7Baggers

Elevance Health Inc
(NYSE:ELV) 

ELV stock logo

Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated

Founded: 1944
CEO: Gail Koziara Boudreaux  
Sector: FINANCE
Industry: HOSPITAL & MEDICAL SERVICE PLANS

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At a glance:
  • Leading Health Benefits Provider with Extensive Reach: Elevance Health operates as one of the largest health insurance companies in the U.S., primarily through its Anthem Blue Cross Blue Shield plans, serving over 47 million members across commercial, Medicare Advantage, and Medicaid programs.
  • Strategic Diversification into Integrated Care and Services: The company is actively expanding beyond traditional insurance through its Carelon segment, which encompasses pharmacy benefits management (CarelonRx), behavioral health, and other care delivery solutions, aiming to create a more integrated health experience and new revenue streams.
  • Consistent Revenue Growth Driven by Government Programs: Elevance Health consistently reports strong revenue expansion, largely fueled by robust enrollment and premium growth in its Medicare Advantage and Medicaid plans, alongside disciplined cost management and strategic investments in its diversified services.
  • Navigating Healthcare Cost Pressures and Regulatory Landscape: The company faces ongoing challenges from rising healthcare costs, intense competition, and a complex and evolving regulatory environment, requiring continuous adaptation in pricing strategies, service offerings, and operational efficiency to maintain profitability and market share.
Bull Thesis:
  • Strong Position in Growing Medicare Advantage Market: Elevance Health is a leading player in the Medicare Advantage (MA) market, which benefits from the aging U.S. population and increasing enrollment. The company's scale and experience allow it to effectively manage costs and offer competitive plans, driving consistent membership growth and stable revenue streams in a high-demand segment.
  • Diversification into Care Delivery and Services (Carelon): The company's strategic pivot and expansion into care delivery and services through its Carelon segment (including PBM, behavioral health, and advanced analytics) offers significant growth opportunities beyond traditional insurance. This diversification can lead to improved care coordination, better health outcomes, and higher-margin revenue streams, reducing reliance on volatile insurance underwriting cycles.
  • Consistent Financial Performance and Shareholder Returns: Elevance Health has a strong track record of consistent earnings growth, robust free cash flow generation, and effective capital allocation. The company regularly returns value to shareholders through dividends and share buybacks, demonstrating financial discipline and a commitment to enhancing shareholder value amidst a stable and essential industry.
Bear Thesis:
  • Regulatory and Political Headwinds: The healthcare industry is highly regulated, and Elevance Health is susceptible to changes in government policy, reimbursement rates (especially for Medicare Advantage), and legislative actions. Political scrutiny, particularly in election years, can lead to pricing pressure, increased compliance costs, or unfavorable changes to healthcare laws that could impact profitability and growth.
  • Rising Medical Cost Trends and Utilization: Higher-than-anticipated medical cost trends, driven by factors such as increased utilization of healthcare services (e.g., post-pandemic catch-up care), the introduction of expensive new drugs (like GLP-1s for weight loss and diabetes), and provider labor shortages, could pressure Elevance Health's medical loss ratio (MLR) and squeeze profit margins.
  • Intense Competition and Pricing Pressure: Elevance Health operates in a highly competitive market with other large national insurers, regional players, and new entrants. This intense competition can lead to pricing pressure, challenges in retaining and attracting members, and increased marketing expenses, potentially limiting market share growth and profitability.
  • Execution Risks in Diversification Strategy: While the diversification into care delivery and services (Carelon) offers growth potential, it also carries execution risks. Successfully integrating new service lines, managing complex care models, and achieving desired synergies require significant operational expertise and investment. Failure to execute effectively could lead to higher costs, slower-than-expected growth, or underperformance of these new segments.
Main Competitors:
  • UnitedHealth Group ($UNH) (UnitedHealthcare (insurance), Optum (PBM, care delivery, tech)), UnitedHealth Group is the largest health insurer in the U.S. and a direct competitor across all major segments, including employer-sponsored, individual, Medicare, and Medicaid plans. Its Optum division also competes with Elevance's CarelonRx and Carelon Services in pharmacy benefit management, care delivery, and health technology solutions.
  • CVS Health ($CVS) (Aetna (insurance), CVS Caremark (PBM), MinuteClinic), CVS Health competes through its Aetna health insurance arm across commercial, Medicare, and Medicaid markets. Its CVS Caremark division is a major pharmacy benefit manager, directly competing with Elevance's CarelonRx. Additionally, CVS's retail presence and MinuteClinic offer care delivery services that can influence member choices and health outcomes.
  • Cigna Group ($CI) (Cigna Healthcare (insurance), Evernorth Health Services (PBM, specialty pharmacy, care solutions)), Cigna Group is a significant competitor in the employer-sponsored and individual health insurance markets through Cigna Healthcare. Its Evernorth Health Services division directly competes with Elevance's CarelonRx and Carelon Services in pharmacy benefit management, specialty pharmacy, and various health services and solutions.
  • Humana Inc. ($HUM) (Medicare Advantage plans, Medicaid plans, employer group plans), Humana is a strong competitor, particularly in the rapidly growing Medicare Advantage market, where it holds a significant share. It also competes in Medicaid and employer group plans, often focusing on integrated care delivery and wellness programs for its members, similar to Elevance's holistic approach.
Moat:
Elevance Health operates in a highly competitive U.S. health insurance market, primarily competing with a few large, diversified players. Its competitive moat is built on its immense scale, extensive provider networks, and strong brand recognition as a major Blue Cross Blue Shield licensee. The company further strengthens its position through integrated capabilities via its CarelonRx (PBM) and Carelon Services divisions, which aim to improve care coordination, manage costs, and enhance member experience. Significant regulatory barriers to entry also protect its market share. Competition is intense across all segments, particularly in employer-sponsored plans, Medicare Advantage, and Medicaid, with rivals increasingly adopting integrated models that combine insurance, pharmacy benefits, and care delivery to control costs and improve health outcomes.
Income Statements:
Quarterly
Annual
    Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2014-03-31 2013-12-31 2013-09-30 2013-06-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-12-31 2011-09-30 2011-06-30 2011-03-31 2010-12-31 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2009-09-30 2009-06-30 2009-03-31 2008-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2006-12-31 2006-09-30 2006-06-30 2006-03-31 2005-12-31 2005-09-30 2005-06-30 2005-03-31 2004-12-31 
                                                                                          
      revenues
                                                                                          
      premiums
    41,024,000,000 40,690,000,000 41,791,000,000 41,271,000,000 40,887,000,000 36,245,000,000 36,809,000,000 35,416,000,000 35,696,000,000 35,138,000,000 35,259,000,000 36,589,000,000 35,868,000,000 33,646,000,000 33,722,000,000 33,076,000,000 32,785,000,000 30,769,000,000 30,395,000,000 28,533,000,000 27,676,000,000 27,108,000,000 26,392,000,000 25,092,000,000 25,517,000,000 24,036,000,000 23,793,000,000 23,501,000,000 22,843,000,000 21,819,000,000 21,451,000,000 21,248,400,000 20,902,800,000 21,086,300,000 20,797,000,000 20,813,100,000 20,951,300,000 20,137,100,000 19,786,100,000 19,948,000,000 18,988,900,000 18,745,300,000 18,513,000,000 18,516,300,000 17,610,500,000 17,577,900,000 17,226,000,000 17,068,900,000 16,517,000,000 16,609,600,000 16,580,900,000 16,493,000,000 16,435,600,000 14,160,100,000 14,037,100,000 14,161,000,000 14,138,500,000 14,190,300,000 14,181,600,000 13,913,600,000 13,684,100,000 13,439,900,000 13,366,700,000 13,257,100,000 13,909,900,000 13,984,800,000 14,070,700,000 14,123,300,000 14,203,200,000 14,291,000,000 14,230,700,000 14,344,900,000 14,234,400,000 14,266,100,000 13,905,600,000 13,935,900,000 13,757,400,000 13,293,900,000 13,180,300,000 12,918,800,000 12,578,900,000 10,410,000,000 10,315,000,000 10,332,900,000 10,158,800,000  
      product revenue
    6,225,000,000 6,460,000,000 6,159,000,000 6,042,000,000 5,809,000,000 6,714,000,000 5,887,000,000 5,530,000,000 4,499,000,000 5,394,000,000 5,177,000,000 4,859,000,000 4,022,000,000 4,137,000,000 3,972,000,000 3,568,000,000 3,301,000,000 3,525,000,000 3,353,000,000 3,042,000,000 2,737,000,000 2,899,000,000 2,598,000,000 2,543,000,000 2,344,000,000                                                              
      service fees
    2,245,000,000 2,161,000,000 2,137,000,000 2,108,000,000 2,069,000,000 2,030,000,000 2,023,000,000 2,277,000,000 2,078,000,000 1,922,000,000 2,044,000,000 1,929,000,000 2,008,000,000                                                                          
      total operating revenue
    49,494,000,000 49,311,000,000 50,087,000,000 49,421,000,000 48,765,000,000 44,989,000,000 44,719,000,000 43,223,000,000 42,273,000,000 42,454,000,000 42,480,000,000 43,377,000,000 41,898,000,000 39,667,000,000 39,625,000,000 38,482,000,000 37,886,000,000 36,018,000,000 35,548,000,000 33,279,000,000 32,098,000,000 31,533,000,000 30,649,000,000 29,178,000,000 29,448,000,000 27,132,000,000 26,444,000,000 25,177,000,000 24,388,000,000 23,304,000,000 22,980,000,000 22,714,800,000 22,342,300,000 22,447,000,000 22,096,700,000 22,198,000,000 22,319,500,000 21,484,900,000 21,125,200,000 21,274,500,000 20,309,400,000 20,023,700,000 19,771,400,000 19,758,300,000 18,851,400,000 18,776,200,000 18,370,700,000 18,230,000,000 17,644,800,000 17,314,900,000 17,733,000,000 17,597,200,000 17,546,300,000 15,271,300,000 15,133,700,000 15,173,300,000 15,150,200,000 15,175,500,000 15,155,100,000 14,879,800,000 14,654,800,000 14,416,200,000 14,334,400,000 14,224,500,000 14,868,700,000 15,057,100,000 15,207,000,000 15,265,800,000 15,298,700,000 15,426,200,000 15,309,400,000 15,477,000,000 15,366,600,000 15,317,400,000 14,966,700,000 15,005,500,000 14,832,400,000 14,319,100,000 14,198,500,000 13,942,300,000 13,614,700,000 11,264,000,000 11,150,300,000 11,136,600,000 10,962,200,000  
      net investment income
    765,000,000 493,000,000 625,000,000 486,000,000 590,000,000 527,000,000 551,000,000 508,000,000 465,000,000 529,000,000 493,000,000 416,000,000 387,000,000 373,000,000 371,000,000 381,000,000 360,000,000 352,000,000 335,000,000 400,000,000 291,000,000 286,000,000 280,000,000 57,000,000 254,000,000 268,000,000 242,000,000 285,000,000 210,000,000 262,000,000 250,000,000 229,300,000 229,200,000 238,900,000 220,200,000 200,200,000 207,200,000 212,600,000 200,900,000 194,900,000 171,100,000 162,100,000 161,200,000 186,700,000 167,600,000 177,800,000 174,400,000 188,500,000 183,700,000 176,300,000 167,600,000 153,200,000 162,000,000 179,100,000 168,600,000 169,400,000 169,000,000 160,200,000 170,900,000 187,800,000 184,800,000 194,500,000 205,400,000 202,300,000 201,100,000 201,600,000 196,600,000 205,700,000 197,100,000 186,600,000 214,200,000 217,600,000 232,700,000 243,400,000 257,700,000 253,400,000 246,600,000 225,300,000 222,800,000 218,500,000 212,100,000 179,900,000 154,700,000 159,800,000 138,700,000  
      net losses on financial instruments
    -78,000,000 -57,000,000 -1,000,000 -131,000,000 -464,000,000 -74,000,000 -125,000,000 -85,000,000 -161,000,000 -89,500,000 -124,000,000 -121,000,000 -113,000,000                                                                          
      total revenues
    50,181,000,000 49,747,000,000 50,711,000,000 49,776,000,000 48,891,000,000 45,442,000,000 45,106,000,000 43,886,000,000 42,577,000,000 42,647,000,000 42,849,000,000 43,672,000,000 42,172,000,000 39,929,000,000 39,939,000,000 38,632,000,000 38,095,000,000 36,581,000,000 35,822,000,000 33,851,000,000 32,385,000,000 31,824,000,000 31,158,000,000 29,264,000,000 29,621,000,000 27,407,000,000 26,674,000,000 25,466,000,000 24,666,000,000 23,373,000,000 23,251,000,000 22,943,700,000 22,537,500,000 22,680,300,000 22,426,000,000 22,407,200,000 22,525,900,000 21,714,400,000 21,403,900,000 21,456,200,000 20,288,500,000 20,187,900,000 19,901,600,000 20,015,500,000 19,051,500,000 18,984,300,000 18,557,000,000 18,473,400,000 17,859,400,000 17,570,900,000 17,969,800,000 17,795,600,000 17,687,200,000 15,536,100,000 15,353,100,000 15,407,300,000 15,415,200,000 15,317,700,000 15,398,000,000 15,100,700,000 14,894,300,000 14,647,900,000 14,598,200,000 14,457,200,000 15,098,500,000 19,046,500,000 15,425,100,000 15,413,200,000 15,143,300,000 15,069,600,000 14,961,000,000 15,666,800,000 15,553,700,000 15,561,400,000 15,233,900,000 15,259,800,000 15,079,200,000 14,555,500,000 14,425,900,000 14,151,900,000 13,819,700,000 11,432,300,000 11,304,600,000 11,299,200,000   
      yoy
    2.64% 9.47% 12.43% 13.42% 14.83% 6.55% 5.27% 0.49% 0.96% 6.81% 7.29% 13.05% 10.70% 9.15% 11.49% 14.12% 17.63% 14.95% 14.97% 15.67% 9.33% 16.12% 16.81% 14.91% 20.09% 17.26% 14.72% 10.99% 9.44% 3.05% 3.68% 2.39% 0.05% 4.45% 4.78% 4.43% 11.03% 7.56% 7.55% 7.20% 6.49% 6.34% 7.25% 8.35% 6.67% 8.04% 3.27% 3.81% 0.97% 13.10% 17.04% 15.50% 14.74% 1.43% -0.29% 2.03% 3.50% 4.57% 5.48% 4.45% -1.35% -23.09% -5.36% -6.20% -0.30% 26.39% 3.10% -1.62% -2.64% -3.16% -1.79% 2.67% 3.15% 6.91% 5.60% 7.83% 9.11% 27.32% 27.61% 25.25%       
      qoq
    0.87% -1.90% 1.88% 1.81% 7.59% 0.74% 2.78% 3.07% -0.16% -0.47% -1.88% 3.56% 5.62% -0.03% 3.38% 1.41% 4.14% 2.12% 5.82% 4.53% 1.76% 2.14% 6.47% -1.21% 8.08% 2.75% 4.74% 3.24% 5.53% 0.52% 1.34% 1.80% -0.63% 1.13% 0.08% -0.53% 3.74% 1.45% -0.24% 5.76% 0.50% 1.44% -0.57% 5.06% 0.35% 2.30% 0.45% 3.44% 1.64% -2.22% 0.98% 0.61% 13.85% 1.19% -0.35% -0.05% 0.64% -0.52% 1.97% 1.39% 1.68% 0.34% 0.98% -4.25% -20.73% 23.48% 0.08% 1.78% 0.49% 0.73% -4.51% 0.73% -0.05% 2.15% -0.17% 1.20% 3.60% 0.90% 1.94% 2.40% 20.88% 1.13% 0.05%    
      expenses
                                                                                          
      benefit expense
    35,615,000,000 38,065,000,000 38,140,000,000 36,706,000,000 35,312,000,000 33,500,000,000 32,949,000,000 30,572,000,000 30,546,000,000 31,334,000,000 30,606,000,000 31,604,000,000 30,786,000,000 30,091,000,000 29,404,000,000 28,777,000,000 28,215,000,000 27,538,000,000 26,645,000,000 24,763,000,000 23,699,000,000 24,088,000,000 22,921,000,000 19,547,000,000 21,489,000,000 21,383,000,000 20,753,000,000 20,368,000,000 19,282,000,000 18,936,000,000 18,185,000,000 17,727,800,000 17,045,900,000 18,672,600,000 18,103,600,000 17,917,200,000 17,542,800,000 17,567,900,000 16,922,500,000 16,805,200,000 15,538,800,000 16,315,500,000 15,469,100,000 15,205,400,000 14,126,900,000 14,857,900,000 14,211,100,000 14,121,300,000 13,664,600,000 14,580,800,000 14,075,000,000 13,832,600,000 13,748,700,000 12,363,800,000 11,984,800,000 12,093,100,000 11,771,900,000 12,434,600,000 12,062,900,000 11,922,000,000 11,228,000,000 11,355,800,000 11,204,700,000 10,985,000,000 11,381,400,000 11,854,400,000 11,416,200,000 11,712,300,000 11,588,200,000 11,924,700,000 11,745,600,000 11,955,600,000 12,116,500,000 11,821,700,000 11,379,800,000 11,405,100,000 11,429,500,000 10,774,900,000 10,720,800,000 10,492,300,000 10,230,800,000 8,340,300,000 8,243,900,000 8,379,800,000 8,255,900,000  
      cost of products sold
    5,463,000,000 5,522,000,000 5,380,000,000 5,293,000,000 4,983,000,000 6,012,000,000 5,093,000,000 4,820,000,000 3,825,000,000 4,837,000,000 4,648,000,000 4,327,000,000 3,481,000,000 3,646,000,000 3,437,000,000 3,069,000,000 2,883,000,000 3,070,000,000 2,898,000,000 2,614,000,000 2,313,000,000 2,522,000,000 2,222,000,000 2,225,000,000 1,984,000,000 1,149,000,000 745,000,000 98,000,000                                                           
      operating expense
    6,330,000,000 5,415,000,000 5,272,000,000 4,997,000,000 5,300,000,000 4,804,000,000 5,269,000,000 5,066,000,000 4,886,000,000 4,999,000,000 5,470,000,000 4,818,000,000 4,800,000,000                                                                          
      interest expense
    357,000,000 366,000,000 351,000,000 341,000,000 344,000,000 340,000,000 300,000,000 280,000,000 265,000,000 259,000,000 259,000,000 261,000,000 251,000,000 229,000,000 213,000,000 208,000,000 201,000,000 200,000,000 201,000,000 205,000,000 192,000,000 191,000,000 198,000,000 201,000,000 194,000,000 190,000,000 185,000,000 184,000,000 187,000,000 189,000,000 188,000,000 191,700,000 184,200,000 163,600,000 150,500,000 189,900,000 235,000,000 177,300,000 172,900,000 185,700,000 187,100,000 179,700,000 164,800,000 154,100,000 154,400,000 153,600,000 155,300,000 145,600,000 146,200,000 145,800,000 151,500,000 151,900,000 153,500,000 151,500,000 133,600,000 117,600,000 109,100,000 112,600,000 108,200,000 103,600,000 105,900,000 113,000,000 106,300,000 100,200,000 99,400,000 103,700,000 110,600,000 117,000,000 116,100,000 115,900,000 118,400,000 116,500,000 119,000,000 125,300,000 119,600,000 100,100,000 102,900,000 100,000,000 105,600,000 103,900,000 94,000,000 58,000,000 56,100,000 58,900,000 53,200,000  
      amortization of other intangible assets
    112,000,000 164,000,000 162,000,000 147,000,000 155,000,000 180,000,000 122,000,000 162,000,000 116,000,000 217,000,000 212,000,000 221,000,000 235,000,000 247,000,000 225,000,000 166,000,000 129,000,000 135,000,000 136,000,000 90,000,000 80,000,000 92,000,000 93,000,000 93,000,000 83,000,000 82,000,000 84,000,000 85,000,000 87,000,000 93,000,000 91,000,000 93,600,000 79,500,000 44,100,000 41,900,000 40,600,000 41,800,000 46,600,000 47,400,000 47,900,000 50,400,000 57,500,000 60,000,000 60,100,000 52,500,000 52,600,000 60,300,000 54,000,000 54,000,000 43,100,000 66,600,000 67,700,000 67,900,000 63,000,000 63,900,000 59,500,000 58,700,000 63,900,000 62,100,000 56,600,000 56,800,000 59,700,000 60,400,000 60,900,000 60,700,000 65,500,000 66,000,000 66,600,000 67,900,000 71,100,000 71,900,000 71,600,000 71,500,000 75,200,000 73,800,000 70,900,000 70,800,000 74,300,000 74,800,000 74,500,000 73,800,000 60,200,000 59,600,000 59,900,000 59,200,000  
      total expenses
    47,877,000,000 49,532,000,000 49,305,000,000 47,484,000,000 46,094,000,000 44,836,000,000 43,733,000,000 40,900,000,000 39,638,000,000 41,646,000,000 41,195,000,000 41,231,000,000 39,553,000,000 38,775,000,000 37,793,000,000 36,489,000,000 35,769,000,000 35,181,000,000 33,826,000,000 31,498,000,000 30,209,000,000 31,213,000,000 30,769,000,000 26,115,000,000 27,532,000,000 26,309,000,000 25,185,000,000 24,013,000,000 22,721,000,000 22,830,000,000 22,009,000,000 21,440,200,000 20,757,200,000 22,556,100,000 21,307,100,000 21,201,500,000 21,010,900,000 21,055,800,000 20,267,400,000 20,007,900,000 18,976,500,000 19,813,600,000 18,772,000,000 18,457,500,000 17,482,400,000 18,097,200,000 17,469,800,000 17,209,700,000 16,729,300,000 17,111,100,000 17,087,000,000 16,585,100,000 16,400,100,000 15,054,700,000 14,327,400,000 14,358,700,000 14,105,400,000 14,839,500,000 14,352,800,000 14,093,300,000 13,467,200,000 13,895,800,000 13,461,400,000 13,327,600,000 13,763,200,000 14,706,800,000 14,307,900,000 14,360,700,000 14,249,700,000 14,561,800,000 14,411,600,000 14,480,800,000 14,674,500,000 14,238,600,000 13,862,500,000 13,942,500,000 13,832,800,000 13,271,700,000 13,171,300,000 12,948,600,000 12,647,000,000 10,390,900,000 10,281,200,000 10,402,600,000   
      income before income tax expense
    2,304,000,000 215,000,000 1,406,000,000 2,292,000,000 2,797,000,000 606,000,000 1,373,000,000 2,986,000,000 2,939,000,000 1,001,000,000 1,654,000,000 2,441,000,000 2,619,000,000 1,154,000,000 2,146,000,000 2,143,000,000 2,326,000,000 1,400,000,000 1,996,000,000 2,353,000,000 2,176,000,000 611,000,000 389,000,000 3,149,000,000 2,089,000,000 1,098,000,000 1,489,000,000 1,453,000,000 1,945,000,000 543,000,000 1,242,000,000 1,503,500,000 1,780,300,000 124,200,000 1,118,900,000 1,205,700,000 1,515,000,000 974,200,000 1,136,500,000 1,448,300,000 1,312,000,000         845,100,000 882,800,000 1,210,500,000 1,287,100,000 481,400,000 1,025,700,000 1,048,600,000 1,309,800,000 478,200,000 1,045,200,000 1,007,400,000 1,427,100,000 752,100,000 1,136,800,000 1,129,600,000 1,335,300,000 4,339,700,000 1,117,200,000 1,052,500,000 893,600,000 507,800,000 549,400,000 1,186,000,000 879,200,000 1,322,800,000 1,371,400,000 1,317,300,000 1,246,400,000 1,283,800,000 1,254,600,000 1,203,300,000 1,172,700,000      
      income tax expense
    544,000,000 -331,000,000 219,000,000 548,000,000 613,000,000 193,000,000 365,000,000 685,000,000 690,000,000 170,000,000 354,000,000 585,000,000 615,000,000 193,000,000 533,000,000 493,000,000 531,000,000 275,000,000 494,000,000 552,000,000 509,000,000 60,000,000 167,000,000 873,000,000 566,000,000 164,000,000 306,000,000 314,000,000 394,000,000 118,000,000 282,000,000 450,100,000 467,800,000 -1,106,500,000 372,000,000 350,400,000 505,100,000 290,200,000 518,700,000 667,700,000 609,000,000 193,400,000 474,800,000 698,900,000 703,900,000 380,400,000 456,300,000 532,600,000 438,700,000 167,000,000 226,600,000 410,400,000 401,900,000 17,200,000 334,500,000 405,000,000 453,300,000 142,900,000 362,000,000 305,800,000 500,500,000 203,300,000 397,700,000 407,200,000 458,500,000   359,000,000 313,200,000   435,500,000 291,100,000 463,700,000 503,400,000 482,100,000 463,300,000 482,700,000 443,800,000 452,100,000 440,900,000      
      net income
    1,760,000,000 546,000,000 1,187,000,000 1,744,000,000 2,184,000,000 413,000,000 1,008,000,000 2,301,000,000 2,249,000,000 831,000,000 1,300,000,000 1,856,000,000 2,004,000,000 961,000,000 1,613,000,000 1,650,000,000 1,795,000,000 1,125,000,000 1,502,000,000 1,801,000,000 1,667,000,000 551,000,000 222,000,000 2,276,000,000 1,523,000,000 934,000,000 1,183,000,000 1,139,000,000 1,551,000,000 425,000,000 960,000,000 1,053,400,000 1,312,500,000 1,230,700,000 746,900,000 855,300,000 1,009,900,000 368,400,000 617,800,000 780,600,000 703,000,000 180,900,000 654,800,000 859,100,000 865,200,000 506,700,000 630,900,000 731,100,000 701,000,000 148,200,000 656,200,000 800,100,000 885,200,000 464,200,000 691,200,000 643,600,000 856,500,000 335,300,000 683,200,000 701,600,000 926,600,000 548,800,000 739,100,000 722,400,000 876,800,000 2,741,800,000 730,200,000 693,500,000 580,400,000 331,400,000 820,700,000 750,500,000 588,100,000 859,100,000 868,000,000 835,200,000 783,100,000 801,100,000 810,800,000 751,200,000 731,800,000 652,000,000 640,700,000 559,400,000 611,700,000  
      yoy
    -19.41% 32.20% 17.76% -24.21% -2.89% -50.30% -22.46% 23.98% 12.23% -13.53% -19.40% 12.48% 11.64% -14.58% 7.39% -8.38% 7.68% 104.17% 576.58% -20.87% 9.46% -41.01% -81.23% 99.82% -1.81% 119.76% 23.23% 8.13% 18.17% -65.47% 28.53% 23.16% 29.96% 234.07% 20.90% 9.57% 43.66% 103.65% -5.65% -9.14% -18.75% -64.30% 3.79% 17.51% 23.42% 241.90% -3.86% -8.62% -20.81% -68.07% -5.06% 24.32% 3.35% 38.44% 1.17% -8.27% -7.57% -38.90% -7.56% -2.88% 5.68% -79.98% 1.22% 4.17% 51.07% 727.34% -11.03% -7.59% -1.31% -61.42% -5.45% -10.14% -24.90% 7.24% 7.05% 11.18% 7.01% 22.87% 26.55% 34.29% 19.63%      
      qoq
    222.34% -54.00% -31.94% -20.15% 428.81% -59.03% -56.19% 2.31% 170.64% -36.08% -29.96% -7.39% 108.53% -40.42% -2.24% -8.08% 59.56% -25.10% -16.60% 8.04% 202.54% 148.20% -90.25% 49.44% 63.06% -21.05% 3.86% -26.56% 264.94% -55.73% -8.87% -19.74% 6.65% 64.77% -12.67% -15.31% 174.13% -40.37% -20.86% 11.04% 288.61% -72.37% -23.78% -0.71% 70.75% -19.69% -13.71% 4.29% 373.01% -77.42% -17.99% -9.61% 90.69% -32.84% 7.40% -24.86% 155.44% -50.92% -2.62% -24.28% 68.84% -25.75% 2.31% -17.61% -68.02% 275.49% 5.29% 19.49% 75.14% -59.62% 9.35% 27.61% -31.54% -1.03% 3.93% 6.65% -2.25% -1.20% 7.93% 2.65% 12.24% 1.76% 14.53% -8.55%   
      net income margin %
    3.51% 1.10% 2.34% 3.50% 4.47% 0.91% 2.23% 5.24% 5.28% 1.95% 3.03% 4.25% 4.75% 2.41% 4.04% 4.27% 4.71% 3.08% 4.19% 5.32% 5.15% 1.73% 0.71% 7.78% 5.14% 3.41% 4.44% 4.47% 6.29% 1.82% 4.13% 4.59% 5.82% 5.43% 3.33% 3.82% 4.48% 1.70% 2.89% 3.64% 3.47% 0.90% 3.29% 4.29% 4.54% 2.67% 3.40% 3.96% 3.93% 0.84% 3.65% 4.50% 5.00% 2.99% 4.50% 4.18% 5.56% 2.19% 4.44% 4.65% 6.22% 3.75% 5.06% 5.00% 5.81% 14.40% 4.73% 4.50% 3.83% 2.20% 5.49% 4.79% 3.78% 5.52% 5.70% 5.47% 5.19% 5.50% 5.62% 5.31% 5.30% 5.70% 5.67% 4.95% Infinity%  
      net loss attributable to noncontrolling interests
    4,000,000  2,000,000   5,000,000 8,000,000   -7,250,000 -11,000,000 -3,000,000 -15,000,000 -12,000,000 5,000,000   12,000,000 7,000,000                                                                    
      shareholders’ net income
    1,764,000,000 547,000,000 1,189,000,000 1,743,000,000 2,183,000,000 418,000,000 1,016,000,000 2,300,000,000 2,246,000,000 856,000,000 1,289,000,000 1,853,000,000 1,989,000,000 949,000,000 1,618,000,000 1,653,000,000 1,805,000,000 1,137,000,000 1,509,000,000 1,793,000,000 1,665,000,000                                                                  
      shareholders’ net income per share
                                                                                          
      basic
    8.03 5.683 5.32 7.74 9.64 5.985 4.38 9.91 9.65 5.425 5.48 7.83 8.37 3.99 6.75 6.87 7.48 4.71 6.2 7.33 6.8                                                                  
      diluted
    5.668 5.32 7.72 9.61 5.953 4.36 9.85 9.59 5.39 5.45 7.79 8.3 3.95 6.68 6.79 7.39 4.64 6.13 7.25 6.71                                                                  
      dividends per share
    1.72 1.283 1.71 1.71 1.71 1.223 1.63 1.63 1.63 1.48 1.48 1.48 1.48 1.28 1.28 1.28 1.28 1.13 1.13 1.13 1.13 0.95 0.95 0.95 0.95 0.8 0.8 0.8 0.8 0.75 0.75 0.75 0.75 0.7 0.7 0.65 0.65 0.65 0.65 0.65 0.65 0.625 0.625 0.625 0.625 0.438 0.438 0.438 0.438 0.375 0.375 0.375 0.375 0.287 0.288 0.288 0.288 0.25 0.25 0.25 0.25                          
      gain on sale of business
          -39,000,000 240,000,000                                                                               
      net income attributable to noncontrolling interests
       -1,000,000 -1,000,000   -1,000,000 -3,000,000           -8,000,000 -2,000,000                                                                  
      administrative fees and other revenue
                 1,884,000,000 1,931,000,000 1,838,000,000 1,800,000,000 1,724,000,000 1,800,000,000 1,704,000,000 1,685,000,000 1,526,000,000 1,659,000,000 1,543,000,000 1,587,000,000 3,096,000,000 2,651,000,000 1,676,000,000 1,545,000,000 1,485,000,000 1,529,000,000 1,466,400,000                                                       
      net gains on financial instruments
                 -111,000,000 -57,000,000 -231,000,000                                                                       
      selling, general and administrative expense
                 4,562,000,000 4,514,000,000 4,269,000,000 4,341,000,000 4,222,000,000 3,946,000,000 3,821,000,000 3,925,000,000 4,318,000,000 5,305,000,000 4,046,000,000 3,781,000,000 3,502,000,000 3,418,000,000 3,278,000,000 3,166,000,000                                                          
      loss on extinguishment of debt
                     16,000,000  5,000,000             19,100,000            3,400,000 300,000 74,800,000 3,000,000 3,000,000  145,300,000                                    
      net income (income) attributable to noncontrolling interests
                   3,000,000 10,000,000                                                                      
      net incomees on financial instruments
                    -151,000,000                                                                      
      net realized gains on financial instruments
                     26,750,000 -61,000,000 172,000,000  -59,000,000 247,000,000 18,000,000 -24,000,000 24,000,000 1,000,000 11,000,000 78,000,000 -185,000,000 27,000,000 4,000,000 -26,100,000 6,600,000 114,700,000 16,200,000 7,300,000 28,700,000 88,800,000 12,500,000                                               
      net realized losses on financial instruments
                        -4,000,000                                                                  
      impairment losses on investments:
                                                                                          
      total impairment losses on investments
                         -29,750,000 -24,000,000  -101,000,000                                                              
      portion of impairment losses recognized in other comprehensive income
                         13,750,000 6,000,000 5,000,000 44,000,000                                                              
      impairment losses recognized in income
                         -16,000,000 -18,000,000  -57,000,000                                                              
      gain on extinguishment of debt
                         8,500,000 30,000,000 3,000,000 1,000,000                                                              
      net income per share
                                                                                          
      basic
                         2.27 0.88 9.02 6.03 3.7 4.64 4.44 6.03 1.64 3.7 4.07 5.13 4.78 2.87 3.23 3.82 2.35 2.97 2.69         1.953 2.21 2.67 2.92 1.56 2.17 1.96 2.56 1.02 1.92 1.92 2.48 1.44 1.86 1.73 1.99 5.81 1.55 1.44 1.17 0.67 1.61 1.44 1.08 1.52 1.47 1.37 1.28 1.3 1.31 1.2 1.12 1.06 1.05 0.92 1.01  
      diluted
                         2.23 0.87 8.91 5.94 3.64 4.55 4.36 5.91 1.61 3.62 3.98 4.99 4.65 2.8 3.16 3.73 1.96 2.3 2.91 2.63         1.923 2.16 2.64 2.89 1.55 2.15 1.94 2.53 1.01 1.9 1.89 2.44 1.42 1.84 1.71 1.96 5.76 1.53 1.43 1.16 0.67 1.6 1.44 1.07 1.5 1.45 1.35 1.26 1.28 1.29 1.17 1.09 1.04 1.02 0.9 0.98  
      impairment recoveries (losses) on investments:
                                                                                          
      total impairment recoveries (losses) on investments
                           6,000,000                                                               
      impairment recoveries (losses) recognized in income
                           11,000,000                                                               
      other-than-temporary impairment losses on investments:
                                                                                          
      total other-than-temporary impairment losses on investments
                             -17,000,000 -14,000,000 -9,000,000 -13,000,000 -9,000,000 -8,000,000 -4,400,000 -7,900,000 -12,200,000 -5,600,000 -7,300,000 -9,600,000 -13,000,000 -15,100,000 -33,800,000 -85,200,000 -31,700,000 -26,600,000 -26,200,000 -15,400,000 -14,300,000 -19,400,000 -11,700,000 -10,800,000 -26,600,000 -27,100,000 -9,000,000 -37,900,000 -17,200,000 -3,800,000 -6,500,000 -13,700,000 -70,000,000 -28,800,000 -11,100,000 -4,800,000 -17,600,000 -10,400,000 -14,900,000 -27,900,000 -56,500,000 -69,100,000 -107,800,000                   
      portion of other-than-temporary impairment losses recognized in other comprehensive income
                              1,000,000 2,000,000 3,000,000 1,000,000 2,000,000     100,000 1,500,000 1,200,000 4,100,000 8,100,000 18,300,000 3,200,000 7,500,000 4,400,000 1,400,000 800,000 5,600,000 800,000  800,000 900,000     600,000 2,800,000 10,400,000 5,900,000 2,700,000 2,400,000 7,200,000 7,200,000 8,800,000 8,200,000 16,000,000 38,400,000 33,800,000                   
      other-than-temporary impairment losses recognized in income
                             -17,000,000 -13,000,000 -7,000,000 -10,000,000 -8,000,000 -6,000,000 -4,400,000 -7,900,000 -12,200,000 -5,600,000 -7,200,000 -8,100,000 -11,800,000 -11,000,000 -25,700,000 -66,900,000 -28,500,000 -19,100,000 -21,800,000 -14,000,000 -13,500,000 -13,800,000 -10,900,000 -10,800,000 -25,800,000 -26,200,000 -9,000,000 -37,900,000 -17,200,000 -3,800,000 -5,900,000 -10,900,000 -59,600,000 -22,900,000 -8,400,000 -2,400,000 -10,400,000 -3,200,000 -6,100,000 -19,700,000 -40,500,000 -30,700,000 -74,000,000                   
      (gain) loss on extinguishment of debt
                             -250,000   -1,000,000 4,250,000 -1,000,000 -900,000          -7,500,000 -2,300,000 -2,900,000                                           
      selling, general and administrative expense:
                                                                                          
      selling expense
                                 243,000,000 330,000,000 323,600,000 318,200,000 353,500,000 347,900,000 345,500,000 348,600,000 351,600,000 338,500,000 351,500,000 349,900,000 350,000,000 359,100,000 363,800,000 368,200,000 356,300,000 374,300,000 388,700,000 370,800,000 387,000,000 377,300,000 376,700,000 385,900,000 410,400,000 390,200,000 393,000,000 393,300,000 411,200,000 403,000,000 405,600,000 397,000,000 404,100,000 400,700,000 403,100,000 402,400,000 411,700,000 420,600,000 421,200,000 432,000,000 440,800,000 448,200,000 445,100,000 444,300,000 433,400,000 430,800,000 429,600,000 423,000,000 424,200,000 415,700,000 413,200,000 401,400,000 376,500,000 370,600,000 367,600,000 359,500,000  
      general and administrative expense
                                 2,357,500,000 3,216,000,000 3,104,400,000 3,110,300,000 3,039,900,000 2,663,200,000 2,708,300,000 2,842,700,000 2,912,400,000 2,786,100,000 2,617,600,000 2,850,300,000 2,918,400,000 2,721,300,000 2,677,000,000 2,777,000,000 2,676,500,000 2,594,000,000 2,497,100,000 2,490,700,000 2,150,400,000 2,202,700,000 2,093,800,000 1,979,100,000 2,001,800,000 1,688,400,000 1,688,800,000 1,772,400,000 1,817,200,000 1,716,600,000 1,605,500,000 1,679,500,000 1,963,200,000 1,689,300,000 1,778,400,000 1,798,200,000 2,141,900,000 1,976,300,000 1,922,300,000 1,933,100,000 1,892,300,000 1,772,000,000 1,773,500,000 1,804,300,000 1,686,300,000 1,759,100,000 1,830,700,000 1,708,600,000 1,830,100,000 1,783,000,000 1,778,900,000 1,771,200,000 1,486,400,000 1,477,200,000 1,465,300,000 1,369,600,000  
      total selling, general and administrative expense
                                 2,600,500,000 3,546,000,000 3,428,000,000 3,428,500,000 3,393,400,000 3,011,100,000 3,053,800,000 3,191,300,000 3,264,000,000 3,124,600,000 2,969,100,000 3,200,200,000 3,268,400,000 3,080,400,000 3,040,800,000 3,145,200,000 3,032,800,000 2,968,300,000 2,885,800,000 2,861,500,000 2,537,400,000 2,580,000,000 2,470,500,000 2,365,000,000 2,412,200,000 2,078,600,000 2,081,800,000 2,165,700,000 2,228,400,000 2,119,600,000 2,011,100,000 2,076,500,000 2,367,300,000 2,090,000,000 2,181,500,000 2,200,600,000 2,553,600,000 2,396,900,000 2,343,500,000 2,365,100,000 2,333,100,000 2,220,200,000 2,218,600,000 2,248,600,000 2,119,700,000 2,189,900,000 2,260,300,000 2,131,600,000 2,254,300,000 2,198,700,000 2,192,100,000 2,172,600,000 1,862,900,000 1,847,800,000 1,832,900,000 1,729,100,000  
      administrative fees
                                    1,408,800,000 1,349,100,000 1,289,200,000 1,378,900,000 1,363,200,000 1,342,000,000 1,330,000,000 1,315,800,000 1,311,000,000 1,270,400,000 1,249,600,000 1,229,500,000 1,227,100,000 1,186,300,000 1,134,400,000 1,151,600,000 1,118,300,000 1,025,500,000 1,027,800,000 988,500,000 990,100,000 1,005,200,000 955,600,000 977,500,000 995,800,000 971,800,000 963,100,000 957,700,000 962,000,000 968,600,000 963,100,000 949,100,000 952,900,000 952,900,000 969,100,000 976,800,000 941,500,000 975,400,000 925,600,000 966,000,000 969,600,000 914,300,000 911,900,000 923,600,000 924,800,000 880,700,000 867,800,000 877,100,000 884,000,000 707,100,000 690,800,000 667,800,000 664,200,000  
      other revenue
                                    30,700,000 11,600,000 10,500,000 6,000,000 5,000,000 5,800,000 9,100,000 10,700,000 9,500,000 8,000,000 8,800,000 12,500,000 13,800,000 12,000,000 10,300,000 9,500,000 9,500,000 -320,200,000 124,300,000 115,700,000 120,600,000 106,000,000 141,000,000 34,800,000 15,900,000 13,400,000 10,400,000 8,500,000 8,700,000 7,700,000 4,600,000 18,300,000 5,900,000 119,400,000 167,200,000 165,700,000 154,000,000 159,800,000 153,100,000 166,100,000 162,600,000 137,000,000 149,200,000 146,000,000 150,200,000 144,500,000 150,400,000 146,400,000 151,800,000 146,900,000 144,500,000 135,900,000 139,200,000  
      selling, general and administrative and expense:
                                                                                          
      net realized gains on investments
                                            -125,100,000 30,600,000 -11,900,000 92,300,000 46,500,000 43,800,000 25,700,000 65,800,000 41,700,000 105,500,000 95,400,000 54,200,000 16,800,000 102,900,000 54,600,000 70,500,000 106,900,000 41,600,000 94,900,000 41,500,000 57,100,000 47,600,000 61,600,000 36,500,000 48,400,000 36,000,000 52,200,000 15,700,000  -543,200,000 -562,600,000 -27,800,000 -45,600,000 600,000 9,500,000 900,000 200,000 11,100,000 4,600,000 -8,900,000  -11,600,000 -400,000 2,800,000 -1,000,000  
      income from continuing operations before income tax expense
                                             374,300,000 1,129,600,000 1,558,000,000 1,569,100,000 887,100,000 1,087,200,000 1,263,700,000 1,130,100,000                                      
      income from continuing operations
                                             180,900,000 654,800,000 859,100,000 865,200,000 506,700,000 630,900,000 731,100,000 691,400,000                                      
      income from discontinued operations, net of tax
                                                    9,600,000                                      
      basic net income per share:
                                                                                          
      basic - continuing operations
                                             0.7 2.51 3.27 3.25 1.89 2.31 2.64 2.43                                      
      basic - discontinued operations
                                                    0.03                                      
      basic net income per share
                                             0.7 2.51 3.27 3.25 1.89 2.31 2.64 2.46                                      
      diluted net income per share:
                                                                                          
      diluted - continuing operations
                                             0.72 2.43 3.13 3.09 1.81 2.22 2.56 2.37                                      
      diluted - discontinued operations
                                                    0.03                                      
      diluted net income per share
                                             0.72 2.43 3.13 3.09 1.81 2.22 2.56 2.4                                      
      cost of products
                                                     49,000,000 68,600,000 62,400,000 65,000,000 64,200,000 66,500,000 6,700,000                               
      impairment of other intangible assets
                                                                 5,275,000   21,100,000                      
      cost of drugs
                                                                     72,600,000 112,700,000 121,300,000 112,400,000 117,000,000 114,100,000 118,500,000 118,900,000 96,700,000 99,400,000 106,100,000 98,000,000 68,200,000 71,400,000 85,800,000 75,800,000 69,500,000 73,800,000 71,100,000 73,600,000  
      impairment of intangible assets
                                                                     51,375,000 205,500,000    141,400,000                
      income tax benefit
                                                                     264,800,000 387,000,000                    
      net realized losses on investments
                                                                        -352,500,000            -7,100,000      
      income tax (benefit) expense
                                                                         113,825,000 -271,300,000                
      income before income taxes
                                                                                     712,225,000 1,023,400,000 896,600,000 928,900,000  
      income taxes
                                                                                     259,275,000 382,700,000 337,200,000 317,200,000  
    Balance Sheets:
    Quarterly
    Annual
      Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2014-03-31 2013-12-31 2013-09-30 2013-06-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-12-31 2011-09-30 2011-06-30 2011-03-31 2010-12-31 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2009-09-30 2009-06-30 2009-03-31 2008-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2006-12-31 2006-09-30 2006-06-30 2006-03-31 2005-12-31 2005-09-30 2005-06-30 2005-03-31 2004-12-31 
                                                                                            
        assets
                                                                                            
        current assets:
                                                                                            
        cash and cash equivalents
      9,657,000,000 9,491,000,000 8,713,000,000 8,560,000,000 7,500,000,000 8,288,000,000 7,866,000,000 6,497,000,000 6,226,000,000 6,526,000,000 10,919,000,000 9,991,000,000 10,142,000,000 7,387,000,000 8,872,000,000 6,456,000,000 6,161,000,000 4,880,000,000 5,490,000,000 5,258,000,000 9,326,000,000 5,741,000,000 3,984,000,000 6,028,000,000 5,345,000,000 4,937,000,000 4,190,000,000 4,078,000,000 4,482,000,000 3,934,000,000 4,260,000,000 4,682,000,000 4,630,600,000 3,608,900,000 6,097,200,000 4,561,200,000 6,772,400,000 4,075,300,000 2,546,000,000 1,582,700,000 1,676,000,000 2,113,500,000 1,547,800,000 1,553,000,000 1,397,000,000 2,151,700,000 1,717,900,000 1,784,600,000 1,971,200,000 1,582,100,000 2,185,700,000 1,347,300,000 1,665,300,000 2,484,600,000 2,442,100,000 1,953,100,000 2,279,100,000 2,201,600,000 2,508,400,000 1,699,800,000 2,402,000,000 1,788,800,000 2,246,200,000 2,027,900,000 3,526,200,000 4,816,100,000 1,842,200,000 1,724,600,000 2,378,100,000 2,183,900,000 2,270,600,000 2,273,800,000 2,552,100,000 2,767,900,000 2,824,000,000 4,205,100,000 3,402,000,000 2,602,100,000 2,229,500,000 1,934,400,000 2,140,000,000 2,740,200,000 2,163,300,000 1,953,300,000 1,490,900,000 1,457,200,000 
        fixed maturity securities
      25,905,000,000 25,884,000,000 26,283,000,000 25,298,000,000 25,437,000,000 25,201,000,000 28,954,000,000 28,900,000,000 29,530,000,000 29,614,000,000 27,811,000,000 28,021,000,000 27,636,000,000 25,952,000,000 25,526,000,000 25,765,000,000 26,219,000,000 26,267,000,000 26,348,000,000 25,848,000,000 24,555,000,000 562,000,000 22,707,000,000 22,018,000,000 19,881,000,000 505,000,000 518,000,000 509,000,000 492,000,000 487,000,000 496,000,000 487,500,000 501,500,000 17,377,300,000 18,697,300,000 18,948,200,000 17,949,700,000 17,163,100,000 18,218,600,000 18,563,200,000 18,355,400,000 16,920,000,000 17,898,000,000 18,236,500,000 18,804,700,000 17,467,400,000 18,284,700,000 18,329,400,000 18,004,000,000 17,038,200,000 17,538,000,000 17,679,800,000 17,819,100,000 16,912,900,000 18,485,500,000 17,206,100,000 16,196,500,000 15,913,100,000 16,479,400,000 16,462,700,000 15,761,300,000 16,069,500,000 16,733,900,000 15,579,500,000 15,601,100,000 15,696,900,000 15,334,500,000 14,765,900,000 1,774,200,000 1,561,300,000 1,640,600,000 1,632,400,000 1,743,400,000 1,832,600,000 1,845,300,000 1,682,000,000 1,607,100,000 465,400,000 466,100,000 481,200,000 515,300,000 15,332,200,000 13,012,700,000 13,322,200,000   
        equity securities
      1,511,000,000 740,000,000 1,220,000,000 934,000,000 715,000,000 1,192,000,000 1,113,000,000 594,000,000 511,000,000 229,000,000 165,000,000 272,000,000 392,000,000 953,000,000 1,503,000,000 1,572,000,000 1,662,000,000 1,881,000,000 2,119,000,000 1,746,000,000 3,630,000,000 1,559,000,000 3,075,000,000 3,470,000,000 570,000,000 30,000,000 29,000,000 33,000,000 33,000,000 33,000,000 34,000,000 32,900,000 32,900,000 3,599,200,000 1,452,600,000 1,823,800,000 1,813,300,000 1,468,500,000 1,480,800,000 1,633,500,000 1,593,800,000 1,441,800,000 1,515,900,000 1,705,400,000 2,103,400,000 1,906,600,000 1,848,300,000 1,887,500,000 1,963,500,000 1,735,500,000 1,484,900,000 1,410,100,000 1,355,400,000 1,212,400,000 1,187,400,000 1,139,400,000 1,224,400,000 1,188,100,000 1,164,800,000 1,375,500,000 1,356,600,000 1,236,200,000 1,072,900,000 962,200,000 1,056,600,000 1,010,700,000 1,025,300,000 851,100,000 810,300,000 1,091,500,000 1,527,500,000 1,908,800,000 2,066,400,000 1,893,700,000 2,081,900,000 2,091,800,000 2,124,600,000 1,984,500,000 1,808,700,000 1,501,000,000 1,579,700,000 1,448,200,000 1,566,700,000 1,341,800,000   
        premium receivables
      11,525,000,000 10,073,000,000 9,535,000,000 10,465,000,000 10,359,000,000 8,011,000,000 7,209,000,000 8,040,000,000 8,931,000,000 7,902,000,000 7,883,000,000 7,431,000,000 8,246,000,000 7,083,000,000 6,682,000,000 6,757,000,000 7,349,000,000 5,681,000,000 6,008,000,000 5,834,000,000 6,111,000,000 5,279,000,000 5,343,000,000 5,456,000,000 5,786,000,000 5,173,000,000 4,782,000,000 4,751,000,000 5,049,000,000 4,465,000,000 4,312,000,000 4,268,300,000                                                       
        self-funded receivables
      5,098,000,000 5,162,000,000 5,122,000,000 5,454,000,000 5,246,000,000 5,044,000,000 5,135,000,000 5,297,000,000 4,242,000,000 4,558,000,000 3,756,000,000 3,896,000,000 3,786,000,000 4,663,000,000 3,873,000,000 3,844,000,000 3,979,000,000 4,010,000,000 3,349,000,000 3,605,000,000 3,109,000,000 2,849,000,000 2,985,000,000 2,460,000,000 2,613,000,000 2,411,000,000 2,555,000,000 2,534,000,000 2,491,000,000 2,278,000,000 2,631,000,000 2,650,000,000                                                       
        other receivables
      6,167,000,000 6,307,000,000 7,692,000,000 7,206,000,000 6,576,000,000 6,016,000,000 6,055,000,000 5,881,000,000 5,120,000,000 5,405,000,000 5,293,000,000 5,196,000,000 4,678,000,000 4,298,000,000 3,651,000,000 3,600,000,000 3,334,000,000 3,749,000,000 3,450,000,000 3,246,000,000 3,071,000,000 2,830,000,000 3,209,000,000 3,072,000,000 2,926,000,000 2,634,000,000 2,870,000,000 2,633,000,000 2,639,000,000 2,558,000,000 2,374,000,000 2,182,600,000 2,305,200,000 2,266,500,000 2,130,200,000 2,525,400,000 2,445,600,000 2,536,600,000 2,016,200,000 2,125,200,000 2,200,900,000 2,421,400,000 2,157,400,000 2,368,000,000 2,549,700,000 2,117,000,000 1,680,700,000 1,333,500,000 1,234,000,000 1,063,300,000 1,018,300,000 994,100,000 928,200,000 928,800,000 847,300,000 935,500,000 943,200,000 943,900,000 991,600,000 909,500,000 916,500,000 878,600,000 908,400,000 1,224,100,000 1,038,100,000 879,500,000 505,000,000 515,300,000 1,400,500,000 1,373,900,000 1,347,800,000 1,274,600,000 1,160,500,000 996,400,000 1,161,800,000 1,261,200,000 1,145,800,000 1,172,700,000 1,129,900,000 1,148,900,000 1,022,500,000 831,400,000 945,900,000 1,298,300,000 953,200,000 876,400,000 
        other current assets
      7,169,000,000 5,344,000,000 5,213,000,000 5,407,000,000 5,288,000,000 4,700,000,000 5,949,000,000 6,464,000,000 6,388,000,000 5,795,000,000 5,358,000,000 4,936,000,000 4,943,000,000 5,281,000,000 5,496,000,000 5,661,000,000 5,193,000,000 4,654,000,000 5,140,000,000 4,701,000,000 4,693,000,000 4,060,000,000 4,147,000,000 4,260,000,000 4,135,000,000 2,319,000,000 2,113,000,000 2,151,000,000 2,172,000,000 2,104,000,000 2,875,000,000 3,106,100,000 3,552,300,000 2,249,300,000 1,822,000,000 1,774,600,000 1,823,600,000 1,781,800,000 1,906,800,000 2,083,300,000 2,494,100,000 1,555,700,000 1,878,000,000 2,178,800,000 2,534,100,000 1,474,600,000 1,922,100,000 2,165,800,000 2,417,600,000 1,677,500,000 1,807,800,000 1,823,000,000 1,891,000,000 1,829,000,000 1,875,500,000 1,913,600,000 1,920,600,000 1,859,000,000 1,600,500,000 1,601,500,000 1,639,300,000 1,534,100,000 1,297,100,000 1,318,700,000 1,323,800,000 1,268,600,000 1,154,000,000 1,141,900,000 1,220,900,000 1,212,200,000 1,050,700,000 1,106,200,000 1,123,800,000 1,050,400,000 1,318,300,000 1,315,100,000 1,318,000,000 1,284,500,000 1,158,400,000 1,167,800,000 1,189,300,000 1,022,700,000 783,300,000 800,700,000 783,400,000 769,900,000 
        total current assets
      67,032,000,000 63,001,000,000 63,778,000,000 63,324,000,000 61,121,000,000 58,942,000,000 62,846,000,000 62,274,000,000 60,948,000,000 60,029,000,000 61,185,000,000 59,743,000,000 59,823,000,000 55,617,000,000 55,603,000,000 53,655,000,000 53,897,000,000 51,122,000,000 51,904,000,000 50,238,000,000 54,495,000,000 45,751,000,000 45,450,000,000 46,764,000,000 41,256,000,000 39,033,000,000 39,504,000,000 37,805,000,000 36,611,000,000 34,321,000,000 37,108,000,000 37,370,400,000 36,974,100,000 36,262,800,000 36,973,700,000 37,130,700,000 37,981,800,000 34,314,900,000 32,924,300,000 32,957,700,000 32,965,000,000 30,862,100,000 31,539,400,000 33,202,200,000 34,740,400,000 32,228,900,000 32,227,100,000 32,428,200,000 31,806,800,000 29,745,800,000 29,596,900,000 28,900,800,000 28,660,700,000 28,268,400,000 29,640,300,000 28,470,100,000 27,543,600,000 27,097,400,000 27,552,300,000 26,756,800,000 26,819,400,000 26,140,800,000 26,939,400,000 26,081,700,000 27,116,500,000 28,070,700,000 25,362,500,000 25,001,400,000 12,483,200,000 12,130,000,000 12,677,900,000 13,040,400,000 13,409,500,000 13,031,800,000 13,687,700,000 15,151,800,000 14,018,400,000 11,806,700,000 11,637,000,000 10,585,100,000 11,011,800,000 25,944,800,000 21,572,400,000 21,456,800,000 20,480,100,000 19,357,500,000 
        long-term investments:
                                                                                            
        other invested assets
      11,009,000,000 10,839,000,000 10,648,000,000 10,466,000,000 10,167,000,000 9,749,000,000 9,394,000,000 6,810,000,000 6,713,000,000 6,107,000,000 6,118,000,000 5,993,000,000 5,971,000,000 5,685,000,000 5,516,000,000 5,398,000,000 5,365,000,000 5,225,000,000 4,959,000,000 4,917,000,000 4,474,000,000 4,285,000,000 4,170,000,000 4,097,000,000 4,181,000,000 4,228,000,000 3,914,000,000 3,719,000,000 3,710,000,000 3,726,000,000 3,572,000,000 3,495,200,000 3,460,800,000                                                      
        property and equipment
      4,657,000,000 4,679,000,000 4,657,000,000 4,641,000,000 4,617,000,000 4,652,000,000 4,505,000,000 4,450,000,000 4,451,000,000 4,359,000,000 4,248,000,000 4,547,000,000 4,418,000,000 4,316,000,000 4,197,000,000 4,090,000,000 3,986,000,000 3,919,000,000 3,835,000,000 3,733,000,000 3,533,000,000 3,483,000,000 3,363,000,000 3,427,000,000 3,350,000,000 3,133,000,000 2,921,000,000 2,837,000,000 2,799,000,000 2,735,000,000 2,592,000,000 2,392,200,000 2,237,600,000 2,174,900,000 2,049,200,000 1,975,700,000 1,957,600,000 1,977,900,000 2,006,600,000 1,989,800,000 1,998,300,000 2,019,800,000 1,930,800,000 1,931,400,000 1,915,900,000 1,944,300,000 1,848,900,000 1,829,200,000 1,811,700,000 1,801,500,000 1,806,500,000 1,769,500,000 1,738,100,000 1,738,300,000 1,536,500,000 1,478,400,000 1,454,600,000 1,418,100,000 1,316,900,000 1,212,900,000 1,186,100,000 1,155,500,000 1,206,700,000 1,171,200,000 1,144,500,000 1,099,600,000 1,067,600,000 1,038,200,000 1,051,800,000 1,054,500,000 1,019,400,000 1,014,200,000 1,002,700,000 995,900,000 957,800,000 968,700,000 979,200,000 988,600,000 993,400,000 1,014,900,000 1,047,400,000 1,078,600,000 966,800,000 999,600,000 1,018,700,000 1,045,200,000 
        goodwill
      28,340,000,000 28,344,000,000 28,451,000,000 28,368,000,000 28,420,000,000 28,277,000,000 25,967,000,000 25,962,000,000 25,947,000,000 25,317,000,000 25,291,000,000 25,274,000,000 25,273,000,000 24,383,000,000 24,381,000,000 24,367,000,000 24,251,000,000 24,228,000,000 24,184,000,000 24,399,000,000 21,708,000,000 21,691,000,000 21,687,000,000 21,641,000,000 21,661,000,000 20,500,000,000 20,500,000,000 20,500,000,000 20,500,000,000 20,504,000,000 20,468,000,000 20,414,500,000 20,185,500,000 19,231,200,000 17,587,800,000 17,561,200,000 17,561,200,000 17,561,200,000 17,562,200,000 17,562,200,000 17,562,200,000 17,562,200,000 17,550,600,000 17,541,700,000 17,570,900,000 17,082,000,000 17,082,000,000 17,082,900,000 16,916,700,000 16,917,200,000 17,497,600,000 17,488,600,000 17,489,500,000 17,510,500,000 14,469,100,000 14,534,300,000 13,858,600,000 13,858,700,000 13,846,900,000 13,263,700,000 13,264,500,000 13,264,900,000 13,265,400,000 13,265,500,000 13,265,700,000 13,264,600,000 13,307,600,000 13,308,900,000 13,460,300,000 13,461,300,000 13,582,100,000 13,539,800,000 13,429,400,000 13,435,400,000 13,544,500,000 13,337,800,000 13,449,600,000 13,383,500,000 13,455,900,000 13,449,200,000 13,465,500,000 13,469,100,000 10,149,400,000 10,044,600,000 9,775,600,000 10,017,900,000 
        other intangible assets
      11,093,000,000 11,200,000,000 11,327,000,000 11,490,000,000 11,940,000,000 12,094,000,000 10,325,000,000 10,447,000,000 10,710,000,000 10,273,000,000 10,491,000,000 10,703,000,000 10,915,000,000 10,315,000,000 10,536,000,000 10,762,000,000 10,588,000,000 10,615,000,000 10,749,000,000 10,540,000,000 9,352,000,000 9,405,000,000 9,497,000,000 9,577,000,000 9,613,000,000 8,674,000,000 8,756,000,000 8,840,000,000 8,925,000,000 9,007,000,000 9,101,000,000 9,224,300,000 9,076,000,000 8,368,400,000 7,840,600,000 7,882,400,000 7,923,000,000 7,964,900,000 8,012,300,000 8,059,700,000 8,107,600,000 8,158,000,000 8,215,500,000 8,275,500,000 8,293,600,000 7,958,100,000 8,010,600,000 8,071,000,000 8,387,300,000 8,441,000,000 8,921,600,000 8,988,100,000 9,055,800,000 9,102,800,000 8,210,500,000 8,126,200,000 7,878,100,000 7,931,700,000 7,994,200,000 7,883,400,000 7,940,100,000 7,996,800,000 8,056,500,000 8,116,900,000 8,177,800,000 8,259,300,000 8,341,400,000 8,612,800,000 8,761,700,000 8,827,200,000 8,895,100,000 9,084,000,000 9,149,700,000 9,220,800,000 9,296,900,000 9,254,500,000 9,325,400,000 9,396,200,000 9,469,000,000 9,538,100,000 9,612,600,000 9,686,400,000 8,041,500,000 8,122,200,000 8,138,100,000 8,211,600,000 
        other noncurrent assets
      2,582,000,000 2,310,000,000 2,777,000,000 2,562,000,000 2,392,000,000 2,140,000,000 2,603,000,000 2,196,000,000 2,245,000,000 1,967,000,000 2,329,000,000 2,133,000,000 1,857,000,000 1,704,000,000 2,171,000,000 2,002,000,000 1,803,000,000 1,719,000,000 1,804,000,000 1,689,000,000 1,563,000,000 1,438,000,000 1,849,000,000 1,950,000,000 1,833,000,000 1,350,000,000 1,667,000,000 1,608,000,000 1,453,000,000 758,000,000 1,074,000,000 950,400,000 832,000,000 565,300,000 850,900,000 778,400,000 640,500,000 467,900,000 1,168,500,000 862,200,000 609,800,000 485,400,000 661,300,000 864,300,000 746,000,000 619,900,000 664,800,000 675,900,000 635,800,000 645,200,000 456,000,000 464,700,000 483,300,000 486,100,000 451,900,000 458,600,000 445,700,000 433,600,000 539,100,000 557,300,000 542,200,000 488,300,000 455,100,000 439,100,000 412,500,000 393,000,000 376,100,000 364,800,000 386,400,000 387,900,000 723,900,000 681,100,000 713,800,000 660,800,000 528,600,000 504,500,000 499,800,000 497,400,000 505,500,000 409,700,000 410,600,000 410,900,000 432,100,000 357,000,000 335,600,000 358,100,000 
        total assets
      125,827,000,000 121,494,000,000 122,749,000,000 121,938,000,000 119,717,000,000 116,889,000,000 116,533,000,000 112,988,000,000 111,894,000,000 108,928,000,000 110,478,000,000 109,168,000,000 109,040,000,000 102,772,000,000 103,026,000,000 100,877,000,000 100,486,000,000 97,460,000,000 98,060,000,000 96,097,000,000 95,683,000,000 86,615,000,000 86,574,000,000 87,976,000,000 82,399,000,000 77,453,000,000 77,809,000,000 75,851,000,000 74,523,000,000 71,571,000,000 74,445,000,000 74,367,400,000 73,300,400,000 70,540,000,000 68,309,900,000 68,237,600,000 68,943,500,000 65,083,100,000 64,399,900,000 64,062,600,000 63,858,700,000 61,717,800,000 62,335,600,000 64,263,800,000 65,546,000,000 62,065,000,000 62,058,200,000 62,303,600,000 61,685,500,000 59,574,500,000 60,263,500,000 59,612,300,000 59,408,600,000 58,955,400,000 55,817,900,000 54,535,000,000 52,496,500,000 52,018,800,000 52,549,900,000 50,877,200,000 50,918,000,000 50,166,900,000 51,032,400,000 50,160,000,000 51,180,900,000 52,125,400,000 49,497,500,000 49,344,300,000 49,414,800,000 48,403,200,000 49,758,600,000 50,975,900,000 51,555,700,000 52,060,000,000 52,899,700,000 54,194,100,000 53,489,200,000 51,759,800,000 51,484,200,000 50,091,800,000 51,365,700,000 51,405,200,000 41,855,600,000 41,691,300,000 40,487,900,000 39,738,400,000 
        liabilities and equity
                                                                                            
        liabilities
                                                                                            
        current liabilities:
                                                                                            
        medical claims payable
      18,425,000,000 17,084,000,000 17,148,000,000 17,155,000,000 16,812,000,000 15,746,000,000 15,346,000,000 15,204,000,000 16,459,000,000 16,111,000,000 16,176,000,000 16,165,000,000 15,728,000,000 15,596,000,000 15,242,000,000 15,127,000,000 14,713,000,000 13,518,000,000 13,562,000,000 13,076,000,000 12,347,000,000 11,359,000,000 10,252,000,000 9,878,000,000 9,902,000,000 8,842,000,000 8,977,000,000 8,758,000,000 8,242,000,000 7,454,000,000 7,658,000,000 7,545,300,000 7,640,300,000 7,991,500,000 7,963,900,000 7,969,500,000 7,920,600,000 7,892,600,000 7,472,900,000 7,498,600,000 7,403,100,000 7,569,800,000 7,110,100,000 7,177,900,000 7,177,100,000 6,861,200,000 6,794,200,000 6,945,100,000 6,707,100,000 6,127,200,000 6,117,300,000 6,158,300,000 6,215,400,000 6,174,500,000 5,523,200,000 5,415,900,000 5,403,300,000 5,489,000,000 5,459,700,000 5,341,600,000 5,070,500,000 4,852,400,000 4,956,300,000 5,080,500,000 5,487,300,000 5,450,500,000 5,763,200,000 5,905,500,000 6,168,000,000 6,184,700,000 6,272,500,000 6,270,300,000 6,398,100,000 5,788,000,000 5,785,400,000 5,702,900,000 5,671,300,000 5,290,300,000 5,309,100,000 5,162,600,000 5,162,500,000 4,923,400,000 4,182,300,000 4,302,900,000 4,349,800,000 4,202,000,000 
        other policyholder liabilities
      3,857,000,000 3,632,000,000 2,447,000,000 3,540,000,000 3,796,000,000 4,204,000,000 4,402,000,000 4,939,000,000 5,298,000,000 5,600,000,000 5,681,000,000 5,954,000,000 6,098,000,000 5,933,000,000 5,482,000,000 5,577,000,000 5,396,000,000 5,521,000,000 5,201,000,000 5,285,000,000 5,075,000,000 4,590,000,000 3,804,000,000 3,586,000,000 3,252,000,000 3,050,000,000 2,503,000,000 2,586,000,000 2,577,000,000 2,590,000,000 2,929,000,000 3,009,800,000 2,918,800,000 2,950,300,000 2,471,700,000 2,447,500,000 2,311,200,000 2,221,100,000 2,092,000,000 2,390,800,000 2,376,700,000 2,256,500,000 2,493,100,000 2,741,400,000 2,782,500,000 2,626,500,000 2,598,000,000 2,190,300,000 2,020,400,000 2,073,200,000 2,322,600,000 2,288,900,000 2,359,700,000 2,345,700,000 2,229,000,000 2,277,300,000 2,257,600,000 2,278,200,000 2,000,500,000 1,955,600,000 2,003,800,000 1,909,100,000 1,705,100,000 1,939,100,000 1,652,900,000 1,617,600,000 1,566,200,000 1,549,500,000 1,677,700,000 1,626,800,000 1,617,100,000 1,620,200,000 1,724,300,000 1,832,200,000 2,212,400,000 2,117,700,000 2,323,700,000 2,240,600,000 2,147,300,000 1,928,500,000 1,945,200,000 1,761,100,000 1,245,300,000 1,219,900,000 1,214,200,000 1,209,500,000 
        unearned income
      1,759,000,000 1,493,000,000 1,831,000,000 1,561,000,000 1,640,000,000 1,508,000,000 1,793,000,000 1,481,000,000 1,474,000,000 1,402,000,000 4,332,000,000 4,458,000,000 4,394,000,000 1,112,000,000 3,702,000,000 971,000,000 1,210,000,000 1,153,000,000 954,000,000 1,081,000,000 1,139,000,000 1,259,000,000 961,000,000 946,000,000 947,000,000 1,017,000,000 948,000,000 900,000,000 998,000,000 902,000,000 896,000,000 2,089,900,000 2,115,900,000 860,300,000 1,950,200,000 1,837,800,000 1,926,100,000 971,900,000 1,613,400,000 832,800,000 1,021,300,000 1,145,500,000 945,100,000 950,500,000 1,079,800,000 1,078,100,000 1,003,500,000 953,500,000 1,073,000,000 822,700,000 939,700,000 823,600,000 865,700,000 968,300,000 823,700,000 1,707,800,000 1,624,100,000 926,500,000 1,638,600,000 1,038,100,000 1,048,000,000 891,400,000 989,400,000 1,035,200,000 1,117,700,000 1,050,000,000 1,089,100,000 1,066,900,000 1,153,100,000 1,087,700,000 1,050,600,000 1,054,600,000 1,151,000,000 1,114,600,000 985,700,000 1,665,700,000 1,655,800,000 987,900,000 1,057,700,000 1,596,500,000 1,635,300,000 1,057,100,000 1,173,000,000 1,052,800,000 1,087,500,000 1,046,600,000 
        accounts payable and accrued expenses
      6,209,000,000 7,322,000,000 6,085,000,000 7,278,000,000 7,131,000,000 6,927,000,000 6,255,000,000 5,760,000,000 5,658,000,000 6,910,000,000 5,983,000,000 5,033,000,000 4,873,000,000 5,607,000,000 4,963,000,000 5,850,000,000 5,493,000,000 4,970,000,000 5,960,000,000 5,598,000,000 5,329,000,000 5,493,000,000 5,550,000,000 5,257,000,000 5,058,000,000 4,198,000,000 4,445,000,000 4,028,000,000 3,951,000,000 4,959,000,000 6,286,000,000 5,931,400,000 5,816,700,000 5,024,400,000 4,454,200,000 3,815,700,000 3,622,100,000 4,014,900,000 3,717,200,000 4,272,200,000 4,164,500,000 3,318,800,000 3,293,300,000 4,433,800,000 4,454,700,000 3,651,800,000 3,447,600,000 4,263,800,000 4,113,100,000 3,426,300,000 3,301,200,000 3,286,600,000 2,936,800,000 3,132,500,000 2,648,500,000 2,788,500,000 2,809,900,000 3,124,100,000 2,814,800,000 2,599,700,000 2,667,400,000 2,942,200,000 2,752,700,000 2,634,300,000 2,686,700,000 2,994,100,000 2,761,800,000 2,754,000,000 3,003,600,000 2,856,500,000 2,798,400,000 2,834,400,000 3,016,700,000 2,909,600,000 3,046,100,000 2,769,600,000 2,787,900,000 3,242,200,000 3,244,200,000 2,656,400,000 2,459,800,000 2,860,400,000 2,250,800,000 1,946,000,000 1,826,900,000 2,222,100,000 
        short-term borrowings
      724,000,000 150,000,000 180,000,000 360,000,000 250,000,000 365,000,000 360,000,000 225,000,000 1,575,000,000 225,000,000  265,000,000 265,000,000 265,000,000 265,000,000 175,000,000 275,000,000 275,000,000 175,000,000 175,000,000   150,000,000  1,075,000,000 700,000,000 710,000,000 1,010,000,000 1,095,000,000 1,145,000,000 1,270,000,000 1,120,000,000 1,125,000,000 1,275,000,000 1,180,000,000 580,000,000 540,000,000 440,000,000 440,000,000 440,000,000 540,000,000 540,000,000 540,000,000 540,000,000 450,000,000 400,000,000 100,000,000 250,000,000 590,000,000 400,000,000 350,000,000 350,000,000 350,000,000 250,000,000 192,000,000 200,000,000 100,000,000 100,000,000 100,000,000 100,000,000 100,000,000 100,000,000 100,000,000 100,000,000   100,000,000 100,000,000 100,000,000 98,000,000 100,000,000                
        current portion of long-term debt
      350,000,000 1,099,000,000 749,000,000 1,648,000,000 1,643,000,000 1,649,000,000 2,100,000,000 2,900,000,000 2,900,000,000 1,649,000,000 799,000,000   1,500,000,000 2,249,000,000 2,248,000,000 3,097,000,000 1,599,000,000 849,000,000 849,000,000 700,000,000 700,000,000 1,599,000,000 1,603,000,000 1,603,000,000 1,598,000,000 700,000,000 850,000,000 851,000,000 849,000,000 849,000,000 650,200,000 650,800,000 1,274,600,000 1,273,400,000 624,400,000 1,152,800,000 928,400,000 927,900,000 927,900,000 399,200,000   624,900,000 625,000,000 625,000,000 625,000,000 509,400,000 518,700,000 518,000,000 100,000 399,600,000 399,400,000 557,100,000 200,000 813,700,000 910,800,000 1,274,500,000 1,274,100,000 456,300,000 359,200,000 705,900,000 706,500,000 1,113,800,000 759,900,000 60,800,000 377,800,000 558,100,000 710,500,000 909,700,000 623,700,000 19,200,000 19,900,000 20,400,000 321,500,000 520,000,000 520,900,000 521,000,000 221,500,000 22,400,000 476,100,000 481,200,000 459,600,000 612,700,000   
        other current liabilities
      13,985,000,000 10,255,000,000 12,438,000,000 12,292,000,000 11,426,000,000 10,029,000,000 11,614,000,000 11,139,000,000 10,970,000,000 9,894,000,000 10,366,000,000 9,696,000,000 10,531,000,000 9,683,000,000 9,384,000,000 9,360,000,000 9,549,000,000 7,849,000,000 8,461,000,000 7,730,000,000 10,159,000,000 6,052,000,000 6,245,000,000 7,252,000,000 5,202,000,000 3,692,000,000 3,867,000,000 3,935,000,000 4,037,000,000 3,190,000,000 3,306,000,000 3,302,800,000 3,475,500,000 3,343,000,000 3,788,400,000 3,668,900,000 3,643,100,000 3,581,300,000 3,129,900,000 2,762,100,000 2,883,900,000 2,816,100,000 2,282,800,000 2,246,300,000 2,171,700,000 1,861,200,000 1,903,600,000 1,901,900,000 1,805,900,000 1,674,700,000 1,828,800,000 1,844,900,000 1,848,000,000 1,713,500,000 1,766,600,000 1,958,300,000 1,660,100,000 1,654,100,000 1,582,400,000 1,640,000,000 1,550,000,000 1,617,300,000 1,652,600,000 1,860,500,000 1,800,200,000 1,775,200,000 1,580,900,000 1,687,800,000 1,766,600,000 1,657,600,000 1,881,400,000 1,965,000,000 1,861,400,000 1,755,000,000 1,648,300,000 1,682,500,000 1,510,600,000 1,397,400,000 1,399,500,000 1,451,300,000 1,410,400,000 1,286,800,000 1,099,300,000 1,198,000,000 1,381,900,000 1,583,700,000 
        total current liabilities
      45,309,000,000 41,035,000,000 40,878,000,000 43,834,000,000 42,698,000,000 40,581,000,000 42,033,000,000 41,813,000,000 44,334,000,000 41,791,000,000 43,337,000,000 41,571,000,000 41,889,000,000 39,696,000,000 41,287,000,000 39,308,000,000 39,733,000,000 34,885,000,000 35,162,000,000 33,794,000,000 34,749,000,000 29,453,000,000 28,561,000,000 28,522,000,000 27,039,000,000 23,617,000,000 23,234,000,000 23,090,000,000 22,682,000,000 21,965,000,000 24,174,000,000 24,505,700,000 24,755,900,000 23,356,000,000 24,412,500,000 22,567,900,000 23,174,200,000 21,294,400,000 21,036,900,000 20,816,800,000 20,810,300,000 19,092,600,000 18,365,800,000 20,673,200,000 21,305,400,000 18,753,400,000 18,395,000,000 19,176,300,000 18,493,700,000 16,351,500,000 16,042,400,000 16,034,100,000 16,030,100,000 15,836,900,000 14,083,100,000 16,177,800,000 15,955,100,000 15,825,700,000 15,786,300,000 14,107,300,000 14,160,300,000 14,009,500,000 14,141,500,000 14,836,500,000 14,810,500,000 14,673,700,000 14,126,400,000 14,342,300,000 15,340,800,000 15,020,300,000 15,062,100,000 14,558,200,000 15,291,600,000 14,388,200,000 15,079,000,000 15,769,500,000 15,755,200,000 15,323,400,000 14,950,600,000 14,342,700,000 15,512,100,000 14,857,200,000 12,281,900,000 12,782,000,000 11,853,400,000 11,570,600,000 
        long-term debt, less current portion
      30,768,000,000 30,797,000,000 31,173,000,000 28,178,000,000 28,110,000,000 29,218,000,000 24,688,000,000 24,561,000,000 21,976,000,000 23,246,000,000 24,045,000,000 24,859,000,000 25,201,000,000 22,349,000,000 21,258,000,000 21,165,000,000 19,883,000,000 21,157,000,000 21,761,000,000 22,217,000,000 22,534,000,000 19,335,000,000 19,094,000,000 19,873,000,000 19,005,000,000 17,787,000,000 18,820,000,000 17,436,000,000 17,396,000,000 17,217,000,000 17,300,000,000 17,515,400,000 18,110,100,000 17,382,200,000 13,777,300,000 15,088,000,000 15,449,900,000 14,358,500,000 14,242,300,000 14,202,400,000 14,864,500,000 15,324,500,000 15,719,600,000 15,468,400,000 14,764,400,000 14,127,200,000 14,538,300,000 14,037,800,000 13,932,100,000 13,573,600,000 14,514,000,000 14,091,500,000 14,030,000,000 14,170,800,000 13,395,700,000 10,135,600,000 8,462,500,000 8,420,900,000 8,622,300,000 8,292,100,000 8,542,000,000 8,147,800,000 8,217,200,000 7,334,800,000 7,630,400,000 8,338,300,000 8,384,400,000 8,513,700,000 8,527,100,000 7,833,900,000 8,491,300,000 9,750,100,000 9,266,500,000 9,023,500,000 8,381,000,000 7,652,200,000 6,585,600,000 6,493,200,000 7,122,200,000 7,446,400,000 6,663,900,000 6,324,700,000     
        deferred tax liabilities
      1,786,000,000 2,110,000,000 2,315,000,000 2,008,000,000 2,121,000,000 2,148,000,000 2,092,000,000 2,037,000,000 2,201,000,000 1,970,000,000 1,779,000,000 1,852,000,000 2,029,000,000 2,034,000,000 1,825,000,000 2,021,000,000 2,349,000,000 2,805,000,000 2,629,000,000 2,397,000,000 1,961,000,000 2,019,000,000 2,375,000,000 2,497,000,000 2,213,000,000 2,227,000,000 2,140,000,000 2,211,000,000 2,116,000,000 1,960,000,000 2,063,000,000 1,902,200,000 1,812,900,000 1,726,500,000 2,609,300,000 2,632,700,000 2,663,900,000 2,779,900,000 2,688,900,000 2,704,900,000 2,663,600,000 2,630,600,000 3,169,400,000 3,226,200,000 3,357,700,000 3,226,000,000 3,284,200,000 3,216,900,000 3,343,100,000 3,325,200,000 3,322,900,000 3,320,800,000 3,287,900,000 3,381,000,000 2,841,500,000 2,868,400,000 2,773,200,000 2,724,000,000 2,754,700,000 2,639,300,000 2,637,300,000 2,586,900,000 2,621,600,000 2,481,000,000 2,501,000,000 2,470,400,000 2,229,800,000 2,302,200,000 2,118,500,000 2,098,900,000                 
        other noncurrent liabilities
      3,922,000,000 3,381,000,000 4,137,000,000 3,904,000,000 3,994,000,000 3,326,000,000 3,593,000,000 1,985,000,000 1,908,000,000 1,738,000,000 1,971,000,000 1,777,000,000 1,650,000,000 1,562,000,000 1,788,000,000 1,694,000,000 1,679,000,000 1,683,000,000 1,912,000,000 1,869,000,000 1,745,000,000 1,815,000,000 1,839,000,000 1,853,000,000 1,695,000,000 1,420,000,000 1,622,000,000 1,666,000,000 1,612,000,000 1,182,000,000 1,145,000,000 1,074,400,000 942,300,000 925,100,000 944,000,000 898,300,000 889,900,000 883,800,000 1,040,700,000 1,479,800,000 1,319,900,000 994,300,000 1,228,700,000 1,225,800,000 1,099,400,000 1,035,800,000 891,000,000 852,700,000 832,400,000 836,000,000 874,200,000 945,800,000 971,800,000 1,013,200,000 957,900,000 1,013,300,000 1,025,000,000 1,029,300,000 965,100,000 1,019,200,000 958,200,000 963,400,000 1,036,600,000 1,060,300,000 1,056,000,000 1,115,100,000 1,229,500,000 1,273,300,000 1,257,600,000 1,353,700,000 1,367,500,000 1,834,500,000 1,851,500,000 1,991,600,000 2,197,200,000 2,231,500,000 2,249,300,000 1,370,300,000 1,300,500,000 1,328,100,000 1,246,800,000 1,244,000,000 1,061,000,000 1,042,500,000 1,080,900,000 1,108,500,000 
        total liabilities
      81,785,000,000 77,468,000,000 78,667,000,000 78,087,000,000 77,097,000,000 75,463,000,000 72,654,000,000 70,691,000,000 71,184,000,000 69,523,000,000 71,939,000,000 70,856,000,000 71,580,000,000 66,378,000,000 66,983,000,000 65,010,000,000 64,455,000,000 61,332,000,000 62,252,000,000 61,051,000,000 61,765,000,000 53,416,000,000 52,653,000,000 53,521,000,000 50,706,000,000 45,725,000,000 46,477,000,000 45,058,000,000 44,525,000,000 43,030,000,000 45,351,000,000 45,642,400,000 46,288,000,000 44,037,100,000 42,361,600,000 41,805,900,000 42,851,600,000 39,982,700,000 39,655,700,000 39,829,000,000 40,311,600,000 38,673,700,000 39,099,500,000 41,201,200,000 41,211,700,000 37,813,700,000 37,764,200,000 37,926,700,000 37,340,200,000 34,809,300,000 35,455,400,000 35,079,800,000 35,090,600,000 35,152,700,000 32,001,400,000 30,891,200,000 28,968,100,000 28,730,600,000 28,831,800,000 26,695,900,000 26,939,900,000 26,354,300,000 26,670,700,000 26,369,500,000 26,661,700,000 27,262,100,000 26,630,100,000 27,091,400,000 27,906,800,000 26,971,500,000 28,085,300,000 29,721,400,000 30,051,600,000 29,069,600,000 29,225,800,000 29,205,300,000 28,349,800,000 27,184,000,000 27,340,800,000 26,854,000,000 27,252,800,000 26,412,100,000 20,620,900,000 21,139,600,000 20,487,200,000 20,279,400,000 
        commitments and contingencies – note 10
                                                                                            
        shareholders’ equity
                                                                                            
        preferred stock, without par value, shares authorized – 100,000,000; shares issued and outstanding – none
                                                                                            
        common stock
      2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 3,000,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,600,000 2,700,000 2,700,000 2,700,000 2,900,000 2,900,000 3,000,000 3,000,000 3,000,000 3,000,000 3,100,000 3,200,000 3,300,000 3,400,000 3,500,000 3,600,000 3,700,000 3,800,000 4,000,000 4,000,000 4,300,000 4,500,000 4,600,000 4,800,000 4,800,000 5,000,000 5,100,000 5,100,000 5,300,000 5,600,000 5,700,000 6,000,000 6,100,000 6,100,000 6,200,000 6,200,000 6,400,000 6,600,000 6,100,000 6,100,000 3,000,000 3,000,000 
        additional paid-in capital
      8,845,000,000 8,938,000,000 8,908,000,000 8,931,000,000 8,866,000,000 8,911,000,000 9,105,000,000 9,001,000,000 8,883,000,000 8,868,000,000 8,830,000,000 8,761,000,000 8,697,000,000 9,084,000,000 9,169,000,000 9,134,000,000 9,151,000,000 9,148,000,000 9,138,000,000 9,109,000,000 9,253,000,000 9,244,000,000 9,352,000,000 9,360,000,000 9,338,000,000 9,448,000,000 9,524,000,000 9,494,000,000 9,482,000,000 9,536,000,000 9,720,000,000 9,747,900,000 8,489,300,000 8,547,400,000 8,765,100,000 8,897,000,000 8,893,400,000 8,805,100,000 8,741,400,000 8,677,500,000 8,616,500,000 8,555,600,000 8,687,900,000 8,707,400,000 9,943,700,000 10,062,300,000 10,094,400,000 10,154,800,000 10,003,500,000 10,765,200,000 10,769,400,000 10,738,800,000 10,697,400,000 10,853,500,000 10,869,700,000 11,204,400,000 11,369,000,000 11,679,200,000 12,009,600,000 12,415,900,000 12,523,100,000 12,862,600,000 13,403,500,000 13,648,300,000 14,552,500,000 15,192,200,000 15,663,500,000 16,031,900,000 16,278,100,000 16,843,000,000 17,016,000,000 17,078,800,000 17,550,700,000 18,441,100,000 18,976,900,000 19,853,000,000 19,959,900,000 19,863,500,000 19,951,200,000 19,846,300,000 20,404,700,000 20,915,400,000 17,751,900,000    
        retained earnings
      35,796,000,000 35,393,000,000 35,586,000,000 35,549,000,000 34,546,000,000 33,549,000,000 35,157,000,000 34,575,000,000 33,088,000,000 31,749,000,000 32,103,000,000 31,608,000,000 30,707,000,000 29,724,000,000 29,604,000,000 28,825,000,000 28,058,000,000 27,088,000,000 26,700,000,000 25,874,000,000 24,793,000,000 23,802,000,000 24,678,000,000 25,346,000,000 23,360,000,000 22,573,000,000 22,104,000,000 21,679,000,000 21,136,000,000 19,988,000,000 20,182,000,000 19,757,300,000 19,241,100,000 18,054,400,000 17,306,600,000 17,667,000,000 17,357,700,000 16,560,600,000 16,364,100,000 15,918,400,000 15,310,400,000 14,778,500,000 14,761,800,000 14,352,200,000 14,150,100,000 14,014,400,000 13,863,800,000 13,744,400,000 14,011,500,000 13,813,900,000 14,040,500,000 13,817,900,000 13,275,100,000 12,647,100,000 12,556,800,000 12,224,000,000 11,921,100,000 11,490,700,000 11,572,800,000 11,418,100,000 11,199,900,000 10,721,600,000 10,581,800,000 9,997,500,000 9,795,600,000 9,598,500,000 7,126,800,000 6,639,500,000 5,970,600,000 5,479,400,000 5,167,200,000 4,396,800,000 3,954,200,000 4,387,600,000 4,612,000,000 5,122,100,000 5,071,100,000 4,656,100,000 4,167,100,000 3,581,500,000 3,775,700,000 4,173,500,000 3,521,500,000 2,880,900,000 2,506,800,000 1,960,100,000 
        accumulated other comprehensive loss
      -741,000,000 -451,000,000 -543,000,000 -760,000,000 -911,000,000 -1,147,000,000 -489,000,000 -1,387,000,000 -1,365,000,000 -1,313,000,000 -2,512,000,000 -2,166,000,000 -2,050,000,000 -2,503,000,000 -2,784,000,000 -2,149,000,000 -1,236,000,000      -112,000,000 -254,000,000 -1,008,000,000 -296,000,000 -299,000,000 -383,000,000 -623,000,000 -986,000,000 -811,000,000 -782,800,000 -720,600,000 -101,500,000 -126,000,000 -134,900,000 -161,800,000 -267,900,000 -363,900,000 -364,900,000 -382,400,000                           -423,300,000 -745,500,000           -196,200,000 -73,900,000      
        total shareholders’ equity
      43,902,000,000 43,882,000,000 43,953,000,000 43,722,000,000 42,503,000,000 41,315,000,000 43,775,000,000 42,191,000,000 40,608,000,000 39,306,000,000 38,423,000,000 38,205,000,000 37,356,000,000 36,307,000,000 35,991,000,000 35,812,000,000 35,975,000,000 36,060,000,000 35,737,000,000 34,968,000,000 33,853,000,000 33,199,000,000 33,921,000,000 34,455,000,000 31,693,000,000 31,728,000,000 31,332,000,000 30,793,000,000 29,998,000,000 28,541,000,000 29,094,000,000 28,725,000,000 27,012,400,000 26,502,900,000 25,948,300,000 26,431,700,000 26,091,900,000 25,100,400,000 24,744,200,000 24,233,600,000 23,547,100,000 23,044,100,000 23,236,100,000 23,062,600,000 24,334,300,000 24,251,300,000 24,294,000,000 24,376,900,000 24,345,300,000 24,765,200,000 24,808,100,000 24,532,500,000 24,318,000,000 23,802,700,000 23,816,500,000 23,643,800,000 23,528,400,000 23,288,200,000 23,718,100,000 24,181,300,000 23,978,100,000 23,812,600,000 24,361,700,000 23,790,500,000 24,519,200,000 24,863,300,000 22,867,400,000 22,252,900,000 21,508,000,000 21,431,700,000 21,673,300,000 21,254,500,000 21,504,100,000 22,990,400,000 23,673,900,000 24,988,800,000 25,139,400,000 24,575,800,000 24,143,400,000 23,237,800,000 24,112,900,000 24,993,100,000 21,234,700,000 20,551,700,000 20,000,700,000 19,459,000,000 
        noncontrolling interests
      140,000,000 144,000,000 129,000,000 129,000,000 117,000,000 111,000,000 104,000,000 106,000,000 102,000,000 99,000,000 116,000,000 107,000,000 104,000,000 87,000,000 52,000,000 55,000,000 56,000,000 68,000,000 71,000,000 78,000,000 65,000,000                                                                  
        total equity
      44,042,000,000 44,026,000,000 44,082,000,000 43,851,000,000 42,620,000,000 41,426,000,000 43,879,000,000 42,297,000,000 40,710,000,000 39,405,000,000 38,539,000,000 38,312,000,000 37,460,000,000 36,394,000,000 36,043,000,000 35,867,000,000 36,031,000,000 36,128,000,000 35,808,000,000 35,046,000,000 33,918,000,000                                                                  
        total liabilities and equity
      125,827,000,000 121,494,000,000 122,749,000,000 121,938,000,000 119,717,000,000 116,889,000,000 116,533,000,000 112,988,000,000 111,894,000,000 108,928,000,000 110,478,000,000 109,168,000,000 109,040,000,000 102,772,000,000 103,026,000,000 100,877,000,000 100,486,000,000 97,460,000,000 98,060,000,000 96,097,000,000 95,683,000,000                                                                  
        assets held for sale
           490,000,000 565,000,000 601,000,000                                          906,900,000                                     
        liabilities held for sale
           153,000,000 163,000,000 165,000,000                                          181,400,000                                     
        reserves for future policy benefits
       145,000,000 164,000,000 163,000,000 174,000,000 190,000,000 248,000,000 295,000,000 765,000,000 778,000,000 807,000,000 797,000,000 811,000,000 737,000,000 825,000,000 822,000,000 811,000,000 802,000,000 788,000,000 774,000,000 776,000,000 794,000,000 784,000,000 776,000,000 754,000,000 85,000,000 77,000,000 77,000,000 78,000,000 75,000,000 71,000,000 72,100,000 71,500,000 69,900,000 72,100,000 69,600,000 76,200,000 71,800,000 68,600,000 69,500,000 69,600,000 71,900,000 69,200,000 67,700,000 68,100,000 68,100,000 68,800,000 61,300,000 65,700,000 63,100,000 60,200,000 58,800,000 57,300,000 61,300,000 60,800,000 61,800,000 60,800,000 55,100,000 58,600,000 56,000,000 57,500,000 56,400,000 57,900,000 61,000,000 59,400,000 62,600,000 61,400,000 61,300,000 63,400,000 64,500,000 63,300,000 65,300,000 66,900,000 63,700,000 74,100,000 76,400,000 78,600,000 76,300,000 81,900,000 82,100,000 83,900,000 82,100,000 133,700,000 137,200,000 136,800,000 145,000,000 
        commitments and contingencies—note 14
                                                                                            
        preferred stock, without par value, shares authorized - 100,000,000; shares issued and outstanding - none
                                                                                            
        commitments and contingencies – note 11
                                                                                            
        liabilities and shareholders’ equity
                                                                                            
        accumulated other comprehensive income
                       -178,000,000 -103,000,000 -17,000,000 -195,000,000 150,000,000                    -292,600,000 -216,200,000 400,000 237,900,000 171,900,000 333,100,000 475,000,000 327,400,000 183,200,000 -4,800,000 -27,200,000 342,500,000 299,100,000 386,900,000 212,200,000 235,000,000 114,900,000 132,200,000 343,700,000 251,400,000 224,600,000 372,400,000 140,700,000 166,800,000 68,100,000 72,500,000   -895,700,000 -515,000,000 -226,200,000 -6,100,000 156,100,000 79,300,000 7,700,000 102,300,000 50,100,000 18,900,000   -20,300,000 52,800,000 129,800,000 -5,400,000 145,800,000 
        fixed maturity securities, current
                           23,433,000,000    19,676,000,000 19,960,000,000 19,123,000,000 17,795,000,000 16,692,000,000 17,390,000,000 17,081,600,000 17,091,500,000                                                      
        total liabilities and shareholders’ equity
                           86,615,000,000 86,574,000,000 87,976,000,000 82,399,000,000 77,453,000,000 77,809,000,000 75,851,000,000 74,523,000,000 71,571,000,000 74,445,000,000 74,367,400,000 73,300,400,000 70,540,000,000 68,309,900,000 68,237,600,000 68,943,500,000 65,083,100,000 64,399,900,000 64,062,600,000 63,858,700,000 61,717,800,000 62,335,600,000 64,263,800,000 65,546,000,000 62,065,000,000 62,058,200,000 62,303,600,000 61,685,500,000 59,574,500,000 60,263,500,000 59,612,300,000 59,408,600,000 58,955,400,000 55,817,900,000 54,535,000,000 52,496,500,000 52,018,800,000 52,549,900,000 50,877,200,000 50,918,000,000 50,166,900,000 51,032,400,000 50,160,000,000 51,180,900,000 52,125,400,000 49,497,500,000 49,344,300,000 49,414,800,000 48,403,200,000 49,758,600,000 50,975,900,000 51,555,700,000 52,060,000,000 52,899,700,000 54,194,100,000 53,489,200,000 51,759,800,000 51,484,200,000 50,091,800,000 51,365,700,000 51,405,200,000 41,855,600,000 41,691,300,000 40,487,900,000 39,738,400,000 
        commitments and contingencies – note 12
                                                                                            
        commitment and contingencies – note 11
                                                                                            
        equity securities, current
                               1,009,000,000 2,300,000,000 1,492,000,000 1,211,000,000 1,493,000,000 2,272,000,000 2,435,300,000 2,341,900,000                                                      
        other invested assets, current
                               13,000,000 10,000,000 14,000,000 20,000,000 21,000,000 21,000,000 23,800,000 24,300,000 17,200,000 16,900,000 19,100,000 19,600,000 15,800,000 13,600,000 18,800,000 19,400,000 19,100,000 17,400,000 23,400,000 25,400,000 20,200,000 19,000,000 23,000,000 25,900,000 16,300,000 15,000,000 15,700,000 17,000,000 14,800,000 16,900,000 16,000,000 21,600,000 14,800,000 15,800,000 20,800,000 23,100,000 21,100,000 17,300,000 17,500,000 19,300,000 26,500,000 18,700,000 17,100,000 16,800,000 23,600,000 34,800,000 40,700,000 35,900,000 40,300,000 38,800,000 63,000,000 49,500,000 72,800,000 406,000,000 402,500,000 429,000,000      
        accrued investment income
                               173,000,000 168,000,000 168,000,000 161,000,000 162,000,000 163,000,000 161,600,000 160,200,000 162,500,000 158,300,000 158,200,000 149,700,000 164,500,000 169,400,000 168,700,000 171,800,000 170,800,000 176,800,000 168,600,000 173,800,000 161,400,000 172,700,000 168,600,000 173,600,000 168,800,000 175,400,000 172,400,000 172,900,000 162,200,000 164,900,000 164,900,000 167,300,000 172,000,000 178,000,000 179,700,000 171,100,000 177,400,000 177,600,000 173,900,000 170,700,000 172,800,000 168,400,000 168,800,000 164,600,000 172,800,000 165,700,000 163,000,000 161,700,000 165,800,000 161,600,000 165,400,000 162,200,000 157,200,000 156,900,000 156,200,000 159,100,000 156,800,000     
        income taxes receivable
                               335,000,000 91,000,000 296,000,000  10,000,000 69,000,000 154,500,000  341,900,000    168,700,000  9,000,000  316,600,000  13,800,000  308,900,000 200,600,000 79,400,000  235,700,000 152,300,000 101,700,000  228,500,000 213,000,000 137,400,000  105,800,000 75,400,000 248,800,000    100,100,000            129,100,000           
        securities lending collateral
                               353,000,000 465,000,000 565,000,000 591,000,000 604,000,000 741,000,000 624,600,000 612,200,000 455,100,000 907,200,000 1,214,500,000 1,234,900,000 1,079,800,000 1,360,100,000 1,512,400,000 1,455,200,000 1,300,400,000 1,518,200,000 1,718,300,000 2,023,600,000 1,515,200,000 1,698,600,000 1,947,000,000 1,325,000,000 969,800,000 837,600,000 670,400,000 577,500,000 564,600,000 700,900,000 765,900,000 715,500,000 871,400,000 771,900,000 810,300,000 788,700,000 900,300,000 893,600,000 733,000,000 600,500,000 394,800,000 383,900,000 325,200,000 461,600,000 529,000,000 633,000,000 715,400,000 756,600,000 854,100,000 891,500,000 985,200,000 753,300,000 904,700,000 899,000,000 703,700,000 1,191,200,000 1,389,900,000 1,000,900,000 735,800,000 836,300,000 658,500,000 
        policy liabilities:
                                                                                            
        total policy liabilities
                               11,977,000,000 11,557,000,000 11,421,000,000 10,897,000,000 10,119,000,000 10,658,000,000 10,627,200,000 10,630,600,000 11,011,700,000 10,507,700,000 10,486,600,000 10,308,000,000 10,185,500,000 9,633,500,000 9,958,900,000 9,849,400,000 9,898,200,000 9,672,400,000 9,987,000,000 10,027,700,000 9,555,800,000 9,461,000,000 9,196,700,000 8,793,200,000 8,263,500,000 8,500,100,000 8,506,000,000 8,632,400,000 8,581,500,000 7,813,000,000 7,755,000,000 7,721,700,000 7,822,300,000 7,518,800,000 7,353,200,000 7,131,800,000 6,817,900,000 6,719,300,000 7,080,600,000 7,199,600,000 7,130,700,000 7,390,800,000 7,516,300,000 7,909,100,000 7,876,000,000 7,952,900,000 7,955,800,000 8,189,300,000 7,683,900,000 8,071,900,000 7,897,000,000 8,073,600,000 7,607,200,000 7,538,300,000 7,173,200,000 7,191,600,000 6,766,600,000 5,561,300,000 5,660,000,000 5,700,800,000 5,556,500,000 
        security trades pending payable
                               84,000,000 542,000,000 382,000,000 158,000,000 197,000,000 168,000,000 159,900,000 134,700,000 112,600,000 164,700,000 227,800,000 257,700,000 93,500,000 155,300,000 110,900,000 333,200,000 73,100,000 110,000,000 172,500,000 189,300,000 66,200,000 156,100,000 154,300,000 177,500,000 95,200,000 284,800,000 152,800,000 215,500,000 69,300,000 138,100,000 188,100,000 146,800,000 51,700,000 84,500,000 108,200,000 121,300,000 33,300,000 264,000,000 277,700,000 263,600,000 37,600,000 33,600,000 54,000,000 27,800,000 5,800,000 7,500,000 13,800,000 26,100,000 50,600,000 92,000,000 249,500,000 138,800,000 124,800,000 50,500,000 9,300,000 163,000,000 181,800,000 83,500,000 1,008,300,000 413,500,000 84,400,000 
        securities lending payable
                               351,000,000 465,000,000 564,000,000 590,000,000 604,000,000 741,000,000 624,300,000 611,800,000 454,400,000 906,400,000 1,213,700,000 1,233,400,000 1,078,900,000 1,359,300,000 1,512,000,000 1,455,300,000 1,300,900,000 1,518,600,000 1,718,200,000 2,023,400,000 1,515,300,000 1,698,200,000 1,946,700,000 1,324,600,000 969,700,000 837,700,000 670,600,000 577,500,000 564,700,000 701,000,000 766,400,000 715,900,000 872,500,000 773,100,000 811,800,000 789,800,000 901,500,000 894,900,000 734,400,000 602,000,000 396,600,000 386,700,000 330,900,000 474,100,000 529,000,000 633,000,000 715,400,000 756,600,000 854,100,000 891,500,000 985,200,000 753,300,000 904,700,000 899,000,000 703,700,000 1,191,200,000 1,389,900,000 1,000,900,000 735,800,000 836,300,000 658,500,000 
        reserves for future policy benefits, noncurrent
                               674,000,000 661,000,000 655,000,000 719,000,000 706,000,000 669,000,000 644,700,000 666,800,000 647,300,000 618,500,000 619,000,000 673,700,000 666,100,000 646,900,000 625,100,000 653,300,000 631,700,000 616,000,000 607,600,000 684,800,000 671,300,000 655,700,000 643,000,000 738,900,000 723,000,000 701,900,000 687,600,000 770,800,000 750,800,000 723,200,000 696,100,000 752,300,000 730,700,000 703,400,000 638,000,000 642,100,000 646,700,000 653,800,000 656,900,000 663,800,000 664,600,000 660,000,000 659,900,000 662,800,000 664,700,000 663,400,000 659,000,000 658,600,000 661,900,000 654,200,000 655,000,000 642,100,000 646,900,000 644,300,000 653,300,000 686,100,000 679,900,000 739,700,000 734,000,000 731,500,000 727,200,000 
        commitments and contingencies—note 13
                                                                                            
        income taxes payable
                                  105,000,000    194,900,000  187,500,000 113,000,000 491,000,000  60,400,000  163,500,000  3,600,000  283,800,000    97,700,000    204,800,000    265,800,000    392,800,000  62,100,000  380,800,000  96,500,000  196,000,000    270,600,000  22,000,000  314,300,000 538,200,000 539,900,000 729,900,000 984,700,000 833,400,000 653,500,000 568,400,000 606,500,000 418,800,000 
        premium and self-funded receivables
                                      6,255,900,000 6,184,900,000 5,692,000,000 6,105,700,000 5,773,000,000 5,860,800,000 5,212,800,000 5,260,900,000 4,998,400,000 4,602,800,000 4,401,400,000 4,940,800,000 4,964,600,000 4,825,500,000 4,438,100,000 4,547,200,000 4,457,500,000 3,968,700,000 4,014,000,000 4,330,000,000 4,098,900,000 3,687,400,000 3,645,700,000 3,890,700,000 3,722,100,000 3,402,900,000 3,309,800,000 3,100,900,000 3,303,400,000 3,041,600,000 3,176,400,000 3,499,500,000 3,298,600,000 3,281,000,000 3,276,300,000 3,457,900,000 3,525,400,000 3,042,900,000 3,265,500,000 3,203,400,000 3,167,000,000 2,870,100,000 2,801,000,000 2,626,800,000 2,790,400,000 2,520,200,000 2,598,000,000 2,360,600,000 2,280,700,000 2,295,200,000 1,757,000,000 1,702,000,000 1,680,100,000 1,574,600,000 
        investments available-for-sale, at fair value:
                                                                                            
        long-term investments available-for-sale, at fair value:
                                                                                            
        other invested assets, long-term
                                       3,343,800,000 2,442,100,000 2,352,100,000 2,287,300,000 2,240,500,000 2,155,900,000 2,088,100,000 2,078,300,000 2,041,100,000 1,838,300,000 1,803,300,000 1,718,400,000 1,695,900,000 1,691,800,000 1,678,100,000 1,593,800,000 1,542,600,000 1,516,800,000 1,510,400,000 1,482,400,000 1,387,700,000 1,236,100,000 1,191,200,000 1,041,300,000 1,003,700,000 1,004,300,000 945,700,000 911,700,000 865,400,000 845,100,000 822,500,000 802,400,000 775,300,000 771,400,000 749,500,000 705,300,000 703,200,000 789,900,000 789,900,000 771,200,000 752,900,000 681,000,000 675,600,000 641,300,000 628,800,000 253,100,000 250,900,000 221,600,000 207,800,000     
        commitment and contingencies – note 10
                                                                                            
        deferred tax assets
                                                428,500,000 295,600,000 164,100,000 280,400,000 244,400,000 162,200,000 234,500,000 383,000,000 367,900,000 356,300,000 135,400,000 243,200,000 61,100,000 347,500,000 353,300,000 424,800,000 456,700,000 347,300,000 457,400,000 460,900,000 416,000,000 445,300,000 481,600,000 523,800,000 361,100,000 681,600,000 730,800,000 779,000,000 741,700,000 669,000,000 642,100,000 559,600,000 563,500,000 627,100,000 665,500,000 642,600,000 784,500,000 728,800,000 505,000,000 728,200,000 342,600,000 302,700,000 460,500,000 434,000,000 
        commitment and contingencies – note 9
                                                                                            
        preferred stock, without par value, shares authorized—100,000,000; shares issued and outstanding—none
                                                                                            
        commitment and contingencies - note 9
                                                                                            
        commitment and contingencies - note 10
                                                                                            
        commitment and contingencies - note 8
                                                                                            
        commitment and contingencies—note 10
                                                                                            
        commitments and contingencies – note 9
                                                                                            
        income tax receivable
                                                                   32,300,000      59,100,000  159,900,000  53,100,000  900,000             
        commitments and contingencies – note 8
                                                                                            
        income tax payable
                                                                       1,228,700,000     14,600,000                
        preferred stock, without par value, shares authorized—100,000,000; shares issued and outstanding – none
                                                                                            
        current assets held for sale
                                                                        1,293,100,000 1,292,900,000                   
        current liabilities held for sale
                                                                        309,200,000 274,300,000                   
        deferred tax liability
                                                                            2,501,000,000 2,919,600,000 2,983,400,000 3,004,400,000 2,914,400,000 2,897,100,000 3,117,600,000 3,350,200,000 3,323,200,000 3,083,500,000 3,143,900,000 3,306,300,000     
        commitments and contingencies – note 14
                                                                                            
        commitments and contingencies – note 13
                                                                                            
        commitments and contingencies—note 18
                                                                                            
        unearned share-based compensation
                                                                                            
        unearned stock compensation
                                                                                       -82,100,000 -97,600,000 -119,100,000 -78,500,000 -83,500,000 
        long-term investments
                                                                                        693,400,000 711,100,000 739,800,000 748,100,000 
        long-term debt
                                                                                        3,918,100,000 4,009,800,000 4,273,200,000 4,276,700,000 
        deferred income taxes
                                                                                        2,620,200,000 2,571,300,000 2,548,200,000 2,596,400,000 
        investments available-for-sale, at fair value
                                                                                          14,275,700,000 13,586,900,000 
        additional paid in capital
                                                                                         17,654,000,000 17,574,800,000 17,433,600,000 
      Cashflow Statements:
      Quarterly
      Annual
        Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2014-03-31 2013-12-31 2013-09-30 2013-06-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-12-31 2011-09-30 2011-06-30 2011-03-31 2010-12-31 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2009-09-30 2009-06-30 2009-03-31 2008-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2006-12-31 2006-09-30 2006-06-30 2006-03-31 2005-12-31 2005-09-30 2005-06-30 2005-03-31 
                                                                                             
          operating activities
                                                                                             
          net income
        1,760,000,000 546,000,000 1,187,000,000 1,744,000,000 2,184,000,000 413,000,000 1,008,000,000 2,301,000,000 2,249,000,000 831,000,000 1,300,000,000 1,856,000,000 2,004,000,000 961,000,000 1,613,000,000 1,650,000,000 1,795,000,000 1,125,000,000 1,502,000,000 1,801,000,000 1,667,000,000 551,000,000 222,000,000 2,276,000,000 1,523,000,000 934,000,000 1,183,000,000 1,139,000,000 1,551,000,000 425,000,000 959,100,000 1,053,400,000 1,312,500,000 1,230,700,000 746,900,000 855,300,000 1,009,900,000 368,400,000 617,800,000 780,600,000 703,000,000 180,900,000 654,800,000 859,100,000 865,200,000 506,700,000 630,900,000 731,100,000 701,000,000 148,200,000 656,200,000 800,100,000 885,200,000 464,200,000 691,200,000 643,600,000 856,500,000 335,300,000 683,200,000 701,600,000 926,600,000 548,800,000 739,100,000 722,400,000 876,800,000 2,741,800,000 730,200,000 693,500,000 580,400,000 331,400,000 820,700,000 750,500,000 588,100,000 859,100,000 868,000,000 835,200,000 783,100,000 801,100,000 810,800,000 751,200,000 731,800,000 652,000,000 640,700,000 559,400,000 611,700,000 
          adjustments to reconcile net income to net cash from operating activities:
                                                                                             
          net losses on financial instruments
        78,000,000 57,000,000 1,000,000 131,000,000 464,000,000 74,000,000 125,000,000 85,000,000 161,000,000  124,000,000 121,000,000 113,000,000 111,000,000                                                                        
          equity in net earnings of other invested assets
        -305,000,000          -3,000,000 43,000,000 30,000,000 11,000,000 -46,000,000 -105,000,000 -153,000,000                                                                     
          depreciation and amortization
        354,000,000 406,000,000 387,000,000 380,000,000 373,000,000 398,000,000 329,000,000 335,000,000 331,000,000 424,000,000 426,000,000 433,000,000 462,000,000 473,000,000 451,000,000 393,000,000 358,000,000 360,000,000 351,000,000 309,000,000 282,000,000 290,000,000 308,000,000 286,000,000 270,000,000                                                             
          deferred income taxes
        -274,000,000 -322,000,000 269,000,000 -52,000,000 -174,000,000 -116,000,000 -224,000,000 -170,000,000 136,000,000 -241,000,000 32,000,000 -138,000,000 -255,000,000 94,000,000 2,000,000 -80,000,000 -92,000,000 212,000,000 122,000,000 -39,000,000 31,000,000 -438,000,000 -162,000,000 3,000,000 57,000,000 110,000,000 -108,000,000 24,000,000 55,000,000 -50,000,000 139,100,000 53,400,000 -51,500,000 -1,034,600,000 -27,600,000 -52,700,000 -157,200,000 45,300,000 -18,100,000 26,400,000 73,300,000 -53,100,000 -60,300,000 -23,100,000 70,600,000 -77,400,000 59,400,000 -36,500,000 85,200,000 71,100,000 -26,400,000 5,300,000 9,100,000 -127,800,000 167,700,000 27,700,000 59,900,000 -77,000,000 40,000,000 66,600,000 44,700,000 -9,200,000 43,300,000 27,500,000 40,200,000 69,000,000 -25,800,000 28,600,000 -10,500,000 -159,200,000 -348,200,000 32,000,000 -6,000,000 123,900,000 -1,300,000 -131,000,000 -97,100,000 245,900,000 68,300,000 -142,100,000 101,600,000 -43,500,000 -14,100,000 -99,500,000 54,500,000 
          impairment of property and equipment
        4,000,000                    3,000,000                        4,000,000 1,700,000 100,000 2,100,000                                     
          share-based compensation
        55,000,000 30,000,000 84,000,000 81,000,000 81,000,000 -29,000,000 66,000,000 92,000,000 62,000,000 72,000,000 78,000,000 78,000,000 61,000,000 73,000,000 69,000,000 72,000,000 50,000,000 59,000,000 63,000,000 69,000,000 64,000,000 69,000,000 80,000,000 67,000,000 67,000,000 68,000,000 86,000,000 70,000,000 70,000,000 91,000,000 56,900,000 35,900,000 42,200,000 38,900,000 43,600,000 44,400,000 42,700,000 40,300,000 41,900,000 44,800,000 37,600,000 37,200,000 42,400,000 41,500,000 27,100,000 43,200,000 36,800,000 50,100,000 38,800,000 42,300,000 40,600,000 41,600,000 21,500,000 22,800,000 52,200,000 39,000,000 32,500,000 36,700,000 37,200,000 38,300,000 22,600,000 39,400,000 39,500,000 43,000,000 14,100,000 37,900,000 39,000,000 51,900,000 24,800,000 26,700,000 39,800,000 52,500,000 37,000,000 23,500,000 51,500,000 61,800,000 40,300,000 34,600,000 71,200,000       
          changes in operating assets and liabilities:
                                                                                             
          receivables
        -1,174,000,000 756,000,000 815,000,000 -923,000,000 -3,174,000,000 -193,000,000 851,000,000 -1,059,000,000 -282,000,000 -1,035,000,000 -428,000,000 -270,000,000 -29,000,000 -1,832,000,000 -16,000,000 686,000,000 -1,348,000,000 -387,000,000 -119,000,000 -374,000,000 -1,258,000,000 589,000,000 -532,000,000 326,000,000 -639,000,000 -173,000,000 -291,000,000 164,000,000 -753,000,000 128,000,000 -252,900,000 -606,800,000 36,700,000 -633,800,000 746,300,000 -411,000,000 276,300,000 -1,204,300,000 156,600,000 -162,300,000 -170,500,000 -496,900,000 772,500,000 111,100,000 -429,600,000 -879,000,000 -181,700,000 -223,000,000 -616,000,000 -50,300,000 251,700,000 -222,000,000 -397,700,000 323,100,000 333,700,000 -164,600,000 -302,300,000 -44,600,000 -298,600,000 209,600,000 -268,200,000 132,500,000 282,500,000 -25,500,000 -279,800,000 -356,800,000 249,100,000 109,600,000 -486,100,000 180,800,000 -126,600,000 -158,900,000 -454,000,000 -7,200,000 -242,500,000 10,100,000 -209,000,000 26,800,000 -208,600,000 -231,100,000 -236,500,000 -12,900,000 -127,800,000 -7,800,000 -85,600,000 
          other invested assets
          -35,000,000 -30,000,000 -5,000,000 -5,000,000 -26,000,000 -18,000,000 -29,000,000 -33,000,000 -4,000,000 -27,000,000 -15,000,000 -35,000,000 14,000,000 25,000,000 7,000,000 -14,000,000 -12,000,000 -24,000,000 -20,000,000 -38,000,000 -18,000,000 -39,000,000 63,000,000 -18,000,000 -2,000,000 -7,000,000 -21,000,000 16,000,000 -6,000,000 -4,200,000 -6,800,000 -9,300,000 -3,800,000 -7,600,000 -14,800,000 -1,700,000 -4,500,000 -7,900,000 -5,300,000 -5,800,000 15,700,000 6,100,000 -10,100,000 -4,100,000 6,000,000 -9,000,000 -14,600,000 -16,800,000 10,700,000 -800,000 -8,200,000 -12,300,000 -12,200,000 6,900,000 -21,300,000 -300,000 10,300,000       -20,000,000 -32,800,000 13,800,000                 
          other assets
        -1,552,000,000 460,000,000 201,000,000 43,000,000 -647,000,000 1,758,000,000 -145,000,000 315,000,000 -1,104,000,000 261,000,000 -407,000,000 -181,000,000 -348,000,000 594,000,000 -55,000,000 -66,000,000 -353,000,000 507,000,000 -223,000,000 41,000,000 -288,000,000 705,000,000 -502,000,000 39,000,000 -525,000,000 110,000,000 -22,000,000 -133,000,000 -125,000,000 708,000,000 -288,800,000 -53,400,000 -391,800,000 -112,000,000 -194,600,000 -117,200,000 -205,200,000 797,500,000 -640,700,000 -167,100,000 -117,400,000 650,600,000 -227,900,000 -197,900,000 -191,000,000 714,700,000 -206,300,000 -33,400,000 -69,500,000 -85,200,000 23,900,000 86,300,000 -58,600,000 112,500,000 44,000,000 -3,000,000 -74,300,000 -152,100,000 30,500,000 22,700,000 -160,300,000 -230,200,000 4,200,000 -19,600,000 -74,500,000 -128,700,000 -23,900,000 40,800,000 -7,500,000 -250,400,000 5,100,000 40,900,000 -135,800,000 235,400,000 -21,900,000 -2,400,000 -36,700,000 -133,000,000 -87,100,000 22,500,000 -164,800,000 -62,900,000 -53,900,000 -25,300,000 -23,500,000 
          policy liabilities
        1,590,000,000 1,101,000,000 -1,260,000,000 -213,000,000 600,000,000 -28,000,000 -446,000,000 -1,397,000,000 31,000,000 -186,000,000 -250,000,000 277,000,000 306,000,000 717,000,000 23,000,000 439,000,000 1,075,000,000 269,000,000 416,000,000 457,000,000 1,455,000,000 1,904,000,000 600,000,000 332,000,000 692,000,000 432,000,000 143,000,000 460,000,000 791,000,000 -503,000,000 53,900,000 -49,100,000 -560,800,000 457,000,000 20,600,000 123,900,000 130,100,000 571,200,000 -303,600,000 81,300,000 -27,200,000 220,400,000 -306,200,000 -104,100,000 382,900,000 110,400,000 277,000,000 307,600,000 545,600,000 -215,500,000 8,400,000 -209,600,000 70,900,000 -36,900,000 85,100,000 -22,900,000 -79,000,000 330,100,000 121,300,000 217,200,000 309,400,000 91,600,000 -364,500,000 -125,900,000 68,100,000 -255,500,000 -125,400,000 -398,500,000 31,200,000 -75,600,000 1,500,000 -233,100,000 502,100,000 -380,300,000 153,200,000 21,200,000 463,600,000 67,400,000 338,000,000 -51,200,000 520,000,000 42,900,000 -103,200,000 -43,000,000 153,300,000 
          unearned income
        266,000,000 -338,000,000 270,000,000 -79,000,000 132,000,000 -505,000,000 312,000,000 8,000,000 72,000,000 -2,930,000,000 -126,000,000 64,000,000 3,282,000,000 -2,590,000,000 2,730,000,000 -239,000,000 57,000,000 195,000,000 -128,000,000 -61,000,000 -119,000,000 297,000,000 15,000,000 -1,000,000 -109,000,000 69,000,000 48,000,000 -98,000,000 96,000,000 6,000,000 -1,199,600,000 -24,600,000 1,182,200,000 -1,089,900,000 103,900,000 -88,300,000 954,200,000 -641,500,000 780,600,000 -188,500,000 -124,200,000 200,400,000 -5,400,000 -129,300,000 -31,800,000 74,600,000 50,000,000 -119,500,000 250,000,000 -116,700,000 116,100,000 -42,100,000 -31,100,000 -90,900,000 -884,100,000 83,700,000 697,600,000 -712,100,000 600,500,000 -9,900,000 156,600,000 -98,000,000 -45,800,000 -82,500,000 67,700,000 -37,600,000 24,400,000 -79,500,000 65,400,000 37,100,000 -4,000,000 -96,200,000 36,400,000 128,900,000 -681,200,000 9,900,000 667,900,000 -70,100,000 -538,800,000 -38,800,000 578,200,000 -160,900,000 116,700,000 -34,900,000 40,900,000 
          accounts payable and other liabilities
        2,886,000,000 -2,259,000,000 -151,000,000 738,000,000 952,000,000 -1,200,000,000 628,000,000 557,000,000 -257,000,000 -77,000,000 1,557,000,000 142,000,000 18,000,000 226,000,000 -34,000,000 204,000,000 428,000,000 -374,000,000 533,000,000 202,000,000 358,000,000 25,000,000 85,000,000 1,280,000,000 588,000,000                                                             
          income taxes
        644,000,000 -284,000,000 -616,000,000 246,000,000 357,000,000 173,000,000 57,000,000 -407,000,000 581,000,000 -360,000,000 -134,000,000 -448,000,000 839,000,000 -297,000,000 118,000,000 -727,000,000 568,000,000 -28,000,000 62,000,000 -332,000,000 438,000,000 -32,000,000 -1,209,000,000 822,000,000 491,000,000 -244,000,000 205,000,000 -401,000,000 115,000,000 50,000,000 85,600,000 -349,400,000 536,800,000 -550,100,000 74,500,000 -378,000,000 659,700,000 -231,800,000 72,400,000 -169,500,000 507,700,000 -321,600,000 15,200,000 -287,100,000 635,000,000 -102,000,000 -111,800,000 -176,200,000 356,000,000 -78,200,000 -46,900,000 -301,200,000 435,600,000 5,600,000 -75,900,000 -394,600,000 391,000,000 -58,700,000 -94,000,000 -335,700,000 443,800,000 -95,900,000 163,700,000 -477,300,000 -830,300,000 1,135,700,000 162,700,000 -254,100,000 347,100,000 -91,200,000 79,000,000 -324,100,000 289,000,000 22,500,000 169,900,000 -245,300,000 500,200,000 38,000,000 -131,600,000 -221,800,000 203,400,000 44,500,000 125,500,000 19,700,000 269,900,000 
          net cash from operating activities
        4,332,000,000 84,000,000 1,135,000,000 2,054,000,000 1,017,000,000 706,000,000 2,677,000,000 447,000,000 1,978,000,000 -2,971,000,000 2,613,000,000 1,950,000,000 6,469,000,000 -1,518,000,000 4,924,000,000 2,452,000,000 2,541,000,000 1,672,000,000 2,504,000,000 1,683,000,000 2,505,000,000 3,813,000,000 -1,150,000,000 5,510,000,000 2,515,000,000 1,327,000,000 1,667,000,000 1,437,000,000 1,630,000,000 463,000,000 606,900,000 542,200,000 2,214,900,000 -1,301,200,000 2,404,700,000 393,100,000 2,688,200,000 274,700,000 963,500,000 662,000,000 1,304,300,000 949,100,000 343,400,000 1,173,000,000 1,650,500,000 305,100,000 605,700,000 1,071,000,000 1,387,500,000 272,800,000 1,397,400,000 425,200,000 956,900,000 759,800,000 240,200,000 521,500,000 1,223,100,000 57,900,000 1,429,800,000 771,800,000 1,114,900,000 587,000,000 896,500,000 256,100,000 -322,900,000 29,700,000 1,439,600,000 377,600,000 1,192,000,000 497,300,000 892,800,000 111,500,000 1,033,800,000 1,104,300,000 533,300,000 725,900,000 1,981,100,000 1,430,900,000 614,700,000 201,000,000 1,797,600,000 963,800,000 928,300,000 654,100,000 710,500,000 
          capital expenditures
        -235,000,000 -293,000,000 -360,000,000 -267,000,000 -196,000,000 -322,000,000 -332,000,000 -323,000,000 -279,000,000 -326,000,000 -319,000,000 -350,000,000 -301,000,000 -298,000,000 -305,000,000 -295,000,000 -254,000,000 -340,000,000 -258,000,000 -285,000,000 -204,000,000 -278,000,000 -306,000,000 -233,000,000 -204,000,000 -351,000,000 -271,000,000 -221,000,000 -234,000,000 -320,000,000 -355,500,000 -314,300,000 -218,200,000 -283,300,000 -218,700,000 -169,600,000 -127,900,000 -168,000,000 -164,400,000 -133,700,000 -117,500,000 -229,900,000 -178,600,000 -140,900,000 -88,800,000 -304,000,000 -139,400,000 -135,500,000 -135,700,000 -238,400,000 -158,600,000 -142,000,000 -107,500,000 -169,800,000 -149,100,000 -102,200,000 -123,800,000 -185,100,000 -127,800,000 -104,700,000 -101,900,000 -117,800,000 -110,800,000 -102,600,000 -120,200,000 -106,100,000 -114,400,000 -89,000,000 -68,900,000 -109,700,000 -79,900,000 -77,000,000 -79,000,000 -110,500,000 -91,400,000 -63,500,000 -56,600,000 -63,400,000 -57,700,000 -36,400,000 -36,400,000 -43,000,000 -33,200,000 -48,500,000 -37,100,000 
          free cash flows
        4,097,000,000 -209,000,000 775,000,000 1,787,000,000 821,000,000 384,000,000 2,345,000,000 124,000,000 1,699,000,000 -3,297,000,000 2,294,000,000 1,600,000,000 6,168,000,000 -1,816,000,000 4,619,000,000 2,157,000,000 2,287,000,000 1,332,000,000 2,246,000,000 1,398,000,000 2,301,000,000 3,535,000,000 -1,456,000,000 5,277,000,000 2,311,000,000 976,000,000 1,396,000,000 1,216,000,000 1,396,000,000 143,000,000 251,400,000 227,900,000 1,996,700,000 -1,584,500,000 2,186,000,000 223,500,000 2,560,300,000 106,700,000 799,100,000 528,300,000 1,186,800,000 719,200,000 164,800,000 1,032,100,000 1,561,700,000 1,100,000 466,300,000 935,500,000 1,251,800,000 34,400,000 1,238,800,000 283,200,000 849,400,000 590,000,000 91,100,000 419,300,000 1,099,300,000 -127,200,000 1,302,000,000 667,100,000 1,013,000,000 469,200,000 785,700,000 153,500,000 -443,100,000 -76,400,000 1,325,200,000 288,600,000 1,123,100,000 387,600,000 812,900,000 34,500,000 954,800,000 993,800,000 441,900,000 662,400,000 1,924,500,000 1,367,500,000 557,000,000 164,600,000 1,761,200,000 920,800,000 895,100,000 605,600,000 673,400,000 
          investing activities
                                                                                             
          purchases of investments
        -4,735,000,000 -2,761,000,000 -4,163,000,000 -4,138,000,000 -3,964,000,000 -3,280,000,000 -4,671,000,000 -3,932,000,000 -6,103,000,000 8,101,000,000 -6,689,000,000 -10,205,000,000 -7,443,000,000 -5,334,000,000 -6,359,000,000 -8,203,000,000 -5,050,000,000 -3,539,000,000 -3,909,000,000 -4,243,000,000 -6,978,000,000 -2,784,000,000 -5,573,000,000 -7,239,000,000 -3,896,000,000                                                          -3,357,200,000 -7,585,300,000 -2,731,500,000 
          proceeds from sale of investments
        3,094,000,000 2,666,000,000 2,975,000,000 3,533,000,000 4,150,000,000 4,936,000,000 4,027,000,000 2,686,000,000 4,898,000,000 2,766,000,000 2,491,000,000 2,850,000,000 2,489,000,000 2,586,000,000 2,262,000,000 4,093,000,000 3,047,000,000 1,930,000,000 1,994,000,000 1,695,000,000 4,650,000,000 2,579,000,000 4,015,000,000 1,996,000,000 2,728,000,000                                                             
          maturities, calls and redemptions from investments
        552,000,000 576,000,000 447,000,000 324,000,000 424,000,000 544,000,000 445,000,000 501,000,000 535,000,000 -11,591,000,000 3,875,000,000 7,123,000,000 3,533,000,000 3,014,000,000 3,259,000,000 3,138,000,000 1,209,000,000 956,000,000 1,142,000,000 1,248,000,000 998,000,000 978,000,000 1,927,000,000 1,239,000,000 597,000,000                                                             
          changes in securities lending collateral
        -313,000,000 191,000,000 -110,000,000 -176,000,000 -290,000,000 233,000,000 161,000,000 -109,000,000 -212,000,000 23,000,000 -90,000,000 -59,000,000 204,000,000 376,000,000 -57,000,000 -179,000,000 -441,000,000 74,000,000 -388,000,000 89,000,000 -731,000,000 -181,000,000    115,000,000 99,000,000 26,000,000 14,000,000 137,000,000 -116,000,000 -12,600,000 -157,400,000 452,000,000 307,300,000 19,700,000 -154,500,000 280,400,000 152,800,000 -56,800,000 -154,400,000 217,700,000 199,600,000 305,100,000 -508,000,000 183,000,000 248,300,000 -622,000,000 -354,900,000 -132,000,000 -167,100,000 -93,100,000 -12,900,000 136,400,000 65,400,000 -50,500,000 156,600,000 -99,300,000 38,500,000 -21,900,000 111,600,000 -6,500,000 -160,500,000 -132,400,000 -205,400,000 -9,900,000 -55,800,000 143,200,000 54,900,000 104,000,000 82,400,000 41,200,000 97,500,000 37,400,000 93,700,000 -231,900,000 151,400,000 -5,700,000 -195,300,000 487,500,000 198,700,000     
          purchases of subsidiaries, net of cash acquired
        5,000,000 33,000,000 1,000,000 50,000,000 4,000,000 -3,685,000,000 -4,000,000 -1,120,000,000 18,000,000 81,000,000 -13,000,000 -1,638,000,000 -26,000,000 -14,000,000 -548,000,000 -61,000,000 -34,000,000 -3,415,000,000 -27,000,000 -3,000,000 -67,000,000 2,000,000 -1,908,000,000     -28,000,000 -9,500,000 -376,400,000 -1,346,100,000 -2,045,700,000                    -3,604,700,000 -87,000,000 -904,100,000 -1,200,000 2,300,000    -100,000 100,000 -300,000 -65,200,000 -1,100,000 10,000,000 -91,200,000 -116,100,000 -400,000         -2,259,500,000 -17,600,000 -202,300,000 -110,300,000 
          purchases of property and equipment
        -235,000,000 -293,000,000 -360,000,000 -267,000,000 -196,000,000 -322,000,000 -332,000,000 -323,000,000 -279,000,000 -326,000,000 -319,000,000 -350,000,000 -301,000,000 -298,000,000 -305,000,000 -295,000,000 -254,000,000 -340,000,000 -258,000,000 -285,000,000 -204,000,000 -278,000,000 -306,000,000 -233,000,000 -204,000,000 -351,000,000 -271,000,000 -221,000,000 -234,000,000 -320,000,000 -355,500,000 -314,300,000 -218,200,000 -283,300,000 -218,700,000 -169,600,000 -127,900,000 -168,000,000 -164,400,000 -133,700,000 -117,500,000 -229,900,000 -178,600,000 -140,900,000 -88,800,000 -304,000,000 -139,400,000 -135,500,000 -135,700,000 -238,400,000 -158,600,000 -142,000,000 -107,500,000 -169,800,000 -149,100,000 -102,200,000 -123,800,000 -185,100,000 -127,800,000 -104,700,000 -101,900,000 -117,800,000 -110,800,000 -102,600,000 -120,200,000 -106,100,000 -114,400,000 -89,000,000 -68,900,000 -109,700,000 -79,900,000 -77,000,000 -79,000,000 -110,500,000 -91,400,000 -63,500,000 -56,600,000 -63,400,000 -57,700,000 -36,400,000 -36,400,000 -43,000,000 -33,200,000 -48,500,000 -37,100,000 
          other
        -10,000,000 -30,000,000 64,000,000 -13,000,000 -25,000,000 -18,000,000 11,000,000   4,000,000 2,000,000 1,000,000 -31,000,000 -2,000,000 -31,000,000 -2,000,000 448,000,000 -124,000,000 -194,000,000 -109,000,000 -171,000,000 15,000,000 137,000,000 13,000,000 -16,000,000 -16,000,000 -45,000,000 -15,000,000 -45,000,000 -54,700,000 -50,900,000 -54,400,000 -112,500,000 -8,700,000 2,800,000 -46,200,000 -42,600,000 -31,600,000 -21,600,000 -700,000 13,200,000 -12,500,000 -9,000,000 3,200,000 -12,300,000 -18,200,000 -29,200,000 -24,500,000 23,100,000 -34,200,000 -17,000,000 -10,500,000 -37,100,000 14,200,000 -7,900,000 -10,000,000 10,800,000 -4,000,000 -10,000,000 -11,000,000 -4,600,000 -5,800,000 -21,100,000 -12,000,000 -4,400,000 3,600,000 -7,800,000 8,500,000 40,900,000 16,900,000 -11,000,000 17,800,000 -8,600,000 3,900,000 -22,100,000 -3,100,000         
          net cash from investing activities
        -1,642,000,000 464,000,000 -1,224,000,000 -687,000,000 103,000,000 -1,638,000,000 -401,000,000 -818,000,000 -2,310,000,000 -1,029,000,000 -687,000,000 -672,000,000 -3,184,000,000 289,000,000 -1,247,000,000 -2,024,000,000 -1,578,000,000 -966,000,000 -1,440,000,000 -4,925,000,000 -2,307,000,000 305,000,000 89,000,000 -4,934,000,000 -2,784,000,000 723,000,000 -1,698,000,000 -1,165,000,000 -652,000,000 773,000,000 -687,800,000 -778,300,000 -565,900,000 -3,620,700,000 807,100,000 -1,041,800,000 -1,227,000,000 670,900,000 523,000,000 -316,800,000 -1,391,000,000 630,700,000 244,500,000 684,900,000 -2,711,600,000 660,100,000 -107,700,000 -783,000,000 -744,300,000 -147,600,000 -23,400,000 -867,800,000 -1,195,600,000 -1,266,500,000 -1,317,900,000 -1,987,300,000 20,100,000 381,200,000 -853,000,000 -752,300,000 282,100,000 -102,600,000 -849,000,000 -511,800,000 191,900,000 4,163,300,000 -201,600,000 -168,000,000 -790,900,000 152,700,000 6,500,000 -600,000 457,600,000 319,700,000 -166,000,000 -260,400,000 -662,200,000 -295,600,000 -488,000,000 939,000,000 -612,700,000 -2,814,600,000 -585,200,000 -169,800,000 -850,600,000 
          financing activities
                                                                                             
          repayments of long-term borrowings
        -750,000,000 3,000,000 -900,000,000 -1,250,000,000 -850,000,000    -1,000,000 -1,908,000,000 -917,000,000 -39,000,000 -929,000,000 -14,000,000 -114,000,000 -2,000,000   -968,000,000 -809,000,000 -103,000,000 -52,000,000 -200,000,000 -850,000,000 -10,000,000 -63,000,000 -291,000,000 -730,000,000 -300,000 -662,700,000 -1,885,200,000 -528,800,000 -401,100,000     -310,700,000 -456,500,000 -1,913,600,000 -16,400,000 700,000 -1,685,700,000 -20,900,000 -24,200,000 -1,245,000,000 -556,900,000 -100,000 -800,100,000 -100,300,000 -350,800,000 -1,300,000 -1,100,000 -1,900,000 -700,800,000                         
          proceeds from short-term borrowings
        724,000,000 515,000,000    65,000,000   1,350,000,000     90,000,000   1,150,000,000   150,000,000 -255,000,000 1,075,000,000 1,110,000,000 1,675,000,000 2,095,000,000 2,710,000,000 3,820,000,000 1,970,000,000 1,825,000,000 1,505,000,000 1,985,000,000 1,660,000,000 1,020,000,000 1,170,000,000 540,000,000 440,000,000 440,000,000 980,000,000 100,000,000 540,000,000 1,270,000,000 850,000,000 300,000,000 100,000,000 680,000,000 970,000,000 500,000,000 500,000,000 100,000,000 250,000,000 92,000,000 200,000,000 100,000,000 100,000,000                         
          repayments of short-term borrowings
        -150,000,000    -115,000,000 -60,000,000    -175,000,000         -150,000,000 -820,000,000 -700,000,000 -1,120,000,000 -1,975,000,000 -2,180,000,000 -2,760,000,000 -3,945,000,000 -1,820,000,000 -1,830,000,000 -1,655,000,000 -1,890,000,000 -1,060,000,000 -980,000,000 -1,070,000,000 -540,000,000 -440,000,000 -540,000,000 -980,000,000 -100,000,000 -540,000,000 -1,180,000,000 -800,000,000 -250,000,000 -1,020,000,000 -780,000,000 -450,000,000    -192,000,000 -100,000,000 -100,000,000 -100,000,000 -100,000,000                         
          changes in securities lending payable
        313,000,000 -190,000,000 110,000,000 176,000,000 290,000,000 -233,000,000 -162,000,000 108,000,000 212,000,000 -23,000,000 91,000,000 60,000,000 -205,000,000 -383,000,000 65,000,000 179,000,000 441,000,000 -74,000,000 388,000,000 -89,000,000 731,000,000 181,000,000    -115,000,000 -99,000,000 -26,000,000 -14,000,000 -137,000,000 117,100,000 12,500,000 157,400,000 -452,000,000 -307,300,000 -19,700,000 154,500,000 -280,400,000 -152,700,000 56,700,000 154,400,000 -217,700,000 -199,600,000 -305,200,000 508,100,000 -182,900,000 -248,500,000 622,100,000 354,900,000 132,000,000 167,100,000 93,100,000 12,800,000 -136,300,000 -65,400,000 50,500,000 -156,600,000 99,400,000 -38,700,000 22,000,000 -111,700,000 6,600,000 160,500,000 132,400,000 205,400,000 9,900,000 55,800,000 -143,200,000 -54,900,000 -104,000,000 -82,400,000 -41,200,000 -97,500,000 -37,400,000 -93,700,000 231,900,000 -151,400,000 5,700,000 195,300,000 -487,500,000 -198,700,000     
          changes in bank overdrafts
        -1,152,000,000 1,235,000,000 -554,000,000 85,000,000 546,000,000 -466,000,000 307,000,000 107,000,000 -586,000,000 637,000,000 -23,000,000 -209,000,000 -291,000,000 752,000,000 -636,000,000           -419,000,000 166,000,000 64,000,000 20,000,000 -307,000,000 27,600,000 193,800,000 -124,400,000 197,500,000 19,700,000 22,700,000 -168,900,000 202,300,000 296,300,000 128,400,000 -113,200,000 -56,700,000 46,000,000 -127,200,000 -105,900,000 200,200,000 -134,000,000 31,800,000 75,000,000 -62,400,000 -147,000,000 188,900,000 30,400,000 77,000,000 -70,700,000 -47,100,000 23,200,000 104,600,000 88,600,000 43,200,000 27,900,000 95,000,000 -26,600,000 -45,600,000 -50,800,000 10,500,000 -205,000,000 -169,100,000 19,500,000 35,300,000 -95,000,000 -40,200,000 144,700,000 -104,200,000 133,000,000 -10,300,000 -135,600,000 -200,000 290,500,000 390,200,000 -266,200,000     
          repurchase and retirement of common stock
        -1,124,000,000 -471,000,000 -876,000,000 -378,000,000 -880,000,000 -1,811,000,000 -60,000,000 -463,000,000 -566,000,000 -928,000,000 -480,000,000 -646,000,000 -622,000,000 -568,000,000 -579,000,000 -624,000,000 -545,000,000 -522,000,000 -451,000,000 -480,000,000 -447,000,000 -1,358,000,000 -758,000,000 -55,000,000 -529,000,000 -305,000,000 -644,000,000 -458,000,000 -294,000,000 -493,000,000 -397,000,000 -400,300,000 -394,700,000 -362,300,000 -1,126,400,000 -458,300,000 -50,700,000     -105,200,000 -636,500,000 -774,100,000 -343,000,000 -578,600,000 -814,400,000 -1,262,800,000 -449,700,000 -554,900,000 -275,300,000 -340,200,000 -668,000,000 -655,200,000 -493,800,000 -679,800,000 -685,600,000 -897,900,000 -714,700,000 -741,600,000 -1,015,200,000 -463,700,000 -1,493,000,000 -1,388,400,000 -827,000,000 -693,200,000 -437,000,000 -681,200,000 -229,200,000 -171,800,000 -866,600,000 -2,008,600,000 -1,826,100,000 -2,367,600,000 -1,322,800,000 -634,900,000 -550,200,000 -399,600,000 -1,688,400,000 -1,912,000,000 -244,900,000 -88,500,000 
          cash dividends
        -376,000,000 -377,000,000 -381,000,000 -385,000,000 -386,000,000 -373,000,000 -378,000,000 -378,000,000 -379,000,000 -346,000,000 -348,000,000 -350,000,000 -351,000,000 -305,000,000 -306,000,000 -309,000,000 -309,000,000 -273,000,000 -276,000,000 -278,000,000 -277,000,000 -234,000,000 -238,000,000 -242,000,000 -240,000,000 -202,000,000 -204,000,000 -206,000,000 -206,000,000 -193,000,000 -194,700,000 -196,400,000 -191,900,000 -179,500,000 -181,400,000 -171,800,000 -172,200,000 -171,300,000 -171,100,000 -170,900,000 -170,700,000 -163,100,000 -163,000,000 -163,900,000 -166,600,000 -117,600,000 -119,200,000 -120,500,000 -123,400,000 -110,500,000 -111,400,000 -112,700,000 -113,400,000 -87,100,000 -90,700,000 -93,500,000 -95,800,000 -85,700,000 -88,200,000 -91,100,000 -92,800,000                         
          proceeds from issuance of common stock under employee stock plans
        37,000,000 58,000,000 -2,000,000 23,000,000 16,000,000 48,000,000 60,000,000 97,000,000 40,000,000 31,000,000 38,000,000 43,000,000 30,000,000 36,000,000 40,000,000 76,000,000 42,000,000 20,000,000 52,000,000 89,000,000 64,000,000 20,000,000 48,000,000 44,000,000 50,000,000 37,000,000 24,000,000 76,000,000 40,000,000 38,200,000 35,400,000 59,400,000 47,700,000 26,600,000 47,500,000 103,500,000 28,200,000 19,500,000 20,800,000 50,900,000 16,100,000 14,700,000 45,900,000 109,300,000 32,900,000 85,900,000 52,400,000 130,100,000 149,800,000 221,600,000 129,600,000 23,700,000 24,100,000 3,000,000 48,000,000 35,700,000 15,800,000 14,000,000 167,700,000 47,500,000                         
          taxes paid through withholding of common stock under employee stock plans
        -34,000,000 -1,000,000 9,000,000 83,000,000 -123,000,000 -3,000,000 -6,000,000 -100,000,000 -1,000,000 -98,000,000 -2,000,000 -3,000,000 -2,000,000 -86,000,000 -1,000,000 -8,000,000 -2,000,000 -91,000,000 -16,000,000 -1,000,000 -4,000,000 -107,000,000 -2,000,000 -2,000,000 -2,000,000 -78,000,000 -4,000,000 -1,400,000 -2,400,000 -73,200,000 -500,000 -400,000 -3,700,000 -41,900,000                                                 
          net cash from financing activities
        -2,515,000,000 236,000,000 243,000,000 -308,000,000 -1,909,000,000 1,408,000,000 -915,000,000 668,000,000 32,000,000 -394,000,000 -994,000,000 -1,430,000,000 -531,000,000 -258,000,000 -1,255,000,000 -127,000,000 322,000,000 -1,315,000,000 -830,000,000 -820,000,000 3,388,000,000 -2,367,000,000 -984,000,000 105,000,000 679,000,000 -1,304,000,000 144,000,000 -677,000,000 -429,000,000 -1,561,000,000 -340,600,000 288,300,000 -627,700,000 2,433,200,000 -1,676,800,000 -1,563,800,000 1,234,300,000 581,500,000 -524,100,000 -437,100,000 -353,200,000 -1,012,400,000 -593,900,000 -1,703,000,000 311,900,000 -528,900,000 -560,900,000 -474,100,000 -258,600,000 -725,800,000 -536,800,000 123,900,000 -579,100,000 547,800,000 1,566,300,000 1,141,800,000 -1,167,000,000 -744,000,000 234,100,000 -723,500,000 -785,800,000 -939,800,000 167,500,000 -1,239,300,000 -1,157,700,000 -1,210,200,000 -1,121,400,000 -864,300,000 -206,900,000 -736,700,000 -902,500,000 -389,200,000 -1,707,200,000 -1,480,100,000 -1,748,400,000 337,600,000 -519,000,000 -762,700,000 168,400,000 -1,345,600,000 -1,785,100,000 2,427,700,000 -133,100,000 -21,900,000 173,800,000 
          effect of foreign exchange rates on cash and cash equivalents
        -9,000,000 -6,000,000 -1,000,000 1,000,000 1,000,000 -8,000,000 7,000,000   1,000,000 -4,000,000 1,000,000 1,000,000 2,000,000 -6,000,000 -6,000,000 -4,000,000 -1,000,000 -2,000,000 -6,000,000 -1,000,000 6,000,000   -2,000,000    -1,000,000 -1,000,000 -600,000 -800,000 400,000 400,000 1,000,000 1,300,000 1,600,000 2,200,000 900,000 -1,400,000 2,400,000 -1,700,000 800,000 1,100,000 -5,500,000 -2,500,000 -3,800,000 -500,000 -300,000 1,800,000 1,200,000 700,000 -1,500,000 1,400,000 400,000 -2,000,000 1,300,000 -1,900,000 -2,300,000 1,800,000 2,000,000 -2,000,000 3,300,000 -3,300,000 -1,200,000 -8,900,000 1,000,000                   
          change in cash and cash equivalents
        166,000,000 778,000,000 153,000,000 1,060,000,000 -788,000,000 468,000,000 1,368,000,000 292,000,000 -300,000,000 -4,393,000,000 928,000,000 -151,000,000 2,755,000,000 -1,485,000,000 2,416,000,000 295,000,000 1,281,000,000 -610,000,000 232,000,000 -4,068,000,000 3,585,000,000 1,757,000,000 -2,044,000,000 683,000,000 408,000,000 747,000,000 112,000,000 -404,000,000 548,000,000 -326,000,000 -422,100,000 51,400,000 1,021,700,000 -2,488,300,000 1,536,000,000 -2,211,200,000 2,697,100,000 1,529,300,000 963,300,000 -93,300,000 -437,500,000 565,700,000 -5,200,000 156,000,000 -754,700,000 433,800,000 -66,700,000 -186,600,000 384,300,000 -598,800,000 838,400,000 -318,000,000 -819,300,000 42,500,000 489,000,000 -326,000,000 77,500,000 -306,800,000 808,600,000 -702,200,000 613,200,000 -457,400,000 218,300,000 -1,498,300,000 -1,289,900,000 2,973,900,000 117,600,000 -653,500,000 194,200,000 -86,700,000 -3,200,000 -278,300,000 -215,800,000 -56,100,000 -1,381,100,000 803,100,000 799,900,000 372,600,000 295,100,000 -205,600,000 -600,200,000 576,900,000 210,000,000 462,400,000 33,700,000 
          cash and cash equivalents at beginning of period
        9,491,000,000  8,288,000,000  6,526,000,000  7,387,000,000  4,880,000,000  5,741,000,000  4,937,000,000  3,934,000,000  100,000 3,608,900,000  4,075,300,000  2,113,500,000  2,151,700,000  1,586,900,000  2,484,600,000  2,201,600,000  1,788,800,000  4,816,100,000  2,183,900,000  2,767,900,000  2,602,100,000  2,740,200,000  1,457,200,000 
          cash and cash equivalents at end of period
        9,657,000,000  153,000,000 1,060,000,000 7,500,000,000  1,369,000,000 271,000,000 6,226,000,000  928,000,000 -151,000,000 10,142,000,000  2,416,000,000 295,000,000 6,161,000,000  232,000,000 -4,068,000,000 9,326,000,000  -2,044,000,000 683,000,000 5,345,000,000  112,000,000 -404,000,000 4,482,000,000  -422,000,000 51,400,000 4,630,600,000  1,536,000,000 -2,211,200,000 6,772,400,000  963,300,000 -93,300,000 1,676,000,000  -5,200,000 156,000,000 1,397,000,000  -66,700,000 -186,600,000 1,971,200,000  838,400,000 -318,000,000 1,665,300,000  489,000,000 -326,000,000 2,279,100,000  808,600,000 -702,200,000 2,402,000,000  218,300,000 -1,498,300,000 3,526,200,000  117,600,000 -653,500,000 2,378,100,000  -3,200,000 -278,300,000 2,552,100,000  -1,381,100,000 803,100,000 3,402,000,000  295,100,000 -205,600,000 2,140,000,000  210,000,000 462,400,000 1,490,900,000 
          gain on sale of business
             39,000,000                                                                               
          equity in net losses of other invested assets
         -147,000,000 -113,000,000 -12,000,000 -126,000,000  -11,000,000 -1,000,000 27,000,000                                                                             
          impairment of property, equipment and right-of-use assets
                                                                                             
          proceeds from sales of subsidiaries, net of cash sold
                                                                                           
          proceeds from long-term borrowings, net issuance costs
                                                                                             
          cash and cash equivalents at beginning of year
                                                                                             
          less cash and cash equivalents included in assets held for sale at end of year
                                                                                             
          cash and cash equivalents at end of year
                                                                                             
          proceeds from sale of subsidiaries, net of cash sold
                                                                                            
          proceeds from long-term borrowings
             5,130,000,000   2,574,000,000 1,785,000,000 -14,000,000   3,462,000,000 -1,000,000 1,000,000 2,184,000,000 300,000,000   2,000,000 100,000 -1,100,000 836,000,000         -2,200,000         1,533,700,000 3,212,300,000      988,500,000   990,300,000   500,000,000   -700,000 2,668,900,000     
          repayments of short-term borrowings, net of issuances
          -1,170,000,000                                                                                   
          cash and cash equivalents included in assets held for sale at end of period
                                                                                             
          less cash and cash equivalents included in assets held for sale at end of period
                                                                                             
          less cash and equivalents included in assets held for sale at end of period
                                                                                             
          net incomees (gains) on financial instruments
                                                                                             
          equity in net earnings (losses) of other invested assets
                                                                                             
          net proceeds from commercial paper borrowings
                   -235,000,000 325,000,000            905,000,000                  268,400,000 58,600,000 638,800,000  -441,400,000 108,500,000 379,400,000    260,300,000    37,800,000    763,100,000            188,100,000      -162,500,000   680,300,000 -74,500,000 196,900,000 5,500,000 
          net (repayments of) proceeds from commercial paper borrowings
                            -250,000,000         -53,000,000 649,700,000 -595,700,000 -108,000,000     124,300,000 47,700,000 -147,900,000 -77,300,000                           23,700,000 -273,100,000                 
          net proceeds from (repayments of) commercial paper borrowings
                        225,000,000           25,000,000 178,000,000     -511,900,000 -661,300,000 -371,300,000 1,719,100,000                     -195,000,000 57,700,000      100,000                     
          net incomees on financial instruments
                        151,000,000                                                                     
          net gains on financial instruments
                                                                                             
          net realized gains on financial instruments
                                                                                             
          net repayments of commercial paper borrowings
                             250,000,000                                        -54,900,000 -109,000,000                       
          net realized (gains) losses on financial instruments
                                   -11,000,000 -78,000,000        -7,300,000                                                 
          net proceeds (repayments of) from commercial paper borrowings
                                                                                             
          net realized losses on financial instruments
                            4,000,000                                                                 
          proceeds from issuance of common stock under equity units stock purchase contracts
                                                                                           
          net realized losses (gains) on financial instruments
                               -18,000,000 24,000,000       -4,000,000 26,100,000      -88,800,000                                               
          other-than-temporary impairment losses recognized in income
                                 17,000,000 13,000,000 7,000,000 10,000,000 8,000,000 5,700,000 4,400,000 7,900,000 12,200,000 5,600,000 7,200,000 8,100,000 11,800,000 11,000,000 25,700,000 66,900,000 28,500,000 19,100,000 21,800,000 14,000,000 13,500,000 13,800,000 10,900,000 10,800,000 25,800,000 26,200,000 9,000,000 37,900,000 17,200,000 3,800,000 5,900,000 10,900,000 59,600,000 22,900,000 8,400,000 2,400,000 10,400,000 3,200,000 6,100,000 19,700,000 40,500,000 30,700,000                   
          loss on extinguishment of debt
                                     -6,000,000 -1,200,000 -900,000 19,100,000           -2,900,000 3,400,000 300,000 74,800,000 3,000,000 3,000,000                                    
          loss on disposal of assets
                                 2,000,000    6,000,000 1,500,000   9,500,000 3,100,000 -300,000 700,000  2,900,000 400,000 200,000  12,600,000 300,000 900,000  -300,000 600,000 100,000 -1,200,000 2,700,000 1,700,000 700,000 3,100,000 1,300,000 300,000 800,000 700,000   600,000 -100,000   7,400,000 8,100,000 600,000 300,000 1,200,000 5,500,000 300,000 200,000 1,000,000 9,200,000   1,300,000 -500,000   600,000    
          amortization, net of accretion
                                 208,000,000 263,000,000 260,000,000 255,000,000 256,000,000 256,900,000 255,400,000 239,700,000 198,500,000 196,200,000 191,600,000 193,400,000 206,100,000 202,300,000 199,700,000 199,700,000 203,500,000 -56,900,000 466,300,000 189,200,000 181,500,000 187,000,000 185,700,000 190,300,000 208,200,000 203,100,000 202,900,000 186,700,000 158,800,000 161,500,000 158,100,000 155,200,000 155,200,000 128,000,000 131,000,000 127,300,000 133,400,000 131,000,000 121,400,000 111,900,000 108,700,000 112,700,000 115,400,000 109,600,000 108,100,000 120,000,000 119,300,000 118,900,000 115,300,000 118,200,000 120,100,000 112,400,000 123,000,000 118,800,000 116,600,000 113,500,000 225,100,000    
          depreciation expense
                                 38,000,000 38,000,000 37,000,000 34,000,000 32,000,000 31,400,000 30,600,000 30,000,000 29,000,000 27,200,000 27,200,000 27,300,000 26,300,000 26,000,000 26,100,000 25,600,000 27,800,000 27,700,000 25,200,000 25,100,000 26,600,000 26,500,000 27,000,000 26,400,000 29,500,000 28,000,000 25,100,000 25,300,000 34,300,000 25,400,000 23,900,000 23,500,000 24,600,000 23,900,000 23,800,000 23,400,000 24,900,000 24,800,000 25,800,000 27,600,000 28,400,000 26,400,000 26,200,000 26,100,000 26,700,000 26,800,000 26,100,000 25,800,000 28,800,000 28,400,000 31,300,000 31,700,000 31,700,000 32,800,000 33,600,000 34,900,000     
          accounts payable and accrued expenses
                                 338,000,000 84,000,000 14,000,000 -1,029,000,000 -634,000,000 727,200,000 329,200,000 -300,400,000 358,100,000 616,700,000 170,800,000 -223,800,000 93,300,000 -256,700,000 269,200,000 10,800,000 84,300,000 -534,700,000 420,500,000 -189,400,000 -3,900,000 -223,500,000 350,300,000 -137,300,000 207,700,000 159,700,000 160,200,000 -224,000,000 40,200,000 -66,300,000 7,900,000 -388,300,000 203,500,000 44,000,000 -112,100,000 -344,100,000 94,200,000 144,400,000 -8,000,000 -288,800,000 709,200,000 215,300,000 -92,000,000 120,300,000 31,400,000 58,500,000 -147,900,000 -48,300,000 -36,200,000 120,900,000 -900,000 -319,000,000 -46,500,000 258,800,000 -200,800,000 -103,200,000 242,200,000 158,700,000 243,200,000 -334,300,000 
          other liabilities
                                 -527,000,000 43,000,000 -43,000,000 675,000,000 -215,000,000 119,900,000 -77,300,000 147,400,000 -371,200,000 169,500,000 41,200,000 40,300,000 224,100,000 398,700,000 -56,600,000 39,500,000 217,100,000 -18,800,000 87,000,000 401,100,000 -239,300,000 19,900,000 104,100,000 107,400,000 -76,600,000 -62,600,000 -50,500,000 35,100,000 -75,300,000 -245,000,000 190,400,000 -2,900,000 -8,500,000 181,100,000 -118,900,000 -67,300,000 -91,800,000 -199,200,000 103,800,000 -21,200,000 -266,800,000 -117,200,000 118,400,000 16,800,000 -350,600,000 -510,600,000 40,600,000 23,600,000 18,200,000 -43,600,000 127,300,000 74,600,000 11,500,000 -58,500,000 64,500,000 116,700,000 93,700,000 26,600,000 -132,200,000 -120,800,000 
          purchases of fixed maturity securities
                                 -2,871,000,000 -2,593,000,000 -2,723,000,000 -2,300,000,000 -1,454,000,000 -1,904,200,000 -2,650,400,000 -2,235,400,000 475,900,000 -2,633,500,000 -3,606,900,000 -4,030,100,000 -2,533,700,000 -2,114,700,000 -2,222,200,000 -3,287,100,000 -1,854,200,000 -2,407,200,000 -2,257,300,000 -3,273,300,000 -2,114,600,000 -2,005,700,000 -2,408,300,000 -3,084,800,000 -2,210,400,000 -4,672,400,000 -2,866,200,000 -3,955,500,000 -3,231,600,000 -4,529,900,000 -4,026,500,000 -3,252,400,000 -1,897,600,000 -3,666,100,000 -3,386,100,000 -2,965,000,000 -2,354,600,000 -3,538,000,000 -3,032,500,000 -1,642,100,000 -1,855,700,000 -1,156,500,000 -2,123,600,000 -2,051,000,000 -683,300,000 -1,007,500,000 -2,257,500,000 -1,742,900,000 -1,380,600,000 -1,735,200,000 -2,978,300,000 -2,417,900,000 -1,887,800,000 -1,168,400,000 -3,207,900,000 -4,933,900,000     
          proceeds from fixed maturity securities:
                                                                                             
          sales
                                 1,995,000,000 1,359,000,000 1,485,000,000 1,075,000,000 1,471,000,000 1,106,500,000 2,000,100,000 1,864,400,000 263,400,000 2,515,400,000 2,301,100,000 2,851,800,000 2,635,000,000 1,754,700,000 1,739,300,000 2,507,000,000 2,374,700,000 2,162,900,000 2,306,600,000 2,065,000,000 2,530,000,000 1,511,200,000 1,963,600,000 2,061,200,000 2,221,500,000 4,293,600,000 1,931,000,000 2,531,800,000 5,242,500,000 2,984,000,000 2,717,900,000 2,731,500,000 2,259,100,000 3,204,200,000 2,437,400,000 2,545,500,000 1,760,700,000 2,356,500,000 2,137,300,000 960,600,000 1,129,400,000 745,900,000 1,351,800,000 869,500,000 583,100,000 879,000,000 1,794,000,000 1,938,800,000 1,389,400,000 1,491,200,000 2,439,300,000 1,389,100,000 935,800,000 1,098,400,000 3,584,600,000 4,011,300,000     
          maturities, calls and redemptions
                                 854,000,000 689,000,000 501,000,000 393,000,000 496,000,000 425,400,000 653,700,000 362,900,000 460,000,000 421,200,000 443,700,000 522,700,000 439,300,000 388,800,000 341,200,000 249,300,000 296,100,000 352,600,000 394,500,000 270,400,000 302,300,000 370,800,000 361,300,000 284,300,000 346,800,000 687,500,000 311,700,000 490,800,000 433,700,000 472,100,000 398,100,000 477,600,000 330,000,000 356,500,000 414,000,000 790,800,000 778,800,000 672,300,000 656,900,000 1,213,700,000 373,000,000 393,400,000 495,800,000 289,500,000 240,300,000 286,400,000 500,200,000 642,700,000 1,023,300,000 150,200,000 272,900,000 172,000,000 294,800,000 67,300,000 137,300,000 222,200,000     
          purchases of equity securities
                                 -2,417,000,000 -3,434,000,000 -2,283,000,000 -3,691,000,000 -84,000,000 -154,100,000 -91,600,000 -566,300,000 -4,935,000,000 24,700,000 -139,000,000 -367,000,000 -298,000,000 -146,000,000 -285,200,000 -747,100,000 -94,500,000 -77,400,000 -338,000,000 -1,051,500,000 -381,800,000 -170,900,000 -130,700,000 -228,600,000 -245,900,000 -423,800,000 -40,800,000 -109,800,000 -47,500,000 -58,500,000 -86,200,000 -100,400,000 -136,600,000 -24,100,000 -61,100,000 -133,800,000 -159,000,000 -69,000,000 -85,500,000 -37,400,000 -123,900,000 -34,700,000 -129,000,000 -31,300,000 -89,700,000 -188,000,000               
          proceeds from sales of equity securities
                                 3,693,000,000 2,612,000,000 2,011,000,000 4,048,000,000 690,000,000 341,900,000 1,300,000 1,775,800,000 2,841,700,000 406,100,000 151,700,000 63,000,000 382,400,000 724,000,000 279,900,000 206,500,000 218,700,000 166,500,000 510,400,000 575,500,000 375,700,000 115,600,000 224,900,000 30,300,000 145,800,000 430,500,000 57,300,000 87,400,000 110,400,000 36,200,000 112,400,000 163,700,000 165,300,000 49,700,000 -2,500,000 74,900,000 40,800,000 40,700,000 70,800,000 45,600,000 124,000,000 33,200,000 251,700,000 168,400,000 148,100,000 142,200,000 415,400,000 377,400,000 -339,200,000 518,900,000 747,700,000 484,300,000 1,109,400,000 541,400,000 651,200,000 648,900,000     
          purchases of other invested assets
                                 -356,000,000 -170,000,000 -38,000,000 -78,000,000 -207,000,000 -77,300,000 -174,400,000 -72,300,000 -911,000,000 -90,500,000 -88,600,000 -73,700,000 -84,800,000 -87,200,000 -114,700,000 -146,400,000 -255,200,000 -89,500,000 -113,000,000 -48,100,000 -66,800,000 -57,000,000 -46,500,000 -35,400,000 -43,600,000 -43,500,000 -36,900,000 -127,500,000 -150,000,000 -57,900,000 -61,100,000 -34,700,000 -68,000,000 -78,600,000 -27,100,000 -34,200,000 -23,500,000 -19,900,000 -19,200,000 -28,800,000 -12,100,000 -12,900,000 -5,200,000 -18,800,000                 
          proceeds from sales of other invested assets
                                 78,000,000 26,000,000 103,000,000 113,000,000 160,000,000 53,200,000 174,700,000 23,100,000 55,300,000 41,900,000 45,300,000 76,500,000 31,800,000 53,700,000 120,100,000 99,300,000 26,300,000 21,300,000 23,300,000 15,000,000 48,300,000 40,600,000 10,200,000 25,600,000 74,100,000 30,400,000 15,000,000 7,600,000 10,100,000 6,700,000 14,900,000 3,800,000 10,100,000 5,300,000 6,400,000 7,600,000 9,100,000 3,700,000 14,300,000 7,400,000 1,100,000 200,000 1,300,000 900,000                 
          changes in collateral and settlement of non-hedging derivatives
                                                                                             
          premiums paid on equity call options
                                                 -100,000 -3,800,000 -12,800,000                                         
          proceeds from sale of put options
                                       300,000        100,000                                         
          change in collateral and settlements of debt-related derivatives
                                    1,000,000 100,000 -2,200,000 24,100,000 26,600,000 -47,200,000 -120,400,000 -8,000,000 673,600,000 -566,500,000                                               
          (gain) loss on extinguishment of debt
                                  -1,000,000             -7,500,000                                            
          excess tax benefits from share-based compensation
                                             -4,800,000 -2,700,000 -6,200,000 -39,800,000 -3,300,000 -3,500,000 -20,200,000 -68,800,000 -6,500,000 -10,600,000 -6,900,000 -22,400,000 -6,600,000 -9,700,000 -9,600,000 -4,200,000 -5,600,000 -500,000 -3,400,000 -19,300,000 -3,800,000 -2,300,000 -13,500,000 -22,600,000 -3,000,000 -2,200,000 -1,300,000 -21,600,000 -4,300,000 -3,600,000 -1,000,000 -700,000 -1,100,000 -1,300,000 -2,500,000 -11,100,000 -11,900,000 -14,300,000 -75,900,000 -51,200,000 -23,100,000 -51,000,000 -26,100,000 -36,300,000     
          proceeds from sales of property and equipment
                                         6,000,000                  100,000   2,400,000 -1,700,000    600,000 2,300,000 3,100,000  200,000 200,000  6,800,000 4,500,000  45,000,000      1,400,000     
          change in collateral and settlements of non-hedging derivatives
                                          67,000,000 -2,500,000 400,000  -35,700,000                                               
          gain on extinguishment of debt
                                                                                             
          gain on disposal from discontinued operations
                                                      -3,200,000                                     
          gain on disposal of assets
                                                                    600,000                200,000    -1,400,000     
          proceeds from sale of subsidiary, net of cash sold
                                                     740,000,000                                     
          purchase of subsidiary, net of cash acquired
                                                  5,400,000 -5,800,000 -635,800,000                                         
          net realized losses (gains) on investments
                                                125,100,000                             543,200,000 562,600,000 27,800,000 45,600,000     -11,100,000        
          settlement of non-hedging derivatives
                                                -600,000 -64,100,000 59,600,000 -32,000,000 -21,200,000 -46,200,000                                     
          collateral paid on debt-related derivatives
                                                -237,100,000                                             
          net realized gains on investments
                                                 -30,600,000 11,900,000 -92,300,000 -46,500,000 -43,800,000 -25,700,000 -65,800,000 -41,700,000 -105,500,000 -95,400,000 -54,200,000 -16,800,000 -102,900,000 -54,600,000 -70,500,000 -106,900,000    -57,100,000 -47,600,000    -36,000,000                 400,000   
          (gain) loss on disposal from discontinued operations
                                                                                             
          less cash and cash equivalents of discontinued operations at end of year
                                                                                             
          cash and cash equivalents of continuing operations at end of year
                                                                                             
          proceeds from equity put options
                                                    12,700,000                                         
          (gain) loss on disposal of assets
                                                                        -500,000                     
          premiums paid on equity options
                                                                                             
          less cash and cash equivalents of discontinued operations at end of period
                                                                                             
          cash and cash equivalents of continuing operations at end of period
                                                      -66,700,000 -186,600,000 1,971,200,000                                     
          loss on disposal from discontinued operations
                                                                                             
          changes in operating assets and liabilities, net of effect of business combinations:
                                                                                             
          impairment of goodwill and other intangible assets
                                                                                             
          net realized gains/losses on investments
                                                                                             
          impairment of other intangible assets
                                                                      21,100,000                     
          other invested assets, current
                                                                    -11,900,000    7,000,000     97,900,000 5,700,000 -4,800,000 4,500,000 -7,500,000 24,400,000 -13,400,000 23,400,000 333,400,000 -3,300,000 26,800,000 -122,000,000     
          changes in operating assets and liabilities, net of effect of business combinations and divestitures:
                                                                                             
          proceeds from sale of property and equipment
                                                                                         2,200,000 1,300,000 5,200,000 1,500,000 
          net proceeds from (repayments of) short-term borrowings
                                                                                             
          repayment of long-term borrowings
                                                                     -1,700,000 -408,200,000 -56,700,000 -15,100,000 -316,400,000 -209,700,000 -165,100,000 -228,100,000 -29,500,000 -3,300,000 -3,200,000 -2,700,000 -303,500,000 -200,800,000 -3,200,000 -2,200,000 -2,600,000 -2,800,000 -452,900,000 -1,703,800,000 -5,100,000    
          proceeds from exercise of employee stock options and employee stock purchase plan
                                                                     27,400,000 23,800,000 22,900,000 69,500,000 48,900,000 34,300,000 25,400,000 17,900,000 17,300,000 19,800,000 26,400,000 57,700,000 179,100,000 67,000,000 276,400,000 262,000,000 97,200,000 196,500,000 68,700,000 197,100,000 56,100,000    
          adjustments to reconcile net income to net cash
                                                                                             
          provided by operating activities:
                                                                                             
          net proceeds from short-term borrowings
                                                                         2,000,000 -2,000,000                
          net realized (gains) losses on investments
                                                                       -36,500,000 -48,400,000            -200,000         
          net (repayments of) proceeds from short-term borrowings
                                                                                             
          impairment of intangible assets
                                                                                            
          net realized losses on investments
                                                                            352,500,000      -9,500,000     8,900,000 7,100,000    1,000,000 
          net repayment of commercial paper borrowings
                                                                                             
          net proceeds from (repayment of) commercial paper borrowings
                                                                                    91,900,000         
          purchase of equity securities
                                                                                -744,900,000 -241,500,000 -330,600,000 -442,000,000 -375,100,000 -298,400,000   -700,200,000     
          adjustments to reconcile net income to net cash provided by operating activities:
                                                                                             
          purchase of subsidiaries, net of cash acquired
                                                                                             
          net (repayment of) proceeds from commercial paper borrowings
                                                                                  199,400,000      -606,700,000     
          loss on repurchase of debt securities
                                                                                             
          proceeds from issuance of common stock under equity security unit stock purchase contracts
                                                                                             
          costs related to issuance of common stock
                                                                                             
          payment for settlement of cash flow hedge
                                                                                      -24,700,000     
          stock-based compensation
                                                                                        54,600,000     
          proceeds from settlement of cash flow hedges
                                                                                             
          proceeds from long term borrowings
                                                                                             
          depreciation
                                                                                             
          sales or maturities of investments
                                                                                          2,821,500,000 7,661,100,000 2,026,800,000 
          proceeds from settlement of cash flow hedge
                                                                                             
          proceeds from long term borrowing and exchange of remarketed subordinated debentures included in equity security units
                                                                                             
          depreciation and amortization, net of accretion
                                                                                           176,400,000 144,100,000 
          loss on sale of assets
                                                                                             
          proceeds from exercise of stock options and employee stock purchase plan
                                                                                           25,000,000 256,800,000 
          gain on sale of assets
                                                                                            -700,000 
          loss on sale of property and equipment
                                                                                             
          income taxes payable
                                                                                             
          proceeds from sales or maturities of investments
                                                                                             
          proceeds from commercial paper borrowings
                                                                                             
          payments on long-term borrowings
                                                                                             
          proceeds from issuance of common stock under equity security units stock purchase contracts
                                                                                             
          proceeds from employee stock purchase plan and exercise of stock options
                                                                                             
          costs related to the issuance of common stock for wellpoint health networks inc. merger and trigon healthcare, inc. acquisition