as described above. Periodically, the Board also receives third party assessments of our information security. The Audit Committee receives regular updates on both information security and data privacy matters, and oversees data privacy, integrity, incident and breach risks.
Cybersecurity Expertise
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.0.1
Basis of Presentation and Significant Accounting Policies (Policies)
12 Months Ended
Dec. 31, 2024
Accounting Policies [Abstract]  
Basis of Presentation
Basis of Presentation: The accompanying consolidated financial statements include the accounts of Elevance Health and its subsidiaries and have been prepared in conformity with U.S. generally accepted accounting principles (“GAAP”). All significant intercompany accounts and transactions have been eliminated in consolidation. Our consolidated financial
statements include the accounts of Elevance Health, Inc. and subsidiaries that we control, including variable interest entities for which we are the primary beneficiary. We are considered the primary beneficiary if we have the power to direct the variable interest entity's most significant economic activities, and we have the right to receive benefits or obligations to absorb losses that could be significant to the entity. We evaluate the following criteria: (1) the structure and purpose of the entity; (2) the risks and rewards created by and shared through the entity; and (3) our ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity.
Consolidation
Basis of Presentation: The accompanying consolidated financial statements include the accounts of Elevance Health and its subsidiaries and have been prepared in conformity with U.S. generally accepted accounting principles (“GAAP”). All significant intercompany accounts and transactions have been eliminated in consolidation. Our consolidated financial
statements include the accounts of Elevance Health, Inc. and subsidiaries that we control, including variable interest entities for which we are the primary beneficiary. We are considered the primary beneficiary if we have the power to direct the variable interest entity's most significant economic activities, and we have the right to receive benefits or obligations to absorb losses that could be significant to the entity. We evaluate the following criteria: (1) the structure and purpose of the entity; (2) the risks and rewards created by and shared through the entity; and (3) our ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity.
Foreign Currency
Certain of our subsidiaries operate outside of the United States and have functional currencies other than the U.S. dollar (“USD”). We translate the assets and liabilities of those subsidiaries to USD using the exchange rate in effect at the end of the period. We translate the revenues and expenses of those subsidiaries to USD using the average exchange rates in effect during the period. The net effect of these translation adjustments is included in “Foreign currency translation adjustments” in our consolidated statements of comprehensive income.
Reclassifications
Reclassifications: Certain prior year amounts have been reclassified to conform to the current year presentation.
Use of Estimates
Use of Estimates: The preparation of consolidated financial statements in conformity with GAAP requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our most significant estimate relates to estimates and judgments for medical claims payable. Actual results could differ from those estimates.
Cash and Cash Equivalents
Cash and Cash Equivalents: Cash and cash equivalents includes available cash and all highly liquid investments with maturities of three months or less when purchased. We control a number of bank accounts that are used exclusively to hold customer funds for the administration of customer benefits, and we have cash and cash equivalents on deposit to meet certain regulatory requirements. These amounts totaled $409 and $294 at December 31, 2024 and 2023, respectively, and are included in the cash and cash equivalents line on our consolidated balance sheets.
Investments
Investments: We classify fixed maturity securities in our investment portfolio as “available-for-sale” and report those securities at fair value. Certain fixed maturity securities are available to support current operations and, accordingly, we classify such investments as current assets without regard to their contractual maturity. Investments used to satisfy contractual, regulatory or other requirements are classified as long-term, without regard to contractual maturity.
If a fixed maturity security is in an unrealized loss position and we have the intent to sell the fixed maturity security, or it is more likely than not that we will have to sell the fixed maturity security before recovery of its amortized cost basis, we write down the fixed maturity security’s cost basis to fair value and record an impairment loss in our consolidated statements of income. For impaired fixed maturity securities that we do not intend to sell or if it is more likely than not that we will not have to sell such securities, but we expect that we will not fully recover the amortized cost basis, we recognize the credit component of the impairment as an allowance for credit loss in our consolidated balance sheets and record an impairment loss in our consolidated statements of income. The non-credit component of the impairment is recognized in accumulated other comprehensive loss. Furthermore, unrealized losses entirely caused by non-credit-related factors related to fixed maturity securities for which we expect to fully recover the amortized cost basis continue to be recognized in accumulated other comprehensive loss.
The credit component of an impairment is determined primarily by comparing the net present value of projected future cash flows with the amortized cost basis of the fixed maturity security. The net present value is calculated by discounting our best estimate of projected future cash flows at the effective interest rate implicit in the fixed maturity security at the date of purchase. For mortgage-backed and asset-backed securities, cash flow estimates are based on assumptions regarding the underlying collateral, including prepayment speeds, vintage, type of underlying asset, geographic concentrations, default rates, recoveries and changes in value. For all other securities, cash flow estimates are driven by assumptions regarding probability of default, including changes in credit ratings and estimates regarding timing and amount of recoveries associated with a default.
For asset-backed securities included in fixed maturity securities, we recognize income using an effective yield based on anticipated prepayments and the estimated economic life of the securities. When estimates of prepayments change, the effective yield is recalculated to reflect actual payments to date and anticipated future payments. The net investment in the securities is adjusted to the amount that would have existed had the new effective yield been applied since the purchase date of the securities. Such adjustments are reported within net investment income.
The changes in fair value of our marketable equity securities are recognized in our results of operations within net gains and losses on financial instruments. Certain marketable equity securities are held to satisfy contractual obligations and are reported under the caption “Other invested assets” in our consolidated balance sheets.
Mortgage loans on real estate are classified as held for investment and are reported at their amortized cost basis net of loss allowance under the caption “Other invested assets” in our consolidated balance sheets. Amortized cost is the amount at which the loan is originated, adjusted for accrued interest, amortization of premium, discount and net deferred fees or costs, collection of cash and write-offs.
We have corporate-owned life insurance policies on certain participants in our deferred compensation plans and other members of management. The cash surrender value of the corporate-owned life insurance policies is reported under the caption “Other invested assets” in our consolidated balance sheets.
We have investments in limited partnerships (“LPs”) and companies in which our ownership interest may enable us to influence the operating or financial decisions of the investee company, including unconsolidated variable interest entities. These investments are accounted for using the equity method of accounting and are reported within “Other invested assets” in our consolidated balance sheets. Our proportionate share of equity in net income for these LPs and unconsolidated investee companies is reported within “Net investment income” in our consolidated statements of income. The carrying value of these investments are written down, or impaired, to fair value when a decline in value is considered to be other-than temporary. In applying the equity method (including assessment for other-than temporary impairment), we use financial information provided by the LPs and investee companies, generally on a one-to three-month lag. We consolidate investee companies in certain other instances where it is deemed to exercise control, or is considered the primary beneficiary of a variable interest entity.
Investment income is recorded when earned. All securities sold resulting in investment realized gains and losses are recorded on the trade date. Realized gains and losses are determined on the basis of the cost or amortized cost of the specific securities sold.
We participate in securities lending programs whereby marketable securities in our investment portfolio are transferred to independent brokers or dealers in exchange for cash and securities collateral. Under Financial Accounting Standards Board (“FASB”) guidance related to accounting for transfers and servicing of financial assets and extinguishments of liabilities, we recognize the collateral as an asset, which is reported in Other current assets on our consolidated balance sheets, and we record a corresponding liability for the obligation to return the collateral to the borrower, which is reported in Other current liabilities. The securities on loan are reported in the applicable investment category on our consolidated balance sheets. Unrealized gains or losses on securities lending collateral are included in accumulated other comprehensive income as a separate component of shareholders’ equity. The market value of loaned securities and that of the collateral pledged can fluctuate in non-synchronized fashions. To the extent the loaned securities’ value appreciates faster or depreciates slower than the value of the collateral pledged, we are exposed to the risk of the shortfall. As a primary mitigating mechanism, the loaned securities and collateral pledged are marked to market on a daily basis and the shortfall, if any, is collected accordingly. Secondarily, the collateral level is set at 102% of the value of the loaned securities, which provides a cushion before any shortfall arises. The investment of the cash collateral is subject to market risk, which is managed by limiting the investments to higher quality and shorter duration instruments.
Receivables
Receivables: Receivables are reported net of amounts for expected credit losses. The allowance for doubtful accounts is based on historical collection trends, future forecasts and our judgment regarding the ability to collect specific accounts.
Premium receivables include the uncollected amounts from insured groups, individuals and government programs. Premium receivables are reported net of an allowance for doubtful accounts of $183 and $212 at December 31, 2024 and 2023, respectively.
Self-funded receivables include administrative fees, claims and other amounts due from fee-based customers. Self-funded receivables are reported net of an allowance for doubtful accounts of $115 and $87 at December 31, 2024 and 2023, respectively.
Other receivables include pharmacy rebates, provider advances, claims recoveries, reinsurance receivables, proceeds due from brokers on investment trades that have not yet settled, accrued investment income and other miscellaneous amounts due
to us. These receivables are reported net of an allowance for doubtful accounts of $1,385 and $941 at December 31, 2024 and 2023, respectively.
Income Taxes
Income Taxes: We file a consolidated U.S. federal income tax return. Deferred income tax assets and liabilities are recognized for temporary differences between the financial statement and tax return basis of assets and liabilities based on enacted tax rates and laws and are reported net on our consolidated balance sheets. The deferred tax benefits of the deferred tax assets are recognized to the extent realization of such benefits is more likely than not. Deferred income tax expense or benefit generally represents the net change in deferred income tax assets and liabilities during the year, excluding the impact from amounts initially recorded for business combinations, if any, and amounts recorded to accumulated other comprehensive income. Current income tax expense represents the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported.
The Internal Revenue Code subjects a U.S. shareholder to tax on Global Intangible Low-Taxed Income (“GILTI”) earned by certain foreign subsidiaries. We have elected to account for GILTI tax in the year the tax is incurred.
The Inflation Reduction Act of 2022 includes a provision that imposes a new corporate alternative minimum tax (the “Corporate AMT”) that became effective for us beginning January 1, 2023. We have elected to account for the effects of the Corporate AMT on deferred tax assets and carryforwards and tax credits in the period they arise. We have also elected to disregard Corporate AMT when evaluating the need for a valuation allowance for non-Corporate AMT deferred tax assets. We do not believe the Corporate AMT will have a material impact on our consolidated financial position, results of operations, cash flows or related disclosures. Additionally, the Inflation Reduction Act of 2022 imposes an excise tax on the fair market value of net stock repurchases made after December 31, 2022. These are included as a charge to retained earnings as a component of the repurchase and retirement of common stock.
We account for income tax contingencies in accordance with FASB guidance that contains a model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing a minimum recognition threshold, which all income tax positions must achieve before being recognized in the financial statements.
Property and Equipment
Property and Equipment: Property and equipment is recorded at cost, net of accumulated depreciation. Depreciation is computed principally by the straight-line method over estimated useful lives ranging from fifteen to thirty years for buildings and improvements, three to five years for computer equipment and software, and seven years for furniture and other equipment. Leasehold improvements are depreciated over the term of the related lease. Certain costs related to the development or purchase of internal-use software are capitalized and amortized over estimated useful lives ranging from three to ten years.
Goodwill and Other Intangible Assets
Goodwill and Other Intangible Assets: FASB guidance requires business combinations to be accounted for using the acquisition method of accounting, and it also specifies the types of acquired intangible assets that are required to be recognized and reported separately from goodwill. Goodwill represents the excess of the cost of acquisition over the fair value of net assets acquired, including other intangible assets. Other intangible assets represent the values assigned to customer relationships, provider and hospital networks, Blue Cross and Blue Shield and other trademarks, licenses and other agreements, such as non-compete agreements. Goodwill and other intangible assets are allocated to reportable segments based on the relative fair value of the components of the businesses acquired.
Goodwill and other intangible assets with indefinite lives are not amortized but are tested for impairment at least annually. Goodwill and other intangible assets are allocated to reporting units for purposes of the annual goodwill impairment test. Other intangible assets with indefinite lives, such as trademarks, are tested for impairment separately. We complete our annual impairment tests of existing goodwill and other intangible assets with indefinite lives during the fourth quarter of each year. Our impairment tests require us to make assumptions and judgments regarding the estimated fair value of our reporting units, including goodwill and other intangible assets with indefinite lives. Certain interim impairment tests are also performed when potential impairment indicators exist or changes in our business or other triggering events occur.
FASB guidance allows for qualitative assessments of whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount for purposes of a goodwill impairment analysis and whether it is more likely than not that an indefinite-lived intangible asset is impaired for purposes of an indefinite-lived intangible asset impairment analysis. Estimated fair values developed based on our assumptions and judgments might be different if other reasonable assumptions and estimates were to be used. Qualitative analysis involves assessing situations and developments that could affect key
drivers used to evaluate whether the fair value of our goodwill and indefinite-lived intangible assets is impaired. Our procedures include assessing our financial performance, macroeconomic conditions, industry and market considerations, various asset specific factors, and entity specific events.
Quantitative analysis must be performed if qualitative analyses are not conclusive. Entities also have the option to bypass the assessment of qualitative factors and proceed directly to performing quantitative analyses. Fair value for purposes of a quantitative goodwill impairment test is calculated using a blend of the projected income and market valuation approaches. The projected income approach is developed using assumptions about future revenue, expenses and net income derived from our internal planning process. Our assumed discount rate is based on our industry’s weighted-average cost of capital and reflects volatility associated with the cost of equity capital. Market valuations include market comparisons to publicly traded companies in our industry and are based on observed multiples of certain measures including revenue; earnings before interest, taxes, depreciation and amortization (“EBITDA”); and book value of invested capital.
A goodwill impairment loss is recognized to the extent that the carrying amount exceeds the asset’s estimated fair value. This determination consists of a one-step test comparing the estimated fair value of a reporting unit, including goodwill, to its carrying amount. If the carrying amount of a reporting unit exceeds its estimated fair value, an impairment loss is recognized. This goodwill impairment loss is equal to the excess of the reporting unit’s carrying amount over its estimated fair value, which is recorded in the results of operations.
Fair value for purposes of a quantitative impairment test for indefinite-lived intangible assets is estimated using a projected income approach. We recognize an impairment loss when the estimated fair value of indefinite-lived intangible assets is less than the carrying value, which is recorded in the results of operations. If significant impairment indicators are noted relative to other intangible assets subject to amortization, we may be required to record impairment losses against future income.
Derivative Financial Instruments
Derivative Financial Instruments: We primarily invest in the following types of derivative financial instruments: interest rate swaps, futures, forward contracts, put and call options, collars, swaptions, embedded derivatives and warrants. Derivatives embedded within non-derivative instruments, such as options embedded in convertible fixed maturity securities, are bifurcated from the host instrument when the embedded derivative is not clearly and closely related to the host instrument. Our use of derivatives is limited by statutes and regulations promulgated by the various regulatory bodies to which we are subject, and by our own derivative policy. Our derivative use is generally limited to hedging purposes, on an economic basis, and we generally do not use derivative instruments for speculative purposes.
We have exposure to economic losses due to interest rate risk arising from changes in the level or volatility of interest rates. We attempt to mitigate our exposure to interest rate risk through active portfolio management, including rebalancing our existing portfolios of assets and liabilities, as well as changing the characteristics of investments to be purchased or sold in the future. In addition, derivative financial instruments are used to modify the interest rate exposure of certain liabilities or forecasted transactions. These strategies include the use of interest rate swaps and forward contracts, which are used to lock-in interest rates or to hedge, on an economic basis, interest rate risks associated with variable rate debt. We have used these types of instruments as designated hedges against specific liabilities.
All investments in derivatives are recorded as assets or liabilities at fair value, except certain put and call options on large blocks of equity securities. Put and call options on large blocks of equity securities are initially recorded at fair value; however, they are not subsequently marked to market. If certain correlation, hedge effectiveness and risk reduction criteria are met, a derivative may be specifically designated as a hedge of exposure to changes in fair value or cash flow. The accounting for changes in the fair value of a derivative depends on the intended use of the derivative and the nature of any hedge designation thereon. Amounts excluded from the assessment of hedge effectiveness, if any, are reported in results of operations immediately. If the derivative is not designated as a hedge, the gain or loss resulting from the change in the fair value of the derivative is recognized in results of operations in the period of change. Cash flows associated with the settlement of non-designated derivatives are shown on a net basis in investing activity in our consolidated statements of cash flow.
From time to time, we may also purchase derivatives to hedge, on an economic basis, our exposure to foreign currency exchange fluctuations associated with the operations of certain of our subsidiaries. We generally use futures or forward
contracts for these transactions. We generally do not designate these contracts as hedges and, accordingly, the changes in fair value of these derivatives are recognized in results of operations immediately.
As part of our international operations, we conduct transactions in foreign currencies, which exposes us to risks associated with fluctuations in foreign currency exchange rates. To manage this exposure, we utilize forward contracts to hedge expenses that are denominated in currencies other than the U.S. dollar. These forward contracts are designated as cash flow hedges and qualify for hedge accounting treatment under the applicable accounting standards.
Credit exposure associated with non-performance by the counterparties to derivative instruments is generally limited to the uncollateralized fair value of the asset related to instruments recognized in the consolidated balance sheets. We attempt to mitigate the risk of non-performance by selecting counterparties with high credit ratings and monitoring their creditworthiness and by diversifying derivatives among multiple counterparties. At December 31, 2024, we believe there were no material concentrations of credit risk with any individual counterparty.
We generally enter into master netting agreements, which reduce credit risk by permitting net settlement of transactions with the same counterparty. Certain of our derivative agreements also contain credit support provisions that require us or the counterparty to post collateral if there are declines in the derivative fair value or our credit rating. The derivative assets and derivative liabilities are reported at their fair values net of collateral and netting by the counterparty.
Retirement Benefits
Retirement Benefits: We recognize the funded status of pension and other postretirement benefit plans on the consolidated balance sheets based on fiscal-year-end measurements of plan assets and benefit obligations. Prepaid pension benefits represent prepaid costs related to defined benefit pension plans and are reported with other noncurrent assets. Prepaid postretirement benefits represent prepaid costs related to retiree medical, life, vision and dental benefits and are reported with other noncurrent assets.
We determine the expected return on plan assets using the calculated value of plan assets, which recognizes changes in the fair value of plan assets in a systematic manner over three years. We apply a corridor approach to amortize unrecognized actuarial gains or losses. Under this approach, only accumulated net actuarial gains or losses in excess of 10% of the greater of the projected benefit obligation or the fair value of plan assets are amortized over the average remaining service or lifetime of the workforce as a component of net periodic benefit cost.
The discount rate reflects the current rate at which the pension liabilities could be effectively settled at the end of the year based on our most recent measurement date. We use the annual spot rate approach for setting our discount rate. Under the spot rate approach, individual spot rates from a full yield curve of published rates are used to discount each plan’s cash flows to determine the plan’s obligations.
The assumed healthcare cost trend rates used to measure the expected cost of other postretirement benefits are based on an initial assumed healthcare cost trend rate declining to an ultimate healthcare cost trend rate over a select number of years.
Medical Claims Payable
Medical Claims Payable: Liabilities for medical claims payable include estimated provisions for incurred but not paid claims on an undiscounted basis, as well as estimated provisions for expenses related to the processing of claims. Incurred but not paid claims include (1) an estimate for claims that are incurred but not reported; (2) claims reported to us but not yet processed through our systems; and (3) claims reported to us and processed through our systems but not yet paid.
Liabilities for claims incurred but not reported and reported but not yet processed through our systems are determined in the aggregate, employing actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. Our reserving practice for claim liabilities is to consistently recognize the appropriate amount of reserve within a level of confidence required by Actuarial Standards of Practice. We determine the amount of the liability for incurred but not yet reported or processed claims by following a detailed actuarial process that uses both historical claim payment patterns as well as emerging medical cost trends to project our best estimate of claim liabilities. Under this process, historical paid claims data is formatted into “claim triangles,” which compare claim incurred dates to the dates of claim payments. This information is analyzed to create “completion factors” that represent the average percentage of total incurred claims that have been paid through a given date after being incurred. Completion factors are applied to claims paid through the period-end date to estimate the ultimate claim expense incurred for the period. Actuarial estimates of incurred but not paid claim liabilities are then determined by subtracting the actual paid claims from the estimate of the ultimate incurred claims.
For the most recent incurred months (typically the most recent two months), the percentage of claims paid for claims incurred in those months is generally low. This makes the completion factor methodology less reliable for such months. Therefore, incurred claims for recent months are not projected from historical completion and payment patterns; rather, they are projected by estimating the claims expense for those months based on recent claims expense levels and healthcare trend levels (“trend factors”).
On a regular basis, we review cost trends and utilization assumptions set upon initial establishment of claim liabilities. We utilize subsequent paid claims activity to monitor and continuously adjust the claims liability and benefit expense. If actual results are determined to be materially different than assumptions regarding cost trends and utilization, future periods of our income statement and overall financial position could be impacted.
Premium deficiencies are recognized when it is probable that expected claims plus administrative expenses will exceed future premiums on existing medical insurance contracts without consideration of investment income. For purposes of evaluating premium deficiencies, contracts are deemed to be either short or long duration and are grouped in a manner consistent with our method of acquiring, servicing and measuring the profitability of such contracts. Once established, reserves for premium deficiencies are released commensurate with actual claims experience over the remaining life of the contract. No reserves for premium deficiencies were established at December 31, 2024 or 2023.
Benefit expense includes incurred medical claims as well as quality improvement expenses for our risk-based members. Quality improvement activities are those designed to improve member health outcomes, prevent hospital readmissions and improve patient safety. They also include expenses for wellness and health promotion provided to our members.
Other Policyholder Liabilities Other Policyholder Liabilities: Other policyholder liabilities include rate stabilization reserves associated with retrospectively rated insurance contracts and certain case-specific reserves. Rate stabilization reserves represent accumulated premiums that exceed what customers owe us based on actual claim experience. The timing of payment of these retrospectively rated refunds is based on the contractual terms with our customers and can vary from period to period based on the specific contractual requirements.
Other policyholder liabilities also include liabilities for premium refunds based upon the minimum medical loss ratio (“MLR”). We are required to meet certain minimum MLR thresholds prescribed by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended (collectively, the “ACA”). If we do not meet or exceed the minimum MLR thresholds specified by the ACA, we are required to pay rebates to certain customers. Minimum MLR rebates are calculated by subsidiary, state and applicable line of business in accordance with regulations issued by the US Department of Health and Human Services (“HHS”). Such calculations are made using estimated calendar year medical loss expense and premiums, as defined by HHS.
We follow HHS guidelines for determining the types of expenses that may be included in our minimum MLR rebate calculations, which differ from benefit expense and premiums as reported in our consolidated financial statements prepared in conformity with GAAP. Certain amounts reported as expense in our consolidated GAAP financial statements may be reported as a reduction of premiums in accordance with HHS regulations. In addition, profit amounts included in our payments to third-party administrative service providers are recorded as benefit expense in our consolidated GAAP financial statements, while HHS does not allow for the inclusion of these expenses within the medical loss expense for purposes of calculating minimum MLR.
Also included are our risk-adjustment payables for certain risk-adjustment programs. The risk-adjustment programs reallocate funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our payable based on the risk of our customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and HHS. Payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.
Reserves for Future Policy Benefits
Reserves for Future Policy Benefits: Future policy benefits include liabilities for insurance policies for which some of the premiums received in earlier years are intended to pay anticipated benefits to be incurred in future years. Future policy benefits are continually monitored and reviewed, and when reserves are adjusted, differences are reflected in benefit expense.
We believe that our liabilities for future policy benefits, along with future premiums received, are adequate to satisfy our ultimate benefit liability; however, these estimates are inherently subject to a number of variable circumstances. Consequently, the actual results could differ materially from the amounts recorded in our consolidated financial statements.
Revenue Recognition
Revenue Recognition: Premiums for risk-based contracts are recognized as revenue over the period insurance coverage is provided, and, if applicable, net of amounts recognized for MLR rebates, risk adjustment, reinsurance and risk corridor under contractual premium stabilization arrangements, the ACA or other regulatory requirements. Premiums may also include performance incentives and penalties, which are recognized based on contractual terms. We estimate amounts receivable and payable under these contractual terms, and to the extent that such estimated amounts vary from the final amounts paid, the adjustments are included in earnings in the period of final settlement. Premium payments from contracted government agencies are based on eligibility lists produced by the government agencies. Premium payments related to the unexpired contractual coverage periods are reflected in the accompanying consolidated balance sheets as Unearned income. Premiums include revenue adjustments for retrospectively rated contracts where revenue is based on the estimated loss experience of the contract. Premium rates for certain lines of business are subject to approval by the Department of Insurance of each respective state. Additionally, delays in annual premium rate changes from contracted government agencies require that we defer the recognition of any increases to the period in which the premium rates become final. The value of the impact can be significant in the period in which it is recognized depending on the magnitude of the premium rate increase, the membership to which it applies and the length of the delay between the effective date of the rate increase and the final contract date. Premium rate decreases are recognized in the period the change in premium rate becomes effective and the change in the rate is known, which may be prior to the period when the contract amendment affecting the rate is finalized.
Service fees include revenue from certain group contracts that provide for the group to be at risk for all, or with supplemental insurance arrangements, a portion, of their claims experience. We charge these fee-based groups an administrative fee, which is based on the number of members in a group and the group’s claim experience. In addition, service fees include amounts received for the administration of Medicare, certain other government programs, and administrative services arrangements of our Carelon subsidiaries. Generally, each fee-based arrangement includes services which constitute a single suite of services provided and for which consideration is based upon an agreed-upon rate, regardless of the amount of services provided in a given period. As with premiums, each fee-based arrangement may include terms with retroactive rate or membership adjustments, performance incentives and penalties, each of which is a form of variable consideration within the transaction price. As such, each fee-based arrangement contains a single performance obligation that constitutes a series, and revenue is recognized over time as the services are performed. All benefit payments under these programs are excluded from benefit expense.
The determination of whether services are distinct performance obligations that should be accounted for separately or combined as one unit of accounting may require significant judgment. The estimation of variable consideration to be recognized requires significant judgment in the determination of the level of achievement of performance incentives, service level achievements subject to performance penalties, and the completion level of tasks subject to implementation fees.
Product revenue represents services performed by CarelonRx for unaffiliated pharmacy customers and includes ingredient costs (net of any rebates or discounts), including co-payments made by or on behalf of the customer, and service fees. Unaffiliated pharmacy customers include our fee-based groups that have contracted with CarelonRx for pharmacy services and third-party health plans. Product revenues and costs of goods sold for our affiliated health plans are eliminated in consolidation, excluding co-payments and subsidies made by or on behalf of affiliated customers. Product revenue for pharmacy services is recognized using the gross method at the negotiated contract price when CarelonRx has concluded that it is the principal, and it controls the services before prescription drugs are transferred to the customer. CarelonRx determined it is the principal due to its contractual rights to design and develop a listing of prescription drugs offered to the customer (formulary management); its control over establishing the pharmacy network available to the customer to have its prescription fulfilled (network management); and its discretion over establishing the pricing for prescription drugs. Overall, control over these activities indicate CarelonRx is primarily responsible for fulfilling the promise to provide pharmacy services. CarelonRx recognizes revenue when control of the prescription drugs is transferred to customers, in an amount it expects to be entitled to in exchange for the products or services provided.
For our non-risk-based contracts, we had no material contract assets, contract liabilities or deferred contract costs recorded on our consolidated balance sheets at December 31, 2024 and 2023. Revenue recognized in 2024 and 2023 from performance obligations related to prior years, such as due to changes in transaction price, was not material. For contracts that
have an original expected duration of greater than one year, revenue expected to be recognized in future periods related to unfulfilled contractual performance obligations and contracts with variable consideration related to undelivered performance obligations is not material.
Cost of Products Sold
Cost of Products Sold: CarelonRx’s cost of products sold includes the cost of prescription drugs dispensed to unaffiliated pharmacy customers (net of rebates or discounts). Cost of products sold includes per-claim administrative fees for prescription fulfillment by its vendor and certain CarelonRx direct costs related to sales and administration of customer contracts.
Share-Based Compensation
Share-Based Compensation: Our current compensation philosophy provides for share-based compensation, including stock options, restricted stock awards and an employee stock purchase plan. Stock options are granted for a fixed number of shares with an exercise price at least equal to the fair value of the shares at the date of the grant. Restricted stock awards are issued at the fair value of the stock on the grant date. The employee stock purchase plan allows for a purchase price per share which is 90% of the fair value of a share of common stock on the lower of the first or last trading day of the plan quarter. The employee stock purchase plan discount is recognized as compensation expense based on GAAP guidance. All other share-based payments to employees are recognized as compensation expense in our consolidated statements of income based on their fair values. Additionally, excess tax benefits, which result from actual tax benefits realized when awards vest or options are exercised exceeding deferred tax benefits previously recognized based on grant date fair value, are recognized as tax benefits in the consolidated statements of income.
Advertising and Marketing Costs
Advertising and Marketing Costs: We use print, broadcast and other advertising to promote our products and to develop our corporate image. We market our products through direct marketing activities and an extensive network of independent agents, brokers and retail partnerships for Individual and Medicare customers, and for certain Employer Group risk-based customers with a smaller employee base. Products for our Employer Group risk-based customers with a larger employee base are generally sold through independent brokers or consultants retained by the customer who work with industry specialists from our in-house sales force. In the Individual and Group markets, we offer products through state or federally facilitated marketplaces, or Public Exchanges, and off-exchange products. The cost of advertising and marketing for product promotion is expensed as incurred, while advertising and marketing costs associated with our corporate image are expensed when first aired. Total advertising and marketing expense was $540, $599 and $511 for the years ended December 31, 2024, 2023 and 2022, respectively.
Leases
Leases: We lease office space and certain computer and related equipment under noncancelable operating leases. We determine whether an arrangement is or contains a lease at its inception. We recognize lease liabilities based on the present value of the minimum lease payments not yet paid by using the lease term, any amounts probable of being owed under any residual value guarantees and the discount rate determined at lease commencement. As our leases do not generally provide an implicit rate, we use our incremental secured borrowing rate commensurate with the underlying lease terms to determine the present value of our lease payments. Our lease liabilities may include amounts for options to extend or terminate a lease when it is reasonably certain that we will exercise that option. We recognize operating right-of-use (“ROU”) assets at an amount equal to the lease liability adjusted for prepaid or accrued rent, the remaining balance of any lease incentives and unamortized initial direct costs.
The operating lease liabilities are reported in Other current liabilities and Other noncurrent liabilities and the related ROU assets are reported in Other noncurrent assets on our consolidated balance sheets. Lease expense for our operating leases is calculated on a straight-line basis over the lease term and is reported in operating expense on our consolidated statements of income. For our office space leases, we account for the lease and non-lease components (such as common area maintenance) as a single lease component. We also do not recognize a lease liability or ROU asset for our office space leases whose lease terms, at commencement, are twelve months or less and that do not include a purchase option or option to extend that we are reasonably certain to exercise.
We assess our ROU assets for impairment when there are indicators of impairment and compare the carrying amount of the ROU asset to its estimated undiscounted future cash flows. If the estimated undiscounted future cash flows are less than the carrying amount of the ROU asset, an impairment calculation is performed. An impairment loss is recorded for the difference of the ROU asset’s carrying value that exceeds its estimated discounted cash flows.
Shareholders’ Earnings per Share
Shareholders Earnings per Share: Earnings per share amounts, on a basic and diluted basis, have been calculated based upon the weighted-average common shares outstanding for the period.
Basic shareholders’ earnings per share excludes dilution and is computed by dividing income available to common shareholders by the weighted-average number of common shares outstanding for the period. Diluted shareholders’ earnings per share may include the dilutive effect of stock options, restricted stock and convertible debentures, using the treasury stock method. The treasury stock method assumes exercise of stock options and vesting of restricted stock, with the assumed proceeds used to purchase common stock at the average market price for the period. The difference between the number of shares assumed issued and the number of shares assumed purchased represents the dilutive shares.
Recently Adopted Accounting Guidance and Recent Accounting Guidance Not Yet Adopted
Recently Adopted Accounting Guidance: In November 2023, the FASB issued Accounting Standards Update No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures (“ASU 2023-07”). The amendments in ASU 2023-07 are intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. ASU 2023-07 is effective for our fiscal year beginning after December 15, 2023, and interim periods within our fiscal year beginning after December 15, 2024. The amendments are to be applied retrospectively to all prior periods presented in the financial statements, and upon transition, the significant segment expense categories and amounts disclosed in the prior periods should be based on the significant segment expense categories identified and disclosed in the period of adoption. The adoption of ASU 2023-07 did not have an impact on our results of operations or our consolidated cash flows.
In November 2020, the FASB issued Accounting Standards Update No. 2020-11, Financial Services—Insurance (Topic 944): Effective Date and Early Application (“ASU 2020-11”). The amendments in ASU 2020-11 changed the effective date and early application of Accounting Standards Update No. 2018-12, Financial Services—Insurance (Topic 944): Targeted Improvements to the Accounting for Long-Duration Contracts, which was issued in November 2018. The amendments in ASU 2020-11 extended the original effective date by one year to our interim and annual reporting periods beginning after December 15, 2022. This standard requires us to review cash flow assumptions for our long-duration insurance contracts at least annually and recognize the effect of changes in future cash flow assumptions in net income. This standard also requires us to update discount rate assumptions quarterly and recognize the effect of changes in these assumptions in other comprehensive income. The rate used to discount our reserves for future policy benefits will be based on an estimate of the yield for an upper-medium grade fixed-income instrument with a duration profile matching that of our liabilities. In addition, this standard changes the amortization method for deferred acquisition costs. We adopted these amendments on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and deferred acquisition costs as of the transition date, January 1, 2021. While the adoption did not have an overall material impact, our prior period financial statements presented in this Annual Report on Form 10-K have been restated to reflect the impacts of our adoption as required by the new standard. An adjustment of $(131) was made to shareholders’ net income for the year ended December 31, 2022, which include an adjustment to benefit expense of $155. In addition, the following balance sheet adjustments were made for the year ended December 31, 2022: $(17) to total assets; $47 to total liabilities; $13 to accumulated other comprehensive loss; and $(64) to shareholders’ equity and total equity.
Recent Accounting Guidance Not Yet Adopted: In November 2024, the FASB issued Accounting Standards Update No. 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses (“ASU 2024-03”). This standard requires additional expense breakdowns in the footnotes for items such as inventory purchases, employee compensation, depreciation, and intangible asset amortization. Public companies must also provide a qualitative description of remaining expense amounts not separately disclosed, as well as the definition and total amount of selling expenses. ASU 2024-03 is effective for our fiscal year beginning after December 15, 2026, and interim periods within our fiscal year beginning after December 15, 2027. The amendments are to be applied either prospectively to financial statements issued for reporting periods after the effective date of the update, or retrospectively to all prior periods presented in the financial statements. We are currently evaluating the effects the adoption of ASU 2024-03 will have on our consolidated financial statements and related disclosures.
In December 2023, the FASB issued Accounting Standards Update No. 2023-09, Income Taxes (Topic 740) (“ASU 2023-09”). The amendments in ASU 2023-09 are intended to improve income tax disclosures, primarily related to the rate reconciliation and income taxes paid information. ASU 2023-09 is effective for our fiscal year beginning after December 15, 2024. The amendments are to be applied on a prospective basis, although retrospective adoption is permitted. We do not believe the adoption of ASU 2023-09 will have a material impact on our consolidated financial statements or disclosures.
In August 2023, the FASB issued Accounting Standards Update No. 2023-05, Business Combinations—Joint Venture Formations (Subtopic 805-60): Recognition and Initial Measurement (“ASU 2023-05”). ASU 2023-05 clarifies existing guidance to reduce diversity in practice and is requiring a joint venture to recognize and initially measure its assets and liabilities using a new basis of accounting, at fair value, upon formation. These amendments are effective prospectively for all joint venture formations with a formation date on or after January 1, 2025. We do not believe the adoption of ASU 2023-05 will have a material impact on our consolidated financial statements and disclosures.
There were no other new accounting pronouncements that were issued or became effective during the year ended December 31, 2024 that had, or are expected to have, a material impact on our financial position, results of operations, cash flows or financial statement disclosures.
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Business Acquisitions and Divestitures (Tables)
12 Months Ended
Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed
Acquired tangible assets (liabilities) at the acquisition date were:
20242023
Cash, cash equivalents and short-term investments$484 $
Accounts receivable and other current assets847 241 
Property, equipment and other long-term assets309 18 
Medical claims and other policyholder liabilities payable(154)— 
Accounts payable and other current liabilities(1,005)(169)
Other long-term liabilities(242)(1)
Deferred tax liabilities(475)(183)
Total net tangible assets (liabilities)
$(236)$(88)
Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination
Acquisition date fair values and weighted-average useful lives assigned to intangible assets include:
20242023
Fair ValueWeighted Average Useful LifeFair ValueWeighted Average Useful Life
Customer-related$1,621 20 years$796 25 years
Provider and hospital relationships70 10 years— 0
Other 181 8 years24 5 years
State Medicaid licenses 426 — — — 
Total intangible assets$2,298 $820 
v3.25.0.1
Investments (Tables)
12 Months Ended
Dec. 31, 2024
Investments [Abstract]  
Schedule of Current and Long-Term Investments, Available-For-Sale
A summary of current and long-term fixed maturity securities, available-for-sale, at December 31, 2024 and 2023 is as follows:
Cost or
Amortized
Cost
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Allowance For Credit LossesEstimated
Fair Value
 
December 31, 2024
Fixed maturity securities:
United States Government securities$1,907 $$(85)$— $1,824 
Government sponsored securities156 — (5)— 151 
Foreign government securities19 — (2)— 17 
States, municipalities and political subdivisions, tax-exempt3,142 33 (123)— 3,052 
Corporate securities14,095 192 (367)(4)13,916 
Residential mortgage-backed securities3,274 13 (236)— 3,051 
Commercial mortgage-backed securities
1,801 (60)(1)1,748 
 Other asset-backed securities2,534 36 (92)(1)2,477 
Total fixed maturity securities$26,928 $284 $(970)$(6)$26,236 
December 31, 2023
Fixed maturity securities:
United States Government securities$1,873 $25 $(54)$— $1,844 
Government sponsored securities112 (3)— 110 
Foreign government securities(2)— 
States, municipalities and political subdivisions, tax-exempt
3,985 69 (152)— 3,902 
Corporate securities14,838 322 (580)(2)14,578 
Residential mortgage-backed securities4,071 40 (279)— 3,832 
Commercial mortgage-backed securities
2,174 13 (138)(2)2,047 
Other asset-backed securities4,278 25 (130)— 4,173 
Total fixed maturity securities$31,336 $496 $(1,338)$(4)$30,490 
Schedule of Aggregate Fair Value and Gross Unrealized Loss of Fixed Maturity Securities in an Unrealized Loss Position
For fixed maturity securities in an unrealized loss position at December 31, 2024 and 2023, the following table summarizes the aggregate fair values and gross unrealized losses by length of time those securities have continuously been in an unrealized loss position.
 Less than 12 Months12 Months or Greater
 Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
Number of
Securities
Estimated
Fair Value
Gross
Unrealized
Loss
(Securities are whole amounts)      
December 31, 2024
Fixed maturity securities:
United States Government securities40$1,240 $(52)25$330 $(33)
Government sponsored securities1089 (2)3642 (3)
Foreign government securities215 (1)2(1)
States, municipalities and political subdivisions, tax-exempt
5271,092 (22)661943 (101)
Corporate securities1,4154,717 (92)1,3172,645 (275)
Residential mortgage-backed securities3061,097 (25)1,3121,291 (211)
Commercial mortgage-backed securities136670 (15)297661 (45)
Other asset-backed securities123293 (9)236735 (83)
Total fixed maturity securities2,559$9,213 $(218)3,886$6,649 $(752)
December 31, 2023
Fixed maturity securities:
United States Government securities
35 $552 $(9)44 $370 $(45)
Government sponsored securities
— — — 40 52 (3)
Foreign government securities— — — (2)
States, municipalities and political subdivisions, tax-exempt
203 354 (2)1,034 1,811 (150)
Corporate securities
389 608 (15)2,624 6,871 (565)
Residential mortgage-backed securities
183 438 (5)1,620 2,075 (274)
Commercial mortgage-backed securities
112 353 (6)534 1,317 (132)
Other asset-backed securities110 394 (18)761 2,342 (112)
Total fixed maturity securities1,032 $2,699 $(55)6,659 $14,842 $(1,283)
Schedule of Amortized Cost and Fair Value of Fixed Maturity Securities, By Contractual Maturity
The amortized cost and fair value of fixed maturity securities at December 31, 2024, by contractual maturity, are shown below. Expected maturities may differ from contractual maturities because the issuers of the securities may have the right to prepay obligations.
Amortized
Cost
Estimated
Fair Value
Due in one year or less$198 $196 
Due after one year through five years4,827 4,772 
Due after five years through ten years10,550 10,378 
Due after ten years6,278 6,090 
Mortgage-backed securities5,075 4,800 
Total fixed maturity securities$26,928 $26,236 
Schedule of Marketable Equity Securities
A summary of current equity securities at December 31, 2024 and 2023 is as follows:
December 31, 2024December 31, 2023
Equity Securities:
Exchange traded funds$1,002 $106 
Common equity securities118 45 
Private equity securities72 78 
Total$1,192 $229 
Schedule of Investment Income
The major categories of net investment income for the years ended December 31, 2024, 2023 and 2022 are as follows:
202420232022
Fixed maturity securities$1,539 $1,387 $971 
Equity securities40 18 48 
Cash equivalents235 305 77 
Other invested assets274 157 432 
Investment income2,088 1,867 1,528 
Investment expenses(37)(42)(43)
Net investment income$2,051 $1,825 $1,485 
Schedule of Net Investment Gains (Losses)
Net investment (losses) gains for the years ended December 31, 2024, 2023 and 2022 are as follows:
202420232022
Net gains (losses):
Fixed maturity securities:
Gross realized gains from sales$158 $47 $52 
Gross realized losses from sales(479)(488)(469)
Impairment losses recognized in income
(17)(15)(31)
Net realized losses on fixed maturity securities
(338)(456)(448)
Equity securities:
Unrealized losses recognized on equity securities still held
(6)(1)(78)
Net realized (losses) gains recognized on equity securities sold(9)(102)
Net (losses) gains on equity securities(15)(180)
Other investments:
Gross gains49 103 96 
Gross losses(25)(63)(64)
Impairment losses recognized in income(126)(291)(34)
Net losses on other investments
(102)(251)(2)
Net losses on investments
$(455)$(702)$(630)
v3.25.0.1
Derivative Financial Instruments (Tables)
12 Months Ended
Dec. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]  
Summary of Aggregate Contractual or Notional Amounts and Carrying Values
A summary of the aggregate contractual or notional amounts and carrying values related to derivative financial instruments at December 31, 2024 and 2023 is as follows:
 Contractual/
Notional
Amount
Balance Sheet Location
Carrying Value
Asset(Liability)
December 31, 2024
Hedging instruments
Interest rate swaps - fixed to floating$6,475 Other assets/other liabilities$$(150)
Foreign currency forwards
322 
Other liabilities
— (6)
Subtotal hedging
6,797 (156)
Non-hedging instruments
Interest rate swaps— — 
Options2,453 
Other liabilities
— (1,415)
Futures/Forwards
124 
Equity securities/other assets
— 
Subtotal non-hedging2,582 Subtotal non-hedging(1,415)
Total derivatives$9,379 Total derivatives11 (1,571)
Amounts netted(6)
Net derivatives$$(1,565)
December 31, 2023
Hedging instruments
Interest rate swaps - fixed to floating$1,475 Other assets/other liabilities$15 $(52)
Non-hedging instruments
Derivatives embedded in convertible securities
15 
Fixed maturity securities
— 
Interest rate swaps— — 
Options161 
Other liabilities
— (85)
Collars19 Equity securities14 (3)
Futures/Forwards
151 
Equity securities/other assets
— 
Subtotal non-hedging351 Subtotal non-hedging22 (88)
Total derivatives$1,826 Total derivatives37 (140)
Amounts netted(15)15 
Net derivatives$22 $(125)
Schedule of Derivative Instruments A summary of our outstanding fair value hedges at December 31, 2024 and 2023 is as follows:
Type of Fair Value HedgesYear
Entered
Into
Outstanding Notional AmountInterest Rate
Received
Expiration Date
20242023
Interest rate swap2024$200 $— 5.500 %April 15, 2032
Interest rate swap20241,000 — 4.750 August 15, 2032
Interest rate swap2024600 — 5.150 December 15, 2028
Interest rate swap20241,000 — 5.375 December 15, 2033
Interest rate swap2024750 — 4.750 August 15, 2029
Interest rate swap2024750 — 4.950 May 1, 2031
Interest rate swap20241,200 — 5.200 August 15, 2034
Interest rate swap2023300 300 5.000 April 15, 2032
Interest rate swap2023150 150 2.550 September 15, 2030
Interest rate swap2023— 500 4.900 February 8, 2026
Interest rate swap2023125 125 4.101 September 1, 2027
Interest rate swap2023100 100 2.250 November 15, 2029
Interest rate swap2022150 150 5.500 April 15, 2032
Interest rate swap202275 75 4.101 September 1, 2027
Interest rate swap202275 75 2.250 November 15, 2029
Total notional amount outstanding
$6,475 $1,475 
Schedule of Amounts Recorded on Consolidated Balance Sheets
The following amounts were recorded on our consolidated balance sheets related to cumulative basis adjustments for fair value hedges at December 31, 2024 and 2023:
Balance Sheet Classification in Which Hedged Item is IncludedCarrying Amount of Hedged LiabilityCumulative Amount of Fair Value Hedging Adjustment Included in the Carrying Amount of the Hedged Liability
2024202320242023
Long-term debt$29,218 $23,246 $(142)$(37)
Schedule of Effect of Non-Hedging Derivatives on Income Statement
A summary of the effect of non-hedging derivatives on our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
Type of Non-hedging DerivativesIncome Statement Location of
Gain (Loss) Recognized
Derivative
(Loss) Gain
Recognized
Year ended December 31, 2024
Options (including swaptions)
Net losses on financial instruments
$(1)
Collars
Net losses on financial instruments
14 
Futures
Net losses on financial instruments
(3)
Total$10 
Year ended December 31, 2023
Derivatives embedded in convertible securities
Net losses on financial instruments
$(2)
Options (including swaptions)
Net losses on financial instruments
Collars
Net losses on financial instruments
(3)
Futures
Net losses on financial instruments
10 
Total$
Year ended December 31, 2022
Derivatives embedded in convertible securities
Net losses on financial instruments
$(3)
Interest rate swaps
Net losses on financial instruments
(4)
Options (including swaptions)
Net losses on financial instruments
13 
Collars
Net losses on financial instruments
10 
Futures64 
Total$80 
v3.25.0.1
Fair Value (Tables)
12 Months Ended
Dec. 31, 2024
Fair Value Disclosures [Abstract]  
Summary of Fair Value Measurements by Level
A summary of fair value measurements by level for assets and liabilities measured at fair value on a recurring basis at December 31, 2024 and 2023 is as follows:
Level ILevel IILevel IIITotal
December 31, 2024
Assets:
Cash equivalents$3,199 $— $— $3,199 
Fixed maturity securities, available-for-sale:
United States Government securities— 1,824 — 1,824 
Government sponsored securities— 151 — 151 
Foreign government securities— 17 — 17 
States, municipalities and political subdivisions, tax-exempt— 3,052 — 3,052 
Corporate securities— 13,873 43 13,916 
Residential mortgage-backed securities— 3,041 10 3,051 
Commercial mortgage-backed securities— 1,748 — 1,748 
Other asset-backed securities— 1,730 747 2,477 
Total fixed maturity securities, available-for-sale— 25,436 800 26,236 
Equity securities:
Exchange traded funds1,002 — — 1,002 
Common equity securities87 31 — 118 
Private equity securities— — 72 72 
Total equity securities1,089 31 72 1,192 
Other invested assets - common equity securities18 — — 18 
Securities lending collateral— 2,306 — 2,306 
Derivatives - other assets— — 
Total assets$4,306 $27,778 $872 $32,956 
Liabilities:
Derivatives - other liabilities$— $(150)$— $(150)
Total liabilities$— $(150)$— $(150)
December 31, 2023
Assets:
Cash equivalents$2,210 $— $— $2,210 
Fixed maturity securities, available-for-sale:
United States Government securities— 1,844 — 1,844 
Government sponsored securities— 110 — 110 
Foreign government securities— — 
States, municipalities and political subdivisions, tax-exempt— 3,902 — 3,902 
Corporate securities— 14,532 46 14,578 
Residential mortgage-backed securities— 3,830 3,832 
Commercial mortgage-backed securities— 2,047 — 2,047 
Other asset-backed securities— 3,634 539 4,173 
Total fixed maturity securities, available-for-sale— 29,903 587 30,490 
Equity securities:
Exchange traded funds106 — — 106 
Common equity securities12 33 — 45 
Private equity securities— — 78 78 
Total equity securities118 33 78 229 
Other invested assets - common equity securities111 — — 111 
Securities lending collateral— 2,382 — 2,382 
Derivatives - other assets— 10 — 10 
Total assets$2,439 $32,328 $665 $35,432 
Liabilities:
Derivatives - other liabilities$— $(40)$— $(40)
Total liabilities$— $(40)$— $(40)
Reconciliation of Assets Measured at Fair Value on a Recurring Basis Using Level III Inputs
A reconciliation of the beginning and ending balances of assets measured at fair value on a recurring basis using Level III inputs for the years ended December 31, 2024, 2023 and 2022 is as follows:
Corporate
Securities
Residential
Mortgage-
backed
Securities
Other Asset-Backed SecuritiesEquity
Securities
Total
Year ended December 31, 2024
Beginning balance at January 1, 2024$46 $$539 $78 $665 
Total gains (losses):
Recognized in net income— — (6)(5)
Recognized in accumulated other comprehensive income— — 12 — 12 
Purchases26 10 118 17 171 
Sales(5)(2)(10)(17)(34)
Settlements(4)— (1)— (5)
Transfers into Level III— — 92 — 92 
Transfers out of Level III(21)— (3)— (24)
Ending balance at December 31, 2024$43 $10 $747 $72 $872 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2024$— $— $— $(5)$(5)
Year ended December 31, 2023
Beginning balance at January 1, 2023$137 $— $356 $88 $581 
Total gains (losses):
Recognized in net income(10)— — (4)(14)
Recognized in accumulated other comprehensive income— — 
Purchases38 — 191 15 244 
Sales(88)— (17)(21)(126)
Settlements(21)— — — (21)
Transfers into Level III— 14 
Transfers out of Level III(22)— — — (22)
Ending balance at December 31, 2023$46 $$539 $78 $665 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2023$— $— $— $(6)$(6)
Year ended December 31, 2022
Beginning balance at January 1, 2022$336 $$19 $89 $449 
Total gains (losses):
Recognized in net income— — (1)— (1)
Recognized in accumulated other comprehensive income(1)— (16)— (17)
Purchases56 — 370 17 443 
Sales(210)— (14)(18)(242)
Settlements(41)— — — (41)
Transfers into Level III— — — 
Transfers out of Level III(12)(5)(2)— (19)
Ending balance at December 31, 2022$137 $— $356 $88 $581 
Change in unrealized gains or losses included in net income related to assets still held at December 31, 2022$— $— $— $— $— 
Summary of Estimated Fair Values of Financial Instruments Recoded at Carrying Value
A summary of the estimated fair values by level of each class of financial instrument that is recorded at its carrying value on our consolidated balance sheets at December 31, 2024 and 2023 is as follows:
 Carrying
Value
Estimated Fair Value
 Level ILevel IILevel IIITotal
December 31, 2024
Assets:
Other invested assets$642 $— $— $610 $610 
Liabilities:
Debt:
Short-term borrowings365 — 365 — 365 
Notes30,867 — 28,460 — 28,460 
Options
1,415 — — 1,873 1,873 
December 31, 2023
Assets:
Other invested assets$302 $— $— $278 $278 
Liabilities:
Debt:
Short-term borrowings225 — 225 — 225 
Notes24,895 — 23,569 — 23,569 
Options
85 — — 85 85 
v3.25.0.1
Income Taxes (Tables)
12 Months Ended
Dec. 31, 2024
Income Tax Disclosure [Abstract]  
Schedule of Deferred Tax Assets and Liabilities
The components of deferred income taxes at December 31, 2024 and 2023 are as follows:
20242023
Deferred income tax assets:
Accrued expenses$826 $595 
Bad debt reserves434 415 
Insurance reserves192 178 
Lease liabilities170 172 
Retirement liabilities126 132 
Deferred compensation45 44 
Federal and state carryforwards
428 368 
Foreign (including Puerto Rico) carryforwards90 87 
Other100 166 
Subtotal2,411 2,157 
Less: valuation allowance(294)(271)
Total deferred income tax assets2,117 1,886 
Deferred income tax liabilities:
U.S. federal and state intangible assets2,584 2,043 
Foreign (including Puerto Rico) intangible assets194 330 
Capitalized software513 485 
Depreciation and amortization38 81 
Investment basis11 11 
Retirement assets330 319 
Lease right-of-use assets
114 110 
Prepaid expenses275 249 
Total deferred income tax liabilities4,059 3,628 
Net deferred income tax liabilities$1,942 $1,742 
Schedule of Components of Provision for Income Taxes
Significant components of the provision for income taxes for the years ended December 31, 2024, 2023 and 2022 consist of the following:
202420232022
Current tax expense:
Federal$1,753 $1,899 $1,455 
Foreign (including Puerto Rico)93 95 98 
State and local448 420 244 
Total current tax expense2,294 2,414 1,797 
Deferred tax benefit
(361)(690)(85)
Total income tax expense$1,933 $1,724 $1,712 
Schedule of Effective Income Tax Rate Reconciliation
A reconciliation of income tax expense recorded in the consolidated statements of income and amounts computed at the statutory federal income tax rate for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
 AmountPercentAmountPercentAmountPercent
Amount at statutory rate$1,660 21.0 %$1,620 21.0 %$1,596 21.0 %
State and local income taxes net of federal tax expense/benefit
216 2.7 124 1.6 190 2.5 
Tax exempt interest and dividends received deduction
(12)(0.1)(15)(0.2)(19)(0.3)
Change in valuation allowance
43 0.6 84 1.1 51 0.7 
Other, net26 0.3 (89)(1.2)(106)(1.4)
Total income tax expense$1,933 24.5 %$1,724 22.3 %$1,712 22.5 %
Schedule of Unrecognized Tax Benefits Roll Forward
The change in the carrying amount of gross unrecognized tax benefits from uncertain tax positions for the years ended December 31, 2024 and 2023 is as follows:
20242023
Balance at January 1$468 $349 
Additions based on:
Tax positions related to current year146 19 
Tax positions related to prior years216 119 
Reductions based on:
Tax positions related to prior years(55)(19)
Balance at December 31$775 $468 
v3.25.0.1
Property and Equipment (Tables)
12 Months Ended
Dec. 31, 2024
Property, Plant and Equipment [Abstract]  
Summary of Property and Equipment
A summary of property and equipment at December 31, 2024 and 2023 is as follows:
20242023
Computer software, purchased and internally developed$6,617 $6,195 
Computer equipment, furniture and other equipment940 955 
Leasehold improvements744 715 
Building and improvements27 37 
Land and improvements
Property and equipment, gross8,329 7,903 
Accumulated depreciation and amortization(3,677)(3,544)
Property and equipment, net$4,652 $4,359 
v3.25.0.1
Goodwill and Other Intangible Assets (Tables)
12 Months Ended
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Summary of the Change in the Carrying Amount of Goodwill By Reportable Segment
A summary of the change in the carrying amount of goodwill for our segments (see Note 20, “Segment Information”) for 2024 and 2023 is as follows:
Health BenefitsCarelonRxCarelon ServicesTotal
Balance as of January 1, 2023$22,088 $59 $2,236 $24,383 
Acquisitions and adjustments16 898 20 934 
Balance as of December 31, 202322,104 957 2,256 25,317 
Acquisitions and adjustments460 958 1,542 2,960 
Balance as of December 31, 2024$22,564 $1,915 $3,798 $28,277 
Accumulated impairment as of December 31, 2024
$— $— $(106)$(106)
Components of Other Intangible Assets
The components of other intangible assets as of December 31, 2024 and 2023 are as follows:
 20242023
Gross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Gross
Carrying
Amount
Accumulated
Amortization
Net
Carrying
Amount
Intangible assets with finite lives:
Customer relationships$7,866 $(4,233)$3,633 $6,263 $(3,817)$2,446 
Provider and hospital relationships377 (165)212 326 (164)162 
Other423 (67)356 242 (44)198 
Total8,666 (4,465)4,201 6,831 (4,025)2,806 
Intangible assets with indefinite lives:
Blue Cross and Blue Shield and other trademarks5,991 — 5,991 5,991 — 5,991 
State Medicaid licenses1,902 — 1,902 1,476 — 1,476 
Total7,893 — 7,893 7,467 — 7,467 
Other intangible assets$16,559 $(4,465)$12,094 $14,298 $(4,025)$10,273 
v3.25.0.1
Retirement Benefits (Tables)
12 Months Ended
Dec. 31, 2024
Retirement Benefits [Abstract]  
Reconciliation of the Benefit Obligation
The reconciliation of the benefit obligations for the plans is as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Benefit obligation at beginning of year$1,393 $1,415 $255 $277 
Interest cost63 68 12 14 
Plan participant contributions— — 16 16 
Actuarial (gain) loss(61)40 (10)(12)
Settlements(27)(27)— — 
Benefits paid(105)(103)(35)(40)
Benefit obligation at end of year$1,263 $1,393 $238 $255 
Changes in the Fair Value of Plan Assets
The changes in the fair value of plan assets are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Fair value of plan assets at beginning of year$1,807 $1,734 $313 $299 
Actual return on plan assets83 199 29 42 
Employer contributions— — 
Plan participant contributions— — 16 16 
Settlements(27)(27)— 
Benefits paid(105)(103)(37)(44)
Fair value of plan assets at end of year$1,764 $1,807 $325 $313 
Schedule of Amounts Recognized on the Balance Sheet The amounts included in the consolidated balance sheets are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Noncurrent assets$539 $459 $87 $58 
Current liabilities(4)(7)— — 
Noncurrent liabilities(34)(38)— — 
Net amount at end of year
$501 $414 $87 $58 
Estimated Future Payments for Pension Benefits and Other Benefits
Our estimated future payments for pension benefits and other benefits are as follows:
Pension
Benefits
Other
Benefits
2025$128 $26 
2026112 26 
2027109 25 
2028106 24 
2029103 24 
2030 - 2034472 99 
Schedule of Net Periodic Benefit
The components of net periodic benefit credit included in the consolidated statements of income are as follows:
202420232022
Pension Benefits
Interest cost$63 $68 $52 
Expected return on assets(117)(127)(101)
Recognized actuarial loss14 16 
Settlement loss28 
Net periodic benefit credit$(34)$(43)$(5)
Other Benefits
Interest Cost
$12 $14 $
Expected return on assets
(22)(21)(26)
Amortization of prior service credit
(1)(2)(4)
Recognized actuarial gain
(1)— — 
Net periodic benefit credit$(12)$(9)$(23)
Schedule of Accumulated Other Comprehensive Income (Loss)
The net amounts included in accumulated other comprehensive income (loss) that have not been recognized as components of net periodic benefit costs are as follows:
 Pension BenefitsOther Benefits
 2024202320242023
Net actuarial gain (loss)
$(580)$(625)$55 $38 
Prior service credit— — — 
Net amount before tax at end of year
$(580)$(625)$55 $40 
Schedule of Defined Benefit Plan Amounts Recognized in Other Comprehensive Income (Loss)
The pre-tax amounts recognized in other comprehensive loss are as follows:
202420232022
Pension Benefits
Net actuarial gain (loss)
$25 $31 $(91)
Recognized actuarial loss
14 16 
Settlement loss
28 
Total pre-tax other comprehensive income (loss)
$45 $47 $(47)
Other Benefits
Net actuarial gain (loss)
$17 $34 $(32)
Recognized actuarial gain
(1)— — 
Prior service credit
(1)(2)(5)
Total pre-tax other comprehensive income (loss)
$15 $32 $(37)
Schedule of Assumptions Used in Calculating the Net Periodic Benefit Cost
The following table represents the significant weighted-average actuarial assumptions for all plans:
 Pension BenefitsOther Benefits
 2024202320242023
Benefit Obligation
Discount rate
5.47 %4.91 %5.34 %4.83 %
Interest Crediting rate
4.50 %4.50 %4.36 %4.50 %
The following table represents the significant weighted-average actuarial assumptions for all plans:
202420232022
Net Periodic Benefit Cost
Pension Benefits
Discount rate4.91 %5.18 %2.70 %
Expected rate of return on plan assets6.47 %6.58 %5.02 %
Interest crediting rate4.50 %4.25 %3.82 %
Other Benefits
Discount rate4.83 %5.12 %2.49 %
Expected rate of return on plan assets6.64 %6.57 %6.43 %
Interest crediting rate4.50 %3.89 %1.56 %
Fair Values of Pension Benefit Assets and Other Benefit Assets by Asset Category and Level Inputs
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2024, excluding cash, investment income receivable and amounts due to/from brokers of $30, and excluding estimated claims settlements to be paid from other benefit assets of $(19), are as follows (see Note 7, “Fair Value,” for additional information regarding the definition of level inputs):
Level ILevel IILevel IIITotal
December 31, 2024
Pension Benefit Assets:
Cash equivalents
$$— $— $
Equity securities:
U.S. securities307 — — 307 
Foreign securities71 — — 71 
Mutual funds44 — — 44 
Fixed maturity securities:
Government securities— 78 — 78 
Corporate securities— 539 — 539 
Asset-backed securities— — 
Other types of investments:
Insurance company contracts— — 143 143 
Total pension benefit assets at fair value$428 $620 $143 1,191 
Alternative investments
543 
Total pension benefit assets$1,734 
Other Benefit Assets:
Equity securities:
U.S. securities$$— $— $
Foreign securities— — 
Mutual funds16 — — 16 
Other types of investments:
Life insurance contracts— — 301 301 
Investment in DOL 103-12 trust— — 
Total other benefit assets at fair value
$25 $$301 335 
Alternative investments
Total other benefit assets
$344 
The fair values of our pension benefit assets and other benefit assets by asset category and level inputs at December 31, 2023, excluding cash, investment income receivable and amounts due to/from brokers of $43, and excluding estimated claims settlements to be paid from other benefit assets of $(23), are as follows:
Level ILevel IILevel IIITotal
December 31, 2023
Pension Benefit Assets:
Cash equivalents
$$— $— $
Equity securities:
U.S. securities390 — — $390 
Foreign securities94 — — 94 
Mutual funds42 — — 42 
Fixed maturity securities:
Government securities— 70 — 70 
Corporate securities— 522 — 522 
Asset-backed securities— — 
Other types of investments:
Insurance company contracts— — 143 143 
Total pension benefit assets at fair value$528 $594 $143 1,265 
Alternative investments
500 
Total pension benefit assets$1,765 
Other Benefit Assets:
Equity securities:
U.S. securities$$— $— $
Foreign securities— — 
Mutual funds17 — — 17 
Other types of investments:
Life insurance contracts— — 289 289 
Investment in DOL 103-12 trust— — 
Total other benefit assets at fair value
$26 $$289 324 
Alternative investments
11 
Total other benefit assets
$335 
Schedule of Investments Measured Using Net Asset Value Per Share
The following table provides additional information on the alternative investments that are measured using NAV as a practical expedient:
Fair Value as of December 31Unfunded Commitments as of December 31, 2024Redemption Frequency (if applicable)Redemption Notice Period
20242023
Collective investment trusts:
Pension benefit assets
$413 $346 
Other benefit assets
Total CITs
421 355 $— 
Daily
2 days
Commingled fund:
Pension benefit assets
69 84 
Other benefit assets
Total commingled fund
70 86 — 
1st & 15th of the month
7 business days
Partnership investments61 70 
Not Applicable
Not Applicable
Total alternative investments$552 $511 $
Reconciliation of the Change in Plan Assets Measured at Fair Value Using Level III Inputs
A reconciliation of the beginning and ending balances of plan assets measured at fair value using Level III inputs for the years ended December 31, 2024, 2023 and 2022 is as follows:
Insurance
Company
Contracts
Life
Insurance
Contracts
Total
Year ended December 31, 2024
Beginning balance at January 1, 2024$143 $289 $432 
Actual return on plan assets relating to assets still held at the reporting date
28 31 
Purchases— 
Sales(9)(16)(25)
Ending balance at December 31, 2024$143 $301 $444 
Year ended December 31, 2023
Beginning balance at January 1, 2023$154 $270 $424 
Actual return on plan assets relating to assets still held at the reporting date
37 40 
Purchases— 
Sales(20)(18)(38)
Ending balance at December 31, 2023$143 $289 $432 
Year ended December 31, 2022
Beginning balance at January 1, 2022$179 $338 $517 
Actual return on plan assets relating to assets still held at the reporting date
(22)(53)(75)
Purchases— 
Sales(12)(15)(27)
Ending balance at December 31, 2022$154 $270 $424 
v3.25.0.1
Medical Claims Payable (Tables)
12 Months Ended
Dec. 31, 2024
Insurance [Abstract]  
Reconciliation of the Beginning And Ending Balances For Medical Claims Payable
A reconciliation of the beginning and ending balances for medical claims payable for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Gross medical claims payable, beginning of year$15,865 $15,348 $13,282 
Ceded medical claims payable, beginning of year(7)(6)(21)
Net medical claims payable, beginning of year15,858 15,342 13,261 
Business combinations and purchase adjustments143 — 133 
Net incurred medical claims:
Current year125,370 121,798 113,414 
Prior years redundancies(1,731)(1,571)(869)
Total net incurred medical claims123,639 120,227 112,545 
Net payments attributable to:
Current year medical claims110,930 107,146 98,997 
Prior years medical claims13,143 12,565 11,600 
Total net payments124,073 119,711 110,597 
Net medical claims payable, end of year15,567 15,858 15,342 
Ceded medical claims payable, end of year13 
Gross medical claims payable, end of year$15,580 $15,865 $15,348 
Schedule of Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense
The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the years ended December 31, 2024, 2023 and 2022, which are the completion and trend factors. These vital assumptions can be affected by variables such as utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing and submission patterns, and operational changes resulting from business combinations.
 Favorable Developments
by Changes in Key Assumptions
 202420232022
Assumed trend factors$(688)$(895)$(859)
Assumed completion factors(1,043)(676)(10)
Total$(1,731)$(1,571)$(869)
Reconciliation of Net Incurred Medical Claims to Benefit Expense
The reconciliation of net incurred medical claims to benefit expense included in the consolidated statements of income is as follows:
Years Ended December 31
202420232022
Total net incurred medical claims$123,639 $120,227 $112,545 
Quality improvement and other claims expense3,928 4,103 4,097 
Benefit expense$127,567 $124,330 $116,642 
Short-Duration Insurance Contracts, Claims Development
Incurred claims development, net of reinsurance, for the years ended December 31, 2024, 2023 and 2022 is as follows:
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202220232024
Claim Years(Unaudited)(Unaudited)
2022 & Prior$125,938 $124,367 $124,041 
2023121,798 120,393 
2024125,513 
Total$369,947 
Paid claims development, net of reinsurance, for the years ended December 31, 2024, 2023 and 2022 is as follows:
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202220232024
Claim Years(Unaudited)(Unaudited)
2022 & Prior$110,597 $123,162 $123,849 
2023107,146 119,601 
2024110,930 
Total$354,380 
Reconciliation of Short Duration Medical Claims Payable to the Consolidated Medical Claims Payable
The reconciliation of incurred and paid claims development information for the three years ended December 31, 2024, reflected in the tables above, to the consolidated ending balance for medical claims payable included in the consolidated balance sheets, as of December 31, 2024, is as follows:
Total
Cumulative incurred claims and allocated claim adjustment expenses, net of reinsurance$369,947 
Less: Cumulative paid claims and allocated claim adjustment expenses, net of reinsurance354,380 
Net medical claims payable, end of year15,567 
Ceded medical claims payable, end of year13 
Insurance lines other than short duration256 
Liabilities held for sale
(90)
Gross medical claims payable, end of year$15,746 
v3.25.0.1
Debt (Tables)
12 Months Ended
Dec. 31, 2024
Debt Disclosure [Abstract]  
Schedule of Long-Term Debt
The carrying value of our long-term debt at December 31, 2024 and 2023 consists of the following:
20242023
Senior unsecured notes:
3.350%, due 2024
$— $850 
3.500%, due 2024
— 799 
2.375%, due 2025
1,250 1,251 
5.350%, due 2025
399 399 
1.500%, due 2026
749 747 
4.500%, due 2026
349 — 
4.900%, due 2026
499 496 
3.650%, due 2027
1,596 1,595 
4.101%, due 2028
1,238 1,236 
2.875%, due 2029
822 821 
5.150%, due 2029
601 — 
2.250%, due 2030
1,075 1,075 
4.750%, due 2030
731 — 
2.550%, due 2031
971 972 
4.950%, due 2031
726 — 
4.100%, due 2032
596 595 
5.500%, due 2032
635 658 
4.750%, due 2033
973 992 
5.375%, due 2034
992 — 
5.950%, due 2034
335 335 
5.200%, due 2035
1,151 — 
5.850%, due 2036
397 397 
6.375%, due 2037
364 364 
5.800%, due 2040
115 114 
4.625%, due 2042
860 860 
4.650%, due 2043
975 975 
4.650%, due 2044
768 768 
5.100%, due 2044
548 548 
4.375%, due 2047
1,389 1,388 
4.550%, due 2048
840 840 
3.700%, due 2049
813 813 
3.125%, due 2050
988 988 
3.600%, due 2051
1,234 1,233 
4.550% due 2052
689 689 
6.100%, due 2052
742 742 
5.125%, due 2053
1,084 1,083 
4.850%, due 2054
247 247 
5.650%, due 2054
985 — 
5.700%, due 2055
1,327 — 
5.850% due 2064
789 — 
Surplus note:
9.000%, due 2027
25 25 
Total Long-Term Debt
30,867 24,895 
Current portion of long-term debt
(1,649)(1,649)
Long-term debt, less current portion
$29,218 $23,246 
v3.25.0.1
Capital Stock (Tables)
12 Months Ended
Dec. 31, 2024
Class of Stock Disclosures [Abstract]  
Summary of Stock Option Activity
A summary of stock option activity for the year ended December 31, 2024 is as follows:
Number of
Shares
Weighted-Average
Option Price
per Share
Weighted-Average
Remaining
Contractual Life
(Years)
Aggregate
Intrinsic
Value
Outstanding at January 1, 20243.0 $327.14 
Granted0.5 499.52 
Exercised(0.5)286.33 
Forfeited or expired(0.1)459.14 
Outstanding at December 31, 20242.9 361.36 5.58$166 
Exercisable at December 31, 20241.9 300.24 4.41$166 
Summary of Nonvested Restricted Stock Activity Including Restricted Stock Units
A summary of the status of nonvested restricted stock activity, including restricted stock units and performance units, for the year ended December 31, 2024 is as follows:
Restricted
Stock Shares
and Units
Weighted-Average
Grant Date
Fair Value
per Share
Nonvested at January 1, 20241.1 $423.94 
Granted0.6 501.78 
Vested(0.6)358.21 
Forfeited(0.1)479.40 
Nonvested at December 31, 20241.0 478.70 
Summary of Weighted-Average Assumptions Used to Estimate the Fair Value of Options Granted During the Periods
The following weighted-average assumptions were used to estimate the fair values of options granted during the years ended December 31, 2024, 2023 and 2022:
202420232022
Risk-free interest rate4.28 %3.95 %1.97 %
Volatility factor28.00 %29.00 %29.00 %
Dividend yield (annual)1.31 %1.30 %1.10 %
Weighted-average expected life (years)4.404.405.10
Schedule of Weighted-Average Fair Values Determined for the Periods
The following weighted-average fair values per share were determined for the years ended December 31, 2024, 2023 and 2022:
202420232022
Options granted during the year$134.61 $126.90 $116.92 
Restricted stock awards granted during the year501.78 467.79 453.70 
Summary of Cash Dividend Activity
A summary of the cash dividend activity for the years ended December 31, 2024 and 2023 is as follows:
Declaration DateRecord DatePayment DateCash Dividend
per Share
Total
Year ended December 31, 2024
January 23, 2024March 8, 2024March 22, 2024$1.63 $379 
April 16, 2024June 10, 2024June 25, 20241.63 378 
July 16, 2024September 10, 2024September 25, 20241.63 378 
October 15, 2024December 5, 2024December 20, 20241.63 373 
Year ended December 31, 2023
January 24, 2023March 10, 2023March 24, 2023$1.48 $351 
April 18, 2023June 9, 2023June 23, 20231.48 350 
July 18, 2023September 8, 2023September 22, 20231.48 348 
October 17, 2023December 6, 2023December 21, 20231.48 346 
Summary of Share Repurchases
A summary of common stock repurchases for the years ended December 31, 2024 and 2023 is as follows:
Years Ended December 31
 20242023
Shares repurchased6.7 5.8 
Average price per share$435.32 $463.53 
Aggregate cost$2,900 $2,676 
Authorization remaining at end of year$9,300 $4,200 
v3.25.0.1
Accumulated Other Comprehensive (Loss) Income (Tables)
12 Months Ended
Dec. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Schedule of Accumulated Other Comprehensive (Loss) Income
A reconciliation of the components of accumulated other comprehensive (loss) income at December 31, 2024, 2023, and 2022 is as follows:
202420232022
Net unrealized investment gains:
Beginning of year balance$(632)$(1,755)$494 
Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $44, $(218), and $926, respectively
(153)760 (2,614)
Amounts reclassified from accumulated other comprehensive income, net of tax expense of $(82), $(113), and $(94), respectively
256 357 354 
Other comprehensive income (loss)
103 1,117 (2,260)
Other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively
11 
End of year balance(523)(632)(1,755)
Non-credit components of impairments on investments:
Beginning of year balance(3)(3)— 
Other comprehensive income (loss), net of tax expense of $(1), $0, and $0, respectively
— (3)
End of year balance(2)(3)(3)
Net cash flow hedges:
Beginning of year balance(211)(229)(239)
Other comprehensive income, net of tax benefit (expense) of $(4), $6, and $(6), respectively
18 10 
End of year balance(207)(211)(229)
Pension and other benefits:
Beginning of year balance(459)(499)(429)
Other comprehensive income (loss), net of tax expense of $0, $(39), and $(23), respectively
60 40 (70)
End of year balance(399)(459)(499)
Future policy benefits:
Beginning of year balance10 13 (19)
Other comprehensive (loss) income, net of tax benefit (expense) of $1, $1, and $(10), respectively
(2)(3)32 
End of year balance10 13 
Foreign currency translation adjustments:
Beginning of year balance(18)(17)(4)
Other comprehensive loss, net of tax benefit of $0, $1, and $6
(6)(1)(13)
End of year balance(24)(18)(17)
Total:
Total beginning of year accumulated other comprehensive loss
(1,313)(2,490)(197)
Total other comprehensive income (loss), net of tax benefit (expense) of $(42), $(362), and $799, respectively
160 1,171 (2,304)
Total other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively
11 
Total end of year accumulated other comprehensive loss
$(1,147)$(1,313)$(2,490)
v3.25.0.1
Reinsurance (Tables)
12 Months Ended
Dec. 31, 2024
Reinsurance Disclosures [Abstract]  
Effect of Reinsurance on Benefit Expense
A summary of direct, assumed and ceded premiums earned for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
Direct$139,479$136,927$127,788
Assumed4,7535,9885,505
Ceded(66)(61)(64)
Net premiums$144,166$142,854$133,229
Percentage—assumed to net premiums
3.3 %4.2 %4.1 %
A summary of net premiums earned by segment (see Note 20, “Segment Information”) for the years ended December 31, 2024, 2023 and 2022 is as follows:
 202420232022
Reportable segments:
Health Benefits$142,668 $141,515 $131,964 
Carelon Services2,630 1,679 1,499 
Eliminations(1,132)(340)(234)
Net premiums$144,166 $142,854 $133,229 
The effect of reinsurance on benefit expense for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Direct$123,602 $119,409 $112,061 
Assumed4,021 4,984 4,633 
Ceded(56)(63)(52)
Net benefit expense$127,567 $124,330 $116,642 
v3.25.0.1
Leases (Tables)
12 Months Ended
Dec. 31, 2024
Leases [Abstract]  
Schedules of Information Related to Operating Leases
The information related to our leases is as follows:
Balance Sheet LocationDecember 31, 2024December 31, 2023
Operating Leases
ROU assetsOther noncurrent assets$567 $584 
Lease liabilities, currentOther current liabilities153 164 
Lease liabilities, noncurrentOther noncurrent liabilities658 685 
Years Ended December 31
202420232022
Lease Expense
Operating lease expense$147$155$143 
Short-term and variable lease expense474335 
Sublease income(6)(5)(3)
Total lease expense$188$193 $175 
Years Ended December 31
20242023
Other information
Operating cash paid for amounts included in the measurement of lease liabilities, operating leases$202$206
ROU assets obtained in exchange for new lease liabilities, operating leases$44$59
Weighted average remaining lease term in years, operating leases66
Weighted average discount rate, operating leases3.96 %3.66 %
Schedule of Future Minimum Rental Payments for Operating Leases
At December 31, 2024, future lease payments for noncancelable operating leases with initial or remaining terms of one year or more are as follows:
2025$184 
2026154 
2027127 
2028112 
2029100 
Thereafter209 
Total future minimum payments 886 
Less imputed interest(75)
Total lease liabilities$811 
v3.25.0.1
Shareholders’ Earnings per Share (Tables)
12 Months Ended
Dec. 31, 2024
Earnings Per Share [Abstract]  
Denominator for Basic and Diluted Earnings Per Share
The denominator for basic and diluted shareholders’ earnings per share at December 31, 2024, 2023 and 2022 is as follows:
202420232022
Denominator for basic shareholders’ earnings per share—weighted-average shares
231.7 235.9 240.0 
Effect of dilutive securities—employee stock options, non-vested restricted stock awards and convertible debentures
1.2 1.5 2.8 
Denominator for diluted shareholders’ earnings per share
232.9 237.4 242.8 
v3.25.0.1
Segment Information (Tables)
12 Months Ended
Dec. 31, 2024
Segment Reporting [Abstract]  
Financial Data by Reportable Segment
Financial data by reportable segment for the years ended December 31, 2024, 2023 and 2022 is as follows:
Carelon
Health
Benefits
CarelonRxCarelon
Services
TotalCorporate
& Other
EliminationsTotal
Year Ended December 31, 2024
Premiums$142,668 $— $2,630 $2,630 $— $(1,132)$144,166 
Product revenue— 22,630 — 22,630 — — 22,630 
Service fees7,607 790 795 — 8,408 
Operating revenue - unaffiliated150,275 22,635 3,420 26,055 (1,132)175,204 
Operating revenue - affiliated— 13,326 14,541 27,867 303 (28,170)— 
Operating revenue - total$150,275 $35,961 $17,961 $53,922 $309 $(29,302)$175,204 
Benefit expense
$126,703 $— $14,388 $14,388 $19 $(13,543)$127,567 
Cost of products sold
— 32,978 — 32,978 — (13,228)19,750 
Operating expense
17,329 811 2,856 3,667 1,560 (2,531)20,025 
Operating gain (loss)$6,243 $2,172 $717 $2,889 $(1,270)$— $7,862 
Year Ended December 31, 2023
Premiums$141,515 $— $1,679 $1,679 $— $(340)$142,854 
Product revenue— 19,452 — 19,452 — — 19,452 
Service fees7,056 813 819 28 — 7,903 
Operating revenue - unaffiliated148,571 19,458 2,492 21,950 28 (340)170,209 
Operating revenue - affiliated— 14,377 11,655 26,032 451 (26,483)— 
Operating revenue - total$148,571 $33,835 $14,147 $47,982 $479 $(26,823)$170,209 
Benefit expense
$123,705 $— $10,610 $10,610 $35 $(10,020)$124,330 
Cost of products sold
— 31,588 — 31,588 — (14,295)17,293 
Operating expense
17,9782722,8573,1291,488(2,508)20,087
Operating gain (loss)$6,888 $1,975 $680 $2,655 $(1,044)$— $8,499 
Year Ended December 31, 2022
Premiums$131,964 $— $1,499 $1,499 $— $(234)$133,229 
Product revenue— 14,978 — 14,978 — — 14,978 
Service fees6,520 — 889 889 44 — 7,453 
Operating revenue - unaffiliated138,484 14,978 2,388 17,366 44 (234)155,660 
Operating revenue - affiliated— 13,548 10,472 24,020 355 (24,375)— 
Operating revenue - total$138,484 $28,526 $12,860 $41,386 $399 $(24,609)$155,660 
Benefit expense
$115,869 $— $9,667 $9,667 $39 $(8,933)$116,642 
Cost of products sold
— 26,544 — 26,544 — (13,509)13,035 
Operating expense
16,5931142,6582,772502(2,167)17,700
Operating gain (loss)$6,022 $1,868 $535 $2,403 $(142)$— $8,283 
Reconciliation of Reportable Segments Operating Revenues to Total Revenues Reported in the Consolidated Statements of Income
A reconciliation of reportable segments’ operating revenue to the amounts of total revenues included in our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Reportable segments’ operating revenues$175,204 $170,209 $155,660 
Net investment income2,051 1,825 1,485 
Net losses on financial instruments
(445)(694)(550)
Gain on sale of business
201 — — 
Total revenues$177,011 $171,340 $156,595 
Reconciliation of Income Before Income Tax Expense to Reportable Segments Operating Gain Included in the Consolidated Statements of Income
A reconciliation of reportable segments’ operating gain to income before income tax expense included in our consolidated statements of income for the years ended December 31, 2024, 2023 and 2022 is as follows:
202420232022
Income before income tax expense$7,904 $7,715 $7,600 
Net investment income(2,051)(1,825)(1,485)
Net losses on financial instruments
445 694 550 
Gain on sale of business
(201)— — 
Interest expense1,185 1,030 851 
Amortization of other intangible assets580 885 767 
Reportable segments’ operating gain$7,862 $8,499 $8,283 
v3.25.0.1
Organization (Details)
individual in Millions
12 Months Ended
Dec. 31, 2024
individual
county
state
segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Number of medical members served | individual 45.7
Number of counties in the Kansas City area the Company does not serve | county 30
Number of states in which the Company is licensed to conduct insurance operations | state 50
Number of reportable segments | segment 4
v3.25.0.1
Basis of Presentation and Significant Accounting Policies (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Property, Plant and Equipment [Line Items]      
Customer funds and cash and cash equivalents on deposit for regulatory requirements $ 409 $ 294  
Securities lending transactions ratio of fair value of collateral held to fair value of securities loaned 102.00% 102.00%  
Premium receivable, allowance for doubtful accounts $ 183 $ 212  
Self-funded receivables, allowance for doubtful accounts 115 87  
Allowance for doubtful accounts, other receivables $ 1,385 941  
Employee stock purchase plan, purchase price per share as a percent of closing price 90.00%    
Advertising and marketing expense $ 540 599 $ 511
Operating lease, impairment loss 17 23 34
Shareholders' net income 5,980 5,987 5,894
Benefit expense 127,567 124,330 116,642
Total assets 116,889 108,928  
Total liabilities 75,463 69,523  
Accumulated other comprehensive loss (1,147) (1,313)  
Total shareholders $ 41,315 $ 39,306  
Revision of Prior Period, Accounting Standards Update, Adjustment      
Property, Plant and Equipment [Line Items]      
Shareholders' net income     (131)
Benefit expense     155
Total assets     (17)
Total liabilities     47
Accumulated other comprehensive loss     13
Total shareholders     $ (64)
Minimum | Building and improvements      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 15 years    
Minimum | Computer equipment and software      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 3 years    
Minimum | Internal-use software      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 3 years    
Maximum | Building and improvements      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 30 years    
Maximum | Computer equipment and software      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 5 years    
Maximum | Furniture and other equipment      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 7 years    
Maximum | Internal-use software      
Property, Plant and Equipment [Line Items]      
Property, plant and equipment, useful life 10 years    
v3.25.0.1
Business Acquisitions and Divestitures - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Business Acquisition [Line Items]      
Goodwill $ 28,277 $ 25,317 $ 24,383
Total net tangible assets (liabilities) (236) (88)  
Gain on sale of business 201 0 0
Discontinued Operations, Disposed of by Sale | StanCorp Financial Group, Inc      
Business Acquisition [Line Items]      
Gain on sale of business 201    
Carelon Services      
Business Acquisition [Line Items]      
Goodwill 3,798 2,256 2,236
CarelonRx      
Business Acquisition [Line Items]      
Goodwill 1,915 957 59
Health Benefits      
Business Acquisition [Line Items]      
Goodwill 22,564 22,104 $ 22,088
Centers Plan for Healthy Living LLC      
Business Acquisition [Line Items]      
Finite-lived intangible assets 152    
Indefinite-lived intangible assets 426    
Goodwill 450    
RSV QOZB LTSS, Inc      
Business Acquisition [Line Items]      
Finite-lived intangible assets 995    
Goodwill 1,631    
Paragon Healthcare, Inc.      
Business Acquisition [Line Items]      
Finite-lived intangible assets 411    
Goodwill 747    
Series of Individually Immaterial Business Acquisitions      
Business Acquisition [Line Items]      
Finite-lived intangible assets 1,872 820  
Indefinite-lived intangible assets 426    
Goodwill 3,066 923  
Total cash considerations 5,128 1,655  
Total net tangible assets (liabilities) (236)    
Total intangible assets 5,364    
Series of Individually Immaterial Business Acquisitions | Carelon Services      
Business Acquisition [Line Items]      
Assets assumed 2,641 20  
Series of Individually Immaterial Business Acquisitions | CarelonRx      
Business Acquisition [Line Items]      
Assets assumed 1,594 $ 1,723  
Series of Individually Immaterial Business Acquisitions | Health Benefits      
Business Acquisition [Line Items]      
Assets assumed $ 1,129    
v3.25.0.1
Business Acquisitions and Divestitures - Acquired Tangible Assets and Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]    
Cash, cash equivalents and short-term investments $ 484 $ 6
Accounts receivable and other current assets 847 241
Property, equipment and other long-term assets 309 18
Medical claims and other policyholder liabilities payable (154) 0
Accounts payable and other current liabilities (1,005) (169)
Other long-term liabilities (242) (1)
Deferred tax liabilities (475) (183)
Total net tangible assets (liabilities) $ (236) $ (88)
v3.25.0.1
Business Acquisitions and Divestitures - Intangible Assets Acquired (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Business Acquisition [Line Items]    
Total intangible assets $ 2,298 $ 820
State Medicaid licenses    
Business Acquisition [Line Items]    
Indefinite-lived intangible assets acquired 426 0
Customer-related    
Business Acquisition [Line Items]    
Fair Value $ 1,621 $ 796
Weighted Average Useful Life 20 years 25 years
Provider and hospital relationships    
Business Acquisition [Line Items]    
Fair Value $ 70 $ 0
Weighted Average Useful Life 10 years 0 years
Other    
Business Acquisition [Line Items]    
Fair Value $ 181 $ 24
Weighted Average Useful Life 8 years 5 years
v3.25.0.1
Business Optimization Initiatives (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Business Optimization Initiatives [Line Items]    
Restructuring Incurred Cost, Statement of Income or Comprehensive Income, Extensible Enumeration Not Disclosed Flag false false
2023-2024 Business Efficiency Program    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date   $ 752
2023-2024 Business Efficiency Program | Information Technology Assets and Related Contract    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date   468
2023-2024 Business Efficiency Program | Employee Termination    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date   230
2023-2024 Business Efficiency Program | Asset Impairments    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date   54
2023-2024 Business Efficiency Program | Corporate & Other Segment    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date $ 268  
2023-2024 Business Efficiency Program | Corporate & Other Segment | Write-Off of Information Technology Assets    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date 72  
2023-2024 Business Efficiency Program | Corporate & Other Segment | Employee Severance and Relocation    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date 165  
2023-2024 Business Efficiency Program | Corporate & Other Segment | Facility Closing    
Business Optimization Initiatives [Line Items]    
Restructuring and related cost, cost incurred to date 31  
2023-2024 Business Efficiency Program | Corporate & Other Segment | Employee Termination    
Business Optimization Initiatives [Line Items]    
Restructuring charges 165 230
Payments for restructuring $ 132 $ 39
v3.25.0.1
Investments - Current and Long-Term Fixed Maturity Securities, Available-For-Sale (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost $ 26,928 $ 31,336
Gross Unrealized Gains 284 496
Gross Unrealized Losses (970) (1,338)
Allowance For Credit Losses (6) (4)
Estimated Fair Value 26,236 30,490
United States Government securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 1,907 1,873
Gross Unrealized Gains 2 25
Gross Unrealized Losses (85) (54)
Allowance For Credit Losses 0 0
Estimated Fair Value 1,824 1,844
Government sponsored securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 156 112
Gross Unrealized Gains 0 1
Gross Unrealized Losses (5) (3)
Allowance For Credit Losses 0 0
Estimated Fair Value 151 110
Foreign government securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 19 5
Gross Unrealized Gains 0 1
Gross Unrealized Losses (2) (2)
Allowance For Credit Losses 0 0
Estimated Fair Value 17 4
States, municipalities and political subdivisions, tax-exempt    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 3,142 3,985
Gross Unrealized Gains 33 69
Gross Unrealized Losses (123) (152)
Allowance For Credit Losses 0 0
Estimated Fair Value 3,052 3,902
Corporate securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 14,095 14,838
Gross Unrealized Gains 192 322
Gross Unrealized Losses (367) (580)
Allowance For Credit Losses (4) (2)
Estimated Fair Value 13,916 14,578
Residential mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 3,274 4,071
Gross Unrealized Gains 13 40
Gross Unrealized Losses (236) (279)
Allowance For Credit Losses 0 0
Estimated Fair Value 3,051 3,832
Commercial mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 1,801 2,174
Gross Unrealized Gains 8 13
Gross Unrealized Losses (60) (138)
Allowance For Credit Losses (1) (2)
Estimated Fair Value 1,748 2,047
Other asset-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Cost or Amortized Cost 2,534 4,278
Gross Unrealized Gains 36 25
Gross Unrealized Losses (92) (130)
Allowance For Credit Losses (1) 0
Estimated Fair Value $ 2,477 $ 4,173
v3.25.0.1
Investments - Aggregate Fair Value and Gross Unrealized Loss of Fixed Maturity Securities in an Unrealized Loss Position (Details)
$ in Millions
Dec. 31, 2024
USD ($)
security
Dec. 31, 2023
USD ($)
security
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 2,559 1,032
Estimated fair value, less than 12 months $ 9,213 $ 2,699
Gross unrealized loss, less than 12 months $ (218) $ (55)
Number of securities, 12 months or greater | security 3,886 6,659
Estimated fair value, 12 months or greater $ 6,649 $ 14,842
Gross unrealized loss, 12 months or greater $ (752) $ (1,283)
United States Government securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 40 35
Estimated fair value, less than 12 months $ 1,240 $ 552
Gross unrealized loss, less than 12 months $ (52) $ (9)
Number of securities, 12 months or greater | security 25 44
Estimated fair value, 12 months or greater $ 330 $ 370
Gross unrealized loss, 12 months or greater $ (33) $ (45)
Government sponsored securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 10 0
Estimated fair value, less than 12 months $ 89 $ 0
Gross unrealized loss, less than 12 months $ (2) $ 0
Number of securities, 12 months or greater | security 36 40
Estimated fair value, 12 months or greater $ 42 $ 52
Gross unrealized loss, 12 months or greater $ (3) $ (3)
Foreign government securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 2 0
Estimated fair value, less than 12 months $ 15 $ 0
Gross unrealized loss, less than 12 months $ (1) $ 0
Number of securities, 12 months or greater | security 2 2
Estimated fair value, 12 months or greater $ 2 $ 4
Gross unrealized loss, 12 months or greater $ (1) $ (2)
States, municipalities and political subdivisions, tax-exempt    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 527 203
Estimated fair value, less than 12 months $ 1,092 $ 354
Gross unrealized loss, less than 12 months $ (22) $ (2)
Number of securities, 12 months or greater | security 661 1,034
Estimated fair value, 12 months or greater $ 943 $ 1,811
Gross unrealized loss, 12 months or greater $ (101) $ (150)
Corporate securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 1,415 389
Estimated fair value, less than 12 months $ 4,717 $ 608
Gross unrealized loss, less than 12 months $ (92) $ (15)
Number of securities, 12 months or greater | security 1,317 2,624
Estimated fair value, 12 months or greater $ 2,645 $ 6,871
Gross unrealized loss, 12 months or greater $ (275) $ (565)
Residential mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 306 183
Estimated fair value, less than 12 months $ 1,097 $ 438
Gross unrealized loss, less than 12 months $ (25) $ (5)
Number of securities, 12 months or greater | security 1,312 1,620
Estimated fair value, 12 months or greater $ 1,291 $ 2,075
Gross unrealized loss, 12 months or greater $ (211) $ (274)
Commercial mortgage-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 136 112
Estimated fair value, less than 12 months $ 670 $ 353
Gross unrealized loss, less than 12 months $ (15) $ (6)
Number of securities, 12 months or greater | security 297 534
Estimated fair value, 12 months or greater $ 661 $ 1,317
Gross unrealized loss, 12 months or greater $ (45) $ (132)
Other asset-backed securities    
Debt Securities, Available-for-sale [Line Items]    
Number of securities, less than 12 months | security 123 110
Estimated fair value, less than 12 months $ 293 $ 394
Gross unrealized loss, less than 12 months $ (9) $ (18)
Number of securities, 12 months or greater | security 236 761
Estimated fair value, 12 months or greater $ 735 $ 2,342
Gross unrealized loss, 12 months or greater $ (83) $ (112)
v3.25.0.1
Investments - Narrative (Details)
$ in Millions
12 Months Ended
Dec. 31, 2024
USD ($)
investment
Dec. 31, 2023
USD ($)
investment
Dec. 31, 2022
USD ($)
Jan. 01, 2025
USD ($)
Aug. 06, 2024
USD ($)
Net Investment Income [Line Items]          
Allowance for credit losses $ 6 $ 4      
Other noncurrent assets 2,140 1,967      
Net investment income $ 2,051 $ 1,825 $ 1,485    
Number of fixed maturity investments that did not produce income | investment 9 11      
Assets held by insurance regulators $ 1,035 $ 876      
Accrued investment income receivable 287 301      
Securities loaned, fair value of collateral $ 2,305 $ 2,380      
Securities lending transactions ratio of fair value of collateral held to fair value of securities loaned 102.00% 102.00%      
Fixed maturity securities          
Net Investment Income [Line Items]          
Proceeds from sale of available-for-sale securities $ 16,334 $ 12,289 $ 22,048    
Third party investments          
Net Investment Income [Line Items]          
Contractual obligation 1,442 1,321      
Rated notes          
Net Investment Income [Line Items]          
Contractual obligation 423 497      
Cash | Overnight and Continuous          
Net Investment Income [Line Items]          
Collateral received for securities loaned, at carrying value 2,115 2,255      
United States Government securities | Overnight and Continuous          
Net Investment Income [Line Items]          
Collateral received for securities loaned, at carrying value 176 99      
Residential mortgage-backed securities | Overnight and Continuous          
Net Investment Income [Line Items]          
Collateral received for securities loaned, at carrying value 14 $ 26      
Mosaic Health          
Net Investment Income [Line Items]          
Commitment to fund 70        
Subsidiary Credit Facilities | Mosaic Health          
Net Investment Income [Line Items]          
Line of credit facility, maximum borrowing capacity 200        
Subsidiary Credit Facilities | Mosaic Health | Equity Method Investee          
Net Investment Income [Line Items]          
Other noncurrent assets 188        
Net investment income 7        
Revolving Credit Facility | Mosaic Health          
Net Investment Income [Line Items]          
Line of credit facility, maximum borrowing capacity $ 500        
Mosaic Health          
Net Investment Income [Line Items]          
Interest ownership 35.00%        
Equity method investments         $ 2,580
Mosaic Health | Subsequent Event          
Net Investment Income [Line Items]          
Additional equity method investment amount       $ 300  
Additional ownership percentage       0.05  
Liberty Dental          
Net Investment Income [Line Items]          
Interest ownership 40.00%        
Redeemable preferred equity shares value $ 250        
Redeemable preferred equity shares disbursed $ 87        
v3.25.0.1
Investments - Schedule of Amortized Cost and Fair Value of Fixed Maturity Securities, By Contractual Maturity (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Amortized Cost    
Due in one year or less $ 198  
Due after one year through five years 4,827  
Due after five years through ten years 10,550  
Due after ten years 6,278  
Mortgage-backed securities 5,075  
Available-for-sale securities, Amortized Cost 26,928 $ 31,336
Estimated Fair Value    
Due in one year or less 196  
Due after one year through five years 4,772  
Due after five years through ten years 10,378  
Due after ten years 6,090  
Mortgage-backed securities 4,800  
Total fixed maturity securities $ 26,236 $ 30,490
v3.25.0.1
Investments - Schedule of Current Equity Securities (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Equity Securities [Line Items]    
Equity securities $ 1,192 $ 229
Exchange traded funds    
Equity Securities [Line Items]    
Equity securities 1,002 106
Common equity securities    
Equity Securities [Line Items]    
Equity securities 118 45
Private equity securities    
Equity Securities [Line Items]    
Equity securities $ 72 $ 78
v3.25.0.1
Investments - Investment Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Net Investment Income [Line Items]      
Investment income $ 2,088 $ 1,867 $ 1,528
Investment expenses (37) (42) (43)
Net investment income 2,051 1,825 1,485
Fixed maturity securities      
Net Investment Income [Line Items]      
Investment income 1,539 1,387 971
Equity securities      
Net Investment Income [Line Items]      
Investment income 40 18 48
Cash equivalents      
Net Investment Income [Line Items]      
Investment income 235 305 77
Other invested assets      
Net Investment Income [Line Items]      
Investment income $ 274 $ 157 $ 432
v3.25.0.1
Investments - Schedule of Net Investment (Losses) Gains (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Other investments:      
Net losses on investments $ (455) $ (702) $ (630)
Fixed maturity securities      
Fixed maturity securities:      
Gross realized gains from sales 158 47 52
Gross realized losses from sales (479) (488) (469)
Impairment losses recognized in income (17) (15) (31)
Net realized losses on fixed maturity securities (338) (456) (448)
Equity securities      
Equity securities:      
Unrealized losses recognized on equity securities still held (6) (1) (78)
Net realized (losses) gains recognized on equity securities sold (9) 6 (102)
Net (losses) gains on equity securities (15) 5 (180)
Other invested assets      
Fixed maturity securities:      
Impairment losses recognized in income (126) (291) (34)
Other investments:      
Gross gains 49 103 96
Gross losses (25) (63) (64)
Net losses on other investments $ (102) $ (251) $ (2)
v3.25.0.1
Derivative Financial Instruments - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosures [Line Items]    
Collateral received $ 142 $ 35
Liberty Dental    
Derivative Instruments and Hedging Activities Disclosures [Line Items]    
Net put option fair value 543 85
Mosaic Health    
Derivative Instruments and Hedging Activities Disclosures [Line Items]    
Net put option fair value 1,330  
Cash Flow Hedging    
Derivative Instruments and Hedging Activities Disclosures [Line Items]    
Unrecognized loss for expired and terminated cash flow hedges 201 211
Total amount of amortization over the next twelve months for all cash flow hedges 13  
Cash Flow Hedging | Terminations    
Derivative Instruments and Hedging Activities Disclosures [Line Items]    
Terminated derivatives $ 900 $ 550
v3.25.0.1
Derivative Financial Instruments - Summary of Aggregate Contractual or Notional Amounts and Estimated Fair Values (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Derivative [Line Items]    
Contractual/ Notional Amount $ 9,379 $ 1,826
Total derivative assets 11 37
Amounts netted (6) (15)
Net derivatives 5 22
Total derivative liabilities (1,571) (140)
Amounts netted 6 15
Net derivative liabilities (1,565) (125)
Hedging instruments    
Derivative [Line Items]    
Contractual/ Notional Amount 6,797  
Total derivative assets 8  
Total derivative liabilities (156)  
Hedging instruments | Interest rate swaps    
Derivative [Line Items]    
Contractual/ Notional Amount 6,475 1,475
Total derivative assets 8 15
Total derivative liabilities (150) (52)
Hedging instruments | Foreign currency forwards    
Derivative [Line Items]    
Contractual/ Notional Amount 322  
Total derivative assets   0
Total derivative liabilities   (6)
Non-hedging instruments    
Derivative [Line Items]    
Contractual/ Notional Amount 2,582 351
Total derivative assets 3 22
Total derivative liabilities (1,415) (88)
Non-hedging instruments | Interest rate swaps    
Derivative [Line Items]    
Contractual/ Notional Amount 5 5
Total derivative assets 0 0
Total derivative liabilities 0 0
Non-hedging instruments | Derivatives embedded in convertible securities    
Derivative [Line Items]    
Contractual/ Notional Amount   15
Total derivative assets   1
Total derivative liabilities   0
Non-hedging instruments | Options    
Derivative [Line Items]    
Contractual/ Notional Amount 2,453 161
Total derivative assets 0 0
Total derivative liabilities (1,415) (85)
Non-hedging instruments | Collars    
Derivative [Line Items]    
Contractual/ Notional Amount   19
Total derivative assets   14
Total derivative liabilities   (3)
Non-hedging instruments | Futures/Forwards    
Derivative [Line Items]    
Contractual/ Notional Amount 124 151
Total derivative assets 3 7
Total derivative liabilities $ 0 $ 0
v3.25.0.1
Derivative Financial Instruments - Summary of Outstanding Fair Value Hedges (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Derivative [Line Items]    
Outstanding Notional Amount $ 9,379 $ 1,826
Hedging instruments    
Derivative [Line Items]    
Outstanding Notional Amount 6,797  
Hedging instruments | Interest rate swaps    
Derivative [Line Items]    
Outstanding Notional Amount 6,475 1,475
Hedging instruments | 5.500% Interest Rate Swap Due 2032    
Derivative [Line Items]    
Outstanding Notional Amount $ 200 $ 0
Interest Rate Received 5.50% 5.50%
Hedging instruments | 4.750% Interest Rate Swap Due 2032    
Derivative [Line Items]    
Outstanding Notional Amount $ 1,000 $ 0
Interest Rate Received 4.75% 4.75%
Hedging instruments | 5.150% Interest Rate Swap Due 2028    
Derivative [Line Items]    
Outstanding Notional Amount $ 600 $ 0
Interest Rate Received 5.15% 5.15%
Hedging instruments | 5.375% Interest Rate Swap Due 2033    
Derivative [Line Items]    
Outstanding Notional Amount $ 1,000 $ 0
Interest Rate Received 5.375% 5.375%
Hedging instruments | 4.750% Interest Rate Swap Due 2029    
Derivative [Line Items]    
Outstanding Notional Amount $ 750 $ 0
Interest Rate Received 4.75% 4.75%
Hedging instruments | 4.950% Interest Rate Swap Due 2031    
Derivative [Line Items]    
Outstanding Notional Amount $ 750 $ 0
Interest Rate Received 4.95% 4.95%
Hedging instruments | 5.200% Interest Rate Swap Due 2034    
Derivative [Line Items]    
Outstanding Notional Amount $ 1,200 $ 0
Interest Rate Received 5.20% 5.20%
Hedging instruments | 5.500% Interest Rate Swap Due 2032    
Derivative [Line Items]    
Outstanding Notional Amount $ 300 $ 300
Interest Rate Received 5.00% 5.00%
Hedging instruments | 2.550% Interest Rate Swap Due 2030    
Derivative [Line Items]    
Outstanding Notional Amount $ 150 $ 150
Interest Rate Received 2.55% 2.55%
Hedging instruments | 4.900% Interest Rate Swap Due 2026    
Derivative [Line Items]    
Outstanding Notional Amount $ 0 $ 500
Interest Rate Received 4.90% 4.90%
Hedging instruments | 4.101% Interest Rate Swap Due 2027    
Derivative [Line Items]    
Outstanding Notional Amount $ 125 $ 125
Interest Rate Received 4.101% 4.101%
Hedging instruments | 2.250% Interest Rate Swap Due 2029    
Derivative [Line Items]    
Outstanding Notional Amount $ 100 $ 100
Interest Rate Received 2.25% 2.25%
Hedging instruments | 5.500% Interest Rate Swap Due 2032    
Derivative [Line Items]    
Outstanding Notional Amount $ 150 $ 150
Interest Rate Received 5.50% 5.50%
Hedging instruments | 4.101% Interest Rate Swap Due 2027    
Derivative [Line Items]    
Outstanding Notional Amount $ 75 $ 75
Interest Rate Received 4.101% 4.101%
Hedging instruments | 2.250% Interest Rate Swap Due 2029    
Derivative [Line Items]    
Outstanding Notional Amount $ 75 $ 75
Interest Rate Received 2.25% 2.25%
v3.25.0.1
Derivative Financial Instruments - Schedule of Amounts Recorded on Consolidated Balance Sheets (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]    
Carrying Amount of Hedged Liability $ 29,218 $ 23,246
Cumulative Amount of Fair Value Hedging Adjustment Included in the Carrying Amount of the Hedged Liability $ (142) $ (37)
v3.25.0.1
Derivative Financial Instruments - Schedule of Effect of Non-Hedging Derivatives on Income Statement (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized $ 10 $ 8 $ 80
Derivative Gain (Loss), Statement Of Income Or Comprehensive Income, Extensible Enumeration Not Disclosed Flag false false false
Derivatives embedded in convertible securities      
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized   $ (2) $ (3)
Interest rate swaps      
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized     (4)
Options (including swaptions)      
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized $ (1) 3 13
Collars      
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized 14 (3) 10
Futures      
Derivative Instruments, Gain (Loss) [Line Items]      
Derivative (Loss) Gain Recognized $ (3) $ 10 $ 64
v3.25.0.1
Fair Value - Schedule of Fair Value Measurements by Level (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Assets    
Cash equivalents $ 3,199 $ 2,210
Fixed maturity securities, available-for-sale: 26,236 30,490
Equity securities: 1,192 229
Other invested assets 9,749 6,107
Securities lending collateral 2,306 2,382
Total assets 32,956 35,432
Liabilities    
Total liabilities (150) (40)
United States Government securities    
Assets    
Fixed maturity securities, available-for-sale: 1,824 1,844
Government sponsored securities    
Assets    
Fixed maturity securities, available-for-sale: 151 110
Foreign government securities    
Assets    
Fixed maturity securities, available-for-sale: 17 4
States, municipalities and political subdivisions, tax-exempt    
Assets    
Fixed maturity securities, available-for-sale: 3,052 3,902
Corporate securities    
Assets    
Fixed maturity securities, available-for-sale: 13,916 14,578
Residential mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 3,051 3,832
Commercial mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 1,748 2,047
Other asset-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 2,477 4,173
Exchange traded funds    
Assets    
Equity securities: 1,002 106
Common equity securities    
Assets    
Equity securities: 118 45
Private equity securities    
Assets    
Equity securities: 72 78
Other invested assets | Common equity securities    
Assets    
Other invested assets 18 111
Derivatives    
Assets    
Derivative assets 5 10
Liabilities    
Derivative liabilities (150) (40)
Level I    
Assets    
Cash equivalents 3,199 2,210
Fixed maturity securities, available-for-sale: 0 0
Equity securities: 1,089 118
Securities lending collateral 0 0
Total assets 4,306 2,439
Liabilities    
Total liabilities 0 0
Level I | United States Government securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Government sponsored securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Foreign government securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | States, municipalities and political subdivisions, tax-exempt    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Corporate securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Residential mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Commercial mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Other asset-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level I | Exchange traded funds    
Assets    
Equity securities: 1,002 106
Level I | Common equity securities    
Assets    
Equity securities: 87 12
Level I | Private equity securities    
Assets    
Equity securities: 0 0
Level I | Other invested assets | Common equity securities    
Assets    
Other invested assets 18 111
Level I | Derivatives    
Assets    
Derivative assets 0 0
Liabilities    
Derivative liabilities 0 0
Level II    
Assets    
Cash equivalents 0 0
Fixed maturity securities, available-for-sale: 25,436 29,903
Equity securities: 31 33
Securities lending collateral 2,306 2,382
Total assets 27,778 32,328
Liabilities    
Total liabilities (150) (40)
Level II | United States Government securities    
Assets    
Fixed maturity securities, available-for-sale: 1,824 1,844
Level II | Government sponsored securities    
Assets    
Fixed maturity securities, available-for-sale: 151 110
Level II | Foreign government securities    
Assets    
Fixed maturity securities, available-for-sale: 17 4
Level II | States, municipalities and political subdivisions, tax-exempt    
Assets    
Fixed maturity securities, available-for-sale: 3,052 3,902
Level II | Corporate securities    
Assets    
Fixed maturity securities, available-for-sale: 13,873 14,532
Level II | Residential mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 3,041 3,830
Level II | Commercial mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 1,748 2,047
Level II | Other asset-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 1,730 3,634
Level II | Exchange traded funds    
Assets    
Equity securities: 0 0
Level II | Common equity securities    
Assets    
Equity securities: 31 33
Level II | Private equity securities    
Assets    
Equity securities: 0 0
Level II | Other invested assets | Common equity securities    
Assets    
Other invested assets 0 0
Level II | Derivatives    
Assets    
Derivative assets 5 10
Liabilities    
Derivative liabilities (150) (40)
Level III    
Assets    
Cash equivalents 0 0
Fixed maturity securities, available-for-sale: 800 587
Equity securities: 72 78
Securities lending collateral 0 0
Total assets 872 665
Liabilities    
Total liabilities 0 0
Level III | United States Government securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level III | Government sponsored securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level III | Foreign government securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level III | States, municipalities and political subdivisions, tax-exempt    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level III | Corporate securities    
Assets    
Fixed maturity securities, available-for-sale: 43 46
Level III | Residential mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 10 2
Level III | Commercial mortgage-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 0 0
Level III | Other asset-backed securities    
Assets    
Fixed maturity securities, available-for-sale: 747 539
Level III | Exchange traded funds    
Assets    
Equity securities: 0 0
Level III | Common equity securities    
Assets    
Equity securities: 0 0
Level III | Private equity securities    
Assets    
Equity securities: 72 78
Level III | Other invested assets | Common equity securities    
Assets    
Other invested assets 0 0
Level III | Derivatives    
Assets    
Derivative assets 0 0
Liabilities    
Derivative liabilities $ 0 $ 0
v3.25.0.1
Fair Value - Reconciliation of the Beginning and Ending Balances of Assets Measured at Fair Value on a Recurring Basis Using Level III Inputs (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]      
Beginning balance $ 665 $ 581 $ 449
Recognized in net income (5) (14) (1)
Recognized in accumulated other comprehensive income 12 9 (17)
Purchases 171 244 443
Sales (34) (126) (242)
Settlements (5) (21) (41)
Transfers into Level III 92 14 9
Transfers out of Level III (24) (22) (19)
Ending balance 872 665 581
Change in unrealized losses included in net income related to assets still held (5) (6) 0
Corporate securities      
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]      
Beginning balance 46 137 336
Recognized in net income 1 (10) 0
Recognized in accumulated other comprehensive income 0 6 (1)
Purchases 26 38 56
Sales (5) (88) (210)
Settlements (4) (21) (41)
Transfers into Level III 0 6 9
Transfers out of Level III (21) (22) (12)
Ending balance 43 46 137
Change in unrealized losses included in net income related to assets still held 0 0 0
Residential mortgage-backed securities      
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]      
Beginning balance 2 0 5
Recognized in net income 0 0 0
Recognized in accumulated other comprehensive income 0 0 0
Purchases 10 0 0
Sales (2) 0 0
Settlements 0 0 0
Transfers into Level III 0 2 0
Transfers out of Level III 0 0 (5)
Ending balance 10 2 0
Change in unrealized losses included in net income related to assets still held 0 0 0
Other asset-backed securities      
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]      
Beginning balance 539 356 19
Recognized in net income 0 0 (1)
Recognized in accumulated other comprehensive income 12 3 (16)
Purchases 118 191 370
Sales (10) (17) (14)
Settlements (1) 0 0
Transfers into Level III 92 6 0
Transfers out of Level III (3) 0 (2)
Ending balance 747 539 356
Change in unrealized losses included in net income related to assets still held 0 0 0
Equity securities      
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]      
Beginning balance 78 88 89
Recognized in net income (6) (4) 0
Recognized in accumulated other comprehensive income 0 0 0
Purchases 17 15 17
Sales (17) (21) (18)
Settlements 0 0 0
Transfers into Level III 0 0 0
Transfers out of Level III 0 0 0
Ending balance 72 78 88
Change in unrealized losses included in net income related to assets still held $ (5) $ (6) $ 0
v3.25.0.1
Fair Value - Narrative (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Mosaic Health    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Net put option fair value $ 1,330  
Liberty Dental    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]    
Net put option fair value $ 543 $ 85
v3.25.0.1
Fair Value - Carrying and Fair Value By Level of Financial Instruments Not Recorded at Fair Value on Consolidated Balance Sheet (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Assets:    
Other invested assets $ 9,749 $ 6,107
Liabilities:    
Short-term borrowings $ 365 $ 225
Derivatives - other liabilities false false
Reported Value Measurement | Carrying Value    
Assets:    
Other invested assets $ 642 $ 302
Liabilities:    
Short-term borrowings 365 225
Notes 30,867 24,895
Options 1,415 85
Estimate of Fair Value Measurement | Fair Value, Recurring    
Assets:    
Other invested assets 610 278
Liabilities:    
Short-term borrowings 365 225
Notes 28,460 23,569
Options 1,873 85
Level I | Estimate of Fair Value Measurement | Fair Value, Recurring    
Assets:    
Other invested assets 0 0
Liabilities:    
Short-term borrowings 0 0
Notes 0 0
Options 0 0
Level II | Estimate of Fair Value Measurement | Fair Value, Recurring    
Assets:    
Other invested assets 0 0
Liabilities:    
Short-term borrowings 365 225
Notes 28,460 23,569
Options 0 0
Level III | Estimate of Fair Value Measurement | Fair Value, Recurring    
Assets:    
Other invested assets 610 278
Liabilities:    
Short-term borrowings 0 0
Notes 0 0
Options $ 1,873 $ 85
v3.25.0.1
Income Taxes - Components of Deferred Income Taxes (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Deferred income tax assets:    
Accrued expenses $ 826 $ 595
Bad debt reserves 434 415
Insurance reserves 192 178
Lease liabilities 170 172
Retirement liabilities 126 132
Deferred compensation 45 44
Federal and state carryforwards 428 368
Foreign (including Puerto Rico) carryforwards 90 87
Other 100 166
Subtotal 2,411 2,157
Less: valuation allowance (294) (271)
Total deferred income tax assets 2,117 1,886
U.S. federal and state intangible assets 2,584 2,043
Foreign (including Puerto Rico) intangible assets 194 330
Capitalized software 513 485
Depreciation and amortization 38 81
Investment basis 11 11
Retirement assets 330 319
Lease right-of-use assets 114 110
Prepaid expenses 275 249
Total deferred income tax liabilities 4,059 3,628
Net deferred income tax liabilities $ 1,942 $ 1,742
v3.25.0.1
Income Taxes - Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Income Tax Contingency [Line Items]      
Deferred tax assets, net $ 206 $ 228  
Deferred tax liabilities, net 2,148 1,970  
Total income tax expense $ 1,933 $ 1,724 $ 1,712
Income tax expense (benefit) per diluted share $ 8.30 $ 7.26 $ 7.05
Unrecognized tax benefits that would impact effective tax rate in future periods, if recognized $ 804 $ 450  
Unrecognized tax benefits that would impact additional paid-in capital in future periods, if recognized 2    
Net interest expense 57 24 $ 13
Interest accrued 165 79  
Penalties expense 7 17 0
Penalties accrued 85 60  
Income taxes receivable 138 543  
Income taxes receivable, current 213 543  
Income taxes payable 75 0  
Income taxes paid 1,303 $ 1,936 $ 1,594
Minimum      
Income Tax Contingency [Line Items]      
Unrecognized tax benefit change reasonably possible due to tax settlements - lower amount 137    
Maximum      
Income Tax Contingency [Line Items]      
Unrecognized tax benefit change reasonably possible due to tax settlements - lower amount 475    
Federal      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 54    
State      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 256    
Tax Year 2032-2044 | Federal      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 33    
Tax Year 2025-2044 | State      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 194    
Tax Year 2033 | Foreign Tax Jurisdiction      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 90    
Indefinite | Federal      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards 21    
Indefinite | State      
Income Tax Contingency [Line Items]      
Net operating loss carry forwards $ 62    
v3.25.0.1
Income Taxes - Components of Provision for Income Taxes (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Current tax expense:      
Federal $ 1,753 $ 1,899 $ 1,455
Foreign (including Puerto Rico) 93 95 98
State and local 448 420 244
Total current tax expense 2,294 2,414 1,797
Deferred tax benefit (361) (690) (85)
Total income tax expense $ 1,933 $ 1,724 $ 1,712
v3.25.0.1
Income Taxes - Reconciliation of Income Tax Expense Computed at the Statutory Federal Income Tax Rate (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Income Tax Disclosure [Abstract]      
Amount at statutory rate $ 1,660 $ 1,620 $ 1,596
Amount at statutory rate, (in percent) 21.00% 21.00% 21.00%
State and local income taxes net of federal tax expense/benefit $ 216 $ 124 $ 190
State and local income taxes net of federal tax expense/benefit (in percent) 2.70% 1.60% 2.50%
Tax exempt interest and dividends received deduction $ (12) $ (15) $ (19)
Tax exempt interest and dividends received deduction (in percent) (0.10%) (0.20%) (0.30%)
Change in valuation allowance $ 43 $ 84 $ 51
Change in valuation allowance (in percent) 0.60% 1.10% 0.70%
Other, net $ 26 $ (89) $ (106)
Other, net (in percent) 0.30% (1.20%) (1.40%)
Total income tax expense $ 1,933 $ 1,724 $ 1,712
Total income tax expense (in percent) 24.50% 22.30% 22.50%
v3.25.0.1
Income Taxes - Change in the Carrying Amount of Gross Unrecognized Tax Benefits From Uncertain Tax Positions (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Change in carrying amount of gross unrecognized tax benefits from uncertain tax positions    
Balance at January 1 $ 468 $ 349
Tax positions related to current year 146 19
Tax positions related to prior years 216 119
Tax positions related to prior years (55) (19)
Balance at December 31 $ 775 $ 468
v3.25.0.1
Property and Equipment - Summary of Property and Equipment (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Property, Plant and Equipment [Line Items]    
Property and equipment, gross $ 8,329 $ 7,903
Accumulated depreciation and amortization (3,677) (3,544)
Property and equipment, net 4,652 4,359
Computer software, purchased and internally developed    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 6,617 6,195
Computer equipment, furniture and other equipment    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 940 955
Leasehold improvements    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 744 715
Building and improvements    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross 27 37
Land and improvements    
Property, Plant and Equipment [Line Items]    
Property and equipment, gross $ 1 $ 1
v3.25.0.1
Property and Equipment - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Property, Plant and Equipment [Abstract]      
Depreciation expense $ 105 $ 107 $ 123
Amortization expense on computer software and leasehold improvements 809 765 661
Computer software amortization 734 685 599
Capitalized costs related to the internal development of software 6,363 5,870  
Impairment of property and equipment $ 72 $ 446 $ 7
v3.25.0.1
Goodwill and Other Intangible Assets - Summary of the Change in the Carrying Amount of Goodwill by Reportable Segment (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Change in the carrying amount of goodwill by reportable segment    
Goodwill, beginning balance $ 25,317 $ 24,383
Acquisitions and adjustments 2,960 934
Goodwill, ending balance 28,277 25,317
Accumulated impairment as of December 31, 2024 (106)  
Health Benefits    
Change in the carrying amount of goodwill by reportable segment    
Goodwill, beginning balance 22,104 22,088
Acquisitions and adjustments 460 16
Goodwill, ending balance 22,564 22,104
Accumulated impairment as of December 31, 2024 0  
CarelonRx    
Change in the carrying amount of goodwill by reportable segment    
Goodwill, beginning balance 957 59
Acquisitions and adjustments 958 898
Goodwill, ending balance 1,915 957
Accumulated impairment as of December 31, 2024 0  
Carelon Services    
Change in the carrying amount of goodwill by reportable segment    
Goodwill, beginning balance 2,256 2,236
Acquisitions and adjustments 1,542 20
Goodwill, ending balance 3,798 $ 2,256
Accumulated impairment as of December 31, 2024 $ (106)  
v3.25.0.1
Goodwill and Other Intangible Assets - Components of Other Intangible Assets (Details) - USD ($)
$ in Thousands
Dec. 31, 2024
Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]    
Gross Carrying Amount $ 8,666,000 $ 6,831,000
Accumulated Amortization (4,465,000) (4,025,000)
Net Carrying Amount 4,201,000 2,806,000
Intangible Assets [Line Items]    
Gross Carrying Amount 7,893,000 7,467,000
Intangible Assets, Net (Excluding Goodwill) [Abstract]    
Gross Carrying Amount, Total Intangible Assets 16,559,000 14,298,000
Net Carrying Amount 12,094,000 10,273,000
Blue Cross and Blue Shield and other trademarks    
Intangible Assets [Line Items]    
Gross Carrying Amount 5,991,000 5,991,000
State Medicaid licenses    
Intangible Assets [Line Items]    
Gross Carrying Amount 1,902,000 1,476,000
Customer relationships    
Finite-Lived Intangible Assets [Line Items]    
Gross Carrying Amount 7,866,000 6,263,000
Accumulated Amortization (4,233,000) (3,817,000)
Net Carrying Amount 3,633,000 2,446,000
Provider and hospital relationships    
Finite-Lived Intangible Assets [Line Items]    
Gross Carrying Amount 377,000 326,000
Accumulated Amortization (165,000) (164,000)
Net Carrying Amount 212,000 162,000
Other    
Finite-Lived Intangible Assets [Line Items]    
Gross Carrying Amount 423,000 242,000
Accumulated Amortization (67,000) (44,000)
Net Carrying Amount $ 356,000 $ 198,000
v3.25.0.1
Goodwill and Other Intangible Assets - Narrative (Details)
$ in Millions
12 Months Ended
Dec. 31, 2024
USD ($)
Goodwill [Line Items]  
2025 $ 671
2026 474
2027 428
2028 377
2029 317
Carelon Services  
Goodwill [Line Items]  
Goodwill impairment losses $ 106
v3.25.0.1
Retirement Benefits - Reconciliation of the Benefit Obligation (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pension Benefits      
Reconciliation of benefit obligation      
Benefit obligation at beginning of year $ 1,393 $ 1,415  
Interest cost 63 68 $ 52
Plan participant contributions 0 0  
Actuarial (gain) loss (61) 40  
Settlements (27) (27)  
Benefits paid (105) (103)  
Benefit obligation at end of year 1,263 1,393 1,415
Other Benefits      
Reconciliation of benefit obligation      
Benefit obligation at beginning of year 255 277  
Interest cost 12 14 7
Plan participant contributions 16 16  
Actuarial (gain) loss (10) (12)  
Settlements 0 0  
Benefits paid (35) (40)  
Benefit obligation at end of year $ 238 $ 255 $ 277
v3.25.0.1
Retirement Benefits - Changes in Fair Value of Plan Assets (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Pension Benefits    
Change in fair value of plan assets    
Fair value of plan assets at beginning of year $ 1,807 $ 1,734
Actual return on plan assets 83 199
Employer contributions 6 4
Plan participant contributions 0 0
Settlements (27) (27)
Benefits paid (105) (103)
Fair value of plan assets at end of year 1,764 1,807
Other Benefits    
Change in fair value of plan assets    
Fair value of plan assets at beginning of year 313 299
Actual return on plan assets 29 42
Employer contributions 0 0
Plan participant contributions 16 16
Settlements 4 0
Benefits paid (37) (44)
Fair value of plan assets at end of year $ 325 $ 313
v3.25.0.1
Retirement Benefits - Net Amount Included in Consolidated Balance Sheets (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Pension Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Noncurrent assets $ 539 $ 459
Current liabilities (4) (7)
Noncurrent liabilities (34) (38)
Net amount at end of year 501 414
Other Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Noncurrent assets 87 58
Current liabilities 0 0
Noncurrent liabilities 0 0
Net amount at end of year $ 87 $ 58
v3.25.0.1
Retirement Benefits - Estimated Future Payments for Pension Benefits and Other Benefits (Details)
$ in Millions
Dec. 31, 2024
USD ($)
Pension Benefits  
Defined Benefit Plan Disclosure [Line Items]  
2025 $ 128
2026 112
2027 109
2028 106
2029 103
2030 - 2034 472
Other Benefits  
Defined Benefit Plan Disclosure [Line Items]  
2025 26
2026 26
2027 25
2028 24
2029 24
2030 - 2034 $ 99
v3.25.0.1
Retirement Benefits - Components of Net Periodic Benefit Cost Benefit Credit (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pension Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Interest cost $ 63 $ 68 $ 52
Expected return on assets (117) (127) (101)
Recognized actuarial gain (loss) 14 9 16
Settlement loss 6 7 28
Net periodic benefit credit (34) (43) (5)
Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Interest cost 12 14 7
Expected return on assets (22) (21) (26)
Amortization of prior service credit (1) (2) (4)
Recognized actuarial gain (loss) (1) 0 0
Net periodic benefit credit $ (12) $ (9) $ (23)
v3.25.0.1
Retirement Benefits - Net Amounts Included in Accumulated Other Comprehensive Loss That Have Not Been Recognized as Components of Net Periodic Benefit Costs (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Pension Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Net actuarial gain (loss) $ (580) $ (625)
Prior service credit 0 0
Net amount before tax at end of year (580) (625)
Other Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Net actuarial gain (loss) 55 38
Prior service credit 0 2
Net amount before tax at end of year $ 55 $ 40
v3.25.0.1
Retirement Benefits - Schedule of Pre-Tax amounts Recognized in Other Comprehensive Loss (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pension Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Net actuarial gain (loss) $ 25 $ 31 $ (91)
Recognized actuarial loss 14 9 16
Settlement loss 6 7 28
Total pre-tax other comprehensive income (loss) 45 47 (47)
Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Net actuarial gain (loss) 17 34 (32)
Recognized actuarial loss (1) 0 0
Prior service credit (1) (2) (5)
Total pre-tax other comprehensive income (loss) $ 15 $ 32 $ (37)
v3.25.0.1
Retirement 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 Benefit Plan, Net Periodic Benefit Cost (Credit) Settlement Gain (Loss), Statement Of Income Or Comprehensive Income Extensible List Not Disclosed Flag Consolidated Statements of Income Consolidated Statements of Income Consolidated Statements of Income
Pension Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Accumulated benefit obligation for the defined benefit pension plans $ 1,262 $ 1,391  
Accumulated benefit obligation in excess of plan assets 38    
Fair value of accumulated benefit obligation in excess of plan assets 0    
Projected benefit obligation in in excess of plan assets 38    
Fair value of projected benefit obligation in excess of plan assets 0    
Settlement loss 6 7 $ 28
Pension Benefits | Elevance Health 401(k) Plan      
Defined Benefit Plan Disclosure [Line Items]      
Contributions made during the year $ 314 $ 316 $ 275
Pre-Medicare | Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Assumed health care cost trend rate to be used for next year to measure expected cost of other benefits 8.00%    
Ultimate health care cost trend rate 4.50%    
Post Medicare - Medical | Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Assumed health care cost trend rate to be used for next year to measure expected cost of other benefits 5.50%    
Ultimate health care cost trend rate 4.50%    
Post Medicare - Pharmacy | Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Assumed health care cost trend rate to be used for next year to measure expected cost of other benefits 10.00%    
Ultimate health care cost trend rate 4.50%    
Equity Securities      
Defined Benefit Plan Disclosure [Line Items]      
Weighted-average target allocation for plan assets 35.00%    
Fixed Maturity Securities      
Defined Benefit Plan Disclosure [Line Items]      
Weighted-average target allocation for plan assets 63.00%    
Other invested assets      
Defined Benefit Plan Disclosure [Line Items]      
Weighted-average target allocation for plan assets 2.00%    
v3.25.0.1
Retirement Benefits - Weighted-Average Assumptions Used in Calculating the Benefit Obligations for All Plans (Details)
Dec. 31, 2024
Dec. 31, 2023
Pension Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Discount rate 5.47% 4.91%
Interest Crediting rate 4.50% 4.50%
Other Benefits    
Defined Benefit Plan Disclosure [Line Items]    
Discount rate 5.34% 4.83%
Interest Crediting rate 4.36% 4.50%
v3.25.0.1
Retirement Benefits - Weighted-Average Assumptions Used in Calculating Net Periodic Benefit Cost For All Plans (Details)
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Pension Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Discount rate 4.91% 5.18% 2.70%
Expected rate of return on plan assets 6.47% 6.58% 5.02%
Interest crediting rate 4.50% 4.25% 3.82%
Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Discount rate 4.83% 5.12% 2.49%
Expected rate of return on plan assets 6.64% 6.57% 6.43%
Interest crediting rate 4.50% 3.89% 1.56%
v3.25.0.1
Retirement Benefits - Fair Values of Pension Benefit Assets and Other Benefit Assets by Asset Category And Level Inputs (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets $ 444 $ 432 $ 424 $ 517
Alternative investments        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 552 511    
Insurance company contracts | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 143 143 154 179
Life insurance contracts | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 301 289 270 $ 338
Pension Benefits        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 1,764 1,807 1,734  
Pension Benefits | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 428 528    
Pension Benefits | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 620 594    
Pension Benefits | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 143 143    
Pension Benefits | Total pension benefit assets        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 1,734 1,765    
Pension Benefits | Alternative investments | Alternative investments        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 543 500    
Pension Benefits | Total Plan Assets Excluding Alternative Investments        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   1,265    
Pension Benefits | Total Plan Assets Excluding Alternative Investments | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 1,191      
Pension Benefits | Cash equivalents        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   2    
Pension Benefits | Cash equivalents | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 6      
Pension Benefits | Cash equivalents | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 6 2    
Pension Benefits | Cash equivalents | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Cash equivalents | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | U.S. securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   390    
Pension Benefits | U.S. securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 307      
Pension Benefits | U.S. securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 307 390    
Pension Benefits | U.S. securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | U.S. securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Foreign securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   94    
Pension Benefits | Foreign securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 71      
Pension Benefits | Foreign securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 71 94    
Pension Benefits | Foreign securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Foreign securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Mutual funds        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   42    
Pension Benefits | Mutual funds | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 44      
Pension Benefits | Mutual funds | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 44 42    
Pension Benefits | Mutual funds | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Mutual funds | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Government securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   70    
Pension Benefits | Government securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 78      
Pension Benefits | Government securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Government securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 78 70    
Pension Benefits | Government securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Corporate securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   522    
Pension Benefits | Corporate securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 539      
Pension Benefits | Corporate securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Corporate securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 539 522    
Pension Benefits | Corporate securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Asset-backed securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   2    
Pension Benefits | Asset-backed securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 3      
Pension Benefits | Asset-backed securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Asset-backed securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 3 2    
Pension Benefits | Asset-backed securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Insurance company contracts        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   143    
Pension Benefits | Insurance company contracts | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 143      
Pension Benefits | Insurance company contracts | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Insurance company contracts | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Pension Benefits | Insurance company contracts | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 143 143    
Pension Benefits | Total Plan Assets Cash, Investment Income Receivable And Amounts Due (To) From Brokers        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 30 43    
Other Benefits        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 325 313 $ 299  
Other Benefits | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 25 26    
Other Benefits | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 9 9    
Other Benefits | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 301 289    
Other Benefits | Total pension benefit assets        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 344 335    
Other Benefits | Alternative investments | Alternative investments        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 9 11    
Other Benefits | Total Plan Assets Excluding Alternative Investments        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   324    
Other Benefits | Total Plan Assets Excluding Alternative Investments | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 335      
Other Benefits | U.S. securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   7    
Other Benefits | U.S. securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 7      
Other Benefits | U.S. securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 7 7    
Other Benefits | U.S. securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | U.S. securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Foreign securities        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   2    
Other Benefits | Foreign securities | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 2      
Other Benefits | Foreign securities | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 2 2    
Other Benefits | Foreign securities | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Foreign securities | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Mutual funds        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   17    
Other Benefits | Mutual funds | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 16      
Other Benefits | Mutual funds | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 16 17    
Other Benefits | Mutual funds | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Mutual funds | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Life insurance contracts        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   289    
Other Benefits | Life insurance contracts | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 301      
Other Benefits | Life insurance contracts | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Life insurance contracts | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Life insurance contracts | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 301 289    
Other Benefits | Investment in DOL 103-12 trust        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets   9    
Other Benefits | Investment in DOL 103-12 trust | Total        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 9      
Other Benefits | Investment in DOL 103-12 trust | Level I        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Investment in DOL 103-12 trust | Level II        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 9 9    
Other Benefits | Investment in DOL 103-12 trust | Level III        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets 0 0    
Other Benefits | Total Plan Assets, Claims Settlements        
Defined Benefit Plan Disclosure [Line Items]        
Fair value of plan assets $ (19) $ (23)    
v3.25.0.1
Retirement Benefits - Fair Value, Investments, Entities that Calculate Net Asset Value Per Share (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Defined Benefit Plan Disclosure [Line Items]      
Unfunded Commitments as of December 31, 2024 $ 1    
Collective investment trusts      
Defined Benefit Plan Disclosure [Line Items]      
Unfunded Commitments as of December 31, 2024 $ 0    
Redemption Notice Period 2 days    
Commingled fund      
Defined Benefit Plan Disclosure [Line Items]      
Unfunded Commitments as of December 31, 2024 $ 0    
Redemption Notice Period 7 days    
Partnership investments      
Defined Benefit Plan Disclosure [Line Items]      
Unfunded Commitments as of December 31, 2024 $ 1    
Pension Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 1,764 $ 1,807 $ 1,734
Other Benefits      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 325 313 $ 299
Alternative investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 552 511  
Alternative investments | Collective investment trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 421 355  
Alternative investments | Commingled fund      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 70 86  
Alternative investments | Partnership investments      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 61 70  
Alternative investments | Pension Benefits | Collective investment trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 413 346  
Alternative investments | Pension Benefits | Commingled fund      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 69 84  
Alternative investments | Other Benefits | Collective investment trusts      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets 8 9  
Alternative investments | Other Benefits | Commingled fund      
Defined Benefit Plan Disclosure [Line Items]      
Fair value of plan assets $ 1 $ 2  
v3.25.0.1
Retirement Benefits - Reconciliation of the Beginning and Ending Balances of Plan Assets Measured at Fair Value Using Level III Inputs (Details) - Level III - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Change in Fair Value of Plan Assets, Level III Reconciliation      
Fair value of plan assets at beginning of year $ 432 $ 424 $ 517
Actual return on plan assets relating to assets still held at the reporting date 31 40 (75)
Purchases 6 6 9
Sales (25) (38) (27)
Fair value of plan assets at end of year 444 432 424
Insurance company contracts      
Change in Fair Value of Plan Assets, Level III Reconciliation      
Fair value of plan assets at beginning of year 143 154 179
Actual return on plan assets relating to assets still held at the reporting date 3 3 (22)
Purchases 6 6 9
Sales (9) (20) (12)
Fair value of plan assets at end of year 143 143 154
Life insurance contracts      
Change in Fair Value of Plan Assets, Level III Reconciliation      
Fair value of plan assets at beginning of year 289 270 338
Actual return on plan assets relating to assets still held at the reporting date 28 37 (53)
Purchases 0 0 0
Sales (16) (18) (15)
Fair value of plan assets at end of year $ 301 $ 289 $ 270
v3.25.0.1
Medical Claims Payable - Reconciliation of the Beginning and Ending Balances for Medical Claims 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]      
Gross medical claims payable, beginning of year $ 15,865 $ 15,348 $ 13,282
Ceded medical claims payable, beginning of year (7) (6) (21)
Net medical claims payable, beginning of year 15,858 15,342 13,261
Business combinations and purchase adjustments 143 0 133
Net incurred medical claims:      
Current year 125,370 121,798 113,414
Prior years redundancies (1,731) (1,571) (869)
Total net incurred medical claims 123,639 120,227 112,545
Net payments attributable to:      
Current year medical claims 110,930 107,146 98,997
Prior years medical claims 13,143 12,565 11,600
Total net payments 124,073 119,711 110,597
Net medical claims payable, end of year 15,567 15,858 15,342
Ceded medical claims payable, end of year 13 7 6
Gross medical claims payable, end of year $ 15,580 $ 15,865 $ 15,348
v3.25.0.1
Medical Claims Payable - Narrative (Details)
claim in Millions, $ in Millions
12 Months Ended
Dec. 31, 2024
USD ($)
claim
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Medical Claims Payable [Line Items]      
Prior year claims and claims adjustment expense $ 1,731 $ 1,571 $ 869
2022      
Medical Claims Payable [Line Items]      
Short-duration insurance contracts, incurred but not reported (IBNR) claims liability, net $ 192    
Short-duration insurance contract, cumulative number of reported claims | claim 507    
2023      
Medical Claims Payable [Line Items]      
Short-duration insurance contracts, incurred but not reported (IBNR) claims liability, net $ 792    
Short-duration insurance contract, cumulative number of reported claims | claim 497    
2024      
Medical Claims Payable [Line Items]      
Short-duration insurance contracts, incurred but not reported (IBNR) claims liability, net $ 14,583    
Short-duration insurance contract, cumulative number of reported claims | claim 454    
v3.25.0.1
Medical Claims Payable - Schedule of Causes of Increase Decrease in Liability for Unpaid Claims and Claims Adjustment Expense (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Insurance [Abstract]      
Assumed trend factors $ (688) $ (895) $ (859)
Assumed completion factors (1,043) (676) (10)
Total $ (1,731) $ (1,571) $ (869)
v3.25.0.1
Medical Claims Payable - Reconciliation of Net Incurred Medical Claims to Benefit Expense (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Insurance [Abstract]      
Total net incurred medical claims $ 123,639 $ 120,227 $ 112,545
Quality improvement and other claims expense 3,928 4,103 4,097
Net benefit expense $ 127,567 $ 124,330 $ 116,642
v3.25.0.1
Medical Claims Payable - Short-Duration Insurance Contracts, Claims Development (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Medical Claims Payable [Line Items]      
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance $ 369,947    
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 354,380    
2022      
Medical Claims Payable [Line Items]      
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 124,041 $ 124,367 $ 125,938
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 123,849 123,162 $ 110,597
2023      
Medical Claims Payable [Line Items]      
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 120,393 121,798  
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 119,601 $ 107,146  
2024      
Medical Claims Payable [Line Items]      
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 125,513    
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance $ 110,930    
v3.25.0.1
Medical Claims Payables - Reconciliation of Short Duration Medical Claims Payable to the Consolidated Medical Claims Payable (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Insurance [Abstract]    
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance $ 369,947  
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance 354,380  
Net medical claims payable, end of year 15,567  
Ceded medical claims payable, end of year 13  
Insurance lines other than short duration 256  
Liabilities held for sale (90)  
Gross medical claims payable, end of year $ 15,746 $ 16,111
v3.25.0.1
Debt - Narrative (Details) - USD ($)
$ in Millions
3 Months Ended 12 Months Ended
Mar. 15, 2023
Mar. 31, 2023
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Jan. 15, 2025
Dec. 01, 2024
Oct. 31, 2024
Aug. 15, 2024
May 30, 2024
Feb. 08, 2023
Jan. 17, 2023
Dec. 01, 2022
Nov. 04, 2022
May 16, 2022
Apr. 29, 2022
Debt Instrument [Line Items]                                
Repayments of long-term debt     $ 1,650 $ 1,909 $ 1,899                      
Interest paid, including capitalized interest, operating and investing activities     1,239 $ 1,032 878                      
2025     1,649                          
2026     1,596                          
2027     1,621                          
2028     1,237                          
2029     1,423                          
Thereafter     $ 23,341                          
3.35% Senior Unsecured Notes | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate             3.35%                  
Debt instruments, repurchased face amount             $ 850                  
4.500%, due 2026 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.50%         4.50%                
Debt instrument, face amount               $ 350                
4.750%, due 2030 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.75%         4.75%                
Debt instrument, face amount               $ 750                
4.950%, due 2031 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.95%         4.95%                
Debt instrument, face amount               $ 750                
5.200%, due 2035 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.20%         5.20%                
Debt instrument, face amount               $ 1,200                
5.700%, due 2055 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.70%         5.70%                
Debt instrument, face amount               $ 1,350                
5.850% due 2064 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.85%         5.85%                
Debt instrument, face amount               $ 800                
5.150%, due 2029 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.15%             5.15%            
Debt instrument, face amount                   $ 600            
3.500%, due 2024 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     3.50% 3.50%         3.50%              
Debt instruments, repurchased face amount                 $ 799              
5.375%, due 2034 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.375%             5.375%            
Debt instrument, face amount                   $ 1,000            
5.650%, due 2054 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.65%             5.65%            
Debt instrument, face amount                   $ 1,000            
4.900%, due 2026 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.90% 4.90%                        
4.900%, due 2026 | Senior Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                     4.90%          
Debt instrument, face amount                     $ 500          
4.750%, due 2033 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.75% 4.75%                        
4.750%, due 2033 | Senior Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                     4.75%          
Debt instrument, face amount                     $ 1,000          
5.125%, due 2053 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.125% 5.125%                        
5.125%, due 2053 | Senior Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                     5.125%          
Debt instrument, face amount                     $ 1,100          
3.300%, due 2023 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                       3.30%        
Debt instruments, repurchased face amount                       $ 1,000        
0.450%, due 2023 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate 0.45%                              
Debt instruments, repurchased face amount $ 500                              
2.950%, due 2022 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                         2.95%      
Debt instruments, repurchased face amount                         $ 750      
5.350%, due 2025 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.35% 5.35%                   5.35%    
Debt instrument, face amount                           $ 400    
5.500%, due 2032 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     5.50% 5.50%                   5.50%    
Debt instrument, face amount                           $ 650    
6.100%, due 2052 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     6.10% 6.10%                   6.10%    
Debt instrument, face amount                           $ 750    
3.125%, due 2022 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate                             3.125%  
Debt instruments, repurchased face amount                             $ 850  
4.100%, due 2032 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.10% 4.10%                       4.10%
Debt instrument, face amount                               $ 600
4.550% due 2052 | Senior Unsecured Notes                                
Debt Instrument [Line Items]                                
Debt instrument interest rate     4.55% 4.55%                       4.55%
Debt instrument, face amount                               $ 700
Convertible Senior Unsecured Notes Due 2042 | Convertible Debt                                
Debt Instrument [Line Items]                                
Debt Instrument, redemption price, percentage 100.00%                              
Repayments of long-term debt $ 5 $ 404     299                      
Aggregate principal amount surrendered for conversion   $ 59     41                      
Interest expense, debt, excluding amortization         $ 2                      
2.375 | Senior Unsecured Notes | Subsequent Event                                
Debt Instrument [Line Items]                                
Debt instrument interest rate           2.375%                    
Debt instruments, repurchased face amount           $ 1,250                    
Revolving Credit Facility | 5-Year Facility | Subsidiary Credit Facilities                                
Debt Instrument [Line Items]                                
Debt instrument, term     5 years                          
Line of credit facility, maximum borrowing capacity     $ 4,000                          
Debt instrument, covenant, debt-to-capital ratio     0.60                          
Debt instrument, debt-to-capital ratio     0.430                          
Long-term line of credit     $ 0 $ 0                        
Commercial Paper                                
Debt Instrument [Line Items]                                
Line of credit facility, maximum borrowing capacity     4,000                          
Line of credit, current     0 0                        
Federal Home Loan Bank Advances                                
Debt Instrument [Line Items]                                
Short-term borrowings     $ 365 $ 225                        
Debt instrument interest rate     4.43%                          
v3.25.0.1
Debt - Schedule of Long-Term Debt (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Oct. 31, 2024
Aug. 15, 2024
May 30, 2024
Dec. 31, 2023
Nov. 04, 2022
Apr. 29, 2022
Debt Instrument [Line Items]              
Total Long-Term Debt $ 30,867       $ 24,895    
Current portion of long-term debt (1,649)       (1,649)    
Long-term debt, less current portion $ 29,218       $ 23,246    
3.350%, due 2024 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.35%       3.35%    
Total Long-Term Debt $ 0       $ 850    
3.500%, due 2024 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.50%   3.50%   3.50%    
Total Long-Term Debt $ 0       $ 799    
2.375%, due 2025 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 2.375%       2.375%    
Total Long-Term Debt $ 1,250       $ 1,251    
5.350%, due 2025 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.35%       5.35% 5.35%  
Total Long-Term Debt $ 399       $ 399    
1.500%, due 2026 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 1.50%       1.50%    
Total Long-Term Debt $ 749       $ 747    
4.500%, due 2026 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.50% 4.50%          
Total Long-Term Debt $ 349       $ 0    
4.900%, due 2026 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.90%       4.90%    
Total Long-Term Debt $ 499       $ 496    
3.650%, due 2027 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.65%       3.65%    
Total Long-Term Debt $ 1,596       $ 1,595    
4.101%, due 2028 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.101%       4.101%    
Total Long-Term Debt $ 1,238       $ 1,236    
2.875%, due 2029 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 2.875%       2.875%    
Total Long-Term Debt $ 822       $ 821    
5.150%, due 2029 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.15%     5.15%      
Total Long-Term Debt $ 601       $ 0    
2.250%, due 2030 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 2.25%       2.25%    
Total Long-Term Debt $ 1,075       $ 1,075    
4.750%, due 2030 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.75% 4.75%          
Total Long-Term Debt $ 731       $ 0    
2.550%, due 2031 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 2.55%       2.55%    
Total Long-Term Debt $ 971       $ 972    
4.950%, due 2031 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.95% 4.95%          
Total Long-Term Debt $ 726       $ 0    
4.100%, due 2032 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.10%       4.10%   4.10%
Total Long-Term Debt $ 596       $ 595    
5.500%, due 2032 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.50%       5.50% 5.50%  
Total Long-Term Debt $ 635       $ 658    
4.750%, due 2033 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.75%       4.75%    
Total Long-Term Debt $ 973       $ 992    
5.375%, due 2034 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.375%     5.375%      
Total Long-Term Debt $ 992       $ 0    
5.950%, due 2034 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.95%       5.95%    
Total Long-Term Debt $ 335       $ 335    
5.200%, due 2035 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.20% 5.20%          
Total Long-Term Debt $ 1,151       $ 0    
5.850%, due 2036 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.85%       5.85%    
Total Long-Term Debt $ 397       $ 397    
6.375%, due 2037 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 6.375%       6.375%    
Total Long-Term Debt $ 364       $ 364    
5.800%, due 2040 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.80%       5.80%    
Total Long-Term Debt $ 115       $ 114    
4.625%, due 2042 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.625%       4.625%    
Total Long-Term Debt $ 860       $ 860    
4.650%, due 2043 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.65%       4.65%    
Total Long-Term Debt $ 975       $ 975    
4.650%, due 2044 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.65%       4.65%    
Total Long-Term Debt $ 768       $ 768    
5.100%, due 2044 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.10%       5.10%    
Total Long-Term Debt $ 548       $ 548    
4.375%, due 2047 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.375%       4.375%    
Total Long-Term Debt $ 1,389       $ 1,388    
4.550%, due 2048 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.55%       4.55%    
Total Long-Term Debt $ 840       $ 840    
3.700%, due 2049 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.70%       3.70%    
Total Long-Term Debt $ 813       $ 813    
3.125%, due 2050 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.125%       3.125%    
Total Long-Term Debt $ 988       $ 988    
3.600%, due 2051 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 3.60%       3.60%    
Total Long-Term Debt $ 1,234       $ 1,233    
4.550% due 2052 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.55%       4.55%   4.55%
Total Long-Term Debt $ 689       $ 689    
6.100%, due 2052 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 6.10%       6.10% 6.10%  
Total Long-Term Debt $ 742       $ 742    
5.125%, due 2053 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.125%       5.125%    
Total Long-Term Debt $ 1,084       $ 1,083    
4.850%, due 2054 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 4.85%       4.85%    
Total Long-Term Debt $ 247       $ 247    
5.650%, due 2054 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.65%     5.65%      
Total Long-Term Debt $ 985       0    
5.700%, due 2055 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.70% 5.70%          
Total Long-Term Debt $ 1,327       0    
5.850% due 2064 | Senior Unsecured Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 5.85% 5.85%          
Total Long-Term Debt $ 789       $ 0    
9.000%, due 2027 | Surplus Notes              
Debt Instrument [Line Items]              
Debt instrument interest rate 9.00%       9.00%    
Total Long-Term Debt $ 25       $ 25    
v3.25.0.1
Commitments and Contingencies (Details)
$ in Millions
1 Months Ended 12 Months Ended
Sep. 30, 2024
USD ($)
Aug. 31, 2022
USD ($)
Mar. 31, 2016
USD ($)
Dec. 31, 2024
USD ($)
Sep. 30, 2023
appeal
Commitments And Contingencies [Line Items]          
Number of notices of appeal | appeal         4
Extension period       3 years  
Financial guarantees       $ 912  
Unfunded loan commitments       $ 501  
Technology Infrastructure And Related Management And Support Services          
Commitments And Contingencies [Line Items]          
Long-term purchase commitment, amount $ 2,065        
BCBS Antitrust Litigation          
Commitments And Contingencies [Line Items]          
Loss contingency accrual, payments   $ 604      
Aggregate settlement amount $ 666        
Anthem, Inc. v. Express Scripts, Inc.          
Commitments And Contingencies [Line Items]          
Proceeds originally received at time of divestiture     $ 4,675    
Anthem, Inc. v. Express Scripts, Inc. | Damages for Pharmacy Pricing          
Commitments And Contingencies [Line Items]          
Approximate amount of damages sought for breaches     14,800    
Anthem, Inc. v. Express Scripts, Inc. | Damages for Operational Breaches          
Commitments And Contingencies [Line Items]          
Approximate amount of damages sought for breaches     $ 158    
v3.25.0.1
Capital Stock - Narrative (Details) - USD ($)
$ / shares in Units, $ in Thousands, shares in Millions
12 Months Ended
Jan. 22, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Oct. 15, 2024
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, number of shares authorized (in shares)   37.5      
Share-based compensation   $ 191,000 $ 289,000 $ 264,000  
Share-based payment arrangement, expense, tax benefit   47,000 73,000 66,000  
Share-based compensation arrangement by share-based payment award, options, exercises in period, intrinsic value   123,000 69,000 120,000  
Deferred tax expense from stock options exercised   21,000 18,000 31,000  
Proceeds from issuance of common stock under employee stock plans   $ 154,000 $ 87,000 $ 120,000  
Granted (in shares)   0.6      
Unrecognized compensation expense related to nonvested stock options   $ 37,000      
Share-based compensation arrangement by share-based payment award, number of shares available for grant   10.2      
Employee stock purchase plan, purchase price per share as a percent of closing price   90.00%      
Stock issued during period, shares, employee stock purchase plans   0.2 0.1 0.1  
Proceeds from issuance of shares under the Stock Purchase Plan   $ 65,000 $ 65,000 $ 62,000  
Increase in stock repurchase program authorization         $ 8,000,000
Subsequent Event          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Dividends per share (in dollars per share) $ 1.71        
Employee Stock Option          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, award vesting period   3 years      
Award term   10 years      
Weighted-average remaining requisite service periods   9 months      
Restricted Stock Units          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, award vesting period   3 years      
Fair value of awards vested in period   $ 298,000 $ 285,000 $ 261,000  
Granted (in shares)   0.2      
Unrecognized compensation expense related to nonvested restricted stock   $ 203,000      
Weighted-average remaining requisite service periods   13 months      
Restricted Stock          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, award vesting period   3 years      
Performance Shares          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, award vesting period   3 years      
Employee Stock          
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]          
Share-based compensation arrangement by share-based payment award, number of shares authorized (in shares)   14.0      
Share-based compensation arrangement by share-based payment award, number of shares available for grant   4.0      
Share-based compensation arrangement by share-based payment award, maximum shares per employee, amount   $ 25      
Share-based compensation arrangement by share-based payment award, minimum employee subscription rate   1.00%      
Share-based compensation arrangement by share-based payment award, maximum employee subscription rate   15.00%      
Employee stock purchase plan, purchase price per share as a percent of closing price   90.00%      
v3.25.0.1
Capital Stock - Summary of Stock Option Activity (Details)
$ / shares in Units, shares in Millions, $ in Millions
12 Months Ended
Dec. 31, 2024
USD ($)
$ / shares
shares
Number of Shares  
Outstanding at beginning of period (in shares) | shares 3.0
Grants (in shares) | shares 0.5
Exercised (in shares) | shares (0.5)
Forfeited (in shares) | shares (0.1)
Outstanding at end of period (in shares) | shares 2.9
Weighted-Average Option Price per Share  
Outstanding at beginning of period (in dollars per share) | $ / shares $ 327.14
Granted (in dollars per share) | $ / shares 499.52
Exercised (in dollars per share) | $ / shares 286.33
Forfeited or expired (in dollars per share) | $ / shares 459.14
Outstanding at end of period (in dollars per share) | $ / shares $ 361.36
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Additional Disclosures [Abstract]  
Exercisable at end of period (in shares) | shares 1.9
Exercisable at end of period (in dollars per share) | $ / shares $ 300.24
Outstanding at end of period, weighted-average remaining contractual life 5 years 6 months 29 days
Exercisable at end of period, weighted-average remaining contractual life 4 years 4 months 28 days
Outstanding at end of period, aggregate intrinsic value | $ $ 166
Exercisable at end of period, aggregate intrinsic value | $ $ 166
v3.25.0.1
Capital Stock - Nonvested Restricted Stock Activity Including Restricted Stock Units (Details) - $ / shares
shares in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Restricted Stock Shares and Units      
Nonvested at beginning of period (in shares) 1.1    
Granted (in shares) 0.6    
Vested (in shares) (0.6)    
Forfeited (in shares) (0.1)    
Nonvested at end of period (in shares) 1.0 1.1  
Weighted-Average Grant Date Fair Value per Share      
Nonvested at beginning of period (in dollars per share) $ 423.94    
Granted (in dollars per share) 501.78 $ 467.79 $ 453.70
Vested (in dollars per share) 358.21    
Forfeited (in dollars per share) 479.40    
Nonvested at end of period (in dollars per share) $ 478.70 $ 423.94  
v3.25.0.1
Capital Stock - Fair Values of Options Granted During the Period Estimated Using Weighted-Average Assumptions (Details)
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Class of Stock Disclosures [Abstract]      
Risk-free interest rate 4.28% 3.95% 1.97%
Volatility factor 28.00% 29.00% 29.00%
Dividend yield (annual) 1.31% 1.30% 1.10%
Weighted-average expected life (years) 4 years 4 months 24 days 4 years 4 months 24 days 5 years 1 month 6 days
v3.25.0.1
Capital Stock - Schedule of Weighted-Average Fair Values Determined for the Periods (Details) - $ / shares
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Class of Stock Disclosures [Abstract]      
Options granted during the period (in dollars per share) $ 134.61 $ 126.90 $ 116.92
Restricted stock awards granted during the period (in dollars per share) $ 501.78 $ 467.79 $ 453.70
v3.25.0.1
Capital Stock - Summary of Cash Dividend Activity (Details) - USD ($)
$ / shares in Units, $ in Millions
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, 2024
Dec. 31, 2023
Dec. 31, 2022
Class of Stock Disclosures [Abstract]                      
Cash Dividend per Share (in dollars per share) $ 1.63 $ 1.63 $ 1.63 $ 1.63 $ 1.48 $ 1.48 $ 1.48 $ 1.48      
Total $ 373 $ 378 $ 378 $ 379 $ 346 $ 348 $ 350 $ 351 $ 1,508 $ 1,395 $ 1,229
v3.25.0.1
Capital Stock - Summary of Share Repurchases (Details) - USD ($)
$ / shares in Units, shares in Millions, $ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Class of Stock Disclosures [Abstract]      
Shares repurchased (in shares) 6.7 5.8  
Average price per share (in dollars per share) $ 435.32 $ 463.53  
Aggregate cost $ 2,900 $ 2,676 $ 2,316
Authorization remaining at end of year $ 9,300 $ 4,200  
v3.25.0.1
Accumulated Other Comprehensive (Loss) Income - Schedule of Reconciliation of the Components of Accumulated Other Comprehensive Loss (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance $ 39,405 $ 36,330 $ 36,140
Other comprehensive income (loss) 160 1,171 (2,304)
Total other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively 6 6 11
Ending balance 41,426 39,405 36,330
AOCI Including Portion Attributable to Noncontrolling Interest      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (1,313) (2,490) (197)
Ending balance (1,147) (1,313) (2,490)
Net unrealized investment gains:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (632) (1,755) 494
Other comprehensive (loss) income before reclassifications, net of tax benefit (expense) of $44, $(218), and $926, respectively (153) 760 (2,614)
Amounts reclassified from accumulated other comprehensive income, net of tax expense of $(82), $(113), and $(94), respectively 256 357 354
Other comprehensive income (loss) 103 1,117 (2,260)
Ending balance (523) (632) (1,755)
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Noncontrolling Interest      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Total other comprehensive income attributable to noncontrolling interests, net of tax benefit (expense) of $1, $1, and $(3), respectively 6 6 11
Non-credit components of impairments on investments:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (3) (3) 0
Other comprehensive income (loss) 1 0 (3)
Ending balance (2) (3) (3)
Net cash flow hedges:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (211) (229) (239)
Other comprehensive income (loss) 4 18 10
Ending balance (207) (211) (229)
Pension and other benefits:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (459) (499) (429)
Other comprehensive income (loss) 60 40 (70)
Ending balance (399) (459) (499)
Future policy benefits:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance 10 13 (19)
Other comprehensive income (loss) (2) (3) 32
Ending balance 8 10 13
Foreign currency translation adjustments:      
AOCI Including Portion Attributable to Noncontrolling Interest, Net of Tax [Roll Forward]      
Beginning balance (18) (17) (4)
Other comprehensive income (loss) (6) (1) (13)
Ending balance $ (24) $ (18) $ (17)
v3.25.0.1
Accumulated Other Comprehensive (Loss) Income - Reconciliation of the Components of Accumulated Other Comprehensive Loss (Parenthetical) (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income attributable to noncontrolling interests, tax $ 1 $ 1 $ (3)
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit (42) (362) 799
Net unrealized investment gains:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income (loss) before reclassifications, tax 44 (218) 926
Reclassification from AOCI, current period, tax (82) (113) (94)
AOCI, Accumulated Gain (Loss), Debt Securities, Available-for-Sale, Noncontrolling Interest      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income attributable to noncontrolling interests, tax 1 1 (3)
Non-credit components of impairments on investments:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit (1) 0 0
Net cash flow hedges:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit (4) 6 (6)
Pension and other benefits:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit 0 (39) (23)
Future policy benefits:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit 1 1 (10)
Foreign currency translation adjustments:      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Net gain (loss) recognized in other comprehensive income, tax (expense) benefit $ 0 $ 1 $ 6
v3.25.0.1
Reinsurance - Summary of Direct, Assumed and Ceded Premiums Earned (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Reinsurance Disclosures [Abstract]      
Direct $ 139,479 $ 136,927 $ 127,788
Assumed 4,753 5,988 5,505
Ceded (66) (61) (64)
Net premiums $ 144,166 $ 142,854 $ 133,229
Percentage—assumed to net premiums 3.30% 4.20% 4.10%
v3.25.0.1
Reinsurance - Summary of Net Premiums Earned by Segment (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Net Premiums Earned By Segment [Line Items]      
Net premiums $ 144,166 $ 142,854 $ 133,229
Eliminations      
Net Premiums Earned By Segment [Line Items]      
Net premiums (1,132) (340) (234)
Health Benefits | Operating Segments      
Net Premiums Earned By Segment [Line Items]      
Net premiums 142,668 141,515 131,964
Carelon Services | Operating Segments      
Net Premiums Earned By Segment [Line Items]      
Net premiums $ 2,630 $ 1,679 $ 1,499
v3.25.0.1
Reinsurance - Effect of Reinsurance on Benefit Expense (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Reinsurance Disclosures [Abstract]      
Direct $ 123,602 $ 119,409 $ 112,061
Assumed 4,021 4,984 4,633
Ceded (56) (63) (52)
Net benefit expense $ 127,567 $ 124,330 $ 116,642
v3.25.0.1
Leases - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Lessee, Lease and Other Information [Line Items]      
Operating lease, impairment loss $ 17 $ 23 $ 34
Minimum      
Lessee, Lease and Other Information [Line Items]      
Lessee, operating lease, term of contract 1 year    
Maximum      
Lessee, Lease and Other Information [Line Items]      
Lessee, operating lease, term of contract 11 years    
v3.25.0.1
Leases - Lease and Other Information (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Operating Leases      
ROU assets $ 567 $ 584  
Other noncurrent assets Other noncurrent assets Other noncurrent assets  
Lease liabilities, current $ 153 $ 164  
Other current liabilities Other current liabilities Other current liabilities  
Lease liabilities, noncurrent $ 658 $ 685  
Other noncurrent liabilities Other noncurrent liabilities Other noncurrent liabilities  
Lease Expense      
Operating lease expense $ 147 $ 155 $ 143
Short-term and variable lease expense 47 43 35
Sublease income (6) (5) (3)
Total lease expense 188 193 $ 175
Operating cash paid for amounts included in the measurement of lease liabilities, operating leases 202 206  
ROU assets obtained in exchange for new lease liabilities, operating leases $ 44 $ 59  
Weighted average remaining lease term in years, operating leases 6 years 6 years  
Weighted average discount rate, operating leases 3.96% 3.66%  
v3.25.0.1
Leases - Reconciliation of Future Lease Payments to Total Lease Liabilities (Details)
$ in Millions
Dec. 31, 2024
USD ($)
Leases [Abstract]  
2025 $ 184
2026 154
2027 127
2028 112
2029 100
Thereafter 209
Total future minimum payments 886
Less imputed interest (75)
Total lease liabilities $ 811
v3.25.0.1
Shareholders’ Earnings per Share - Denominator for Basic and Diluted Earnings Per Share (Details) - shares
shares in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Earnings Per Share [Abstract]      
Denominator for basic shareholders’ earnings per share—weighted-average shares (in shares) 231.7 235.9 240.0
Effect of dilutive securities—employee stock options, non-vested restricted stock awards and convertible debentures (in shares) 1.2 1.5 2.8
Denominator for diluted shareholders’ earnings per share (in shares) 232.9 237.4 242.8
v3.25.0.1
Shareholders' Earnings per Share - Narrative (Details) - shares
shares in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Employee Stock Option      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Antidilutive shares (in shares) 0.7 0.8 0.4
Share-based compensation arrangement by share-based payment award, award vesting period 3 years    
Restricted Stock Units      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Antidilutive shares (in shares) 0.2 0.2 0.2
Share-based compensation arrangement by share-based payment award, award vesting period 3 years    
v3.25.0.1
Segment Information Segment Information - Narrative (Details) - segment
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Segment Reporting Information [Line Items]      
Number of reportable segments 4    
Revenue Benchmark | Customer Concentration Risk | Health Benefits      
Segment Reporting Information [Line Items]      
Concentration risk 31.00% 29.00% 28.00%
v3.25.0.1
Segment Information - Financial Data by Reportable Segment (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Segment Reporting Information [Line Items]      
Premiums $ 144,166 $ 142,854 $ 133,229
Operating revenue - total 175,204 170,209 155,660
Benefit expense 127,567 124,330 116,642
Cost of products sold 19,750 17,293 13,035
Operating expense 20,025 20,087 17,700
Operating gain (loss) 7,862 8,499 8,283
Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 22,630 19,452 14,978
Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 8,408 7,903 7,453
Eliminations      
Segment Reporting Information [Line Items]      
Premiums (1,132) (340) (234)
Operating revenue - total (29,302) (26,823) (24,609)
Benefit expense (13,543) (10,020) (8,933)
Cost of products sold (13,228) (14,295) (13,509)
Operating expense (2,531) (2,508) (2,167)
Operating gain (loss) 0 0 0
Eliminations | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 0 0 0
Eliminations | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 0 0 0
Health Benefits | Operating Segments      
Segment Reporting Information [Line Items]      
Premiums 142,668 141,515 131,964
Operating revenue - total 150,275 148,571 138,484
Benefit expense 126,703 123,705 115,869
Cost of products sold 0 0 0
Operating expense 17,329 17,978 16,593
Operating gain (loss) 6,243 6,888 6,022
Health Benefits | Operating Segments | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 0 0 0
Health Benefits | Operating Segments | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 7,607 7,056 6,520
Total | Operating Segments      
Segment Reporting Information [Line Items]      
Premiums 2,630 1,679 1,499
Operating revenue - total 53,922 47,982 41,386
Benefit expense 14,388 10,610 9,667
Cost of products sold 32,978 31,588 26,544
Operating expense 3,667 3,129 2,772
Operating gain (loss) 2,889 2,655 2,403
Total | Operating Segments | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 22,630 19,452 14,978
Total | Operating Segments | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 795 819 889
CarelonRx | Operating Segments      
Segment Reporting Information [Line Items]      
Premiums 0 0 0
Operating revenue - total 35,961 33,835 28,526
Benefit expense 0 0 0
Cost of products sold 32,978 31,588 26,544
Operating expense 811 272 114
Operating gain (loss) 2,172 1,975 1,868
CarelonRx | Operating Segments | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 22,630 19,452 14,978
CarelonRx | Operating Segments | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 5 6 0
Carelon Services | Operating Segments      
Segment Reporting Information [Line Items]      
Premiums 2,630 1,679 1,499
Operating revenue - total 17,961 14,147 12,860
Benefit expense 14,388 10,610 9,667
Cost of products sold 0 0 0
Operating expense 2,856 2,857 2,658
Operating gain (loss) 717 680 535
Carelon Services | Operating Segments | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 0 0 0
Carelon Services | Operating Segments | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 790 813 889
Corporate & Other | Operating Segments      
Segment Reporting Information [Line Items]      
Premiums 0 0 0
Operating revenue - total 309 479 399
Benefit expense 19 35 39
Cost of products sold 0 0 0
Operating expense 1,560 1,488 502
Operating gain (loss) (1,270) (1,044) (142)
Corporate & Other | Operating Segments | Product revenue      
Segment Reporting Information [Line Items]      
Product and service revenue 0 0 0
Corporate & Other | Operating Segments | Service fees      
Segment Reporting Information [Line Items]      
Product and service revenue 6 28 44
Operating revenue - unaffiliated      
Segment Reporting Information [Line Items]      
Operating revenue - total 175,204 170,209 155,660
Operating revenue - unaffiliated | Eliminations      
Segment Reporting Information [Line Items]      
Operating revenue - total (1,132) (340) (234)
Operating revenue - unaffiliated | Health Benefits | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 150,275 148,571 138,484
Operating revenue - unaffiliated | Total | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 26,055 21,950 17,366
Operating revenue - unaffiliated | CarelonRx | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 22,635 19,458 14,978
Operating revenue - unaffiliated | Carelon Services | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 3,420 2,492 2,388
Operating revenue - unaffiliated | Corporate & Other | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 6 28 44
Operating revenue - affiliated      
Segment Reporting Information [Line Items]      
Operating revenue - total 0 0 0
Operating revenue - affiliated | Eliminations      
Segment Reporting Information [Line Items]      
Operating revenue - total (28,170) (26,483) (24,375)
Operating revenue - affiliated | Health Benefits | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 0 0 0
Operating revenue - affiliated | Total | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 27,867 26,032 24,020
Operating revenue - affiliated | CarelonRx | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 13,326 14,377 13,548
Operating revenue - affiliated | Carelon Services | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total 14,541 11,655 10,472
Operating revenue - affiliated | Corporate & Other | Operating Segments      
Segment Reporting Information [Line Items]      
Operating revenue - total $ 303 $ 451 $ 355
v3.25.0.1
Segment Information - Reconciliation of Reportable Segments Operating Revenues to Total Revenues Reported in the Consolidated Statements of Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Segment Reporting Information [Line Items]      
Reportable segments’ operating revenues $ 175,204 $ 170,209 $ 155,660
Net investment income 2,051 1,825 1,485
Net losses on financial instruments (445) (694) (550)
Gain on sale of business 201 0 0
Total revenues 177,011 171,340 156,595
Reportable Segments      
Segment Reporting Information [Line Items]      
Reportable segments’ operating revenues 175,204 170,209 155,660
Net investment income 2,051 1,825 1,485
Net losses on financial instruments (445) (694) (550)
Gain on sale of business 201 0 0
Total revenues $ 177,011 $ 171,340 $ 156,595
v3.25.0.1
Segment Information - Reconciliation of Income Before Income Tax Expense to Reportable Segments Operating Gain Included in the Consolidated Statements of Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Segment Reporting Information [Line Items]      
Income before income tax expense $ 7,904 $ 7,715 $ 7,600
Net investment income (2,051) (1,825) (1,485)
Net losses on financial instruments 445 694 550
Gain on sale of business 201 0 0
Interest expense 1,185 1,030 851
Amortization of other intangible assets 580 885 767
Reportable segments’ operating gain 7,862 8,499 8,283
Reportable Segments      
Segment Reporting Information [Line Items]      
Income before income tax expense 7,904 7,715 7,600
Net investment income (2,051) (1,825) (1,485)
Net losses on financial instruments 445 694 550
Gain on sale of business 201 0 0
Interest expense 1,185 1,030 851
Amortization of other intangible assets 580 885 767
Reportable segments’ operating gain $ 7,862 $ 8,499 $ 8,283
v3.25.0.1
Related Party Transactions (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Related Party Transaction [Line Items]      
Operating expense $ 20,025 $ 20,087 $ 17,700
APC Passe, LLC      
Related Party Transaction [Line Items]      
Assumed - Premium written 490 481 $ 501
Liberty Dental      
Related Party Transaction [Line Items]      
Operating expense $ 519 $ 426  
v3.25.0.1
Statutory Information (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Statutory Accounting Practices [Line Items]      
Statutory risk-based capital necessary to satisfy regulatory requirements   $ 8,100 $ 7,800
Total Shareholders   41,315 39,306
Statutory accounting practices, dividends paid with approval of regulatory agency   6,322  
Forecast      
Statutory Accounting Practices [Line Items]      
Statutory accounting practices, dividends paid with approval of regulatory agency $ 2,700    
California Department of Managed Health Care      
Statutory Accounting Practices [Line Items]      
Statutory risk-based capital necessary to satisfy regulatory requirements   970 950
Insurance, HMO Subsidiaries and Other Regulated Entities, Excluding the California Department of Managed Health Care      
Statutory Accounting Practices [Line Items]      
Statutory-basis capital and surplus   18,668 19,808
California Department of Managed Health Care Regulated Entities      
Statutory Accounting Practices [Line Items]      
Total Shareholders   $ 3,817 $ 3,975
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Balance Sheets (Details) - USD ($)
$ / shares in Units, $ in Millions
Dec. 31, 2024
Dec. 31, 2023
Current assets:    
Cash and cash equivalents $ 8,288 $ 6,526
Equity securities 1,192 229
Other receivables 6,016 5,405
Other current assets 4,700 5,795
Total current assets 58,942 60,029
Other invested assets 9,749 6,107
Property and equipment, net 4,652 4,359
Other noncurrent assets 2,140 1,967
Total assets 116,889 108,928
Current liabilities:    
Accounts payable and accrued expenses 6,927 6,910
Other current liabilities 10,029 9,894
Current portion of long-term debt 1,649 1,649
Total current liabilities 40,581 41,791
Long-term debt, less current portion 29,218 23,246
Deferred tax liabilities, net 2,148 1,970
Other noncurrent liabilities 3,326 1,738
Total liabilities 75,463 69,523
Commitments and contingencies-Note 5
Shareholders’ equity    
Preferred stock, without par value, shares authorized - 100,000,000; shares issued and outstanding - none 0 0
Common stock, par value $0.01, shares authorized - 900,000,000; shares issued and outstanding - 227,479,695 and 233,071,088 2 2
Additional paid-in capital 8,911 8,868
Retained earnings 33,549 31,749
Accumulated other comprehensive loss (1,147) (1,313)
Total shareholders’ equity 41,315 39,306
Total liabilities and equity $ 116,889 $ 108,928
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 900,000,000 900,000,000
Preferred stock, shares authorized (in shares) 100,000,000 100,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Elevance Health, Inc.    
Current assets:    
Cash and cash equivalents $ 1,870 $ 1,483
Equity securities 487 80
Other receivables 49 58
Other current assets 705 959
Total current assets 7,808 2,580
Other invested assets 3,636 822
Property and equipment, net 159 178
Deferred tax assets, net 0 199
Investment in subsidiaries 63,173 63,426
Other noncurrent assets 584 217
Total assets 75,360 67,422
Current liabilities:    
Accounts payable and accrued expenses 737 1,709
Current portion of long-term debt 1,649 1,649
Total current liabilities 2,996 4,505
Long-term debt, less current portion 29,193 23,221
Deferred tax liabilities, net 55 0
Other noncurrent liabilities 1,801 390
Total liabilities 34,045 28,116
Commitments and contingencies-Note 5
Shareholders’ equity    
Preferred stock, without par value, shares authorized - 100,000,000; shares issued and outstanding - none 0 0
Common stock, par value $0.01, shares authorized - 900,000,000; shares issued and outstanding - 227,479,695 and 233,071,088 2 2
Additional paid-in capital 8,911 8,868
Retained earnings 33,549 31,749
Accumulated other comprehensive loss (1,147) (1,313)
Total shareholders’ equity 41,315 39,306
Total liabilities and equity $ 75,360 $ 67,422
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 900,000,000 900,000,000
Preferred stock, shares authorized (in shares) 100,000,000 100,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Elevance Health, Inc. | Nonrelated Party    
Current liabilities:    
Other current liabilities $ 610 $ 413
Elevance Health, Inc. | Subsidiaries    
Current assets:    
Other receivables 4,697 0
Current liabilities:    
Other current liabilities $ 0 $ 734
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Balance Sheets (Parenthetical) (Details) - USD ($)
$ / shares in Units, $ in Millions
Dec. 31, 2024
Dec. 31, 2023
Condensed Financial Statements, Captions [Line Items]    
Available for sale securities, amortized cost $ 26,928 $ 31,336
Allowance For Credit Losses $ (6) $ (4)
Preferred stock, shares authorized (in shares) 100,000,000 100,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 900,000,000 900,000,000
Common stock, shares issued (in shares) 227,479,695 233,071,088
Common stock, shares outstanding (in shares) 227,479,695 233,071,088
Elevance Health, Inc.    
Condensed Financial Statements, Captions [Line Items]    
Preferred stock, shares authorized (in shares) 100,000,000 100,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 900,000,000 900,000,000
Common stock, shares issued (in shares) 227,479,695 233,071,088
Common stock, shares outstanding (in shares) 227,479,695 233,071,088
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Statements of Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Condensed Financial Statements, Captions [Line Items]      
Net investment income $ 2,051 $ 1,825 $ 1,485
Total revenues 177,011 171,340 156,595
Interest expense 1,185 1,030 851
Total expenses 169,107 163,625 148,995
Shareholders’ net income 5,980 5,987 5,894
Elevance Health, Inc.      
Condensed Financial Statements, Captions [Line Items]      
Net investment income 110 25 4
Net (losses) gains on financial instruments (23) (100) 2
Service fees 9 8 7
Total revenues 96 (67) 13
Operating expense 279 352 188
Interest expense 1,172 1,017 845
Total expenses 1,451 1,369 1,033
Loss before income tax credits and equity in net income of subsidiaries (1,355) (1,436) (1,020)
Income tax credits (477) (214) (461)
Equity in net income of subsidiaries 6,858 7,209 6,453
Shareholders’ net income $ 5,980 $ 5,987 $ 5,894
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Statement of Comprehensive Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Condensed Financial Statements, Captions [Line Items]      
Shareholders' net income $ 5,980 $ 5,987 $ 5,894
Other comprehensive income (loss), net of tax:      
Change in net unrealized gains/losses on investments 103 1,117 (2,260)
Change in non-credit component of impairment losses on investments (1) 0 3
Change in net unrealized gains/losses on cash flow hedges 4 18 10
Change in net periodic pension and other benefit costs 60 40 (70)
Change in future policy benefits (2) (3) 32
Foreign currency translation adjustments (6) (1) (13)
Total shareholders’ comprehensive income 6,146 7,164 3,601
Elevance Health, Inc.      
Condensed Financial Statements, Captions [Line Items]      
Shareholders' net income 5,980 5,987 5,894
Other comprehensive income (loss), net of tax:      
Change in net unrealized gains/losses on investments 109 1,123 (2,249)
Change in non-credit component of impairment losses on investments 1 0 (3)
Change in net unrealized gains/losses on cash flow hedges 4 18 10
Change in net periodic pension and other benefit costs 60 40 (70)
Change in future policy benefits (2) (3) 32
Foreign currency translation adjustments (6) (1) (13)
Other comprehensive (loss) income 166 1,177 (2,293)
Total shareholders’ comprehensive income $ 6,146 $ 7,164 $ 3,601
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Statement of Cash Flows (Details) - USD ($)
$ in Millions
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, 2024
Dec. 31, 2023
Dec. 31, 2022
Operating activities                      
Net cash provided by operating activities                 $ 5,808 $ 8,061 $ 8,399
Investing activities                      
Purchases of investments                 (17,986) (16,236) (24,946)
Changes in securities lending collateral                 73 78 (301)
Net cash used in investing activities                 (5,167) (5,572) (4,560)
Financing activities                      
Proceeds from long-term borrowings                 7,710 2,574 3,071
Repayments of long-term borrowings                 (1,650) (1,909) (1,899)
Changes in securities lending payable                 (75) (77) 302
Repurchase and retirement of common stock                 (2,900) (2,676) (2,316)
Cash dividends $ (373) $ (378) $ (378) $ (379) $ (346) $ (348) $ (350) $ (351) (1,508) (1,395) (1,229)
Proceeds from issuance of common stock under employee stock plans                 154 87 120
Taxes paid through withholding of common stock under employee stock plans                 (109) (99) (93)
Other, net                 2 7 41
Net cash provided by (used in) financing activities                 1,193 (3,349) (1,318)
Change in cash and cash equivalents                 1,828 (861) 2,507
Cash and cash equivalents at beginning of year       6,526       7,387 6,526 7,387 4,880
Cash and cash equivalents at end of year 8,288       6,526       8,288 6,526 7,387
Elevance Health, Inc.                      
Operating activities                      
Net cash provided by operating activities                 1,451 4,113 1,447
Investing activities                      
Purchases of investments                 (3,240) (95) (367)
Proceeds from sales, maturities, calls and redemptions of investments                 1,567 212 618
Repayment of note to subsidiary                 0 0 1,500
Capitalization of subsidiaries                 (324) (363) (411)
Changes in securities lending collateral                 (16) 42 36
Purchases of property and equipment, net of sales                 (36) (55) (47)
Net cash used in investing activities                 (2,049) (259) 1,329
Financing activities                      
Net repayments of short-term borrowings                 0 0 (300)
Proceeds from long-term borrowings                 7,710 2,574 3,071
Repayments of long-term borrowings                 (1,650) (1,909) (1,899)
Changes in securities lending payable                 16 (42) (36)
Repurchase and retirement of common stock                 (2,900) (2,676) (2,316)
Cash dividends                 (1,586) (1,466) (1,290)
Proceeds from issuance of common stock under employee stock plans                 221 152 182
Taxes paid through withholding of common stock under employee stock plans                 (109) (99) (93)
Other, net                 (717) 153 217
Net cash provided by (used in) financing activities                 985 (3,313) (2,464)
Change in cash and cash equivalents                 387 541 312
Cash and cash equivalents at beginning of year       $ 1,483       $ 942 1,483 942 630
Cash and cash equivalents at end of year $ 1,870       $ 1,483       $ 1,870 $ 1,483 $ 942
v3.25.0.1
Schedule II-Condensed Financial Information of Registrant - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Condensed Financial Statements, Captions [Line Items]        
Due from subsidiaries $ 6,016 $ 5,405    
Due to subsidiaries (10,029) (9,894)    
Elevance Health, Inc.        
Condensed Financial Statements, Captions [Line Items]        
Cash dividends received from subsidiaries 6,322 4,909 $ 3,097  
Cash dividends paid to subsidiaries 78 71 61  
Capital contribution to subsidiaries 324 363 $ 411  
Due from subsidiaries 49 58    
Parental guarantees 912      
Elevance Health, Inc. | Subsidiaries        
Condensed Financial Statements, Captions [Line Items]        
Due from subsidiaries 4,697 0    
Due to subsidiaries $ 0 $ (734)    
Elevance Health, Inc. | Subsidiaries | Notes Receivable        
Condensed Financial Statements, Captions [Line Items]        
Due from subsidiaries       $ 1,500