v3.25.3
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash Flows from Operating Activities    
Net income $ 5,014 $ 2,242
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 2,053 2,129
Investment (gains) losses, net (76) 2,805
Deferred income tax benefit (174) (351)
(Gain) loss on sale of businesses (79) 106
Net changes in assets and liabilities, net of non-operating effects:    
Accounts receivable, net (6,911) (10,600)
Inventories 1,060 577
Reinsurance recoverable and Other assets (537) (358)
Insurance liabilities 1,662 (214)
Pharmacy and other service costs payable 1,837 8,979
Accounts payable and Accrued expenses and other liabilities (857) (819)
Other, net 460 655
NET CASH PROVIDED BY OPERATING ACTIVITIES 3,452 5,151
Proceeds from investments sold:    
Debt securities and equity securities 518 569
Investment maturities and repayments:    
Debt securities and equity securities 745 585
Commercial mortgage loans 198 79
Other sales, maturities and repayments (primarily short-term and other long-term investments) 656 567
Investments purchased or originated:    
Debt securities and equity securities (5,271) (943)
Commercial mortgage loans (117) (54)
Other (primarily short-term and other long-term investments) (1,066) (1,028)
Property and equipment purchases, net (890) (1,069)
Acquisitions, net of cash acquired (597) (132)
Divestitures, net of cash sold 2,346 0
Renewable energy tax credit equity investments (485) (466)
Other, net (24) (19)
NET CASH USED IN INVESTING ACTIVITIES (3,987) (1,911)
Cash Flows from Financing Activities    
Deposits and interest credited to contractholder deposit funds 113 120
Withdrawals and benefit payments from contractholder deposit funds (201) (180)
Net change in short-term debt, excluding term loan (915) 366
Net proceeds on issuance of term loan 1,999 0
Repayment of term loan (2,000) 0
Repayment of long-term debt (1,643) (3,000)
Net proceeds on issuance of long-term debt 4,461 4,462
Repurchase of common stock (2,620) (5,012)
Issuance of common stock 178 283
Common stock dividend paid (1,215) (1,183)
Other, net (512) (255)
NET CASH USED IN FINANCING ACTIVITIES (2,355) (4,399)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash 30 6
Net decrease in cash, cash equivalents and restricted cash (2,860) (1,153)
Cash, cash equivalents and restricted cash January 1, including held for sale assets [1] 8,931 8,337
Cash, cash equivalents and restricted cash December 31, including held for sale assets [1] 6,071 7,184
Cash and cash equivalents reclassified to assets of businesses held for sale 0 (1,249)
Cash, cash equivalents and restricted cash and cash equivalents December 31, [1] 6,071 5,935
Supplemental Disclosure of Cash Information:    
Income taxes paid, net of refunds 356 839
Interest paid $ 1,043 $ 1,037
[1] Restricted cash and cash equivalents were reported in other long-term investments and Other assets.