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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Cash Flows from Operating Activities    
Net income $ 1,417 $ 2,816
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 1,479 1,504
Realized investment losses, net 1,884 30
Deferred income tax benefit (199) (207)
Loss on sale of businesses 19 0
Net changes in assets and liabilities, net of non-operating effects:    
Accounts receivable, net (7,313) (1,144)
Inventories 472 263
Reinsurance recoverable and Other assets (559) 109
Insurance liabilities (125) 1,727
Pharmacy and other service costs payable 7,820 1,547
Accounts payable and Accrued expenses and other liabilities (15) 638
Other, net 225 237
NET CASH PROVIDED BY OPERATING ACTIVITIES 5,105 7,520 Close
Proceeds from investments sold:    
Debt securities and equity securities 393 646
Investment maturities and repayments:    
Debt securities and equity securities 414 502
Commercial mortgage loans 37 82
Other sales, maturities and repayments (primarily short-term and other long-term investments) 451 313
Investments purchased or originated:    
Debt securities and equity securities (493) (3,339)
Commercial mortgage loans (52) (59)
Other (primarily short-term and other long-term investments) (865) (685)
Property and equipment purchases, net (670) (805)
Divestitures, net of cash sold 0 27
Other, net (350) (79)
NET CASH USED IN INVESTING ACTIVITIES (1,135) (3,397) Close
Cash Flows from Financing Activities    
Deposits and interest credited to contractholder deposit funds 84 96
Withdrawals and benefit payments from contractholder deposit funds (135) (100)
Net change in short-term debt (467) 183
Repayment of long-term debt (3,000) (80)
Net proceeds on issuance of long-term debt 4,462 1,491
Repurchase of common stock (5,012) (1,116)
Issuance of common stock 221 59
Common stock dividend paid (793) (730)
Other, net (198) (275)
NET CASH USED IN FINANCING ACTIVITIES (4,838) (472) Close
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash (12) 9 Close
Net (decrease) increase in cash, cash equivalents and restricted cash (880) 3,660 Close
Cash, cash equivalents and restricted cash January 1, including held for sale assets 8,337 [1] 5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets [2] 7,457 9,636
Cash and cash equivalents reclassified to assets of businesses held for sale (625) 0
Cash, cash equivalents and restricted cash and cash equivalents December 31, [2] 6,832 9,636
Supplemental Disclosure of Cash Information:    
Income taxes paid, net of refunds 567 926
Interest paid $ 643 $ 632
[1] Includes $467 million reported in Assets of businesses held for sale as of January 1, 2024.
[2] Restricted cash and cash equivalents were reported in other long-term investments.