View Filing Data

Cover Page - shares	3 Months Ended
Cover Page - shares	Mar. 31, 2020	Apr. 24, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Transition Report	false
Entity File Number	001-31719
Entity Registrant Name	MOLINA HEALTHCARE, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-4204626
Entity Address, Address Line One	200 Oceangate, Suite 100
Entity Address, City or Town	Long Beach,
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	90802
City Area Code	562
Local Phone Number	435-3666
Title of 12(b) Security	Common Stock, $0.001 Par Value
Trading Symbol	MOH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		59,200,000
Entity Central Index Key	0001179929
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	3 Months Ended
CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	Mar. 31, 2020	Mar. 31, 2019
Revenue:
Premium revenue	$ 4,304	$ 3,952
Premium tax revenue	150	138
Health insurer fees reimbursed	66	0
Investment income and other revenue	29	29
Total revenue	4,549	4,119
Operating expenses:
Medical care costs	3,716	3,371
General and administrative expenses	317	302
Premium tax expenses	150	138
Health insurer fees	68	0
Depreciation and amortization	20	25
Other	4	3
Total operating expenses	4,275	3,839
Operating income	274	280
Other expenses, net:
Interest expense	21	23
Other income, net	0	(3)
Total other expenses, net	21	20
Income before income tax expense	253	260
Income tax expense	75	62
Net income	$ 178	$ 198
Net income per share:
Basic (in dollars per share)	$ 2.95	$ 3.19
Diluted (in dollars per share)	$ 2.92	$ 2.99

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income	$ 178	$ 198
Other comprehensive (loss) income:
Unrealized investment (loss) income	(25)	7
Less: effect of income taxes	(6)	2
Other comprehensive (loss) income, net of tax	(19)	5
Comprehensive income	$ 159	$ 203

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 2,365	$ 2,452
Investments	2,010	1,946
Receivables	1,603	1,406
Prepaid expenses and other current assets	346	163
Total current assets	6,324	5,967
Property, equipment, and capitalized software, net	385	385
Goodwill and intangible assets, net	168	172
Restricted investments	82	79
Deferred income taxes	71	79
Other assets	99	105
Total assets	7,129	6,787
Current liabilities:
Medical claims and benefits payable	1,981	1,854
Amounts due government agencies	777	664
Accounts payable, accrued liabilities and other	743	484
Deferred revenue	43	249
Current portion of long-term debt	26	18
Total current liabilities	3,570	3,269
Long-term debt	1,596	1,237
Finance lease liabilities	229	231
Other long-term liabilities	87	90
Total liabilities	5,482	4,827
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at March 31, 2020, and 62 million shares at December 31, 2019	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	140	175
Accumulated other comprehensive (loss) income	(15)	4
Retained earnings	1,522	1,781
Total stockholders’ equity	1,647	1,960
Total liabilities and stockholders' equity	$ 7,129	$ 6,787

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares outstanding (in shares)	59,000,000	62,000,000
Preferred stock, par value (usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	20,000,000	20,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings
Beginning Balance (in shares) at Dec. 31, 2018	62,100	62,000
Beginning Balance at Dec. 31, 2018	$ 1,647	$ 0	$ 643	$ (8)	$ 1,012
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	198				198
Termination of warrants	(103)		(103)
Other comprehensive income (loss), net	5			5
Share-based compensation (in shares)		1,000
Share-based compensation	3		3
Ending Balance (in shares) at Mar. 31, 2019		63,000
Ending Balance at Mar. 31, 2019	$ 1,835	$ 0	543	(3)	1,295
Beginning Balance (in shares) at Dec. 31, 2019	61,900	62,000
Beginning Balance at Dec. 31, 2019	$ 1,960	$ 0	175	4	1,781
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	178				178
Common stock purchases (in shares)		(3,400)
Common stock purchases	(446)	$ (446)	(9)		(437)
Termination of warrants	(30)		(30)
Other comprehensive income (loss), net	(19)			(19)
Share-based compensation (in shares)		98
Share-based compensation	4		4
Ending Balance (in shares) at Mar. 31, 2020		59,000
Ending Balance at Mar. 31, 2020	$ 1,647	$ 0	$ 140	$ (15)	$ 1,522

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net income	$ 178	$ 198
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	20	25
Deferred income taxes	14	15
Share-based compensation	12	9
Gain on debt repayment	0	(3)
Other, net	(3)	6
Changes in operating assets and liabilities:
Receivables	(197)	(29)
Prepaid expenses and other current assets	(229)	20
Medical claims and benefits payable	127	34
Amounts due government agencies	113	(35)
Accounts payable, accrued liabilities and other	247	(30)
Deferred revenue	(206)	(4)
Income taxes	60	43
Net cash provided by operating activities	136	249
Investing activities:
Purchases of investments	(578)	(185)
Proceeds from sales and maturities of investments	493	366
Purchases of property, equipment and capitalized software	(21)	(6)
Other, net	3	(4)
Net cash (used in) provided by investing activities	(103)	171
Financing activities:
Common stock purchases	(453)	0
Proceeds from borrowings under term loan facility	380	100
Cash paid for partial termination of warrants	(30)	(103)
Cash paid for partial settlement of conversion option	(27)	(115)
Cash received for partial settlement of call option	27	115
Repayment of principal amount of convertible senior notes	(12)	(46)
Other, net	(3)	1
Net cash used in financing activities	(118)	(48)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(85)	372
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	2,508	2,926
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	2,423	3,298
Schedule of non-cash investing and financing activities:
Common stock used for share-based compensation	(7)	(7)
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	0	0
1.125% Call Option
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	(2)	155
1.125% Conversion Option
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	$ 2	$ (155)

Organization and Basis of Presentation

3 Months Ended

Mar. 31, 2020

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Basis of Presentation

Organization and Operations

Molina Healthcare, Inc. provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). We currently have two reportable segments: the Health Plans segment and the Other segment. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.

The Health Plans segment consists of health plans operating in 14 states and the Commonwealth of Puerto Rico. As of March 31, 2020, these health plans served approximately 3.4 million members eligible for Medicaid, Medicare, and other government-sponsored healthcare programs for low-income families and individuals including Marketplace members, most of whom receive government subsidies for premiums. The health plans are generally operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (“HMO”).

Our state Medicaid contracts typically have terms of three to five years, contain renewal options exercisable by the state Medicaid agency, and allow either the state or the health plan to terminate the contract with or without cause. Such contracts are subject to risk of loss in states that issue requests for proposal (“RFPs”) open to competitive bidding by other health plans. If one of our health plans is not a successful responsive bidder to a state RFP, its contract may not be renewed.

In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled; and regions or service areas.

Recent Developments – Health Plans Segment

Refer to Note 11, “Subsequent Events,” for the description of a recent acquisition transaction.

Puerto Rico. We have decided to sell our Puerto Rico Medicaid business. In doing so, we will work closely with the regulatory authorities and the provider community, to ensure that our members in Puerto Rico are cared for and have reliable continuity of care.

Texas. On March 25, 2020, the Texas Health and Human Services Commission (“HHSC”) notified our Texas health plan that HHSC has canceled all contracts associated with their ABD program (known in Texas as “STAR+PLUS”) re-procurement awards announced in October 2019, and canceled the solicitation associated with their TANF and CHIP programs (known in Texas as “STAR/CHIP”) re-procurement. HHSC further indicated that it is currently deliberating next steps with respect to both re-procurements. Previously, in October 2019, the HHSC had awarded contracts to our Texas health plan for the STAR+PLUS program in two service areas, consisting of one legacy service area and one new service area. This would have been a reduction from our current footprint of six service areas. Also, in 2019, our Texas health plan submitted an RFP response for STAR/CHIP.

Illinois. In March 2020, we terminated our agreement to acquire all of the capital stock of NextLevel Health Partners, Inc. due to the seller’s stated unwillingness to close pursuant to the terms of the acquisition agreement.

Consolidation and Interim Financial Information

The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2020, are not necessarily indicative of the results for the entire year ending December 31, 2020.

The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2019. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2019, audited consolidated financial statements have been omitted.

These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2019.

Use of Estimates

The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include:


•	The determination of medical claims and benefits payable of our Health Plans segment;


•	Health Plans segment contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract;


•	Health Plans segment quality incentives that allow us to recognize incremental revenue if certain quality standards are met;


•	Settlements under risk or savings sharing programs;


•	The assessment of long-lived and intangible assets, and goodwill for impairment;


•	The determination of reserves for potential absorption of claims unpaid by insolvent providers;


•	The determination of reserves for the outcome of litigation;


•	The determination of valuation allowances for deferred tax assets; and

•

The determination of unrecognized tax benefits.

Significant Accounting Policies

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Significant Accounting Policies

Cash and Cash Equivalents

Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.



	March 31,
	2020		2019
	(In millions)
Cash and cash equivalents	$	2,365	$	3,224
Restricted cash and cash equivalents	58		74
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,423	$	3,298

Investments

Our investments are principally held in debt securities, which are grouped into two separate categories for accounting and reporting purposes: available-for-sale securities, and held-to-maturity securities. Available-for-sale (“AFS”) securities are recorded at fair value and unrealized gains and losses, if any, are recorded in stockholders’ equity as other comprehensive income (loss), net of applicable income taxes. Held-to-maturity (“HTM”) securities are recorded at amortized cost, which approximates fair value, and unrealized holding gains or losses are not generally recognized. Realized gains and losses, and unrealized losses arising from credit-related factors with respect to AFS and HTM securities are included in the determination of net income. The cost of securities sold is determined using the specific-identification method.

Our investment policy requires that all our investments have final maturities of less than 10 years, or less than 10 years average life for structured securities. Investments and restricted investments are subject to interest rate risk and will decrease in value if market rates increase. Declines in interest rates over time will reduce our investment income.

In general, our AFS securities are classified as current assets without regard to the securities’ contractual maturity dates because they may be readily liquidated. We monitor our investments for credit-related impairment. For comprehensive discussions of the fair value and classification of our investments, see Note 4, “Fair Value Measurements,” and Note 5, “Investments.”

Accrued interest receivable relating to our AFS and HTM securities is presented within “Prepaid expenses and other current assets” in the accompanying consolidated balance sheets, and amounted to $11 million and $12 million at March 31, 2020, and December 31, 2019, respectively. We do not measure an allowance for credit losses on accrued interest receivable. Instead, we write off accrued interest receivable that has not been collected within 90 days of the interest payment due date. We recognize such write offs as a reversal of interest income. No accrued interest was written off during the three months ended March 31, 2020.

Premium Revenue Recognition and Premiums Receivable

Premium revenue is generated from our Health Plans segment contracts related to our Medicaid, Medicare and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premiums revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. The state Medicaid programs and the federal Medicare program periodically adjust premiums. Additionally, many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions.

Contractual Provisions That May Adjust or Limit Revenue or Profit

Medicaid Program

Medical Cost Floors (Minimums), and Medical Cost Corridors. A portion of our premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs. In the aggregate, we recorded liabilities under the terms of such contract provisions of $74 million at each of March 31, 2020, and December 31, 2019, respectively. Approximately $69 million of the liabilities accrued at each of March 31, 2020, and December 31, 2019, respectively, relate to our participation in Medicaid Expansion programs.

In certain circumstances, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined maximum threshold. Receivables relating to such provisions were insignificant at March 31, 2020, and December 31, 2019.

Profit Sharing and Profit Ceiling. Our contracts with certain states contain profit-sharing or profit ceiling provisions under which we refund amounts to the states if our health plans generate profit above a certain specified percentage. In some cases, we are limited in the amount of administrative costs that we may deduct in calculating the refund, if any. Liabilities for profits in excess of the amount we are allowed to retain under these provisions were insignificant at March 31, 2020, and December 31, 2019.

Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we must adjust our premium revenue in the period in which we learn of the adjustment, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted.

Medicare Program

Risk Adjusted Premiums. Our Medicare premiums are subject to retroactive increase or decrease based on the health status of our Medicare members (as measured by member risk score). We estimate our members’ risk scores and the related amount of Medicare revenue that will ultimately be realized for the periods presented based on our knowledge of our members’ health status, risk scores and Centers for Medicare and Medicaid Services (“CMS”) practices. Consolidated balance sheet amounts related to anticipated Medicare risk adjusted premiums and Medicare Part D settlements were insignificant at March 31, 2020, and December 31, 2019.

Minimum MLR. The Affordable Care Act (“ACA”) has established a minimum annual medical loss ratio (“Minimum MLR”) of 85% for Medicare. The medical loss ratio represents medical costs as a percentage of premium revenue. Federal regulations define what constitutes medical costs and premium revenue. If the Minimum MLR is not met, we may be required to pay rebates to the federal government. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of income. The amounts payable for the Medicare Minimum MLR were insignificant at March 31, 2020, and December 31, 2019.

Marketplace Program

Refer to Note 11, “Subsequent Events,” for the description of a recent United States Supreme Court decision regarding Marketplace risk corridors.

Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score

(risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of March 31, 2020, Marketplace risk adjustment payables amounted to $456 million and related receivables amounted to $76 million, for a net payable of $380 million, of which $80 million relates to 2020 and $300 million relates primarily to 2019. As of December 31, 2019, Marketplace risk adjustment payables amounted to $368 million and related receivables amounted to $63 million, for a net payable of $305 million, which relates primarily to 2019 and prior periods.

Minimum MLR. The ACA has established a Minimum MLR of 80% for the Marketplace. If the Minimum MLR is not met, we may be required to pay rebates to our Marketplace policyholders. The Marketplace risk adjustment program is taken into consideration when computing the Minimum MLR. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of income. Aggregate balance sheet amounts related to the Minimum MLR were insignificant at March 31, 2020, and December 31, 2019.

A summary of the categories of amounts due government agencies is as follows:



	March 31, 2020		December 31, 2019
	(In millions)
Medicaid program:
Medical cost floors and corridors	$	74	$	74
Other amounts due to states	76		84
Marketplace program:
Risk adjustment	456		368
Other	171		138
Total amounts due government agencies	$	777	$	664

Quality Incentives

At many of our health plans, revenue ranging from approximately 1% to 4% of certain health plan premiums is earned only if certain performance measures are met. Such performance measures are generally found in our Medicaid and MMP contracts. As described in Note 1, “Organization and Basis of Presentation–Use of Estimates,” recognition of quality incentive premium revenue is subject to the use of estimates.

The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the periods presented and prior periods.



		Three Months Ended March 31,
		2020			2019
	(In millions)
Maximum available quality incentive premium - current period		$	61		$	45

Quality incentive premium revenue recognized in current period:
Earned current period		$	44		$	26
Earned prior periods		12			20
Total		$	56		46

Quality incentive premium revenue recognized as a percentage of total premium revenue		1.3		%	1.2		%

Receivables

Receivables consist primarily of amounts due from government agencies, which may be subject to potential retroactive adjustments. Because substantially all our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant.



	March 31, 2020		December 31, 2019
	(In millions)
Government receivables	$	1,167	$	1,056
Pharmacy rebate receivables	160		150
Health insurer fee reimbursement receivables	71		5
Other	205		195
Total	$	1,603	$	1,406

Concentrations of Credit Risk

Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 10 years, or less than 10 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state or commonwealth in which our health plan subsidiaries operate.

Health Insurer Fee

Under the Affordable Care Act, the federal government imposes an annual fee, or excise tax, on health insurers for each calendar year (the “HIF”). Public Law No. 115-120 provided for a HIF moratorium in 2019; therefore, there was no HIF incurred or reimbursed in that year. The HIF is reinstated in 2020, but the Further Consolidated Appropriations Act, 2020, repealed the HIF effective for years after 2020. The HIF is allocated to health insurers based on each health insurer's share of net premiums for all U.S. health insurers in the year preceding the assessment. Our estimated HIF liability for 2020 is $271 million, and was accrued as of January 1, 2020, with a corresponding deferred expense asset that will be amortized to expense through December 31, 2020, on a straight-line basis. The HIF is not deductible for income tax purposes, and is payable by September 30, 2020. Due to the reinstatement of the HIF in 2020, our effective tax rate is higher in 2020 compared with 2019.

Within our Medicaid program, we must secure additional reimbursement from our state partners for this added cost. We have obtained a contractual commitments or are receiving payments from all states in which we operate Medicaid programs to reimburse us for the HIF, and such HIF revenue is being recognized ratably throughout the year.

Income Taxes

The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, nondeductible expenses such as the HIF, certain compensation, and other general and administrative expenses.

The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.

Recent Accounting Pronouncements Adopted

Credit Losses. In June 2016, the FASB issued Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which was subsequently modified by several ASUs issued in 2018 and 2019. We adopted Topic 326 effective January 1, 2020,

using the modified retrospective approach. Under this method we recognized the cumulative effect of adopting the standard as an adjustment to the opening balance of retained earnings on January 1, 2020, which was immaterial.

Recent Accounting Pronouncements Not Yet Adopted

Reference Rate Reform. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying generally accepted accounting principles to contracts, hedging relationships, and other transactions affected by a change in the reference rate from LIBOR or another reference rate expected to be discontinued, if certain conditions are met. ASU 2020-04 is effective immediately and expires after December 31, 2022. We are evaluating the effect of reference rate reform and this guidance on our contracts and other transactions.

Other recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.

Net Income per Share

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Net Income per Share

The following table sets forth the calculation of net income per share:



		Three Months Ended March 31,
		2020			2019
	(In millions, except net income per share)
Numerator:
Net income		$	178		$	198
Denominator:
Shares outstanding at the beginning of the period		61.9			62.1
Weighted-average number of shares issued:
Stock purchases		(1.7		)	—
Stock-based compensation		—			—
Denominator for basic net income per share		60.2			62.1
Effect of dilutive securities: ⁽¹⁾
Warrants		0.1			3.5
Stock-based compensation		0.7			0.6
Denominator for diluted net income per share		61.0			66.2

Net income per share - Basic ⁽²⁾		$	2.95		$	3.19
Net income per share - Diluted ⁽²⁾		$	2.92		$	2.99

______________________________

(1)

The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. Approximately 0.1 million anti-dilutive shares were not included in the computation of diluted net income per share for the three months ended March 31, 2019. All warrants outstanding as of December 31, 2019, were settled in the first quarter of 2020. For more information refer to Note 8, “Stockholders' Equity.”

(2)

Source data for calculations in thousands.

Fair Value Measurements

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Fair Value Measurements

We consider the carrying amounts of current assets and current liabilities (not including the current portion of long-term debt) to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to the three-tier fair value hierarchy. For a description of the methods and assumptions that we use to a) estimate the fair value; and b) determine the

classification according to the fair value hierarchy for each financial instrument, refer to our 2019 Annual Report on Form 10-K, Note 4, “Fair Value Measurements.”

Our financial instruments measured at fair value on a recurring basis at March 31, 2020, were as follows:



	Total		Observable Inputs (Level 1)		Directly or Indirectly Observable Inputs (Level 2)		Unobservable Inputs (Level 3)
	(In millions)
Corporate debt securities	$	1,260	$	—	$	1,260	$	—
Mortgage-backed securities	451		—		451		—
Asset-backed securities	143		—		143		—
Municipal securities	138		—		138		—
Certificates of deposit	7		—		7		—
Government-sponsored enterprise securities (“GSEs”)	6		—		6		—
U.S. Treasury notes	5		—		5		—
Total assets	$	2,010	$	—	$	2,010	$	—

Our financial instruments measured at fair value on a recurring basis at December 31, 2019, were as follows:



	Total		Observable Inputs (Level 1)		Directly or Indirectly Observable Inputs (Level 2)		Unobservable Inputs (Level 3)
	(In millions)
Corporate debt securities	$	1,178	$	—	$	1,178	$	—
Mortgage-backed securities	420		—		420		—
Asset-backed securities	127		—		127		—
Municipal securities	78		—		78		—
Certificates of deposit	1		—		1		—
GSEs	49		—		49		—
U.S. Treasury notes	86		—		86		—
Foreign securities	7		—		7		—
Subtotal	1,946		—		1,946		—
Call option derivative asset	29		—		—		29
Total assets	$	1,975	$	—	$	1,946	$	29

Conversion option derivative liability	$	29	$	—	$	—	$	29
Total liabilities	$	29	$	—	$	—	$	29

The net changes in fair value of Level 3 financial instruments were insignificant to our results of operations for the three months ended March 31, 2020.

Derivatives

The following table summarizes the fair values and the presentation of our derivative financial instruments in the accompanying consolidated balance sheets:



	Balance Sheet Location	March 31, 2020		December 31, 2019
		(In millions)
Derivative asset:
Call option	Current assets: Prepaid expenses and other current assets	$	—	$	29
Derivative liability:
Conversion option	Current liabilities: Accounts payable, accrued liabilities and other	$	—	$	29

For additional description of our derivative financial instruments, see Note 11, “Debt,” and Note 12, “Derivatives,” in our 2019 Annual Report on Form 10-K. Our derivative financial instruments did not qualify for hedge treatment; therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of income, and reported in “Other income, net.” Gains and losses for our derivative financial instruments are presented individually in the accompanying consolidated statements of cash flows, “Supplemental cash flow information.”

In the first quarter of 2020, we received $27 million for the settlement of the call option derivative asset, and we paid $39 million to settle the outstanding $12 million principal amount of the 1.125% Convertible Notes, and settle the related conversion option. For more information, refer to Notes 7, “Debt,” and 8, “Stockholders' Equity.”

Fair Value Measurements – Disclosure Only

The carrying amounts and estimated fair values of our notes payable are classified as Level 2 financial instruments. Fair value for these securities is determined using a market approach based on quoted market prices for similar securities in active markets or quoted prices for identical securities in inactive markets. The carrying amount and estimated fair value of the Term Loan Facility is classified as a Level 3 financial instrument, because certain inputs used to determine its fair value are not observable. As of March 31, 2020, the carrying amount of the Term Loan Facility approximated fair value because its interest rate is a variable rate that approximates rates currently available to us.



	March 31, 2020				December 31, 2019
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(In millions)
5.375% Notes	$	696	$	701	$	696	$	745
4.875% Notes	326		310		327		340
Term Loan Facility	600		600		220		220
1.125% Convertible Notes ⁽¹⁾	—		—		12		42
Totals	$	1,622	$	1,611	$	1,255	$	1,347

______________________

(1)

For more information on debt repayments, refer to Note 7, “Debt.”

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Investments

3 Months Ended

Mar. 31, 2020

Investments, Debt and Equity Securities [Abstract]

Investments

Available-for-Sale Investments

We consider all our investments classified as current assets to be available-for-sale. The following tables summarize our investments as of the dates indicated:



	March 31, 2020
	Amortized		Gross Unrealized				Estimated Fair
	Cost		Gains		Losses		Value
	(In millions)
Corporate debt securities	$	1,277	$	4	$	21	$	1,260
Mortgage-backed securities	453		6		8		451
Asset-backed securities	144		—		1		143
Municipal securities	138		—		—		138
Certificates of deposit	7		—		—		7
GSEs	6		—		—		6
U.S. Treasury notes	5		—		—		5
Totals	$	2,030	$	10	$	30	$	2,010



	December 31, 2019
	Amortized		Gross Unrealized				Estimated Fair
	Cost		Gains		Losses		Value
	(In millions)
Corporate debt securities	$	1,174	$	5	$	1	$	1,178
Mortgage-backed securities	420		1		1		420
Asset-backed securities	126		1		—		127
Municipal securities	78		—		—		78
Certificates of deposit	1		—		—		1
GSEs	49		—		—		49
U.S. Treasury notes	86		—		—		86
Foreign securities	7		—		—		7
Totals	$	1,941	$	7	$	2	$	1,946

The contractual maturities of our available-for-sale investments as of March 31, 2020 are summarized below:



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	375	$	375
Due after one year through five years	1,032		1,017
Due after five years through ten years	183		181
Due after ten years	440		437
Totals	$	2,030	$	2,010

Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains amounted to $5 million in the three months ended March 31, 2020. Gross realized investment losses were insignificant in the three months ended March 31, 2020. Gross realized investment gains and losses were insignificant in the three months ended March 31, 2019.

We have determined that unrealized losses at March 31, 2020, and December 31, 2019, have primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we have determined that an allowance for credit losses is not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant.

The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of March 31, 2020:



	In a Continuous Loss Position for Less than 12 Months					In a Continuous Loss Position for 12 Months or More
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions
	(Dollars in millions)
Corporate debt securities	$	805	$	21	627	$	—	$	—	—
Mortgage-backed securities	211		8		128	—		—		—
Asset-backed securities	90		1		70	—		—		—
Totals	$	1,106	$	30	825	$	—	$	—	—



	In a Continuous Loss Position for Less than 12 Months					In a Continuous Loss Position for 12 Months or More
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions
	(Dollars in millions)
Corporate debt securities	$	222	$	1	167	$	—	$	—	—
Mortgage-backed securities	143		1		72	—		—		—
Totals	$	365	$	2	239	$	—	$	—	—

Held-to-Maturity Investments

Pursuant to the regulations governing our Health Plans segment subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets.

We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value. Such investments amounted to $82 million at March 31, 2020, of which $79 million will mature in one year or less, and $3 million will mature in after one through five years.

Medical Claims and Benefits Payable

3 Months Ended

Mar. 31, 2020

Other Liabilities Disclosure [Abstract]

Medical Claims and Benefits Payable

The following table provides the details of our medical claims and benefits payable as of the dates indicated.



	March 31, 2020		December 31, 2019
	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	1,444	$	1,406
Pharmacy payable	150		126
Capitation payable	62		55
Other	325		267
	$	1,981	$	1,854

“Other” medical claims and benefits payable includes amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $116 million and $132 million as of March 31, 2020, and December 31, 2019, respectively.

The following table presents the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior periods” represent the amounts by which our original estimate of medical claims and benefits payable at the beginning of the period were more than the actual amount of the liability, based on information (principally the payment of claims) developed since that liability was first reported.



	Three Months Ended March 31,
	2020			2019
	(In millions)
Medical claims and benefits payable, beginning balance	$	1,854		$	1,961
Components of medical care costs related to:
Current period	3,817			3,560
Prior periods	(101		)	(189		)
Total medical care costs	3,716			3,371
Change in non-risk and other provider payables	(10		)	171
Payments for medical care costs related to:
Current period	2,274			2,197
Prior periods	1,305			1,311
Total paid	3,579			3,508
Medical claims and benefits payable, ending balance	$	1,981		$	1,995

Our estimates of medical claims and benefits payable recorded at December 31, 2019, and 2018 developed favorably by approximately $101 million and $189 million as of March 31, 2020, and 2019, respectively.

The favorable prior year development recognized in the three months ended March 31, 2020, was primarily due to lower than expected utilization of medical services by our Medicaid members, and improved operating performance. Consequently, the ultimate costs recognized in 2020, as claims payments were processed, were lower than our original estimates in 2019.

Debt

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Debt

All our debt is held at the parent, which is reported in the Other segment. The following table summarizes our outstanding debt obligations and their classification in the accompanying consolidated balance sheets:



	March 31, 2020			December 31, 2019
	(In millions)
Current portion of long-term debt:
Term Loan Facility	$	26		$	6
1.125% Convertible Notes, net of unamortized discount	—			12
Total	$	26		$	18
Non-current portion of long-term debt:
5.375% Notes due 2022	$	700		$	700
4.875% Notes due 2025	330			330
Term Loan Facility	574			214
Debt issuance costs	(8		)	(7		)
Total	$	1,596		$	1,237

Credit Agreement

We are party to a Credit Agreement, which provides for an unsecured delayed draw term loan facility (the “Term Loan Facility”), and an unsecured revolving credit facility (the “Credit Facility”), both described in further detail below. Borrowings under the Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case the applicable margin. In addition to interest payable on the principal amount of

indebtedness outstanding from time to time under the Credit Agreement, we are required to pay a quarterly commitment fee.

The Credit Agreement contains customary non-financial and financial covenants. As of March 31, 2020, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt.

Term Loan Facility. In March 2020, we drew down the Term Loan Facility’s remaining available capacity of $380 million, for an outstanding balance of $600 million as of March 31, 2020. The Term Loan Facility amortizes in quarterly installments, commencing on September 30, 2020, equal to the principal amount of the Term Loan Facility outstanding multiplied by rates ranging from 1.25% to 2.50% (depending on the applicable fiscal quarter) for each fiscal quarter. Because each advance under the Term Loan Facility results in a permanent reduction to its borrowing capacity, no further advances are available. Any remaining outstanding balance under the Term Loan Facility will be due and payable on its January 31, 2024 expiration date.

Credit Facility. Our Credit Facility provides for borrowings up to $500 million, and expires on January 31, 2022; therefore, any amounts outstanding will be due and payable on that date. As of March 31, 2020, no amounts were outstanding under the Credit Facility, and outstanding letters of credit amounting to $1 million reduced our borrowing capacity under the Credit Facility to $499 million.

5.375% Notes due 2022

We had $700 million aggregate principal amount of senior notes (the “5.375% Notes”) outstanding as of March 31, 2020, which are due November 15, 2022, unless earlier redeemed. Interest, at a rate of 5.375% per annum, is payable semiannually in arrears on May 15 and November 15. The 5.375% Notes contain customary non-financial covenants and change in control provisions.

4.875% Notes due 2025

We had $330 million aggregate principal amount of senior notes (the “4.875% Notes”) outstanding as of March 31, 2020, which are due June 15, 2025, unless earlier redeemed. Interest, at a rate of 4.875% per annum, is payable semiannually in arrears on June 15 and December 15. The 4.875% Notes contain customary non-financial covenants and change of control provisions.

1.125% Cash Convertible Senior Notes due 2020

For a description of the 1.125% cash convertible senior notes due January 15, 2020 (the “1.125% Convertible Notes”), see Note 11, “Debt,” in our 2019 Annual Report on Form 10-K. In January 2020, we paid $39 million to settle the outstanding $12 million principal amount of the 1.125% Convertible Notes, and settle the related conversion option.

Cross-Default Provisions

The indentures governing the 4.875% Notes and the 5.375% Notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture.

Stockholders' Equity

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Stockholders' Equity

Stock Purchase Program

In early December 2019, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This program was funded by existing cash on hand and was completed in March 2020.

Under this program, pursuant to Rule 10b5-1 trading plans, we purchased approximately 3.4 million shares of our common stock for $446 million in the first quarter of 2020 (average cost of $132.45 per share). In the first quarter of 2020, we also paid $7 million to settle shares purchased in late December 2019.

1.125% Warrants

For a description of the 1.125% Warrants, refer to our 2019 Annual Report on Form 10-K, Note 12, “Derivatives,” and Note 14, “Stockholders’ Equity.” Approximately 310,000 of the 1.125% Warrants were outstanding at December 31, 2019. In the first quarter of 2020, we entered into privately negotiated termination agreements under which we paid $30 million to the Counterparties for the termination of the remaining 1.125% Warrants outstanding, which resulted in a reduction of additional paid-in-capital for the same amount.

Share-Based Compensation

In connection with our employee stock plans, approximately 98,000 shares of common stock vested or were purchased, net of shares used to settle employees’ income tax obligations, during the three months ended March 31, 2020.

Share-based compensation is recorded to “General and administrative expenses” in the accompanying consolidated statements of income. Total share-based compensation expense amounted to $12 million and $9 million, respectively, in the three months ended March 31, 2020 and 2019.

As of March 31, 2020, there was $89 million of total unrecognized compensation expense related to unvested restricted stock awards (“RSAs”), and performance stock units (“PSUs”), which we expect to recognize over remaining weighted-average periods of 2.9 years and 1.9 years, respectively. This unrecognized compensation cost assumes an estimated forfeiture rate of 10.7% for non-executive employees as of March 31, 2020.

As of March 31, 2020, there was also $3 million of total unrecognized compensation expense related to unvested stock options, which we expect to recognize over a weighted-average period of 0.5 years. No stock options were granted or exercised in the three months ended March 31, 2020.

Activity for RSAs and PSUs is summarized below:



	RSAs		PSUs		Total		Weighted Average Grant Date Fair Value
Unvested balance, December 31, 2019	447,680		324,078		771,758		$	102.01
Granted	294,319		160,929		455,248		122.20
Vested	(151,110	)	(7,368	)	(158,478	)	92.92
Forfeited	(12,202	)	(22,826	)	(35,028	)	101.60
Unvested balance, March 31, 2020	578,687		454,813		1,033,500		$	112.31

The aggregate fair values of RSAs and PSUs granted and vested are presented in the following table:



	Three Months Ended March 31,
	2020		2019
	(In millions)
Granted:
RSAs	$	36	$	30
PSUs	19		18
Total granted	$	55	$	48
Vested:
RSAs	$	19	$	16
PSUs	1		2
Total vested	$	20	$	18

Segments

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Segments

We currently have two reportable segments: the Health Plans segment and the Other segment. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.

Margin is the appropriate earnings measure for our reportable segments, based on how our chief operating decision maker currently reviews results, assesses performance, and allocates resources.

The key metrics used to assess the performance of our Health Plans segment are premium revenue, medical margin and MCR. MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying margin, or the amount earned by the Health Plans segment after medical costs are deducted from premium revenue, is the most important measure of earnings reviewed by management. Margin for our Health Plans segment is referred to as “Medical Margin.”

The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.



	Three Months Ended March 31,
	2020		2019
	(In millions)
Total revenue:
Health Plans	$	4,545	$	4,117
Other	4		2
Consolidated	$	4,549	$	4,119

The following table reconciles margin to consolidated income before income taxes:



	Three Months Ended March 31,
	2020			2019
	(In millions)
Margin:
Health Plans	$	588		$	581
Add: other operating revenues ⁽¹⁾	245			167
Less: other operating expenses ⁽²⁾	(559		)	(468		)
Operating income	274			280
Other expenses, net	21			20
Income before income tax expense	$	253		$	260

______________________


(1)	Other operating revenues include premium tax revenue, health insurer fees reimbursed, and investment income and other revenue.

(2)

Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other costs.

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies COVID-19 Pandemic On March 11, 2020, the World Health Organization officially declared COVID-19, the disease caused by the novel coronavirus, a pandemic. The ultimate effects of the pandemic, and the duration of any such effects, including any impact to our medical care ratio (which could increase or decrease), are not known or quantifiable at this time. As of March 31, 2020, we have not experienced any significant interruptions in the services we provide, nor was there a material impact of the pandemic to our consolidated financial position, results of operations, and cash flows in the first quarter of 2020. Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Penalties associated with violations of these laws and regulations include significant fines, exclusion from participating in publicly funded programs, and the repayment of previously collected revenues. In the ordinary course of business we are involved in legal actions, some of which seek monetary damages which are not covered by insurance. We have accrued liabilities for certain matters for which we deem the loss to be both probable and reasonably estimable, but the outcome of legal actions is inherently uncertain and our estimates of such losses could be understated, and could also subsequently change as a result of further developments of these matters. For certain pending matters, accruals have not been established because we believe we are not liable or because such matters have not progressed sufficiently through discovery or factual development to enable us to reasonably estimate a range of possible loss. An adverse determination in one or more of these pending matters could have an adverse effect on our consolidated financial position, results of operations, or cash flows.

Subsequent Events (Notes)	3 Months Ended
Subsequent Events (Notes)	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Acquisition of Magellan Complete Care On April 30, 2020, we entered into a definitive agreement to acquire the Magellan Complete Care (“MCC”) line of business of Magellan Health, Inc. The purchase price for the transaction is approximately $820 million, net of certain tax benefits, which we intend to fund with cash on hand. MCC is a managed care organization serving members in six states, including Medicaid members in Arizona and statewide in Virginia. Through its Senior Whole Health branded plans, MCC provides fully integrated plans for Medicaid and Medicare dual beneficiaries in Massachusetts, as well as Managed Long Term Care (“MLTC,” commonly known nationally as “MLTSS”) in New York. As of December 31, 2019, MCC served approximately 155,000 members, with full year 2019 revenues greater than $2.7 billion. The transaction is subject to federal and state regulatory approvals, and other customary closing conditions, and is expected to close in the first quarter of 2021. In connection with this transaction, Magellan Health, Inc. has agreed to provide certain transition services following the closing. In connection with the MCC acquisition, we entered into a commitment letter on April 30, 2020, pursuant to which, among other things, the lenders have committed to provide us with debt financing in the aggregate principal amount of up to $400 million. Marketplace Risk Corridor Ruling On April 27, 2020, the United States Supreme Court issued its opinion in Maine Community Health Options v. United States. The Supreme Court held that §1342 of the Affordable Care Act obligated the federal government to pay participating insurers the full Marketplace risk corridor amounts calculated by that statute, that such payment obligations survived Congress’ appropriations riders, and that impacted insurers may sue the federal government in the U.S. Court of Federal Claims to recover damages for breach of that obligation. There are no distinguishing factors regarding liability or damages between this case and the cases we ourselves have brought against the federal government for its failure to pay our Marketplace risk corridors claims for 2014, 2015, and 2016. We have already obtained summary judgment for our 2014 and 2015 risk corridor claims in the approximate amount of $52 million, and we have brought another claim for approximately $76 million for the government’s failure to pay our 2016 risk corridor claims. The timing of recognition and collection of these outstanding Marketplace risk corridor claims is uncertain, but we will request that the Court of Claims act as expeditiously as possible to enter judgment for all of the risk corridors amounts owed to us.

Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Consolidation and Interim Financial Information

These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2019.

Use of Estimates


•	The determination of medical claims and benefits payable of our Health Plans segment;


•	Health Plans segment contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract;


•	Health Plans segment quality incentives that allow us to recognize incremental revenue if certain quality standards are met;


•	Settlements under risk or savings sharing programs;


•	The assessment of long-lived and intangible assets, and goodwill for impairment;


•	The determination of reserves for potential absorption of claims unpaid by insolvent providers;


•	The determination of reserves for the outcome of litigation;


•	The determination of valuation allowances for deferred tax assets; and

•

The determination of unrecognized tax benefits.

Cash and Cash Equivalents

Investments

Premium Revenue and Contractual Provisions That May Adjust or Limit Revenue or Profit

Premium Revenue Recognition and Premiums Receivable

Contractual Provisions That May Adjust or Limit Revenue or Profit

Medicaid Program

Medicare Program

Marketplace Program

Refer to Note 11, “Subsequent Events,” for the description of a recent United States Supreme Court decision regarding Marketplace risk corridors.

Receivables

Concentrations of Credit Risk

Income Taxes

Recent Accounting Pronouncements Adopted and Not Yet Adopted

Recent Accounting Pronouncements Adopted

Recent Accounting Pronouncements Not Yet Adopted

Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2020

Accounting Policies [Abstract]

Schedule of Cash and Cash Equivalents

The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.



	March 31,
	2020		2019
	(In millions)
Cash and cash equivalents	$	2,365	$	3,224
Restricted cash and cash equivalents	58		74
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,423	$	3,298

Restricted Cash and Cash Equivalents



	March 31,
	2020		2019
	(In millions)
Cash and cash equivalents	$	2,365	$	3,224
Restricted cash and cash equivalents	58		74
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,423	$	3,298

Amounts Due to Government Agencies

A summary of the categories of amounts due government agencies is as follows:



	March 31, 2020		December 31, 2019
	(In millions)
Medicaid program:
Medical cost floors and corridors	$	74	$	74
Other amounts due to states	76		84
Marketplace program:
Risk adjustment	456		368
Other	171		138
Total amounts due government agencies	$	777	$	664

Quality Incentive Premium Revenue Recognized

The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the periods presented and prior periods.



		Three Months Ended March 31,
		2020			2019
	(In millions)
Maximum available quality incentive premium - current period		$	61		$	45

Quality incentive premium revenue recognized in current period:
Earned current period		$	44		$	26
Earned prior periods		12			20
Total		$	56		46

Quality incentive premium revenue recognized as a percentage of total premium revenue		1.3		%	1.2		%

Schedule of receivables



	March 31, 2020		December 31, 2019
	(In millions)
Government receivables	$	1,167	$	1,056
Pharmacy rebate receivables	160		150
Health insurer fee reimbursement receivables	71		5
Other	205		195
Total	$	1,603	$	1,406

Net Income per Share (Tables)

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Summary of Denominators for the Computation of Basic and Diluted Net Income (Loss) Per Share

The following table sets forth the calculation of net income per share:



		Three Months Ended March 31,
		2020			2019
	(In millions, except net income per share)
Numerator:
Net income		$	178		$	198
Denominator:
Shares outstanding at the beginning of the period		61.9			62.1
Weighted-average number of shares issued:
Stock purchases		(1.7		)	—
Stock-based compensation		—			—
Denominator for basic net income per share		60.2			62.1
Effect of dilutive securities: ⁽¹⁾
Warrants		0.1			3.5
Stock-based compensation		0.7			0.6
Denominator for diluted net income per share		61.0			66.2

Net income per share - Basic ⁽²⁾		$	2.95		$	3.19
Net income per share - Diluted ⁽²⁾		$	2.92		$	2.99

______________________________

(1)

(2)

Source data for calculations in thousands.

Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Fair Value of Assets Measured on Recurring Basis

Our financial instruments measured at fair value on a recurring basis at March 31, 2020, were as follows:



	Total		Observable Inputs (Level 1)		Directly or Indirectly Observable Inputs (Level 2)		Unobservable Inputs (Level 3)
	(In millions)
Corporate debt securities	$	1,260	$	—	$	1,260	$	—
Mortgage-backed securities	451		—		451		—
Asset-backed securities	143		—		143		—
Municipal securities	138		—		138		—
Certificates of deposit	7		—		7		—
Government-sponsored enterprise securities (“GSEs”)	6		—		6		—
U.S. Treasury notes	5		—		5		—
Total assets	$	2,010	$	—	$	2,010	$	—

Our financial instruments measured at fair value on a recurring basis at December 31, 2019, were as follows:



	Total		Observable Inputs (Level 1)		Directly or Indirectly Observable Inputs (Level 2)		Unobservable Inputs (Level 3)
	(In millions)
Corporate debt securities	$	1,178	$	—	$	1,178	$	—
Mortgage-backed securities	420		—		420		—
Asset-backed securities	127		—		127		—
Municipal securities	78		—		78		—
Certificates of deposit	1		—		1		—
GSEs	49		—		49		—
U.S. Treasury notes	86		—		86		—
Foreign securities	7		—		7		—
Subtotal	1,946		—		1,946		—
Call option derivative asset	29		—		—		29
Total assets	$	1,975	$	—	$	1,946	$	29

Conversion option derivative liability	$	29	$	—	$	—	$	29
Total liabilities	$	29	$	—	$	—	$	29

Fair Value, by Balance Sheet Grouping

The following table summarizes the fair values and the presentation of our derivative financial instruments in the accompanying consolidated balance sheets:



	Balance Sheet Location	March 31, 2020		December 31, 2019
		(In millions)
Derivative asset:
Call option	Current assets: Prepaid expenses and other current assets	$	—	$	29
Derivative liability:
Conversion option	Current liabilities: Accounts payable, accrued liabilities and other	$	—	$	29

Schedule of Fair Value, Asset and Liabilities Measured on Recurring Basis - Disclosure Only



	March 31, 2020				December 31, 2019
	Carrying Amount		Fair Value		Carrying Amount		Fair Value
	(In millions)
5.375% Notes	$	696	$	701	$	696	$	745
4.875% Notes	326		310		327		340
Term Loan Facility	600		600		220		220
1.125% Convertible Notes ⁽¹⁾	—		—		12		42
Totals	$	1,622	$	1,611	$	1,255	$	1,347

______________________

(1)

For more information on debt repayments, refer to Note 7, “Debt.”

Investments (Tables)

3 Months Ended

Mar. 31, 2020

Investments, Debt and Equity Securities [Abstract]

Available-for-Sale Investments

The following tables summarize our investments as of the dates indicated:



	March 31, 2020
	Amortized		Gross Unrealized				Estimated Fair
	Cost		Gains		Losses		Value
	(In millions)
Corporate debt securities	$	1,277	$	4	$	21	$	1,260
Mortgage-backed securities	453		6		8		451
Asset-backed securities	144		—		1		143
Municipal securities	138		—		—		138
Certificates of deposit	7		—		—		7
GSEs	6		—		—		6
U.S. Treasury notes	5		—		—		5
Totals	$	2,030	$	10	$	30	$	2,010



	December 31, 2019
	Amortized		Gross Unrealized				Estimated Fair
	Cost		Gains		Losses		Value
	(In millions)
Corporate debt securities	$	1,174	$	5	$	1	$	1,178
Mortgage-backed securities	420		1		1		420
Asset-backed securities	126		1		—		127
Municipal securities	78		—		—		78
Certificates of deposit	1		—		—		1
GSEs	49		—		—		49
U.S. Treasury notes	86		—		—		86
Foreign securities	7		—		—		7
Totals	$	1,941	$	7	$	2	$	1,946

Contractual Maturities of Investments

The contractual maturities of our available-for-sale investments as of March 31, 2020 are summarized below:



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	375	$	375
Due after one year through five years	1,032		1,017
Due after five years through ten years	183		181
Due after ten years	440		437
Totals	$	2,030	$	2,010

Available-for-Sale Investments in a Continuous Loss Position



	In a Continuous Loss Position for Less than 12 Months					In a Continuous Loss Position for 12 Months or More
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions
	(Dollars in millions)
Corporate debt securities	$	805	$	21	627	$	—	$	—	—
Mortgage-backed securities	211		8		128	—		—		—
Asset-backed securities	90		1		70	—		—		—
Totals	$	1,106	$	30	825	$	—	$	—	—



	In a Continuous Loss Position for Less than 12 Months					In a Continuous Loss Position for 12 Months or More
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions
	(Dollars in millions)
Corporate debt securities	$	222	$	1	167	$	—	$	—	—
Mortgage-backed securities	143		1		72	—		—		—
Totals	$	365	$	2	239	$	—	$	—	—

Medical Claims and Benefits Payable (Tables)

3 Months Ended

Mar. 31, 2020

Other Liabilities Disclosure [Abstract]

Medical Claims and Benefits Payable

The following table provides the details of our medical claims and benefits payable as of the dates indicated.



	March 31, 2020		December 31, 2019
	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	1,444	$	1,406
Pharmacy payable	150		126
Capitation payable	62		55
Other	325		267
	$	1,981	$	1,854

Components of Components of Change in Medical Claims and Benefits Payable



	Three Months Ended March 31,
	2020			2019
	(In millions)
Medical claims and benefits payable, beginning balance	$	1,854		$	1,961
Components of medical care costs related to:
Current period	3,817			3,560
Prior periods	(101		)	(189		)
Total medical care costs	3,716			3,371
Change in non-risk and other provider payables	(10		)	171
Payments for medical care costs related to:
Current period	2,274			2,197
Prior periods	1,305			1,311
Total paid	3,579			3,508
Medical claims and benefits payable, ending balance	$	1,981		$	1,995

Debt (Tables)

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Schedule of Long-Term Debt

The following table summarizes our outstanding debt obligations and their classification in the accompanying consolidated balance sheets:



	March 31, 2020			December 31, 2019
	(In millions)
Current portion of long-term debt:
Term Loan Facility	$	26		$	6
1.125% Convertible Notes, net of unamortized discount	—			12
Total	$	26		$	18
Non-current portion of long-term debt:
5.375% Notes due 2022	$	700		$	700
4.875% Notes due 2025	330			330
Term Loan Facility	574			214
Debt issuance costs	(8		)	(7		)
Total	$	1,596		$	1,237

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28551-108399

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21521-112644

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21538-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

Stockholders' Equity (Tables)

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Restricted Share Activity

Activity for RSAs and PSUs is summarized below:



	RSAs		PSUs		Total		Weighted Average Grant Date Fair Value
Unvested balance, December 31, 2019	447,680		324,078		771,758		$	102.01
Granted	294,319		160,929		455,248		122.20
Vested	(151,110	)	(7,368	)	(158,478	)	92.92
Forfeited	(12,202	)	(22,826	)	(35,028	)	101.60
Unvested balance, March 31, 2020	578,687		454,813		1,033,500		$	112.31

The aggregate fair values of RSAs and PSUs granted and vested are presented in the following table:



	Three Months Ended March 31,
	2020		2019
	(In millions)
Granted:
RSAs	$	36	$	30
PSUs	19		18
Total granted	$	55	$	48
Vested:
RSAs	$	19	$	16
PSUs	1		2
Total vested	$	20	$	18

Segments (Tables)

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Operating Segment Information

The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.



	Three Months Ended March 31,
	2020		2019
	(In millions)
Total revenue:
Health Plans	$	4,545	$	4,117
Other	4		2
Consolidated	$	4,549	$	4,119

The following table reconciles margin to consolidated income before income taxes:



	Three Months Ended March 31,
	2020			2019
	(In millions)
Margin:
Health Plans	$	588		$	581
Add: other operating revenues ⁽¹⁾	245			167
Less: other operating expenses ⁽²⁾	(559		)	(468		)
Operating income	274			280
Other expenses, net	21			20
Income before income tax expense	$	253		$	260

______________________


(1)	Other operating revenues include premium tax revenue, health insurer fees reimbursed, and investment income and other revenue.


(2)	Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other costs.

Organization and Basis of Presentation (Details) member in Millions	3 Months Ended
	Mar. 31, 2020 member segment state
Segment Reporting Information [Line Items]
Number of reportable segments (in segment) \| segment	2
Health Plans
Segment Reporting Information [Line Items]
Number of states in which entity operates (in state) \| state	14
Number of members eligible for the health care programs, approximately (in member) \| member	3.4
Minimum \| Health Plans
Segment Reporting Information [Line Items]
Contract term	3 years
Maximum \| Health Plans
Segment Reporting Information [Line Items]
Contract term	5 years

Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019	Mar. 31, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Cash and cash equivalents	$ 2,365	$ 2,452	$ 3,224
Restricted cash and cash equivalents	58		74
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 2,423	$ 2,508	$ 3,298	$ 2,926

Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Schedule of Premium Revenue by Health Plan Type [Line Items]
Maturity period	10 years
Average maturity period	10 years
Interest receivable	$ 11	$ 12
Medical cost floors and corridors	74	74
Amounts due government agencies	777	664
Risk adjustment payable	456	368
Risk adjustment receivable	76	63
Risk adjustment, net payable	380	305
Risk adjustment, net payable, current year	80
Risk adjustment, net payable, prior year	300
Receivables from state and federal government agencies	1,603	1,406
HIF liabilities	271
Medicaid Expansion
Schedule of Premium Revenue by Health Plan Type [Line Items]
Amounts due government agencies	$ 69	$ 69

Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Medicaid program:
Medical cost floors and corridors	$ 74	$ 74
Other amounts due to states	76	84
Marketplace program:
Risk adjustment	456	368
Other	171	138
Total amounts due government agencies	$ 777	$ 664

Significant Accounting Policies - Quality Incentive Premium Revenue Recognized (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Schedule of Premium Revenue by Health Plan Type [Line Items]
Maximum available quality incentive premium - current period	$ 61	$ 45
Quality incentive premium revenue recognized in current period:
Earned current period	44	26
Earned prior periods	12	20
Total	$ 56	$ 46
Quality incentive premium revenue recognized as a percentage of total premium revenue	1.30%	1.20%
Select Health Plans \| Minimum
Schedule of Premium Revenue by Health Plan Type [Line Items]
Percentage of additional incremental revenue earned	1.00%
Select Health Plans \| Maximum
Schedule of Premium Revenue by Health Plan Type [Line Items]
Percentage of additional incremental revenue earned	4.00%

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivables	$ 1,603	$ 1,406
Government receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivables	1,167	1,056
Pharmacy rebate receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivables	160	150
Health insurer fee reimbursement receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivables	71	5
Other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Receivables	$ 205	$ 195

Net Income per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019	Dec. 31, 2018
Numerator:
Net income	$ 178	$ 198
Denominator:
Shares outstanding at the beginning of the period (in shares)			61.9	62.1
Weighted-average number of shares issued:
Stock purchases (in shares)	(1.7)	0.0
Stock-based compensation (in shares)	0.0	0.0
Denominator for net income per share, basic (in shares)	60.2	62.1
Effect of dilutive securities:
Warrants (in shares)	0.1	3.5
Stock-based compensation (in shares)	0.7	0.6
Denominator for net income per share, diluted (in shares)	61.0	66.2
Net income per share:
Basic (in dollars per share)	$ 2.95	$ 3.19
Diluted (in dollars per share)	$ 2.92	$ 2.99
Potentially dilutive common shares (in shares)		0.1

Fair Value Measurements - Fair Value of Financial Instruments on Recurring Basis (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 2,010	$ 1,946
Total assets	2,010	1,975
Total liabilities		29
Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,260	1,178
Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	451	420
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	143	127
Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	138	78
Certificates of deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	7	1
Government-sponsored enterprise securities (“GSEs”)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	6	49
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	5	86
Foreign securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		7
Call option derivative asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Call option derivative asset		29
Conversion option derivative liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Conversion option derivative liability		29
Observable Inputs (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		0
Total assets	0	0
Total liabilities		0
Observable Inputs (Level 1) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Certificates of deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Government-sponsored enterprise securities (“GSEs”)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Observable Inputs (Level 1) \| Foreign securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		0
Observable Inputs (Level 1) \| Call option derivative asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Call option derivative asset		0
Observable Inputs (Level 1) \| Conversion option derivative liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Conversion option derivative liability		0
Directly or Indirectly Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		1,946
Total assets	2,010	1,946
Total liabilities		0
Directly or Indirectly Observable Inputs (Level 2) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,260	1,178
Directly or Indirectly Observable Inputs (Level 2) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	451	420
Directly or Indirectly Observable Inputs (Level 2) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	143	127
Directly or Indirectly Observable Inputs (Level 2) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	138	78
Directly or Indirectly Observable Inputs (Level 2) \| Certificates of deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	7	1
Directly or Indirectly Observable Inputs (Level 2) \| Government-sponsored enterprise securities (“GSEs”)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	6	49
Directly or Indirectly Observable Inputs (Level 2) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	5	86
Directly or Indirectly Observable Inputs (Level 2) \| Foreign securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		7
Directly or Indirectly Observable Inputs (Level 2) \| Call option derivative asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Call option derivative asset		0
Directly or Indirectly Observable Inputs (Level 2) \| Conversion option derivative liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Conversion option derivative liability		0
Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		0
Total assets	0	29
Total liabilities		29
Unobservable Inputs (Level 3) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| Certificates of deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| Government-sponsored enterprise securities (“GSEs”)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
Unobservable Inputs (Level 3) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 0	0
Unobservable Inputs (Level 3) \| Foreign securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale		0
Unobservable Inputs (Level 3) \| Call option derivative asset
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Call option derivative asset		29
Unobservable Inputs (Level 3) \| Conversion option derivative liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Conversion option derivative liability		$ 29

Fair Value Measurements - Balance Sheet Grouping (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Current assets: Prepaid expenses and other current assets \| Call option
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative assets	$ 0	$ 29
Current liabilities: Accounts payable, accrued liabilities and other \| Conversion option
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative liabilities	$ 0	$ 29

Fair Value Measurements - Details of Long-Term Debt (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Sep. 30, 2019	Mar. 31, 2019	Dec. 31, 2019
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash received for settlement of call option	$ 27		$ 115
Current liabilities: Derivative liability \| 1.125% Conversion Option
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative liabilities	$ 0			$ 29
5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate on notes	5.375%
4.875% Notes due 2025
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate on notes	4.875%
1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate on notes	1.125%
Senior Notes \| 5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate on notes	5.375%
Senior Notes \| 4.875% Notes due 2025
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate on notes	4.875%
Convertible Notes \| 1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash received for settlement of call option	$ 27
Repayments of debt		$ 39
Debt net of unamortized discount	$ 0			12
Percentage of contractual interest rate on notes	1.125%
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 1,622			1,255
Carrying Amount \| Senior Notes \| 5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	696			696
Carrying Amount \| Senior Notes \| 4.875% Notes due 2025
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	326			327
Carrying Amount \| Term Loan Facility
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	600			220
Carrying Amount \| Convertible Notes \| 1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	0			12
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	1,611			1,347
Fair Value \| Senior Notes \| 5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	701			745
Fair Value \| Senior Notes \| 4.875% Notes due 2025
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	310			340
Fair Value \| Term Loan Facility
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	600			220
Fair Value \| Convertible Notes \| 1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 0			$ 42

Investments - Summary of Investments (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 2,030	$ 1,941
Gross Unrealized Gains	10	7
Gross Unrealized Losses	30	2
Estimated Fair Value	2,010	1,946
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	1,277	1,174
Gross Unrealized Gains	4	5
Gross Unrealized Losses	21	1
Estimated Fair Value	1,260	1,178
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	453	420
Gross Unrealized Gains	6	1
Gross Unrealized Losses	8	1
Estimated Fair Value	451	420
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	144	126
Gross Unrealized Gains	0	1
Gross Unrealized Losses	1	0
Estimated Fair Value	143	127
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	138	78
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	138	78
Certificates of deposit
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	7	1
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	7	1
GSEs
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	6	49
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	6	49
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	5	86
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	$ 5	86
Foreign securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost		7
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Estimated Fair Value		$ 7

Investments - Contractual Maturities of Investments (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Amortized Cost
Due in one year or less	$ 375
Due after one year through five years	1,032
Due after five years through ten years	183
Due after ten years	440
Amortized Cost	2,030	$ 1,941
Estimated Fair Value
Due in one year or less	375
Due after one year through five years	1,017
Due after five years through ten years	181
Due after ten years	437
Estimated Fair Value	$ 2,010

Investments - Narrative (Details) $ in Millions	3 Months Ended
Investments - Narrative (Details) $ in Millions	Mar. 31, 2020 USD ($)
Investments, Debt and Equity Securities [Abstract]
Gross realized investment gains	$ 5
Debt securities held to maturity	82
Held-to-maturity, within one year, amortized cost	79
Held-to-maturity, over one year to five years, amortized cost	$ 3

Investments - Available-for-Sale Investments (Details) $ in Millions	Mar. 31, 2020 USD ($) Security	Dec. 31, 2019 USD ($) Security
Estimated Fair Value
In a Continuous Loss Position for Less than 12 Months	$ 1,106	$ 365
In a Continuous Loss Position for 12 Months or More	0	0
Unrealized Losses
In a Continuous Loss Position for Less than 12 Months	30	2
In a Continuous Loss Position for 12 Months or More	$ 0	$ 0
Total Number of Positions
In a Continuous Loss Position for Less than 12 Months \| Security	825	239
In a Continuous Loss Position for 12 Months or More \| Security	0	0
Corporate debt securities
Estimated Fair Value
In a Continuous Loss Position for Less than 12 Months	$ 805	$ 222
In a Continuous Loss Position for 12 Months or More	0	0
Unrealized Losses
In a Continuous Loss Position for Less than 12 Months	21	1
In a Continuous Loss Position for 12 Months or More	$ 0	$ 0
Total Number of Positions
In a Continuous Loss Position for Less than 12 Months \| Security	627	167
In a Continuous Loss Position for 12 Months or More \| Security	0	0
Mortgage-backed securities
Estimated Fair Value
In a Continuous Loss Position for Less than 12 Months	$ 211	$ 143
In a Continuous Loss Position for 12 Months or More	0	0
Unrealized Losses
In a Continuous Loss Position for Less than 12 Months	8	1
In a Continuous Loss Position for 12 Months or More	$ 0	$ 0
Total Number of Positions
In a Continuous Loss Position for Less than 12 Months \| Security	128	72
In a Continuous Loss Position for 12 Months or More \| Security	0	0
Asset-backed securities
Estimated Fair Value
In a Continuous Loss Position for Less than 12 Months	$ 90
In a Continuous Loss Position for 12 Months or More	0
Unrealized Losses
In a Continuous Loss Position for Less than 12 Months	1
In a Continuous Loss Position for 12 Months or More	$ 0
Total Number of Positions
In a Continuous Loss Position for Less than 12 Months \| Security	70
In a Continuous Loss Position for 12 Months or More \| Security	0

Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019	Mar. 31, 2019	Dec. 31, 2018
Other Liabilities Disclosure [Abstract]
Fee-for-service claims incurred but not paid (“IBNP”)	$ 1,444	$ 1,406
Pharmacy payable	150	126
Capitation payable	62	55
Other	325	267
Medical claims and benefits payable	$ 1,981	$ 1,854	$ 1,995	$ 1,961

Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Other Liabilities Disclosure [Abstract]
Non-risk provider payables	$ 116		$ 132
Prior period claims, favorable development	$ 101	$ 189

Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Insurance Claims
Medical claims and benefits payable, beginning balance	$ 1,854	$ 1,961
Components of medical care costs related to:
Current period	3,817	3,560
Prior periods	(101)	(189)
Total medical care costs	3,716	3,371
Change in non-risk and other provider payables	(10)	171
Payments for medical care costs related to:
Current period	2,274	2,197
Prior periods	1,305	1,311
Total paid	3,579	3,508
Medical claims and benefits payable, ending balance	$ 1,981	$ 1,995

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Current portion of long-term debt:
Current portion of long-term debt	$ 26	$ 18
Non-current portion of long-term debt:
Debt issuance costs	(8)	(7)
Total	$ 1,596	1,237
1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.125%
5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	5.375%
4.875% Notes due 2025
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.875%
Convertible Notes \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.125%
Current portion of long-term debt:
Debt net of unamortized discount	$ 0	12
Term Loan Facility \| Term Loan Facility
Current portion of long-term debt:
Debt net of unamortized discount	26	6
Non-current portion of long-term debt:
Debt net of unamortized debt discount	$ 574	214
Senior Notes \| 5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	5.375%
Non-current portion of long-term debt:
Debt net of unamortized debt discount	$ 700	700
Senior Notes \| 4.875% Notes due 2025
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.875%
Non-current portion of long-term debt:
Debt net of unamortized debt discount	$ 330	$ 330

Debt - Narrative (Details) - USD ($)	3 Months Ended
Debt - Narrative (Details) - USD ($)	Mar. 31, 2020	Sep. 30, 2019	Dec. 31, 2019
5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	5.375%
4.875% Notes due 2025
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.875%
1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	1.125%
Term Loan Facility \| Term Loan Facility
Debt Instrument [Line Items]
Current borrowing capacity	$ 380,000,000
Aggregate principal amount of notes outstanding	600,000,000
Debt net of unamortized discount	$ 26,000,000		$ 6,000,000
Senior Notes \| 5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	5.375%
Face amount	$ 700,000,000
Senior Notes \| 4.875% Notes due 2025
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.875%
Face amount	$ 330,000,000
Convertible Notes \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	1.125%
Repayments of debt		$ 39,000,000
Debt net of unamortized discount	$ 0		$ 12,000,000
Credit Facility \| Term Loan Facility
Debt Instrument [Line Items]
Current borrowing capacity	499,000,000
Maximum borrowing capacity	500,000,000
Amount outstanding under letter of credit	$ 0
Credit Facility \| Minimum \| Term Loan Facility
Debt Instrument [Line Items]
Amortization payment percentage	1.25%
Credit Facility \| Maximum \| Term Loan Facility
Debt Instrument [Line Items]
Amortization payment percentage	2.50%
Letter of Credit \| Term Loan Facility
Debt Instrument [Line Items]
Amount outstanding under letter of credit	$ 1,000,000

Stockholders' Equity - Narrative (Details) - USD ($)	3 Months Ended
Stockholders' Equity - Narrative (Details) - USD ($)	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Class of Stock [Line Items]
Shares repurchased, value	$ 446,000,000
Common stock purchases	453,000,000	$ 0
Cash paid for partial termination of 1.125% Warrants	30,000,000	103,000,000
Share-based compensation	12,000,000	$ 9,000,000
Unrecognized compensation expense	$ 89,000,000
Unrecognized compensation forfeiture rate	10.70%
Stock options granted (in shares)	0
RSAs
Class of Stock [Line Items]
Weighted average period for recognition	2 years 10 months 24 days
PSUs
Class of Stock [Line Items]
Weighted average period for recognition	1 year 10 months 24 days
Employee Stock Option
Class of Stock [Line Items]
Unrecognized compensation expense	$ 3,000,000
Weighted average period for recognition	6 months
1.125% Warrants
Class of Stock [Line Items]
Stated percentage of warrants	1.125%
Warrants outstanding			310,000
Cash paid for partial termination of 1.125% Warrants	$ 30,000,000
Common Stock
Class of Stock [Line Items]
Authorized amount			$ 500,000,000
Shares repurchased (in shares)	3,400,000
Shares repurchased, value	$ 446,000,000
Shares repurchased (in dollars per share)	$ 132.45
Common stock purchases	$ 7,000,000
Number of common stock issued (in shares)	98,000	1,000,000

Stockholders' Equity - Share Activity (Details)	3 Months Ended
Stockholders' Equity - Share Activity (Details)	Mar. 31, 2020 $ / shares shares
Number of Shares
Beginning Balance (shares)	771,758
Granted (shares)	455,248
Vested (shares)	(158,478)
Forfeited (shares)	(35,028)
Ending Balance (shares)	1,033,500
Weighted Average Grant Date Fair Value
Begining Balance (usd per share) \| $ / shares	$ 102.01
Granted (usd per share) \| $ / shares	122.20
Vested (usd per share) \| $ / shares	92.92
Forfeited (usd per share) \| $ / shares	101.60
Ending Balance (usd per share) \| $ / shares	$ 112.31
RSAs
Number of Shares
Beginning Balance (shares)	447,680
Granted (shares)	294,319
Vested (shares)	(151,110)
Forfeited (shares)	(12,202)
Ending Balance (shares)	578,687
PSUs
Number of Shares
Beginning Balance (shares)	324,078
Granted (shares)	160,929
Vested (shares)	(7,368)
Forfeited (shares)	(22,826)
Ending Balance (shares)	454,813

Stockholders' Equity - Fair Value of Awards Granted and Vested (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total granted	$ 55	$ 48
Total vested	20	18
RSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total granted	36	30
Total vested	19	16
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total granted	19	18
Total vested	$ 1	$ 2

Segments - Narrative (Details)	3 Months Ended
Segments - Narrative (Details)	Mar. 31, 2020 segment
Segment Reporting [Abstract]
Number of reportable segments (in segment)	2

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Total revenue	$ 4,549	$ 4,119
Add: other operating revenues	4,549	4,119
Less: other operating expenses	(4,275)	(3,839)
Operating income	274	280
Other expenses, net	21	20
Income before income tax expense	253	260
Other operating
Segment Reporting Information [Line Items]
Total revenue	245	167
Add: other operating revenues	245	167
Less: other operating expenses	(559)	(468)
Health Plans
Segment Reporting Information [Line Items]
Total revenue	4,545	4,117
Add: other operating revenues	4,545	4,117
Health Plans \| Operating Segments
Segment Reporting Information [Line Items]
Gross margin	588	581
Other
Segment Reporting Information [Line Items]
Total revenue	4	2
Add: other operating revenues	$ 4	$ 2

Subsequent Events (Details) member in Thousands			3 Months Ended		12 Months Ended
Subsequent Events (Details) member in Thousands	Apr. 30, 2020 USD ($)	Apr. 27, 2020 USD ($)	Mar. 31, 2020 USD ($)	Mar. 31, 2019 USD ($)	Dec. 31, 2019 USD ($) member state
Subsequent Event [Line Items]
Total revenue			$ 4,549,000,000	$ 4,119,000,000
Magellan Complete Care \| Subsequent event
Subsequent Event [Line Items]
Net purchase price	$ 820,000,000
Face amount	$ 400,000,000
Maine Community Health Options v. United States
Subsequent Event [Line Items]
Claims settled			$ 52,000,000
Maine Community Health Options v. United States \| Subsequent event
Subsequent Event [Line Items]
Claims sought		$ 76,000,000
Magellan Complete Care
Subsequent Event [Line Items]
Number of states with programs \| state					6
Members served by government-sponsored healthcare programs \| member					155
Total revenue					$ 2,700,000,000

Label	Element	Value
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ 85,000,000
Retained Earnings [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ 85,000,000