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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
    
FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2024
or

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from _________ to_________

Commission File Number: 001-01011

cvshealtha39.jpg
CVS HEALTH CORPORATION
(Exact name of registrant as specified in its charter)
Delaware05-0494040
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
One CVS Drive,Woonsocket, Rhode Island02895
 (Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code:     
(401)765-1500
Former name, former address and former fiscal year, if changed since last report:
N/A
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.01 per shareCVSNew York Stock Exchange

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).      Yes No

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No

As of April 24, 2024, the registrant had 1,255,372,972 shares of common stock issued and outstanding.







Part I.Financial Information

Item 1.Financial Statements

Index to Condensed Consolidated Financial Statements
Page
Condensed Consolidated Statements of Operations (Unaudited) for the three months ended March 31, 2024 and 2023
Condensed Consolidated Statements of Comprehensive Income (Unaudited) for the three months ended March 31, 2024 and 2023
Condensed Consolidated Balance Sheets (Unaudited) as of March 31, 2024 and December 31, 2023
Condensed Consolidated Statements of Cash Flows (Unaudited) for the three months ended March 31, 2024 and 2023
Condensed Consolidated Statements of Shareholders’ Equity (Unaudited) for the three months ended March 31, 2024 and 2023
Notes to Condensed Consolidated Financial Statements (Unaudited)
Report of Independent Registered Public Accounting Firm


1

CVS Health Corporation
Condensed Consolidated Statements of Operations
(Unaudited)
Three Months Ended
March 31,
In millions, except per share amounts20242023
Revenues:
Products$53,724 $58,147 
Premiums30,391 24,352 
Services3,868 2,445 
Net investment income454 334 
Total revenues88,437 85,278 
Operating costs:
Cost of products sold48,073 51,455 
Health care costs27,803 20,448 
Loss on assets held for sale 349 
Operating expenses10,290 9,580 
Total operating costs86,166 81,832 
Operating income 2,271 3,446 
Interest expense716 589 
Other income(25)(22)
Income before income tax provision 1,580 2,879 
Income tax provision 456 737 
Net income 1,124 2,142 
Net income attributable to noncontrolling interests(11)(6)
Net income attributable to CVS Health$1,113 $2,136 
Net income per share attributable to CVS Health:
Basic$0.88 $1.66 
Diluted$0.88 $1.65 
Weighted average shares outstanding:
Basic1,260 1,283 
Diluted1,267 1,291 
Dividends declared per share$0.665 $0.605 
See accompanying notes to condensed consolidated financial statements (unaudited).
2

CVS Health Corporation
Condensed Consolidated Statements of Comprehensive Income
(Unaudited)
Three Months Ended
March 31,
In millions20242023
Net income $1,124 $2,142 
Other comprehensive income (loss), net of tax:
Net unrealized investment gains (losses)(108)470 
Change in discount rate on long-duration insurance reserves68 (74)
Foreign currency translation adjustments (1)
Net cash flow hedges(4)(6)
Other comprehensive income (loss)(44)389 
Comprehensive income1,080 2,531 
Comprehensive income attributable to noncontrolling interests(11)(6)
Comprehensive income attributable to CVS Health$1,069 $2,525 

See accompanying notes to condensed consolidated financial statements (unaudited).
3

CVS Health Corporation
Condensed Consolidated Balance Sheets
(Unaudited)
In millions, except per share amountsMarch 31,
2024
December 31,
2023
Assets: 
Cash and cash equivalents$9,801 $8,196 
Investments3,288 3,259 
Accounts receivable, net32,217 35,227 
Inventories16,346 18,025 
Other current assets5,821 3,151 
Total current assets67,473 67,858 
Long-term investments24,074 23,019 
Property and equipment, net13,037 13,183 
Operating lease right-of-use assets17,045 17,252 
Goodwill91,272 91,272 
Intangible assets, net28,770 29,234 
Separate accounts assets3,271 3,250 
Other assets4,801 4,660 
Total assets$249,743 $249,728 
Liabilities:
Accounts payable$13,717 $14,897 
Pharmacy claims and discounts payable22,289 22,874 
Health care costs payable 14,368 12,049 
Policyholders’ funds1,081 1,326 
Accrued expenses22,350 22,189 
Other insurance liabilities1,158 1,141 
Current portion of operating lease liabilities1,906 1,741 
Short-term debt2,719 200 
Current portion of long-term debt3,731 2,772 
Total current liabilities83,319 79,189 
Long-term operating lease liabilities15,742 16,034 
Long-term debt57,694 58,638 
Deferred income taxes4,184 4,311 
Separate accounts liabilities3,271 3,250 
Other long-term insurance liabilities5,178 5,459 
Other long-term liabilities6,205 6,211 
Total liabilities175,593 173,092 
Shareholders’ equity:
Preferred stock, par value $0.01: 0.1 shares authorized; none issued or outstanding
  
Common stock, par value $0.01: 3,200 shares authorized; 1,771 shares issued and 1,252 shares outstanding at March 31, 2024 and 1,768 shares issued and 1,288 shares outstanding at December 31, 2023 and capital surplus
49,209 48,992 
Treasury stock, at cost: 519 shares at March 31, 2024 and 480 shares at December 31, 2023
(36,773)(33,838)
Retained earnings61,873 61,604 
Accumulated other comprehensive loss(341)(297)
Total CVS Health shareholders’ equity73,968 76,461 
Noncontrolling interests182 175 
Total shareholders’ equity74,150 76,636 
Total liabilities and shareholders’ equity$249,743 $249,728 

See accompanying notes to condensed consolidated financial statements (unaudited).
4

CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Three Months Ended
March 31,
In millions20242023
Cash flows from operating activities:
Cash receipts from customers$84,997 $87,798 
Cash paid for inventory, prescriptions dispensed and health services rendered(44,824)(50,223)
Insurance benefits paid (24,894)(19,757)
Cash paid to other suppliers and employees(9,677)(9,958)
Interest and investment income received407 426 
Interest paid(1,043)(773)
Income taxes paid(63)(75)
Net cash provided by operating activities4,903 7,438 
Cash flows from investing activities:
Proceeds from sales and maturities of investments2,153 1,891 
Purchases of investments(3,545)(2,358)
Purchases of property and equipment(705)(984)
Acquisitions (net of cash and restricted cash acquired)(25)(7,094)
Other28 31 
Net cash used in investing activities(2,094)(8,514)
Cash flows from financing activities:
Commercial paper borrowings (repayments), net2,519  
Proceeds from issuance of long-term debt 5,951 
Repayments of long-term debt(18)(362)
Repurchase of common stock(3,027)(2,018)
Dividends paid(840)(779)
Proceeds from exercise of stock options203 96 
Payments for taxes related to net share settlement of equity awards(31)(34)
Other(33)(128)
Net cash provided by (used in) financing activities(1,227)2,726 
Net increase in cash, cash equivalents and restricted cash1,582 1,650 
Cash, cash equivalents and restricted cash at the beginning of the period8,525 13,305 
Cash, cash equivalents and restricted cash at the end of the period$10,107 $14,955 

5

CVS Health Corporation
Condensed Consolidated Statements of Cash Flows
(Unaudited)
Three Months Ended
March 31,
In millions20242023
Reconciliation of net income to net cash provided by operating activities:
Net income$1,124 $2,142 
Adjustments required to reconcile net income to net cash provided by operating activities:
Depreciation and amortization1,138 1,001 
Stock-based compensation137 103 
Deferred income taxes and other noncash items(217)155 
Change in operating assets and liabilities, net of effects from acquisitions:
Accounts receivable, net3,008 (751)
Inventories1,660 828 
Other assets(2,836)(1,255)
Accounts payable and pharmacy claims and discounts payable(1,410)(1,203)
Health care costs payable and other insurance liabilities2,253 4,382 
Other liabilities46 2,036 
Net cash provided by operating activities$4,903 $7,438 

See accompanying notes to condensed consolidated financial statements (unaudited).

6

CVS Health Corporation
Condensed Consolidated Statements of Shareholders’ Equity
(Unaudited)
Attributable to CVS Health
Number of shares
outstanding
Common
Stock and
Capital
Surplus (2)
Treasury
Stock (1)
Retained
Earnings
Accumulated
Other
Comprehensive
Loss
Total
CVS Health
Shareholders’
 Equity
Noncontrolling
Interests
Total
Shareholders’
Equity
Common
Shares
Treasury
Shares (1)
In millions
Balance at December 31, 20231,768 (480)$48,992 $(33,838)$61,604 $(297)$76,461 $175 $76,636 
Net income— — — — 1,113 — 1,113 11 1,124 
Other comprehensive loss (Note 8)— — — — — (44)(44)— (44)
Stock option activity, stock awards and other3 — 244 — — — 244 — 244 
Purchase of treasury shares, net of ESPP issuances— (39)(27)(2,935)— — (2,962)— (2,962)
Common stock dividends— — — — (844)— (844)— (844)
Other decreases in noncontrolling interests— — — — — — — (4)(4)
Balance at March 31, 20241,771 (519)$49,209 $(36,773)$61,873 $(341)$73,968 $182 $74,150 
Balance at December 31, 20221,758 (458)$48,193 $(31,858)$56,398 $(1,264)$71,469 $300 $71,769 
Net income— — — — 2,136 — 2,136 6 2,142 
Other comprehensive income (Note 8)— — — — — 389 389 — 389 
Stock option activity, stock awards and other1 — 122 — — — 122 — 122 
Purchase of treasury shares, net of ESPP issuances— (22)(18)(1,944)— — (1,962)— (1,962)
Common stock dividends— — — — (781)— (781)— (781)
Other increases (decreases) in noncontrolling interests— — 9 — — — 9 (108)(99)
Balance at March 31, 20231,759 (480)$48,306 $(33,802)$57,753 $(875)$71,382 $198 $71,580 
_____________________________________________
(1)Treasury shares include 1 million shares held in trust and treasury stock includes $29 million related to shares held in trust as of March 31, 2024 and 2023 and December 31, 2023 and 2022.
(2)Common stock and capital surplus includes the par value of common stock of $18 million as of March 31, 2024 and 2023 and December 31, 2023 and 2022.

See accompanying notes to condensed consolidated financial statements (unaudited).
7

Notes to Condensed Consolidated Financial Statements (Unaudited)

1.Significant Accounting Policies

Description of Business 

CVS Health Corporation, together with its subsidiaries (collectively, “CVS Health” or the “Company”), has more than 9,000 retail locations, more than 1,000 walk-in medical clinics, 205 primary care medical clinics, a leading pharmacy benefits manager with approximately 90 million plan members and expanding specialty pharmacy solutions, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 36 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan (“PDP”). The Company is creating new sources of value through its integrated model allowing it to expand into personalized, technology driven care delivery and health services, increasing access to quality care, delivering better health outcomes and lowering overall health care costs.

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

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

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

Pharmacy & Consumer Wellness Segment
The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also conducts long-term care pharmacy (“LTC”) operations, which distribute prescription drugs and provide related pharmacy consulting and ancillary services to long-term care facilities and other care settings, and provides pharmacy fulfillment services
8


to support the Health Services segment’s specialty and mail order pharmacy offerings. As of March 31, 2024, the Pharmacy & Consumer Wellness segment operated more than 9,000 retail locations, as well as online retail pharmacy websites, LTC pharmacies and on-site pharmacies, retail specialty pharmacy stores, compounding pharmacies and branches for infusion and enteral nutrition services.

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

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

Basis of Presentation

The accompanying unaudited condensed consolidated financial statements of CVS Health and its subsidiaries have been prepared in accordance with the rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. In accordance with such rules and regulations, certain information and accompanying note disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) have been omitted, although the Company believes the disclosures included herein are adequate to make the information presented not misleading. These unaudited condensed consolidated financial statements should be read in conjunction with the audited consolidated financial statements and notes thereto which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (the “2023 Form 10-K”).
 
In the opinion of management, the accompanying unaudited condensed consolidated financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the results for the interim periods presented. Because of the influence of various factors on the Company’s operations, including business combinations, certain holidays and other seasonal influences, net income for any interim period may not be comparable to the same interim period in previous years or necessarily indicative of income for the full year.

Principles of Consolidation

The unaudited condensed consolidated financial statements include the accounts of the Company and its majority-owned subsidiaries and variable interest entities (“VIEs”) for which the Company is the primary beneficiary. All material intercompany balances and transactions have been eliminated.
 
The Company continually evaluates its investments to determine if they represent variable interests in a VIE. If the Company determines that it has a variable interest in a VIE, the Company then evaluates if it is the primary beneficiary of the VIE. The evaluation is a qualitative assessment as to whether the Company has the ability to direct the activities of a VIE that most significantly impact the entity’s economic performance. The Company consolidates a VIE if it is considered to be the primary beneficiary.

Assets and liabilities of VIEs for which the Company is the primary beneficiary were not significant to the Company’s unaudited condensed consolidated financial statements. VIE creditors do not have recourse against the general credit of the Company.

Reclassifications

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

Restricted Cash

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

9


The following is a reconciliation of cash and cash equivalents on the unaudited condensed consolidated balance sheets to total cash, cash equivalents and restricted cash on the unaudited condensed consolidated statements of cash flows:
In millionsMarch 31,
2024
December 31,
2023
Cash and cash equivalents$9,801 $8,196 
Restricted cash (included in other current assets)51 90 
Restricted cash (included in other assets)255 239 
Total cash, cash equivalents and restricted cash in the statements of cash flows$10,107 $8,525 

Accounts Receivable

Accounts receivable are stated net of allowances for credit losses, customer credit allowances, contractual allowances and estimated terminations. Accounts receivable, net at March 31, 2024 and December 31, 2023 was composed of the following:
In millionsMarch 31,
2024
December 31,
2023
Trade receivables$10,586 $11,908 
Vendor and manufacturer receivables12,681 15,711 
Premium receivables5,420 3,714 
Other receivables3,530 3,894 
   Total accounts receivable, net$32,217 $35,227 

The Company’s allowance for credit losses was $402 million and $343 million as of March 31, 2024 and December 31, 2023, respectively. When developing an estimate of the Company’s expected credit losses, the Company considers all available relevant information regarding the collectability of cash flows, including historical information, current conditions and reasonable and supportable forecasts of future economic conditions over the contractual life of the receivable. The Company’s accounts receivable are short duration in nature and typically settle in less than 30 days.

Health Care Contract Acquisition Costs

Insurance products included in the Health Care Benefits segment are cancellable by either the customer or the member monthly upon written notice. Acquisition costs related to prepaid health care and health indemnity contracts are generally expensed as incurred. For certain long-duration insurance contracts, acquisition costs directly related to the successful acquisition of a new or renewal insurance contract, including commissions, are deferred and are recorded as other current assets or other assets on the unaudited condensed consolidated balance sheets. Contracts are grouped by product and issue year into cohorts consistent with the grouping used in estimating the associated liability and are amortized on a constant level basis based on the remaining in-force policies over the estimated term of the contracts to approximate straight-line amortization. Changes to the Company’s assumptions, including assumptions related to persistency, are reflected at the cohort level at the time of change and are recognized prospectively over the estimated terms of the contract. The amortization of deferred acquisition costs is recorded in operating expenses in the unaudited condensed consolidated statements of operations.

The following is a roll forward of deferred acquisition costs for the three months ended March 31, 2024 and 2023:
Three Months Ended
March 31,
In millions20242023
Deferred acquisition costs, beginning of the period$1,502$1,219
Capitalizations134135
Amortization expense(76)(64)
Deferred acquisition costs, end of the period$1,560$1,290


10


Revenue Recognition

Disaggregation of Revenue
The following table disaggregates the Company’s revenue by major source in each segment for the three months ended March 31, 2024 and 2023:
In millionsHealth Care
Benefits
Health
Services
Pharmacy &
Consumer
Wellness
Corporate/
Other
Intersegment
Eliminations
Consolidated
Totals
Three Months Ended March 31, 2024
Major goods/services lines:
Pharmacy$ $37,726 $22,784 $ $(12,113)$48,397 
Front Store  5,370   5,370 
Premiums30,379   12  30,391 
Net investment income353   101  454 
Other1,504 2,559 571 2 (811)3,825 
Total$32,236 $40,285 $28,725 $115 $(12,924)$88,437 
Health Services distribution channel:
Pharmacy network (1)
$20,464 
Mail & specialty (2)
17,262 
Other2,559 
Total$40,285 
Three Months Ended March 31, 2023
Major goods/services lines:
Pharmacy$ $43,737 $21,780 $ $(12,732)$52,785 
Front Store  5,597   5,597 
Premiums24,339   13  24,352 
Net investment income (loss)164  (3)173  334 
Other1,374 854 548 2 (568)2,210 
Total$25,877 $44,591 $27,922 $188 $(13,300)$85,278 
Health Services distribution channel:
Pharmacy network (1)
$27,592 
Mail & specialty (2)
16,145 
Other854 
Total$44,591 

_____________________________________________
(1)Health Services pharmacy network is defined as claims filled at retail and specialty retail pharmacies, including the Company’s retail pharmacies and LTC pharmacies, as well as activity associated with Maintenance Choice®, which permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS pharmacy retail store for the same price as mail order.
(2)Health Services mail & specialty is defined as specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as mail order and specialty claims fulfilled by the Pharmacy & Consumer Wellness segment.

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

11


The following table provides information about receivables and contract liabilities from contracts with customers:
In millionsMarch 31,
2024
December 31,
2023
Trade receivables (included in accounts receivable, net)$10,586 $11,908 
Contract liabilities (included in accrued expenses)117 149 

Related Party Transactions

The Company has an equity method investment in SureScripts, LLC (“SureScripts”), which operates a clinical health information network. The Company utilizes this clinical health information network in providing services to its client plan members and retail customers. The Company expensed fees for the use of this network of $6 million and $17 million in the three months ended March 31, 2024 and 2023, respectively. The Company’s investment in and equity in the earnings of SureScripts for all periods presented is immaterial.

New Accounting Pronouncements Recently Adopted

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

New Accounting Pronouncements Not Yet Adopted

Income Taxes
In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. The standard requires the Company to provide further disaggregated income tax disclosures for specific categories on the effective tax rate reconciliation, as well as additional information about federal, state/local and foreign income taxes. The standard also requires the Company to annually disclose its income taxes paid (net of refunds received), disaggregated by jurisdiction. The standard is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The standard is to be applied on a prospective basis, although optional retrospective application is permitted. While the standard will require additional disclosures related to the Company’s income taxes, the standard is not expected to have any impact on the Company’s consolidated operating results, financial condition or cash flows.

2.Acquisition

Oak Street Health Acquisition

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

There were no measurement period adjustments to assets acquired and liabilities assumed during the three months ended March 31, 2024. The assessment of fair value is preliminary and is based on information that was available to management at the time the unaudited condensed consolidated financial statements were prepared. The most significant open items include the
12


accounting for contingencies and the accounting for income taxes as management is awaiting additional information to complete its assessment of these matters. The finalization of the Company’s purchase accounting assessment could result in changes in the valuation of assets acquired and liabilities assumed, which could be material.

3.Investments

Total investments at March 31, 2024 and December 31, 2023 were as follows:
 March 31, 2024December 31, 2023
In millionsCurrentLong-termTotalCurrentLong-termTotal
Debt securities available for sale$3,121 $19,505 $22,626 $3,131 $18,582 $21,713 
Mortgage loans167 1,195 1,362 128 1,183 1,311 
Other investments 3,374 3,374  3,254 3,254 
Total investments$3,288 $24,074 $27,362 $3,259 $23,019 $26,278 

Debt Securities

Debt securities available for sale at March 31, 2024 and December 31, 2023 were as follows:
In millions
Amortized
 Cost (1)
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair
Value
March 31, 2024
Debt securities:  
U.S. government securities$2,205 $8 $(66)$2,147 
States, municipalities and political subdivisions2,029 18 (39)2,008 
U.S. corporate securities10,951 94 (474)10,571 
Foreign securities2,594 33 (124)2,503 
Residential mortgage-backed securities857 5 (62)800 
Commercial mortgage-backed securities1,121 8 (93)1,036 
Other asset-backed securities3,533 25 (15)3,543 
Redeemable preferred securities18   18 
Total debt securities (2)
$23,308 $191 $(873)$22,626 
December 31, 2023
Debt securities:
U.S. government securities$2,071 $19 $(54)$2,036 
States, municipalities and political subdivisions2,219 31 (35)2,215 
U.S. corporate securities10,156 133 (446)9,843 
Foreign securities2,593 41 (122)2,512 
Residential mortgage-backed securities862 8 (60)810 
Commercial mortgage-backed securities1,066 9 (100)975 
Other asset-backed securities3,294 26 (18)3,302 
Redeemable preferred securities21  (1)20 
Total debt securities (2)
$22,282 $267 $(836)$21,713 
_____________________________________________
(1)There was no allowance for expected credit losses recorded on available-for-sale debt securities at March 31, 2024 or December 31, 2023.
(2)Investment risks associated with the Company’s experience-rated products generally do not impact the Company’s consolidated operating results. At March 31, 2024, debt securities with a fair value of $552 million, gross unrealized capital gains of $7 million and gross unrealized capital losses of $32 million, and at December 31, 2023, debt securities with a fair value of $592 million, gross unrealized capital gains of $10 million and gross unrealized capital losses of $28 million were included in total debt securities, but support experience-rated products. Changes in net unrealized capital gains (losses) on these securities are not reflected in accumulated other comprehensive loss.

13


The amortized cost and fair value of debt securities at March 31, 2024 are shown below by contractual maturity. Actual maturities may differ from contractual maturities because securities may be restructured, called or prepaid, or the Company intends to sell a security prior to maturity.
In millionsAmortized
Cost
Fair
Value
Due to mature: 
Less than one year$1,262 $1,245 
One year through five years8,032 7,836 
After five years through ten years4,588 4,463 
Greater than ten years3,915 3,703 
Residential mortgage-backed securities857 800 
Commercial mortgage-backed securities1,121 1,036 
Other asset-backed securities3,533 3,543 
Total$23,308 $22,626 

14


Summarized below are the debt securities the Company held at March 31, 2024 and December 31, 2023 that were in an unrealized capital loss position, aggregated by the length of time the investments have been in that position:
Less than 12 monthsGreater than 12 monthsTotal
In millions, except number of securitiesNumber
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
Number
of
Securities
Fair
Value
Unrealized
Losses
March 31, 2024  
Debt securities:  
U.S. government securities210 $846 $12 273 $856 $54 483 $1,702 $66 
States, municipalities and political subdivisions260 489 3 434 682 36 694 1,171 39 
U.S. corporate securities1,413 1,720 19 3,995 5,260 455 5,408 6,980 474 
Foreign securities324 444 7 915 1,299 117 1,239 1,743 124 
Residential mortgage-backed securities41 143 1 429 468 61 470 611 62 
Commercial mortgage-backed securities36 84  310 635 93 346 719 93 
Other asset-backed securities351 852 5 213 451 10 564 1,303 15 
Redeemable preferred securities   7 13  7 13  
Total debt securities 2,635 $4,578 $47 6,576 $9,664 $826 9,211 $14,242 $873 
December 31, 2023  
Debt securities:  
U.S. government securities74 $194 $2 280 $891 $52 354 $1,085 $54 
States, municipalities and political subdivisions95 181 1 455 733 34 550 914 35 
U.S. corporate securities576 672 14 4,120 5,602 432 4,696 6,274 446 
Foreign securities160 243 4 964 1,407 118 1,124 1,650 122 
Residential mortgage-backed securities33 97 1 461 517 59 494 614 60 
Commercial mortgage-backed securities44 94 2 287 581 98 331 675 100 
Other asset-backed securities196 449 4 443 867 14 639 1,316 18 
Redeemable preferred securities4 2  8 18 1 12 20 1 
Total debt securities 1,182 $1,932 $28 7,018 $10,616 $808 8,200 $12,548 $836 

The Company reviewed the securities in the table above and concluded that they are performing assets generating investment income to support the needs of the Company’s business. In performing this review, the Company considered factors such as the quality of the investment security based on research performed by the Company’s internal credit analysts and external rating agencies and the prospects of realizing the carrying value of the security based on the investment’s current prospects for recovery. Unrealized capital losses at March 31, 2024 were generally caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities. As of March 31, 2024, the Company did not intend to sell these securities, and did not believe it was more likely than not that it would be required to sell these securities prior to the anticipated recovery of their amortized cost basis.






15


The maturity dates for debt securities in an unrealized capital loss position at March 31, 2024 were as follows:
 Supporting
experience-rated products
Supporting
remaining products
Total
In millionsFair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Fair
Value
Unrealized
Losses
Due to mature:      
Less than one year$14 $ $1,093 $19 $1,107 $19 
One year through five years126 4 5,402 231 5,528 235 
After five years through ten years78 8 2,426 173 2,504 181 
Greater than ten years165 18 2,305 250 2,470 268 
Residential mortgage-backed securities7  604 62 611 62 
Commercial mortgage-backed securities15 1 704 92 719 93 
Other asset-backed securities15 1 1,288 14 1,303 15 
Total$420 $32 $13,822 $841 $14,242 $873 

Mortgage Loans

The Company’s mortgage loans are collateralized by commercial real estate. During the three months ended March 31, 2024 and 2023, the Company had the following activity in its mortgage loan portfolio: