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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Operating activities:    
Net income $ 928 $ 875
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 138 128
Deferred income taxes 14 (33)
Share-based compensation 98 88
Other, net 8 3
Changes in operating assets and liabilities:    
Receivables (31) (132)
Prepaid expenses and other current assets (6) (69)
Medical claims and benefits payable 65 611
Amounts due government agencies (289) 377
Accounts payable, accrued liabilities and other (33) (137)
Deferred revenue (53) 332
Income taxes 29 309
Net cash provided by operating activities 868 2,352 Close
Investing activities:    
Purchases of investments (989) (1,295)
Proceeds from sales and maturities of investments 871 670
Net cash paid in business combinations (344) (3)
Purchases of property, equipment and capitalized software (89) (89)
Other, net 68 (2)
Net cash used in investing activities (483) (719) Close
Financing activities:    
Common stock purchases (500) 0
Proceeds from borrowings under credit facility 300 0
Repayment of credit facility (150) 0
Common stock withheld to settle employee tax obligations (57) (60)
Other, net (7) (1)
Net cash used in financing activities (414) (61) Close
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents (29) 1,572 Close
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period 4,908 4,048
Cash, cash equivalents, and restricted cash and cash equivalents at end of period $ 4,879 $ 5,620