0001179929-24-000033 | 10-K | XBRL Viewer

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Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
ROU assets
Other assets	$ 43	$ 43
Lease liabilities
Accounts payable and accrued liabilities (current)	20	41
Other long-term liabilities (non-current)	85	77
Total operating lease liabilities	105	118
ROU assets
Property, equipment, and capitalized software, net	67	72
Lease liabilities
Accounts payable and accrued liabilities (current)	21	22
Finance lease liabilities (non-current)	205	215
Total finance lease liabilities	$ 226	$ 237
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Other assets	Other assets
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]	Accounts Payable and Accrued Liabilities, Current	Accounts Payable and Accrued Liabilities, Current
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]	Accounts Payable and Accrued Liabilities, Current	Accounts Payable and Accrued Liabilities, Current
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Other long-term liabilities	Other long-term liabilities

Significant Accounting Policies (Policies)	12 Months Ended
Significant Accounting Policies (Policies)	Dec. 31, 2023
Accounting Policies [Abstract]
Consolidation and Presentation	Consolidation and Presentation The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. All significant inter-company balances and transactions have been eliminated in consolidation. Financial information related to subsidiaries acquired during any year is included only for periods subsequent to their acquisition. We have reclassified certain 2022 amounts in the deferred tax asset and liabilities table in Note 12, “Income Taxes,” to conform to the 2023 presentation. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the periods presented have been included; such adjustments consist of normal recurring adjustments.
Use of Estimates	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.
Cash and Cash Equivalents	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.
Investments	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, 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 of our investments have final maturities of less than 15 years, or less than 15 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.
Receivables	Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. We apply the current expected credit loss model to measure expected credits losses on our receivables based on available information about past events and reasonable and supportable forecasts. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.
Business Combinations	Business Combinations We account for business combinations using the acquisition method of accounting, which requires us to recognize the assets acquired and the liabilities assumed at their acquisition date fair values. As discussed below, the excess of the purchase consideration transferred over the fair value of the net tangible and intangible assets acquired is recorded as goodwill. While we use our best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Measurement period adjustments are recorded in the period in which they are determined, as if they had been completed at the acquisition date. Upon the conclusion of the final determination of the values of assets acquired or liabilities assumed, or one year after the date of acquisition, whichever comes first, any subsequent adjustments are recorded within our consolidated results of operations.
Long-Lived Assets, including Intangible Assets	Long-Lived Assets, including Intangible Assets Long-lived assets consist primarily of property, equipment, capitalized software (see Note 7, “Property, Equipment, and Capitalized Software, Net”), and intangible assets resulting from acquisitions. Long-lived assets are subject to impairment tests when events or circumstances indicate that the asset’s (or asset group’s) carrying value may not be recoverable. Finite-lived, separately-identified intangible assets acquired in business combinations are assets that represent future expected benefits but lack physical substance (such as purchased contract rights and provider contracts). Intangible assets are initially recorded at fair value and are then amortized on a straight-line basis over their expected useful lives, generally between five and 16 years. Determining the fair value of separately identifiable intangible assets requires management to make estimates, which are based on all available information and in some cases assumptions with respect to the timing and amount of future revenues and expenses associated with an asset. Determining the useful life of an intangible asset also requires judgment, as different types of intangible assets will have different useful lives. The most significant intangible asset we typically record in a business combination is contract rights associated with membership acquired. In determining the estimated fair value of the intangible assets, we typically apply the income approach, which discounts the projected future net cash flows using an appropriate discount rate that reflects the risk associated with such projected future cash flows. The most critical assumptions used in determining the fair value of contract rights include forecasted operating margins and the weighted average cost of capital. Property and equipment are stated at historical cost. Replacements and major improvements are capitalized, and repairs and maintenance are charged to expense as incurred. Software developed for internal use is capitalized. Property and equipment are generally depreciated using the straight-line method over estimated useful lives ranging from three to seven years. Software is generally amortized over its estimated useful life of three years. Leasehold improvements are amortized over the term of the lease, or over their useful lives from five to 10 years, whichever is shorter. Buildings are depreciated over their estimated useful lives of 31.5 to 40 years.
Intangible Assets	Our intangible assets are subject to impairment tests when events or circumstances indicate that a finite-lived intangible asset’s (or asset group’s) carrying value may not be recoverable. Consideration is given to a number of potential impairment indicators, including the ability of our health plan subsidiaries to obtain the renewal by amendment of their contracts in each state prior to the actual expiration of their contracts. However, there can be no assurance that these contracts will continue to be renewed. Following the identification of any potential impairment indicators, to determine whether an impairment exists, we would compare the carrying amount of a finite-lived intangible asset with the greater of the undiscounted cash flows that are expected to result from the use of the asset or related group of assets, or its value under the asset liquidation method. If it is determined that the carrying amount of the asset is not recoverable, the amount by which the carrying value exceeds the estimated fair value is recorded as an impairment.
Goodwill	Goodwill Goodwill represents the excess of the purchase consideration over the fair value of net assets acquired in business combinations. Goodwill is not amortized but is tested for impairment on an annual basis and more frequently if impairment indicators are present. Impairment indicators may include experienced or expected operating cash-flow deterioration or losses, significant losses of membership, loss of state funding, loss of state contracts, and other factors. Goodwill is impaired if the carrying amount of a reporting unit exceeds its estimated fair value. This excess is recorded as an impairment loss and adjusted if necessary for the impact of tax-deductible goodwill. The loss recognized may not exceed the total goodwill allocated to the reporting unit. When testing goodwill for impairment, we may first assess qualitative factors, such as industry and market factors, the dynamic economic and political environments in which we operate, cost factors, and changes in overall performance, to determine if it is more likely than not that the carrying value of our reporting units exceed their estimated fair values. If our qualitative assessment indicates that it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value, we perform the quantitative assessment. We may also elect to bypass the qualitative assessment and proceed directly to the quantitative assessment. We performed a qualitative goodwill assessment of our reporting units in the fourth quarter of 2023, and did not identify any factors indicating that the carrying value of our reporting units exceeded their estimated fair values. If performing a quantitative assessment, we generally estimate the fair values of our reporting units by applying the income approach, using discounted cash flows. The base year in the reporting units’ discounted cash flows is derived from the annual financial planning cycle, which commences in the fourth quarter of the year. As part of a quantitative assessment, we may also apply the asset liquidation method to estimate the fair value of individual reporting units, which is computed as total assets minus total liabilities, excluding intangible assets and deferred taxes. Finally, we apply a market approach to reconcile the value of our reporting units to our consolidated market value. Under the market approach, we consider publicly-traded comparable company information to determine revenue and earnings multiples which are used to estimate our reporting units’ fair values. The assumptions used are consistent with those used in our long-range business plan and annual planning process. However, if these assumptions differ from actual results, the outcome of our goodwill impairment tests could be adversely affected.
Leases	Leases Right-of-use (“ROU”) assets represent our right to use the underlying assets over the lease term, and lease liabilities represent our obligation for lease payments arising from the related leases. ROU assets and lease liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. Lease terms may include options to extend or terminate the lease when we believe it is reasonably certain that we will exercise such options. If applicable, we account for lease and non-lease components within a lease as a single lease component. Because most of our leases do not provide an implicit interest rate, we generally use our incremental borrowing rate to determine the present value of lease payments. Lease expenses for operating lease payments are recognized on a straight-line basis over the lease term, and the related ROU assets and liabilities are reduced to the present value of the remaining lease payments at the end of each period. Finance lease payments reduce finance lease liabilities, the related ROU assets are amortized on a straight-line basis over the lease term, and interest expense is recognized using the effective interest method. The significant majority of our operating leases consist of long-term operating leases for office space. Short-term leases (those with terms of 12 months or less) are not recorded as ROU assets or liabilities in the consolidated balance sheets. For certain leases that represent a portfolio of similar assets, such as a fleet of vehicles, we apply a portfolio approach to account for the related ROU assets and liabilities, rather than account for such assets and the related liabilities individually. A nominal number of our lease agreements include rental payments that adjust periodically for inflation. Our lease agreements do not contain any material residual value guarantees or material restrictive covenants.
Medical Claims and Benefits Payable	Medical Claims and Benefits Payable Medical care costs are recognized in the period in which services are provided and include fee-for-service claims, pharmacy benefits, capitation payments to providers, and various other medically-related costs. Under fee-for-service claims arrangements with providers, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of hospital and physician services. Such medical care costs include amounts paid by us as well as estimated medical claims and benefits payable for costs that were incurred but not paid as of the reporting date (“IBNP”). Pharmacy benefits represent payments for members' prescription drug costs, net of rebates from drug manufacturers. We estimate pharmacy rebates based on historical and current utilization of prescription drugs and contractual provisions. Capitation payments represent monthly contractual fees paid to providers, who are responsible for providing medical care to members, which could include medical or ancillary costs like dental, vision and other supplemental health benefits. Such capitation costs are fixed in advance of the periods covered and are not subject to significant accounting estimates. Other medical care costs include all medically-related administrative costs, amounts due to providers pursuant to risk-sharing or other incentive arrangements, provider claims, and other healthcare expenses. Examples of medically-related administrative costs include expenses relating to health education, quality assurance, case management, care coordination, disease management, and 24-hour on-call nurses. Additionally, we include an estimate for the cost of settling claims incurred through the reporting date in our medical claims and benefits payable liability. Medical claims and benefits payable consist mainly of fee-for-service IBNP, unpaid pharmacy claims, capitation costs, other medical costs, including amounts payable to providers pursuant to risk-sharing or other incentive arrangements and amounts payable to providers on behalf of certain state agencies for certain state assessments in which we assume no financial risk. IBNP includes the costs of claims incurred as of the balance sheet date which have been reported to us, and our best estimate of the cost of claims incurred but not yet reported to us. When more complete claims payment information and healthcare cost trend data becomes available, we reflect changes in these estimates as an increase or decrease to medical care costs in the consolidated results of operations in the period in which they are determined. The estimation of the IBNP liability requires a significant degree of judgment in applying actuarial methods, determining the appropriate assumptions and considering numerous factors. Of those factors, we consider estimated completion factors and the assumed healthcare cost trend to be the most critical assumptions. Other relevant factors also include, but are not limited to, healthcare service utilization trends, claim inventory levels, changes in membership, product mix, seasonality, benefit changes or changes in Medicaid fee schedules, provider contract changes, prior authorizations and the incidence of catastrophic or pandemic cases. Because of the significant degree of judgment involved in estimation of our IBNP liability, there is considerable variability and uncertainty inherent in such estimates. Each reporting period, the recognized IBNP liability represents our best estimate of the total amount of unpaid claims incurred as of the balance sheet date using a consistent methodology in estimating our IBNP liability, including a provision for moderately adverse conditions for each current period. We believe our current estimates are reasonable and adequate; however, the development of our estimate is a continuous process that we monitor and update as more complete claims payment information and healthcare cost trend data becomes available. Actual medical care costs may be less than we previously estimated (favorable development) or more than we previously estimated (unfavorable development), and any differences could be material. Any adjustments to reflect favorable development would be recognized as a decrease to medical care costs, and any adjustments to reflect unfavorable development would be recognized as an increase to medical care costs, in the period in which the adjustments are determined. Refer to Note 10, “Medical Claims and Benefits Payable,” for a table presenting the components of the change in our medical claims and benefits payable, for all periods presented in the accompanying consolidated financial statements. Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the 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 premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. Many of our contracts contain provisions that may adjust or limit revenue or profit. Consequently, we recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies” in the accompanying consolidated balance sheets. State Medicaid programs and the federal Medicare program periodically adjust premium rates, including certain components of premium revenue that are subject to accounting estimates further discussed below. Minimum MLR, Medical Cost Corridors and Profit Sharing. A portion of our Medicaid premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined maximum threshold. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19. Our contracts with certain states contain profit sharing 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. The Affordable Care Act (“ACA”) established a Minimum MLR of 85% for Medicare. 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. Our dual-eligible plans may also be subject to state-specific Minimum MLRs, medical cost corridors, and profit-sharing provisions. We recognize estimated rebates as an adjustment to premium revenue in our consolidated statements of income. We recorded a liability under the terms of such contract provisions of $64 million and $84 million at December 31, 2023 and 2022, respectively, to amounts due government agencies. The ACA 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 discussed below 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. The amounts were insignificant at December 31, 2023 and 2022. Risk Adjustment. 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 CMS practices. We also estimate amounts owed to CMS for Part D settlements. We recorded a liability under the terms of such contract provisions of $66 million and $76 million at December 31, 2023 and 2022, respectively, to amounts due government agencies. Under this program for our Marketplace business, 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. Other Premium Adjustments. State Medicaid programs periodically adjust premium revenues on a retroactive basis for rate changes and changes in membership and eligibility data. In certain states, adjustments are made based on the health status of our members (as measured through a risk score). In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. 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. Quality incentive premium revenue is recognized when it is earned under such provisions.
Reinsurance	Reinsurance We bear underwriting and reserving risks associated with our health plan subsidiaries. In certain cases, we limit our risk of significant catastrophic losses by maintaining high deductible reinsurance coverage with a highly-rated, unaffiliated insurance company (the “third-party reinsurer”). Because we remain liable for losses in the event the third-party reinsurer is unable to pay its portion of the losses, we continually monitor the third-party reinsurer’s financial condition, including its ability to maintain high credit ratings. Intercompany transactions with our captive are eliminated in consolidation. We report reinsurance premiums as a reduction to premium revenue, while related reinsurance recoveries are reported as a reduction to medical care costs.
Income Taxes	Income Taxes We account for income taxes under the asset and liability method. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates expected to be in effect during the year in which the basis differences reverse. Valuation allowances are established when management determines it is more likely than not that some portion, or all, of the deferred tax assets will not be realized.
Taxes Based on Premiums	Taxes Based on Premiums Premium and Use Tax. Certain of our health plans are assessed a tax based on premium revenue collected. The premium revenues we receive from these states include reimbursement for the premium tax assessment. We have reported these taxes on a gross basis, as premium tax revenue and as premium tax expenses in the consolidated statements of income.
Concentrations of Credit Risk	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 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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 in which our health plan subsidiaries operate.
Risks and Uncertainties	Risks and Uncertainties Our profitability depends in large part on our ability to accurately predict and effectively manage medical care costs. We continually review our medical costs in light of our underlying claims experience and revised actuarial data. However, several factors could adversely affect medical care costs. These factors, which include changes in healthcare practices, inflation, new technologies, major epidemics, natural disasters, and malpractice litigation, are beyond our control and may have an adverse effect on our ability to accurately predict and effectively control medical care costs. Costs in excess of those anticipated could have a material adverse effect on our financial condition, results of operations, or cash flows. We operate health plans primarily as a direct contractor with the states, and in Los Angeles County, California, as a subcontractor to another health plan holding a direct contract with the state. We are therefore dependent upon a relatively small number of contracts to support our revenue. The loss of any one of those contracts could have a material adverse effect on our financial position, results of operations, or cash flows. In addition, our ability to arrange for the provision of medical services to our members is dependent upon our ability to develop and maintain adequate provider networks. Our inability to develop or maintain such networks might, in certain circumstances, have a material adverse effect on our financial position, results of operations, or cash flows.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-07, Improvements to Reportable Segment Disclosures, which will require disclosure of incremental segment information on an annual and interim basis for all public entities. The amendments do not change how a public entity identifies its operating segments, aggregates those operating segments, or applies the quantitative thresholds to determine its reportable segments. ASU 2023-07 is effective for annual reporting beginning with the fiscal year ending December 31, 2024, and for interim periods thereafter. We are currently evaluating the incremental disclosures that will be required in the footnotes to our consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, Improvements to Income Tax Disclosures, which will require incremental income tax disclosures on an annual basis for all public entities. The amendments require that public business entities disclose specific categories in the rate reconciliation and provide additional information for reconciling items meeting a quantitative threshold. The amendments also require disclosure of income taxes paid to be disaggregated by jurisdiction, and disclosure of income tax expense disaggregated by federal, state, and foreign. ASU 2023-09 is effective for annual reporting beginning with the fiscal year ending December 31, 2025. We are currently evaluating the incremental disclosures that will be required in our consolidated financial statements. 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.
Fair Value Measurements	Fair Value Measurements We consider the carrying amounts of current assets and current liabilities 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 a three-tier fair value hierarchy as follows: Level 1 — Observable Inputs. Level 1 financial instruments are actively traded and therefore the fair value for these securities is based on quoted market prices for identical securities in active markets. Level 2 — Directly or Indirectly Observable Inputs. Fair value for these investments is determined using a market approach based on quoted prices for similar securities in active markets or quoted prices for identical securities in inactive markets. Level 3 — Unobservable Inputs. Level 3 financial instruments are valued using unobservable inputs that represent management’s best estimate of what market participants would use in pricing the financial instrument at the measurement date. As of December 31, 2022, our Level 3 financial instruments consisted of contingent consideration liabilities.

Net Income Per Share

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Net Income Per Share

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


	Year Ended December 31,
	2023		2022		2021

	(In millions, except net income per share)
Numerator:
Net income	$	1,091	$	792	$	659
Denominator:
Shares outstanding at the beginning of the period	57.4		57.9		58.0
Weighted-average number of shares issued:
Stock purchases	—		(0.5)		(0.5)
Stock-based compensation	0.3		0.4		0.3
Denominator for basic net income per share	57.7		57.8		57.8
Effect of dilutive securities: (1)
Stock-based compensation	0.4		0.7		0.8

Denominator for diluted net income per share	58.1		58.5		58.6

Net income per share - Basic (2)	$	18.91	$	13.72	$	11.40
Net income per share - Diluted (2)	$	18.77	$	13.55	$	11.25

_______________________________

(1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. Certain potentially dilutive common shares issuable are not included in the computation of diluted net income per share because to do so would have been anti-dilutive.

(2) Source data for calculations in thousands.

Property, Equipment, and Capitalized Software, Net - Summary of Property, Equipment, and Capitalized Software (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total cost	$ 932	$ 882
Less: accumulated amortization - capitalized software	(537)	(482)
Less: accumulated depreciation and amortization - property, equipment, building, and improvements	(192)	(213)
Total accumulated depreciation and amortization	(729)	(695)
ROU assets - finance leases	67	72
Property, equipment, and capitalized software, net	270	259
Capitalized software
Property, Plant and Equipment [Line Items]
Total cost	687	615
Property and equipment
Property, Plant and Equipment [Line Items]
Total cost	199	221
Building and improvements
Property, Plant and Equipment [Line Items]
Total cost	41	41
Land
Property, Plant and Equipment [Line Items]
Total cost	$ 5	$ 5

Cover Page - USD ($) shares in Millions, $ in Billions	12 Months Ended
Cover Page - USD ($) shares in Millions, $ in Billions	Dec. 31, 2023	Feb. 09, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	1-31719
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
Entity Address, Address Line Two	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 Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 17.4
Entity Common Stock, Shares Outstanding		58.4
Documents Incorporated by Reference	Portions of the registrant’s Proxy Statement for the 2024 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10-K, to the extent described therein.
Entity Central Index Key	0001179929
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY

Employee Benefit Plans (Details) - USD ($) $ in Millions	12 Months Ended
Employee Benefit Plans (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Postemployment Benefits [Abstract]
Maximum matching contribution by employer under defined contribution plan	4.00%
Expense recognized in connection with contributions	$ 54	$ 45	$ 41
Deferred compensation plan	$ 39	$ 26

Condensed Financial Information of Registrant (Tables)

12 Months Ended

Dec. 31, 2023

Condensed Financial Information Disclosure [Abstract]

Schedule of Condensed Balance Sheets

Condensed Balance Sheets


	December 31,
	2023		2022

	(In millions, except per-share data)
ASSETS
Current assets:
Cash and cash equivalents	$	694	$	329
Investments	48		46

Due from affiliates	174		143
Prepaid expenses and other current assets	133		106
Total current assets	1,049		624
Property, equipment, and capitalized software, net	234		224
Goodwill and intangible assets, net	825		731
Investments in subsidiaries	4,911		4,142
Deferred income taxes, net	57		37
Advances to related parties and other assets	94		78
Total assets	$	7,170	$	5,836
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable, accrued liabilities and other	$	527	$	448
Total current liabilities	527		448
Long-term debt	2,180		2,176
Finance lease liabilities	205		215
Other long-term liabilities	43		33
Total liabilities	2,955		2,872
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding: 58 million shares at each of December 31, 2023 and December 31, 2022	—		—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	—		—
Additional paid-in capital	410		328
Accumulated other comprehensive loss	(82)		(160)
Retained earnings	3,887		2,796
Total stockholders’ equity	4,215		2,964
Total liabilities and stockholders’ equity	$	7,170	$	5,836

Schedule of Condensed Statements of Income

Condensed Statements of Income


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Revenue:
Administrative services fees	$	2,038	$	1,826	$	1,496
Investment income and other revenue	27		8		11
Total revenue	2,065		1,834		1,507
Expenses:
General and administrative expenses	1,952		1,721		1,424
Depreciation and amortization	131		141		98
Impairment	—		138		—
Other	20		—		5
Total operating expenses	2,103		2,000		1,527
Operating loss	(38)		(166)		(20)
Interest expense	109		110		120
Other expenses, net	—		—		25
Total other expenses, net	109		110		145
Loss before income tax benefit and equity in net earnings of subsidiaries	(147)		(276)		(165)
Income tax benefit	(7)		(42)		(21)
Net loss before equity in net earnings of subsidiaries	(140)		(234)		(144)
Equity in net earnings of subsidiaries	1,231		1,026		803
Net income	$	1,091	$	792	$	659

Schedule of Condensed Statements of Comprehensive Income

Condensed Statements of Comprehensive Income


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Net income	$	1,091	$	792	$	659
Other comprehensive income (loss):
Unrealized investment income (loss)	102		(204)		(55)
Less: effect of income taxes	24		(49)		(13)
Other comprehensive income (loss), net of tax	78		(155)		(42)
Comprehensive income	$	1,169	$	637	$	617

Schedule of Condensed Statements of Cash Flows

Condensed Statements of Cash Flows


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Operating activities:
Net cash provided by operating activities	$	81	$	119	$	60
Investing activities:
Capital contributions to subsidiaries	(221)		(159)		(440)
Dividends received from subsidiaries	705		668		564
Purchases of investments	(2)		(29)		(27)
Proceeds from sales and maturities of investments	1		49		21
Purchases of property, equipment and capitalized software	(79)		(86)		(70)
Net cash paid in business combinations	(74)		—		(263)
Change in amounts due to/from affiliates	5		(69)		40
Other, net	7		3		(3)
Net cash provided by (used in) investing activities	342		377		(178)
Financing activities:
Common stock purchases	—		(400)		(128)
Common stock withheld to settle employee tax obligations	(60)		(54)		(53)
Contingent consideration liabilities settled	—		(20)		(20)
Proceeds from senior notes offering, net of issuance costs	—		—		740
Repayment of senior notes	—		—		(723)






Other, net	2		33		1
Net cash used in financing activities	(58)		(441)		(183)
Net increase (decrease) in cash and cash equivalents	365		55		(301)
Cash and cash equivalents at beginning of period	329		274		575
Cash and cash equivalents at end of period	$	694	$	329	$	274

Property, Equipment, and Capitalized Software, Net - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2023
Property and equipment
Property, Plant and Equipment [Line Items]
Impairment on property and equipment	$ 16
Property and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		3 years
Property and equipment \| Maximum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		7 years
Software
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		3 years
Leasehold improvements \| Minimum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		5 years
Leasehold improvements \| Maximum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		10 years
Building and improvements \| Minimum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		31 years 6 months
Building and improvements \| Maximum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment		40 years

Stockholders' Equity - Additional Information (Details) - USD ($)	1 Months Ended	12 Months Ended
	Feb. 09, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Forfeiture rate		8.00%
Stock option expiration period		4 years
Granted (in shares)		0	0	0
Exercised (in shares)		5,000
Unvested stock options (in shares)		0
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee purchase price as a percentage of stock price		85.00%
Offering period		6 months
Maximum annual contribution per employee		$ 25,000
Risk-free interest rate, minimum		0.10%
Risk-free interest rate, maximum		5.40%
Minimum expected volatility rate inputs for fair value measurement		28.00%
Maximum expected volatility rate inputs for fair value measurement		54.00%
Dividend yield		0.00%
Expected term of awards		6 months
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum award vesting period		4 years
Granted (in dollars per share)		$ 277.37	$ 312.27	$ 224.63
Unrecognized compensation expense		$ 88,000,000
Weighted average period for recognition		2 years 1 month 6 days
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum award vesting period		3 years
Granted (in dollars per share)		$ 233.50	$ 214.94	$ 74.52
Unrecognized compensation expense		$ 52,000,000
Weighted average period for recognition		1 year 1 month 6 days
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum award vesting period		4 years
Stock option expiration period		10 years
2019 EIP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares issued under ESPP (in shares)		2,900,000
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock authorized					$ 750,000,000
Repurchases of common stock (in shares)		0
Share-based compensation (in shares)			1,000,000
Common Stock \| Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Repurchases of common stock (in shares)	0
Common Stock \| Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation (in shares)		442,000	755,000

Leases - Lease Maturities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Operating
2024	$ 24
2025	20
2026	14
2027	11
2028	9
Thereafter	50
Subtotal - undiscounted lease payments	128
Less imputed interest	(23)
Total operating lease liabilities	105	$ 118
Finance
2024	34
2025	30
2026	26
2027	24
2028	25
Thereafter	194
Subtotal - undiscounted lease payments	333
Less imputed interest	(107)
Total finance lease liabilities	$ 226	$ 237

Segments (Tables)

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Schedule of Operating Segment Information

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


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Total revenue:
Medicaid	$	27,707	$	25,783	$	21,231
Medicare	4,227		3,824		3,379
Marketplace	2,062		2,296		3,091
Other	76		71		70
Consolidated	$	34,072	$	31,974	$	27,771

The following table reconciles margin by segment to consolidated income before income tax expense:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Margin:
Medicaid	$	2,973	$	2,981	$	2,322
Medicare	388		437		430
Marketplace	499		290		399
Other	9		11		14
Total margin	3,869		3,719		3,165
Add: other operating revenues (1)	1,467		1,020		846
Less: other operating expenses (2)	(3,763)		(3,566)		(2,991)
Operating income	1,573		1,173		1,020
Less: other expenses, net (3)	109		110		145
Income before income tax expense	$	1,464	$	1,063	$	875

______________________

(1)Other operating revenues include premium tax revenue, investment income and certain other revenue.

(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, impairment, and certain other operating expenses.

(3)Other expenses, net include interest expense and non-operating other expenses.

Goodwill and Intangible Assets, Net - Intangible Assets Balances (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Cost	$ 601	$ 583
Accumulated Amortization	393	308
Carrying Amount	208	275
Contract rights and licenses
Finite-Lived Intangible Assets [Line Items]
Cost	520	507
Accumulated Amortization	357	279
Carrying Amount	163	228
Provider networks
Finite-Lived Intangible Assets [Line Items]
Cost	59	57
Accumulated Amortization	29	24
Carrying Amount	30	33
Trade names
Finite-Lived Intangible Assets [Line Items]
Cost	22	19
Accumulated Amortization	7	5
Carrying Amount	$ 15	$ 14

Fair Value Measurements

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

We consider the carrying amounts of current assets and current liabilities 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 a three-tier fair value hierarchy as follows:

Level 1 — Observable Inputs. Level 1 financial instruments are actively traded and therefore the fair value for these securities is based on quoted market prices for identical securities in active markets.

Level 2 — Directly or Indirectly Observable Inputs. Fair value for these investments is determined using a market approach based on quoted prices for similar securities in active markets or quoted prices for identical securities in inactive markets.

Level 3 — Unobservable Inputs. Level 3 financial instruments are valued using unobservable inputs that represent management’s best estimate of what market participants would use in pricing the financial instrument at the measurement date. As of December 31, 2022, our Level 3 financial instruments consisted of contingent consideration liabilities.

Our financial instruments measured at fair value on a recurring basis at December 31, 2023, were as follows:


	Total		Level 1		Level 2		Level 3

	(In millions)
Corporate debt securities	$	2,732	$	—	$	2,732	$	—
Mortgage-backed securities	911		—		911		—
Asset-backed securities	365		—		365		—
Municipal securities	166		—		166		—
U.S. Treasury notes	40		—		40		—


Other	45		—		45		—
Total assets	$	4,259	$	—	$	4,259	$	—

Our financial instruments measured at fair value on a recurring basis at December 31, 2022, were as follows:


	Total		Level 1		Level 2		Level 3

	(In millions)
Corporate debt securities	$	2,184	$	—	$	2,184	$	—
Mortgage-backed securities	731		—		731		—
Asset-backed securities	288		—		288		—
Municipal securities	149		—		149		—
U.S. Treasury notes	105		—		105		—


Other	42		—		42		—
Total assets	$	3,499	$	—	$	3,499	$	—

Contingent consideration liabilities	$	8	$	—	$	—	$	8
Total liabilities	$	8	$	—	$	—	$	8

Level 3 Contingent Consideration Liabilities

The net changes in fair value of Level 3 financial instruments are reported in “Other” operating expenses in our consolidated statements of income. In the year ended December 31, 2022, we recognized a loss of $4 million, primarily for the increase in the fair value of the contingent consideration liability described below.

In the year ended December 31, 2023, we paid the seller $8 million in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., which represented the final payment of the consideration due relating to an operating income guarantee. The amount paid in the year ended December 31, 2023, has been presented in “Operating activities” in the accompanying consolidated statements of cash flows.

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.


	December 31, 2023				December 31, 2022
	Carrying Amount		Fair Value		Carrying Amount		Fair Value

	(In millions)
4.375% Notes due 2028	$	794	$	757	$	792	$	729
3.875% Notes due 2030	644		583		643		554
3.875% Notes due 2032	742		654		741		629
Total	$	2,180	$	1,994	$	2,176	$	1,912

- 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

Medical Claims and Benefits Payable - Cumulative Paid Claims and Allocated Claims Adjustment Expenses (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Product Information [Line Items]
Claims paid	$ 76,560
Benefit Year 2021
Product Information [Line Items]
Claims paid	23,894	$ 23,871	$ 21,148
Benefit Year 2022
Product Information [Line Items]
Claims paid	27,051	$ 24,345
Benefit Year 2023
Product Information [Line Items]
Claims paid	$ 25,615

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

We are a party to operating and finance leases primarily for our corporate and health plan offices. Our operating leases have remaining lease terms up to 12 years, some of which include options to extend the leases for up to 10 years. As of December 31, 2023, the weighted average remaining operating lease term is 8 years.

Our finance leases have remaining lease terms up to 15 years, some of which include options to extend the leases for up to 25 years. As of December 31, 2023, the weighted average remaining finance lease term is 12 years.

In the year ended December 31, 2022, the Company recognized $192 million of ROU asset impairments associated with our reduction in leased space used in our business operations to accommodate our move to a remote work environment.

As of December 31, 2023, the weighted-average discount rate used to compute the present value of lease payments was 4.8% for operating lease liabilities, and 6.4% for finance lease liabilities. The components of lease expense for the years ended December 31, 2023, 2022, and 2021 are presented in the following table.


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Operating lease expense	$	15	$	31	$	34

Finance lease expense:
Amortization of ROU assets	$	18	$	28	$	25
Interest on lease liabilities	15		15		15
Total finance lease expense	$	33	$	43	$	40

Supplemental consolidated cash flow information related to leases follows:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Cash used in operating activities:
Operating leases	$	28	$	31	$	33
Finance leases	15		15		15
Cash used in financing activities:
Finance leases	24		15		18
ROU assets recognized in exchange for lease obligations:
Operating leases	12		10		86
Finance leases	13		18		18

Supplemental information related to leases, including location of amounts reported in the accompanying consolidated balance sheets, follows:


	December 31,
	2023		2022

	(In millions)
Operating leases:
ROU assets
Other assets	$	43	$	43
Lease liabilities
Accounts payable and accrued liabilities (current)	$	20	$	41
Other long-term liabilities (non-current)	85		77
Total operating lease liabilities	$	105	$	118
Finance leases:
ROU assets
Property, equipment, and capitalized software, net	$	67	$	72
Lease liabilities
Accounts payable and accrued liabilities (current)	$	21	$	22
Finance lease liabilities (non-current)	205		215
Total finance lease liabilities	$	226	$	237

Maturities of lease liabilities as of December 31, 2023, were as follows:


	Operating		Finance
	Leases		Leases

	(In millions)
2024	$	24	$	34
2025	20		30
2026	14		26
2027	11		24
2028	9		25
Thereafter	50		194
Subtotal - undiscounted lease payments	128		333
Less imputed interest	(23)		(107)
Total	$	105	$	226

Leases


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Operating lease expense	$	15	$	31	$	34

Finance lease expense:
Amortization of ROU assets	$	18	$	28	$	25
Interest on lease liabilities	15		15		15
Total finance lease expense	$	33	$	43	$	40

Supplemental consolidated cash flow information related to leases follows:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Cash used in operating activities:
Operating leases	$	28	$	31	$	33
Finance leases	15		15		15
Cash used in financing activities:
Finance leases	24		15		18
ROU assets recognized in exchange for lease obligations:
Operating leases	12		10		86
Finance leases	13		18		18

Supplemental information related to leases, including location of amounts reported in the accompanying consolidated balance sheets, follows:


	December 31,
	2023		2022

	(In millions)
Operating leases:
ROU assets
Other assets	$	43	$	43
Lease liabilities
Accounts payable and accrued liabilities (current)	$	20	$	41
Other long-term liabilities (non-current)	85		77
Total operating lease liabilities	$	105	$	118
Finance leases:
ROU assets
Property, equipment, and capitalized software, net	$	67	$	72
Lease liabilities
Accounts payable and accrued liabilities (current)	$	21	$	22
Finance lease liabilities (non-current)	205		215
Total finance lease liabilities	$	226	$	237

Maturities of lease liabilities as of December 31, 2023, were as follows:


	Operating		Finance
	Leases		Leases

	(In millions)
2024	$	24	$	34
2025	20		30
2026	14		26
2027	11		24
2028	9		25
Thereafter	50		194
Subtotal - undiscounted lease payments	128		333
Less imputed interest	(23)		(107)
Total	$	105	$	226

Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

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.


	December 31,
	2023		2022		2021

	(In millions)
Cash and cash equivalents	$	4,848	$	4,006	$	4,438
Restricted cash and cash equivalents	60		42		68
Total cash and cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,908	$	4,048	$	4,506

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, 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 of our investments have final maturities of less than 15 years, or less than 15 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 5, “Fair Value Measurements,” and Note 6, “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 $53 million and $35 million at December 31, 2023, and 2022, 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 investment income. No accrued interest was written off during the year ended December 31, 2023 and 2022.

Receivables

Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. We apply the current expected credit loss model to measure expected credits losses on our receivables based on available information about past events and reasonable and supportable forecasts. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.


	December 31,
	2023		2022

	(In millions)
Government receivables	$	2,354	$	1,702
Pharmacy rebate receivables	330		291

Other	420		309
Total receivables	$	3,104	$	2,302

Business Combinations

We account for business combinations using the acquisition method of accounting, which requires us to recognize the assets acquired and the liabilities assumed at their acquisition date fair values. As discussed below, the excess of the purchase consideration transferred over the fair value of the net tangible and intangible assets acquired is recorded as goodwill. While we use our best estimates and assumptions to accurately value assets acquired and liabilities assumed at the acquisition date, our estimates are inherently uncertain and subject to refinement. As a result, during the measurement period, which may be up to one year from the acquisition date, we may record adjustments to the assets acquired and liabilities assumed with the corresponding offset to goodwill. Measurement period adjustments are recorded in the period in which they are determined, as if they had been completed at the acquisition date. Upon the conclusion of the final determination of the values of assets acquired or liabilities assumed, or one year after the date of acquisition, whichever comes first, any subsequent adjustments are recorded within our consolidated results of operations.

Refer to Note 4, “Business Combinations,” and Note 9, “Goodwill and Intangible Assets, Net,” for further details.

Long-Lived Assets, including Intangible Assets

Long-lived assets consist primarily of property, equipment, capitalized software (see Note 7, “Property, Equipment, and Capitalized Software, Net”), and intangible assets resulting from acquisitions. Long-lived assets are subject to impairment tests when events or circumstances indicate that the asset’s (or asset group’s) carrying value may not be recoverable. Finite-lived, separately-identified intangible assets acquired in business combinations are assets that represent future expected benefits but lack physical substance (such as purchased contract rights and provider contracts). Intangible assets are initially recorded at fair value and are then amortized on a straight-line basis over their expected useful lives, generally between five and 16 years.

Determining the fair value of separately identifiable intangible assets requires management to make estimates, which are based on all available information and in some cases assumptions with respect to the timing and amount of future revenues and expenses associated with an asset. Determining the useful life of an intangible asset also requires judgment, as different types of intangible assets will have different useful lives. The most significant intangible asset we typically record in a business combination is contract rights associated with membership acquired. In determining the estimated fair value of the intangible assets, we typically apply the income approach, which discounts the projected future net cash flows using an appropriate discount rate that reflects the risk associated with such projected future cash flows. The most critical assumptions used in determining the fair value of contract rights include forecasted operating margins and the weighted average cost of capital.

Our intangible assets are subject to impairment tests when events or circumstances indicate that a finite-lived intangible asset’s (or asset group’s) carrying value may not be recoverable. Consideration is given to a number of potential impairment indicators, including the ability of our health plan subsidiaries to obtain the renewal by amendment of their contracts in each state prior to the actual expiration of their contracts. However, there can be no assurance that these contracts will continue to be renewed. Following the identification of any potential impairment indicators, to determine whether an impairment exists, we would compare the carrying amount of a finite-lived intangible asset with the greater of the undiscounted cash flows that are expected to result from the use of the asset or related group of assets, or its value under the asset liquidation method. If it is determined that the carrying amount of the asset is not recoverable, the amount by which the carrying value exceeds the estimated fair value is recorded as an impairment. Refer to Note 9, “Goodwill and Intangible Assets, Net,” for further details.

Goodwill

Goodwill represents the excess of the purchase consideration over the fair value of net assets acquired in business combinations. Goodwill is not amortized but is tested for impairment on an annual basis and more frequently if impairment indicators are present. Impairment indicators may include experienced or expected operating cash-flow deterioration or losses, significant losses of membership, loss of state funding, loss of state contracts, and other factors. Goodwill is impaired if the carrying amount of a reporting unit exceeds its estimated fair value. This excess is recorded as an impairment loss and adjusted if necessary for the impact of tax-deductible goodwill. The loss recognized may not exceed the total goodwill allocated to the reporting unit.

When testing goodwill for impairment, we may first assess qualitative factors, such as industry and market factors, the dynamic economic and political environments in which we operate, cost factors, and changes in overall performance, to determine if it is more likely than not that the carrying value of our reporting units exceed their estimated fair values. If our qualitative assessment indicates that it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value, we perform the quantitative assessment. We may also elect to bypass the qualitative assessment and proceed directly to the quantitative assessment. We performed a qualitative

goodwill assessment of our reporting units in the fourth quarter of 2023, and did not identify any factors indicating that the carrying value of our reporting units exceeded their estimated fair values.

If performing a quantitative assessment, we generally estimate the fair values of our reporting units by applying the income approach, using discounted cash flows. The base year in the reporting units’ discounted cash flows is derived from the annual financial planning cycle, which commences in the fourth quarter of the year. As part of a quantitative assessment, we may also apply the asset liquidation method to estimate the fair value of individual reporting units, which is computed as total assets minus total liabilities, excluding intangible assets and deferred taxes. Finally, we apply a market approach to reconcile the value of our reporting units to our consolidated market value. Under the market approach, we consider publicly-traded comparable company information to determine revenue and earnings multiples which are used to estimate our reporting units’ fair values. The assumptions used are consistent with those used in our long-range business plan and annual planning process. However, if these assumptions differ from actual results, the outcome of our goodwill impairment tests could be adversely affected.

Leases

Right-of-use (“ROU”) assets represent our right to use the underlying assets over the lease term, and lease liabilities represent our obligation for lease payments arising from the related leases. ROU assets and lease liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. Lease terms may include options to extend or terminate the lease when we believe it is reasonably certain that we will exercise such options. If applicable, we account for lease and non-lease components within a lease as a single lease component.

Because most of our leases do not provide an implicit interest rate, we generally use our incremental borrowing rate to determine the present value of lease payments. Lease expenses for operating lease payments are recognized on a straight-line basis over the lease term, and the related ROU assets and liabilities are reduced to the present value of the remaining lease payments at the end of each period. Finance lease payments reduce finance lease liabilities, the related ROU assets are amortized on a straight-line basis over the lease term, and interest expense is recognized using the effective interest method.

The significant majority of our operating leases consist of long-term operating leases for office space. Short-term leases (those with terms of 12 months or less) are not recorded as ROU assets or liabilities in the consolidated balance sheets. For certain leases that represent a portfolio of similar assets, such as a fleet of vehicles, we apply a portfolio approach to account for the related ROU assets and liabilities, rather than account for such assets and the related liabilities individually. A nominal number of our lease agreements include rental payments that adjust periodically for inflation. Our lease agreements do not contain any material residual value guarantees or material restrictive covenants. Refer to Note 8, “Leases,” for further details.

Medical Claims and Benefits Payable

Medical care costs are recognized in the period in which services are provided and include fee-for-service claims, pharmacy benefits, capitation payments to providers, and various other medically-related costs. Under fee-for-service claims arrangements with providers, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of hospital and physician services. Such medical care costs include amounts paid by us as well as estimated medical claims and benefits payable for costs that were incurred but not paid as of the reporting date (“IBNP”). Pharmacy benefits represent payments for members' prescription drug costs, net of rebates from drug manufacturers. We estimate pharmacy rebates based on historical and current utilization of prescription drugs and contractual provisions. Capitation payments represent monthly contractual fees paid to providers, who are responsible for providing medical care to members, which could include medical or ancillary costs like dental, vision and other supplemental health benefits. Such capitation costs are fixed in advance of the periods covered and are not subject to significant accounting estimates. Other medical care costs include all medically-related administrative costs, amounts due to providers pursuant to risk-sharing or other incentive arrangements, provider claims, and other healthcare expenses. Examples of medically-related administrative costs include expenses relating to health education, quality assurance, case management, care coordination, disease management, and 24-hour on-call nurses. Additionally, we include an estimate for the cost of settling claims incurred through the reporting date in our medical claims and benefits payable liability.

Medical claims and benefits payable consist mainly of fee-for-service IBNP, unpaid pharmacy claims, capitation costs, other medical costs, including amounts payable to providers pursuant to risk-sharing or other incentive arrangements and amounts payable to providers on behalf of certain state agencies for certain state assessments in which we assume no financial risk. IBNP includes the costs of claims incurred as of the balance sheet date which have been reported to us, and our best estimate of the cost of claims incurred but not yet reported to us. When more complete claims payment information and healthcare cost trend data becomes available, we reflect changes

in these estimates as an increase or decrease to medical care costs in the consolidated results of operations in the period in which they are determined.

The estimation of the IBNP liability requires a significant degree of judgment in applying actuarial methods, determining the appropriate assumptions and considering numerous factors. Of those factors, we consider estimated completion factors and the assumed healthcare cost trend to be the most critical assumptions. Other relevant factors also include, but are not limited to, healthcare service utilization trends, claim inventory levels, changes in membership, product mix, seasonality, benefit changes or changes in Medicaid fee schedules, provider contract changes, prior authorizations and the incidence of catastrophic or pandemic cases.

Because of the significant degree of judgment involved in estimation of our IBNP liability, there is considerable variability and uncertainty inherent in such estimates. Each reporting period, the recognized IBNP liability represents our best estimate of the total amount of unpaid claims incurred as of the balance sheet date using a consistent methodology in estimating our IBNP liability, including a provision for moderately adverse conditions for each current period. We believe our current estimates are reasonable and adequate; however, the development of our estimate is a continuous process that we monitor and update as more complete claims payment information and healthcare cost trend data becomes available. Actual medical care costs may be less than we previously estimated (favorable development) or more than we previously estimated (unfavorable development), and any differences could be material. Any adjustments to reflect favorable development would be recognized as a decrease to medical care costs, and any adjustments to reflect unfavorable development would be recognized as an increase to medical care costs, in the period in which the adjustments are determined.

Refer to Note 10, “Medical Claims and Benefits Payable,” for a table presenting the components of the change in our medical claims and benefits payable, for all periods presented in the accompanying consolidated financial statements.

Premium Revenue Recognition and Amounts Due Government Agencies

Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the 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 premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. Many of our contracts contain provisions that may adjust or limit revenue or profit. Consequently, we recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies” in the accompanying consolidated balance sheets. State Medicaid programs and the federal Medicare program periodically adjust premium rates, including certain components of premium revenue that are subject to accounting estimates further discussed below.

Minimum MLR, Medical Cost Corridors and Profit Sharing. A portion of our Medicaid premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined maximum threshold. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19. Our contracts with certain states contain profit sharing 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. We recorded aggregate liabilities under the terms of such contract provisions of $1,344 million and $1,145 million at December 31, 2023 and 2022, respectively, to amounts due government agencies.

The Affordable Care Act (“ACA”) established a Minimum MLR of 85% for Medicare. 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. Our dual-eligible plans may also be subject to state-specific Minimum MLRs, medical cost corridors, and profit-sharing provisions. We recognize estimated rebates as an adjustment to premium revenue in our consolidated statements of income. We recorded a liability under the terms of such contract provisions of $64 million and $84 million at December 31, 2023 and 2022, respectively, to amounts due government agencies.

The ACA 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 discussed below 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. The amounts were insignificant at December 31, 2023 and 2022.

Risk Adjustment. 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 CMS practices. We also estimate amounts owed to CMS for Part D settlements. We recorded a liability under the terms of such contract provisions of $66 million and $76 million at December 31, 2023 and 2022, respectively, to amounts due government agencies.

Under this program for our Marketplace business, 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 December 31, 2023, Marketplace risk adjustment payables amounted to $201 million and related receivables amounted to $241 million, for a net receivable of $40 million. Marketplace risk adjustment receivables at December 31, 2023 are net of a $41 million credit loss allowance resulting from a credit loss recognized in the third quarter of 2023 on 2022 Marketplace risk adjustment receivables due to the insolvency of an issuer in the Texas risk pool. This charge is included in other operating expenses in the accompanying consolidated statements of income. As of December 31, 2022, Marketplace risk adjustment payables amounted to $230 million and related receivables amounted to $135 million, for a net payable of $95 million.

Other Premium Adjustments. State Medicaid programs periodically adjust premium revenues on a retroactive basis for rate changes and changes in membership and eligibility data. In certain states, adjustments are made based on the health status of our members (as measured through a risk score). In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted.

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. Quality incentive premium revenue is recognized when it is earned under such provisions.

Reinsurance

We bear underwriting and reserving risks associated with our health plan subsidiaries. In certain cases, we limit our risk of significant catastrophic losses by maintaining high deductible reinsurance coverage with a highly-rated, unaffiliated insurance company (the “third-party reinsurer”). Because we remain liable for losses in the event the third-party reinsurer is unable to pay its portion of the losses, we continually monitor the third-party reinsurer’s financial condition, including its ability to maintain high credit ratings. Intercompany transactions with our captive are eliminated in consolidation.

We report reinsurance premiums as a reduction to premium revenue, while related reinsurance recoveries are reported as a reduction to medical care costs. In certain cases, we participate in state-run reinsurance programs for which no reinsurance premium is paid. Reinsurance premiums amounted to $11 million, $2 million, and $2 million for the years ended December 31, 2023, 2022, and 2021, respectively. Reinsurance recoveries amounted to $21 million, $35 million, and $33 million for the years ended December 31, 2023, 2022, and 2021, respectively. Reinsurance recoverable of $28 million, and $27 million, as of December 31, 2023, and 2022, respectively, is included in “Receivables” in the accompanying consolidated balance sheets.

Premium Deficiency Reserves on Loss Contracts

We assess the profitability of our contracts to determine if it is probable that a loss will be incurred in the future by reviewing current results and forecasts. For purposes of this assessment, contracts are grouped in a manner consistent with our method of acquiring, servicing and measuring the profitability of such contracts. A premium deficiency reserve (“PDR”) is recognized if anticipated future medical care and administrative costs exceed anticipated future premium revenue, investment income and reinsurance recoveries.

Income Taxes

We account for income taxes under the asset and liability method. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates expected to be in effect during the year in which the basis differences reverse. Valuation allowances are

established when management determines it is more likely than not that some portion, or all, of the deferred tax assets will not be realized. For further discussion and disclosure, see Note 12, “Income Taxes.”

Taxes Based on Premiums

Premium and Use Tax. Certain of our health plans are assessed a tax based on premium revenue collected. The premium revenues we receive from these states include reimbursement for the premium tax assessment. We have reported these taxes on a gross basis, as premium tax revenue and as premium tax expenses in the consolidated statements of income.

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 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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 in which our health plan subsidiaries operate.

Risks and Uncertainties

Our profitability depends in large part on our ability to accurately predict and effectively manage medical care costs. We continually review our medical costs in light of our underlying claims experience and revised actuarial data. However, several factors could adversely affect medical care costs. These factors, which include changes in healthcare practices, inflation, new technologies, major epidemics, natural disasters, and malpractice litigation, are beyond our control and may have an adverse effect on our ability to accurately predict and effectively control medical care costs. Costs in excess of those anticipated could have a material adverse effect on our financial condition, results of operations, or cash flows.

We operate health plans primarily as a direct contractor with the states, and in Los Angeles County, California, as a subcontractor to another health plan holding a direct contract with the state. We are therefore dependent upon a relatively small number of contracts to support our revenue. The loss of any one of those contracts could have a material adverse effect on our financial position, results of operations, or cash flows. In addition, our ability to arrange for the provision of medical services to our members is dependent upon our ability to develop and maintain adequate provider networks. Our inability to develop or maintain such networks might, in certain circumstances, have a material adverse effect on our financial position, results of operations, or cash flows.

Significant Customers

We receive the majority of our revenues under contracts or subcontracts with state Medicaid managed care programs, which are considered individual external customers. Instances where these contracts were at least 10% of our total premium revenue for the year ended December 31, 2023 were Washington with 14.0%, Texas with 13.9%, and New York with 11.4%.

Recent Accounting Pronouncements

In November 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-07, Improvements to Reportable Segment Disclosures, which will require disclosure of incremental segment information on an annual and interim basis for all public entities. The amendments do not change how a public entity identifies its operating segments, aggregates those operating segments, or applies the quantitative thresholds to determine its reportable segments. ASU 2023-07 is effective for annual reporting beginning with the fiscal year ending December 31, 2024, and for interim periods thereafter. We are currently evaluating the incremental disclosures that will be required in the footnotes to our consolidated financial statements.

In December 2023, the FASB issued ASU 2023-09, Improvements to Income Tax Disclosures, which will require incremental income tax disclosures on an annual basis for all public entities. The amendments require that public business entities disclose specific categories in the rate reconciliation and provide additional information for reconciling items meeting a quantitative threshold. The amendments also require disclosure of income taxes paid to be disaggregated by jurisdiction, and disclosure of income tax expense disaggregated by federal, state, and foreign. ASU 2023-09 is effective for annual reporting beginning with the fiscal year ending December 31, 2025. We are currently evaluating the incremental disclosures that will be required in our consolidated financial statements.

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.

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Regulatory Capital Requirements and Dividend Restrictions Our health plans, which are generally operated by our respective wholly owned subsidiaries in those states in which our health plans operate, are subject to state laws and regulations that, among other things, require the maintenance of minimum levels of statutory capital, as defined by each state. The National Association of Insurance Commissioners (“NAIC”), has adopted model rules which, if implemented by the states, set minimum capitalization requirements for insurance companies, HMOs, and other entities bearing risk for healthcare coverage. The requirements take the form of risk-based capital (“RBC”) rules which may vary from state to state. Regulators in some states may also enforce capital requirements that require the retention of net worth in excess of amounts formally required by statute or regulation. All of our health plans except California, Florida, Massachusetts and New York, are subject to the RBC rules. The minimum statutory capital requirements in these states are based on a percentage of annualized premium revenue, a percentage of annualized health care costs, a percentage of certain liabilities, or other financial ratios. If our California, Florida, Massachusetts or New York health plans became subject to RBC rules, minimum capital required for those states could increase. Our Massachusetts health plan maintains a $35 million performance bond, effective through December 31, 2024, to partially satisfy minimum net worth requirements in that state. Statutes, regulations and informal capital requirements also restrict the timing, payment, and amount of dividends and other distributions that may be paid to us as the sole stockholder. To the extent our subsidiaries must comply with these regulations, they may not have the financial flexibility to transfer funds to us. Based on current statutes and regulations, the net assets in these subsidiaries, which may not be transferable to us in the form of loans, advances, or cash dividends was approximately $3.7 billion at December 31, 2023. Because of the statutory restrictions that inhibit the ability of our health plans to transfer net assets to us, the amount of retained earnings readily available to pay dividends to our stockholders is generally limited to cash, cash equivalents and investments held by the parent company—Molina Healthcare, Inc. Such cash, cash equivalents and investments amounted to $742 million and $375 million as of December 31, 2023 and 2022, respectively. As of December 31, 2023, our health plans had aggregate statutory capital and surplus of approximately $4.1 billion, which was in excess of the required minimum aggregate statutory capital and surplus of approximately $2.3 billion. We have the ability and commitment to provide additional capital to each of our health plans when necessary to ensure that statutory capital and surplus continues to meet regulatory requirements. Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments, as well as various contractual provisions, governing our operations. Compliance with these laws, regulations, and contractual provisions can be subject to government audit, review, and interpretation, as well as regulatory actions. Penalties associated with violations of these laws, regulations, and contractual provisions can include significant fines and penalties, temporary or permanent exclusion from participating in publicly funded programs, a limitation on our ability to market or sell products, the repayment of previously billed and collected revenues, and reputational damage. We are involved in legal actions in the ordinary course of business including, but not limited to, various employment claims, vendor disputes and provider claims. Some of these legal actions seek monetary damages, including claims for punitive damages, which may not be covered by insurance. We review legal matters and update our estimates, or range of estimates, of reasonably possible losses and related disclosures, as necessary. We have accrued liabilities for legal matters for which we deem the loss to be both probable and reasonably estimable. These liability estimates could change as a result of further developments. The outcome of these legal actions are inherently uncertain. An adverse determination in one or more of these pending matters could have a material adverse effect on our consolidated financial position, results of operations, or cash flows. Kentucky RFP. On September 4, 2020, Anthem Kentucky Managed Care Plan, Inc. (“Anthem”) brought an action in Franklin County Circuit Court against the Kentucky Finance and Administration Cabinet, the Kentucky Cabinet for Health and Family Services, and all of the five winning bidder health plans, including our Kentucky health plan. On September 9, 2022, the Kentucky Court of Appeals ruled that, with regard to the earlier Circuit Court ruling granting Anthem relief, the Circuit Court should not have invalidated the 2020 procurement and thus should not have awarded a contract to Anthem. Anthem sought discretionary review by the Kentucky Supreme Court (“KSC”) of the ruling by the Court of Appeals. On April 19, 2023, KSC granted Anthem’s request for discretionary review and ordered legal briefing, which the parties completed in September 2023. KSC has scheduled oral arguments on March 7, 2024. Pending further KSC order, our Kentucky health plan will continue to operate for the foreseeable future under its current Medicaid contract. At this time, the Company cannot predict the outcome, or provide a reasonable estimate or range of estimates of the possible outcome or loss, if any, in this matter. Puerto Rico. On August 13, 2021, Molina Healthcare of Puerto Rico, Inc. (“MHPR”) filed a complaint with the Commonwealth of Puerto Rico, Court of First Instance, San Juan (State Court) asserting, among other claims, breach of contract against Puerto Rico Health Insurance Administration (“ASES”). On September 13, 2021, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. The parties are engaged in settlement conversations. A status hearing was held on September 28, 2023, in which ASES and Molina informed the Court of the ongoing settlement conversations. On January 15, 2024, ASES and Molina informed the court that they had reached an agreement in principle, and the Court has scheduled a status conference on March 5, 2024. The Company cannot predict the outcome, or provide a reasonable estimate or range of estimates of the possible outcome or loss, if any, in this matter. Texas Qui Tam Litigation. On May 7, 2013, a relator filed under seal a qui tam action in Texas state court against Molina Healthcare, Inc. and Molina Healthcare of Texas, Inc., asserting claims under the Texas Medicaid Fraud Prevention Act (“TMFPA”) on behalf of the State of Texas. The original petition alleged that Molina Healthcare of Texas knowingly failed to assess its STAR+PLUS members in accordance with the terms of its Medicaid contract with the State and made false statements to the State concerning those assessments that permitted Molina Healthcare of Texas to receive from the State unnecessary payments. As required by the TMFPA, the original petition was filed in camera and under seal, and without Molina’s awareness, to permit the State to decide whether to intervene and assume responsibility for prosecuting the lawsuit. In 2019, the State declined to intervene. In June 2019, as a result of the State’s election to decline intervention, the trial court unsealed the original petition, at which time Molina became aware of the lawsuit. The relator amended her original petition and served Molina in July 2019. In September 2019, Molina filed a motion to dismiss the relator’s claims under the Texas Citizens Participation Act. After the trial court denied the motion, and following extended appellate proceedings which automatically stayed all trial court proceedings, discovery in the lawsuit commenced in late 2021. The relator’s third amended petition was filed on January 19, 2024. The petition alleges that, during the periods in question some ten years ago, Molina failed to assess STAR+PLUS members for personal attendant services, failed to provide those members with contractually required health care benefits, and misrepresented to the State Molina’s capacity to perform the assessments and the status of the assessments. Based on these allegations, the relator contends that Molina is liable to the State under the TMFPA for statutorily defined civil remedies, disgorgement of previous capitation payments, and interest. Molina denies the relator’s allegations as well as any liability in the lawsuit, and intends to defend against the relator’s allegations vigorously. The lawsuit is currently in the discovery phase, with trial set before the Texas District Court, Travis County in late September 2024. The case remains subject to significant additional proceedings, and due to numerous factors of uncertainty presented in the case, we are currently unable to make a reasonable estimate, or range of estimates, with regard to the ultimate outcome of this matter. Professional Liability Insurance We carry medical professional liability insurance for healthcare services rendered in our primary care locations and throughout the communities we serve. In addition, we carry managed care errors and omissions insurance for all managed care services that we provide.

Stockholders' Equity - Restricted and Performance Stock Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
RSUs
RSAs and PSUs
Unvested balance, beginning of period (in shares)	511,105
Granted (in shares)	294,604
Vested (in shares)	(224,269)
Forfeited (in shares)	(45,993)
Unvested balance, shares end of period (in shares)	535,447	511,105
Weighted Average Grant Date Fair Value
Unvested balance, beginning balance (in dollars per share)	$ 237.10
Granted (in dollars per share)	277.37	$ 312.27	$ 224.63
Vested (in dollars per share)	210.22
Forfeited (in dollars per share)	261.71
Unvested balance, ending balance (in dollars per share)	$ 268.41	$ 237.10
PSUs
RSAs and PSUs
Unvested balance, beginning of period (in shares)	312,830
Granted (in shares)	470,284
Vested (in shares)	(328,998)
Forfeited (in shares)	(43,742)
Unvested balance, shares end of period (in shares)	410,374	312,830
Weighted Average Grant Date Fair Value
Unvested balance, beginning balance (in dollars per share)	$ 193.09
Granted (in dollars per share)	233.50	$ 214.94	$ 74.52
Vested (in dollars per share)	124.98
Forfeited (in dollars per share)	261.01
Unvested balance, ending balance (in dollars per share)	$ 286.77	$ 193.09

Investments - Contractual Maturities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Amortized Cost
Due in one year or less	$ 538
Due after one year through five years	2,437
Due after five years through ten years	406
Due after ten years	986
Amortized Cost	4,367	$ 3,709
Estimated Fair Value
Due in one year or less	530
Due after one year through five years	2,384
Due after five years through ten years	405
Due after ten years	940
Amortized Cost	$ 4,259	$ 3,499

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

Income tax expense for continuing operations consisted of the following:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Current:
Federal	$	349	$	297	$	209
State	55		40		31

Total current	404		337		240
Deferred:
Federal	(28)		(66)		(17)
State	(3)		—		(7)

Total deferred	(31)		(66)		(24)
Income tax expense	$	373	$	271	$	216

Schedule of Effective Income Tax Rate Reconciliation to The Statutory Federal Income Tax Rate

A reconciliation of the U.S. federal statutory income tax rate to the combined effective income tax rate for continuing operations is as follows:


	Year Ended December 31,
	2023		2022		2021
Statutory federal tax (benefit) rate	21.0	%	21.0	%	21.0	%
State income provision (benefit), net of federal benefit	2.8		3.0		2.2


Nondeductible compensation	1.4		1.8		1.5

Other	0.3		(0.3)		—
Effective tax expense rate	25.5	%	25.5	%	24.7	%

Schedule of Significant Components of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities as of December 31, 2023 and 2022 were as follows:


	December 31,
	2023		2022

	(In millions)
Accrued expenses and reserve liabilities	$	94	$	77
Other accrued medical costs	26		24
Net operating losses	7		9
Unearned premiums	19		16
Lease liabilities	87		88
Unrealized losses	26		49
Fixed assets and intangibles	24		9
Tax credit carryover	5		5
Other	6		5
Valuation allowance	(24)		(18)
Total deferred income tax assets, net of valuation allowance	270		264

Right-of-use assets	(29)		(29)
Prepaid expenses	(14)		(15)


Total deferred income tax liabilities	(43)		(44)
Net deferred income tax asset	$	227	$	220

Schedule of Unrecognized Tax Benefits Roll Forward

The roll forward of our unrecognized tax benefits is as follows:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Gross unrecognized tax benefits at beginning of period	$	(5)	$	(15)	$	(20)




Settlements	—		—		5
Lapse in statute of limitations	—		10		—
Gross unrecognized tax benefits at end of period	$	(5)	$	(5)	$	(15)

Leases - Supplemental Cash Flow (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash used in operating activities:
Operating leases	$ 28	$ 31	$ 33
Finance leases	15	15	15
Cash used in financing activities:
Finance leases	24	15	18
ROU assets recognized in exchange for lease obligations:
Operating leases	12	10	86
Finance leases	$ 13	$ 18	$ 18

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 4,848	$ 4,006
Investments	4,259	3,499
Receivables	3,104	2,302
Prepaid expenses and other current assets	331	277
Total current assets	12,542	10,084
Property, equipment, and capitalized software, net	270	259
Goodwill and intangible assets, net	1,449	1,390
Restricted investments	261	238
Deferred income taxes, net	227	220
Other assets	143	123
Total assets	14,892	12,314
Current liabilities:
Medical claims and benefits payable	4,204	3,528
Amounts due government agencies	2,294	2,079
Accounts payable, accrued liabilities and other	1,252	889
Deferred revenue	418	359
Total current liabilities	8,168	6,855
Long-term debt	2,180	2,176
Finance lease liabilities	205	215
Other long-term liabilities	124	104
Total liabilities	10,677	9,350
Stockholders’ equity:
Common stock, $0.001 par value per share; 150 million shares authorized; outstanding: 58 million shares at each of December 31, 2023, and December 31, 2022	0	0
Preferred stock, $0.001 par value per share; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	410	328
Accumulated other comprehensive loss	(82)	(160)
Retained earnings	3,887	2,796
Total stockholders’ equity	4,215	2,964
Total liabilities and stockholders’ equity	$ 14,892	$ 12,314

Condensed Financial Information of Registrant - Condensed Balance Sheets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 4,848	$ 4,006	$ 4,438
Investments	4,259	3,499
Prepaid expenses and other current assets	331	277
Total current assets	12,542	10,084
Property, equipment, and capitalized software, net	270	259
Goodwill and intangible assets, net	1,449	1,390
Deferred income taxes, net	227	220
Total assets	14,892	12,314
Current liabilities:
Accounts payable, accrued liabilities and other	1,252	889
Total current liabilities	8,168	6,855
Long-term debt	2,180	2,176
Finance lease liabilities	205	215
Other long-term liabilities	124	104
Total liabilities	10,677	9,350
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding: 58 million shares at each of December 31, 2023 and December 31, 2022	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	410	328
Accumulated other comprehensive loss	(82)	(160)
Retained earnings	3,887	2,796
Total stockholders’ equity	4,215	2,964	$ 2,630	$ 2,096
Total liabilities and stockholders’ equity	14,892	12,314
Parent Company
Current assets:
Cash and cash equivalents	694	329
Investments	48	46
Prepaid expenses and other current assets	133	106
Total current assets	1,049	624
Property, equipment, and capitalized software, net	234	224
Goodwill and intangible assets, net	825	731
Investments in subsidiaries	4,911	4,142
Deferred income taxes, net	57	37
Advances to related parties and other assets	94	78
Total assets	7,170	5,836
Current liabilities:
Accounts payable, accrued liabilities and other	527	448
Total current liabilities	527	448
Long-term debt	2,180	2,176
Finance lease liabilities	205	215
Other long-term liabilities	43	33
Total liabilities	2,955	2,872
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding: 58 million shares at each of December 31, 2023 and December 31, 2022	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	410	328
Accumulated other comprehensive loss	(82)	(160)
Retained earnings	3,887	2,796
Total stockholders’ equity	4,215	2,964
Total liabilities and stockholders’ equity	7,170	5,836
Parent Company \| Affiliated Entity
Current assets:
Due from affiliates	$ 174	$ 143

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Schedule of Fair Value of Assets Measured on Recurring Basis

Our financial instruments measured at fair value on a recurring basis at December 31, 2023, were as follows:


	Total		Level 1		Level 2		Level 3

	(In millions)
Corporate debt securities	$	2,732	$	—	$	2,732	$	—
Mortgage-backed securities	911		—		911		—
Asset-backed securities	365		—		365		—
Municipal securities	166		—		166		—
U.S. Treasury notes	40		—		40		—


Other	45		—		45		—
Total assets	$	4,259	$	—	$	4,259	$	—

Our financial instruments measured at fair value on a recurring basis at December 31, 2022, were as follows:


	Total		Level 1		Level 2		Level 3

	(In millions)
Corporate debt securities	$	2,184	$	—	$	2,184	$	—
Mortgage-backed securities	731		—		731		—
Asset-backed securities	288		—		288		—
Municipal securities	149		—		149		—
U.S. Treasury notes	105		—		105		—


Other	42		—		42		—
Total assets	$	3,499	$	—	$	3,499	$	—

Contingent consideration liabilities	$	8	$	—	$	—	$	8
Total liabilities	$	8	$	—	$	—	$	8

Schedule of Fair Value Measurements of Senior Notes


	December 31, 2023				December 31, 2022
	Carrying Amount		Fair Value		Carrying Amount		Fair Value

	(In millions)
4.375% Notes due 2028	$	794	$	757	$	792	$	729
3.875% Notes due 2030	644		583		643		554
3.875% Notes due 2032	742		654		741		629
Total	$	2,180	$	1,994	$	2,176	$	1,912

Condensed Financial Information of Registrant - Condensed Statements of Cash Flows (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net cash provided by operating activities	$ 1,662	$ 773	$ 2,119
Investing activities:
Purchases of investments	(1,433)	(1,913)	(2,713)
Proceeds from sales and maturities of investments	772	1,398	1,329
Purchases of property, equipment and capitalized software	(84)	(91)	(77)
Other, net	4	(50)	(63)
Net cash used in investing activities	(744)	(790)	(1,653)
Financing activities:
Common stock purchases	0	(400)	(128)
Common stock withheld to settle employee tax obligations	(60)	(54)	(53)
Contingent consideration liabilities settled	0	(20)	(20)
Proceeds from senior notes offerings, net of issuance costs	0	0	740
Repayment of senior notes	0	0	(723)
Other, net	2	33	1
Net cash used in financing activities	(58)	(441)	(183)
Net increase (decrease) in cash and cash equivalents, and restricted cash and cash equivalents	860	(458)	283
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period	4,048	4,506	4,223
Cash and cash equivalents, and restricted cash and cash equivalents at end of period	4,908	4,048	4,506
Parent Company
Operating activities:
Net cash provided by operating activities	81	119	60
Investing activities:
Capital contributions to subsidiaries	(221)	(159)	(440)
Dividends received from subsidiaries	705	668	564
Purchases of investments	(2)	(29)	(27)
Proceeds from sales and maturities of investments	1	49	21
Purchases of property, equipment and capitalized software	(79)	(86)	(70)
Net cash paid in business combinations	(74)	0	(263)
Change in amounts due to/from affiliates	5	(69)	40
Other, net	7	3	(3)
Net cash used in investing activities	342	377	(178)
Financing activities:
Common stock purchases	0	(400)	(128)
Common stock withheld to settle employee tax obligations	(60)	(54)	(53)
Contingent consideration liabilities settled	0	(20)	(20)
Proceeds from senior notes offerings, net of issuance costs	0	0	740
Repayment of senior notes	0	0	(723)
Other, net	2	33	1
Net cash used in financing activities	(58)	(441)	(183)
Net increase (decrease) in cash and cash equivalents, and restricted cash and cash equivalents	365	55	(301)
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period	329	274	575
Cash and cash equivalents, and restricted cash and cash equivalents at end of period	$ 694	$ 329	$ 274

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Stock Based Compensation Expense

Total share-based compensation expense is reported in “General and administrative expenses” in the accompanying consolidated statements of income, and summarized below.


	Year Ended December 31,
	2023				2022				2021

	(In millions)
	Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount
RSAs and PSUs (defined below)	$	108	$	102	$	97	$	90	$	66	$	62
Employee stock purchase plan and stock options	7		7		6		6		6		6
Total	$	115	$	109	$	103	$	96	$	72	$	68

Schedule of Restricted and Performance Stock Activity

Activity for stock-based awards in the year ended December 31, 2023, is summarized below.


	RSAs	Weighted Average Grant Date Fair Value		PSUs	Weighted Average Grant Date Fair Value
Unvested balance, December 31, 2022	511,105	$	237.10	312,830	$	193.09
Granted	294,604	277.37		470,284	233.50
Vested	(224,269)	210.22		(328,998)	124.98
Forfeited	(45,993)	261.71		(43,742)	261.01
Unvested balance, December 31, 2023	535,447	$	268.41	410,374	$	286.77

Schedule of Stock Options, Activity

The total fair value of awards vested is presented in the following table.


	Year Ended December 31,
	2023		2022		2021

	(In millions)





RSAs	$	62	$	70	$	53
PSUs	90		69		71
Total vested	$	152	$	139	$	124

Stock option activity for the year ended December 31, 2023, is summarized below.


	Number of Shares	Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual term

		(Per share)		(In millions)		(Years)
Stock options outstanding as of December 31, 2022	5,000	$	33.02
Exercised	(5,000)	33.02
Stock options outstanding, vested, and exercisable as of December 31, 2023	—	—		$	—	0.0

Segments - Narrative (Details)	12 Months Ended
Segments - Narrative (Details)	Dec. 31, 2023 segment
Segment Reporting [Abstract]
Number of reportable segments	4

Debt - Credit Agreement (Details) - Line of Credit	12 Months Ended
Debt - Credit Agreement (Details) - Line of Credit	Dec. 31, 2023 USD ($)
Line of Credit Facility [Line Items]
Agreement term	5 years
Credit Facility
Line of Credit Facility [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Amount outstanding under letter of credit	$ 0

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

Business Combinations - Narrative (Details) $ in Millions			12 Months Ended
Business Combinations - Narrative (Details) $ in Millions	Jan. 01, 2024 USD ($)	Sep. 01, 2023 USD ($)	Dec. 31, 2023 USD ($) combination	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Number of business combinations \| combination			1
Acquisition costs			$ 4
Goodwill			$ 1,241	$ 1,115	$ 982
My Choice Wisconsin
Business Acquisition [Line Items]
Purchase price		$ 74
Goodwill		$ 126
Weighted-average life		6 years 6 months
My Choice Wisconsin \| Medicaid Segment
Business Acquisition [Line Items]
Goodwill		$ 95
My Choice Wisconsin \| Medicare Segment
Business Acquisition [Line Items]
Goodwill		$ 31
Bright \| Medicare Segment \| Subsequent Event
Business Acquisition [Line Items]
Purchase price	$ 441

Medical Claims and Benefits Payable - Incurred Claims and Allocated Adjustment Expense (Details) claim in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) claim	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 28,669	$ 27,175	$ 23,704
Incurred Claims and Allocated Claims Adjustment Expenses	80,136
Total IBNP	2,898
Benefit Year 2021
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	23,912	23,979	$ 24,167
Total IBNP	$ 18
Cumulative number of reported claims (in claim) \| claim	133
Benefit Year 2022
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 27,128	$ 27,459
Total IBNP	$ 77
Cumulative number of reported claims (in claim) \| claim	163
Benefit Year 2023
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 29,096
Total IBNP	$ 2,803
Cumulative number of reported claims (in claim) \| claim	153

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net income	$ 1,091	$ 792	$ 659
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	171	176	131
Deferred income taxes	(31)	(66)	(24)
Share-based compensation	115	103	72
Loss on debt repayment	0	0	25
Impairment	0	208	0
Other, net	2	8	33
Changes in operating assets and liabilities, net of the effect of acquisitions:
Receivables	(778)	(95)	(415)
Prepaid expenses and other current assets	(69)	(124)	(19)
Medical claims and benefits payable	580	153	471
Amounts due government agencies	196	(428)	1,046
Accounts payable, accrued liabilities and other	328	55	138
Deferred revenue	59	(11)	(5)
Income taxes	(2)	2	7
Net cash provided by operating activities	1,662	773	2,119
Investing activities:
Purchases of investments	(1,433)	(1,913)	(2,713)
Proceeds from sales and maturities of investments	772	1,398	1,329
Net cash paid in business combinations	(3)	(134)	(129)
Purchases of property, equipment and capitalized software	(84)	(91)	(77)
Other, net	4	(50)	(63)
Net cash used in investing activities	(744)	(790)	(1,653)
Financing activities:
Common stock purchases	0	(400)	(128)
Common stock withheld to settle employee tax obligations	(60)	(54)	(53)
Contingent consideration liabilities settled	0	(20)	(20)
Proceeds from senior notes offerings, net of issuance costs	0	0	740
Repayment of senior notes	0	0	(723)
Other, net	2	33	1
Net cash used in financing activities	(58)	(441)	(183)
Net increase (decrease) in cash and cash equivalents, and restricted cash and cash equivalents	860	(458)	283
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period	4,048	4,506	4,223
Cash and cash equivalents, and restricted cash and cash equivalents at end of period	4,908	4,048	4,506
Cash paid during the period for:
Income taxes, net	405	340	235
Interest	$ 108	$ 108	$ 127

Investments - Schedule of Investments (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 4,367	$ 3,709
Gross Unrealized Gains	21	2
Gross Unrealized Losses	129	212
Estimated Fair Value	4,259	3,499
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,781	2,303
Gross Unrealized Gains	16	2
Gross Unrealized Losses	65	121
Estimated Fair Value	2,732	2,184
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	951	787
Gross Unrealized Gains	4	0
Gross Unrealized Losses	44	56
Estimated Fair Value	911	731
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	376	308
Gross Unrealized Gains	1	0
Gross Unrealized Losses	12	20
Estimated Fair Value	365	288
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	172	160
Gross Unrealized Gains	0	0
Gross Unrealized Losses	6	11
Estimated Fair Value	166	149
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	40	106
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	1
Estimated Fair Value	40	105
Other
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	47	45
Gross Unrealized Gains	0	0
Gross Unrealized Losses	2	3
Estimated Fair Value	$ 45	$ 42

Medical Claims and Benefits Payable

12 Months Ended

Dec. 31, 2023

Insurance [Abstract]

Medical Claims and Benefits Payable

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


	December 31,
	2023		2022		2021

	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	2,901	$	2,597	$	2,486
Pharmacy payable	202		206		219
Capitation payable	100		94		82
Other	1,001		631		576
Total	$	4,204	$	3,528	$	3,363

“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 $481 million, $228 million and $226 million, as of December 31, 2023, 2022, and 2021, respectively.

The following tables present the components of the change in our medical claims and benefits payable for the periods indicated.


	Year Ended December 31, 2023
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,815	$	452	$	261	$	3,528
Components of medical care costs related to:
Current year	23,749		3,802		1,545		29,096
Prior years	(395)		(11)		(21)		(427)
Total medical care costs	23,354		3,791		1,524		28,669
Payments for medical care costs related to:
Current year	20,999		3,293		1,323		25,615
Prior years	2,069		431		234		2,734
Total paid	23,068		3,724		1,557		28,349
Acquired balances, net of post-acquisition adjustments	82		14		—		96
Change in non-risk and other provider payables	261		(1)		—		260
Medical claims and benefits payable, ending balance	$	3,444	$	532	$	228	$	4,204


	Year Ended December 31, 2022
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,580	$	404	$	379	$	3,363
Components of medical care costs related to:
Current year	22,097		3,390		1,972		27,459
Prior years	(251)		(32)		(1)		(284)
Total medical care costs	21,846		3,358		1,971		27,175
Payments for medical care costs related to:
Current year	19,655		2,944		1,746		24,345
Prior years	1,966		361		343		2,670
Total paid	21,621		3,305		2,089		27,015
Acquired balances, net of post-acquisition adjustments	12		—		—		12
Change in non-risk and other provider payables	(2)		(5)		—		(7)
Medical claims and benefits payable, ending balance	$	2,815	$	452	$	261	$	3,528


	Year Ended December 31, 2021
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,129	$	392	$	175	$	2,696
Components of medical care costs related to:
Current year	18,321		2,970		2,652		23,943
Prior years	(182)		(39)		(18)		(239)
Total medical care costs	18,139		2,931		2,634		23,704
Payments for medical care costs related to:
Current year	16,284		2,573		2,291		21,148
Prior years	1,601		340		139		2,080
Total paid	17,885		2,913		2,430		23,228
Acquired balances, net of post-acquisition adjustments	205		(8)		—		197
Change in non-risk and other provider payables	(8)		2		—		(6)
Medical claims and benefits payable, ending balance	$	2,580	$	404	$	379	$	3,363

The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.

Our estimates of medical claims and benefits payable recorded at December 31, 2023, 2022 and 2021 developed favorably by approximately $427 million, $284 million and $239 million in 2023, 2022 and 2021, respectively. The favorable prior year development recognized in 2023 was primarily due to lower than expected utilization of medical services by our members and improved operating performance, mainly in the Medicaid segment. Consequently, the ultimate costs recognized in 2023, as claims payments were processed, were lower than our estimates in 2022.

The favorable prior year development recognized in 2022 was primarily due to lower than expected utilization of medical services by our members and improved operating performance, mainly in the Medicaid segment. Consequently, the ultimate costs recognized in 2022, as claims payments were processed, were lower than our estimates in 2021, which was not discernible until additional information was provided, and as claims payments were processed.

The favorable prior year development recognized in 2021 was primarily due to lower than expected utilization of medical services by our Medicaid members, and to a lesser extent our Medicare and Marketplace members, and improved operating performance. Consequently, the ultimate costs recognized in 2021 were lower than our original estimates in 2020, which was not discernible until additional information was provided, and as claims payments were processed.

The following tables provide information about our consolidated incurred and paid claims development as of December 31, 2023, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. The pattern of incurred and paid claims development is consistent across each of our segments. The cumulative claim frequency is measured by claim event, and includes claims covered under capitated arrangements.


Incurred Claims and Allocated Claims Adjustment Expenses							Total IBNP		Cumulative number of reported claims
Benefit Year	2021		2022		2023

	(Unaudited)		(Unaudited)
	(In millions)
2021	$	24,167	$	23,979	$	23,912	$	18	133
2022			27,459		27,128		77		163
2023					29,096		2,803		153
					$	80,136	$	2,898


Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year	2021		2022		2023

	(Unaudited)		(Unaudited)
	(In millions)
2021	$	21,148	$	23,871	$	23,894
2022			24,345		27,051
2023					25,615
					$	76,560

The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.


	2023

	(In millions)
Incurred claims and allocated claims adjustment expenses	$	80,136
Less: cumulative paid claims and allocated claims adjustment expenses	(76,560)
All outstanding liabilities before 2021	3
Acquired balances	96
Non-risk and other provider payables	529
Medical claims and benefits payable	$	4,204

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 1,091	$ 792	$ 659
Other comprehensive income (loss):
Unrealized investment income (loss)	102	(204)	(55)
Less: effect of income taxes	24	(49)	(13)
Other comprehensive income (loss), net of tax	78	(155)	(42)
Comprehensive income	$ 1,169	$ 637	$ 617

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481687/323-10-50-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482907/825-10-50-28

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482765/220-10-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480175/815-40-65-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-8

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-9

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-11

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-11

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-4

Reference 13: http://www.xbrl.org/2003/role/exampleRef
-Topic 946
-SubTopic 830
-Name Accounting Standards Codification
-Section 55
-Paragraph 10
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+ Details

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Components of Lease Expense and Supplemental Consolidated Cash flow Information

The components of lease expense for the years ended December 31, 2023, 2022, and 2021 are presented in the following table.


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Operating lease expense	$	15	$	31	$	34

Finance lease expense:
Amortization of ROU assets	$	18	$	28	$	25
Interest on lease liabilities	15		15		15
Total finance lease expense	$	33	$	43	$	40

Supplemental consolidated cash flow information related to leases follows:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Cash used in operating activities:
Operating leases	$	28	$	31	$	33
Finance leases	15		15		15
Cash used in financing activities:
Finance leases	24		15		18
ROU assets recognized in exchange for lease obligations:
Operating leases	12		10		86
Finance leases	13		18		18

Schedule of Supplemental Lease Information

Supplemental information related to leases, including location of amounts reported in the accompanying consolidated balance sheets, follows:


	December 31,
	2023		2022

	(In millions)
Operating leases:
ROU assets
Other assets	$	43	$	43
Lease liabilities
Accounts payable and accrued liabilities (current)	$	20	$	41
Other long-term liabilities (non-current)	85		77
Total operating lease liabilities	$	105	$	118
Finance leases:
ROU assets
Property, equipment, and capitalized software, net	$	67	$	72
Lease liabilities
Accounts payable and accrued liabilities (current)	$	21	$	22
Finance lease liabilities (non-current)	205		215
Total finance lease liabilities	$	226	$	237

Schedule of Operating Lease Maturities

Maturities of lease liabilities as of December 31, 2023, were as follows:


	Operating		Finance
	Leases		Leases

	(In millions)
2024	$	24	$	34
2025	20		30
2026	14		26
2027	11		24
2028	9		25
Thereafter	50		194
Subtotal - undiscounted lease payments	128		333
Less imputed interest	(23)		(107)
Total	$	105	$	226

Schedule of Finance Lease Maturities

Maturities of lease liabilities as of December 31, 2023, were as follows:


	Operating		Finance
	Leases		Leases

	(In millions)
2024	$	24	$	34
2025	20		30
2026	14		26
2027	11		24
2028	9		25
Thereafter	50		194
Subtotal - undiscounted lease payments	128		333
Less imputed interest	(23)		(107)
Total	$	105	$	226

Investments

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Investments

Available-for-Sale

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


	December 31, 2023
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	2,781	$	16	$	65	$	2,732
Mortgage-backed securities	951		4		44		911
Asset-backed securities	376		1		12		365
Municipal securities	172		—		6		166
U.S. Treasury notes	40		—		—		40


Other	47		—		2		45
Total	$	4,367	$	21	$	129	$	4,259


	December 31, 2022
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	2,303	$	2	$	121	$	2,184
Mortgage-backed securities	787		—		56		731
Asset-backed securities	308		—		20		288
Municipal securities	160		—		11		149
U.S. Treasury notes	106		—		1		105


Other	45		—		3		42
Total	$	3,709	$	2	$	212	$	3,499

Expected maturities may differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties. The contractual maturities of our current investments as of December 31, 2023 are summarized below:


	Amortized Cost		Estimated Fair Value

	(In millions)
Due in one year or less	$	538	$	530
Due after one year through five years	2,437		2,384
Due after five years through ten years	406		405
Due after ten years	986		940
Total	$	4,367	$	4,259

In the years ended December 31, 2023, 2022, and 2021, maturities and redemptions of available-for-sale securities amounted to $513 million, $1,069 million, and $948 million, respectively, and sales amounted to $259 million, $329 million, and $381 million, respectively. 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 $1 million, $1 million and $10 million in the years ended December 31, 2023, 2022 and 2021, respectively, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses amounted to $11 million and $7 million in the years ended December 31, 2023 and 2022, respectively, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses were insignificant in the year ended December 31, 2021.

We have determined that unrealized losses at December 31, 2023 and 2022 primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience realized 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 December 31, 2023:


	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	$	263	$	1	160	$	1,553	$	64	754
Mortgage-backed securities	123		2		98	549		42		283
Asset-backed securities	—		—		—	195		12		91
Municipal securities	—		—		—	117		6		116


Other	—		—		—	17		2		17

Total	$	386	$	3	258	$	2,431	$	126	1,261


	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	$	1,124	$	45	683	$	887	$	76	371
Mortgage-backed securities	395		20		220	319		36		131
Asset-backed securities	161		6		108	118		14		59
Municipal securities	75		4		83	57		7		57
U.S. Treasury notes	88		1		6	—		—		—

Other	15		1		16	17		2		6

Total	$	1,858	$	77	1,116	$	1,398	$	135	624

Restricted Investments Held-to-Maturity

Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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, of which $190 million will mature in one year or less, $65 million will mature in one through five years, and $6 million will mature after five years.

The following table presents the balances of restricted investments:


	December 31,
	2023		2022

	(In millions)
Cash and cash equivalents	$	60	$	42
U.S. Treasury notes	167		159
Corporate debt securities	34		37
Total restricted investments	$	261	$	238

Goodwill and Intangible Assets, Net

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets, Net

Goodwill

The following table presents the changes in the carrying amounts of goodwill by segment, for the periods presented.


	Medicaid		Medicare		Other		Consolidated

	(In millions)
Balance, December 31, 2021	$	769	$	169	$	44	$	982
Acquisitions and measurement period adjustments	130		3		—		133


Balance, December 31, 2022	899		172		44		1,115




Acquisitions and measurement period adjustments	95		31		—		126


Balance, December 31, 2023	$	994	$	203	$	44	$	1,241

The changes in the carrying amounts of both goodwill and intangible assets, net, in 2023, were due to the

acquisition described in Note 4, “Business Combinations.”

Intangible Assets, Net

The following table provides the details of identified intangible assets, by major class, for the periods presented.


	December 31, 2023						December 31, 2022
	Cost		Accumulated Amortization		Carrying Amount		Cost		Accumulated Amortization		Carrying Amount

	(In millions)
Contract rights and licenses	$	520	$	357	$	163	$	507	$	279	$	228
Provider networks	59		29		30		57		24		33
Trade names	22		7		15		19		5		14
Total	$	601	$	393	$	208	$	583	$	308	$	275

As of December 31, 2023, we estimate that our intangible asset amortization will be approximately $71 million in 2024, $67 million in 2025, $27 million in 2026, $15 million in 2027, and $8 million in 2028.

Net Income Per Share (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Schedule of Denominators for The Computation of Basic and Diluted Earnings Per Share

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


	Year Ended December 31,
	2023		2022		2021

	(In millions, except net income per share)
Numerator:
Net income	$	1,091	$	792	$	659
Denominator:
Shares outstanding at the beginning of the period	57.4		57.9		58.0
Weighted-average number of shares issued:
Stock purchases	—		(0.5)		(0.5)
Stock-based compensation	0.3		0.4		0.3
Denominator for basic net income per share	57.7		57.8		57.8
Effect of dilutive securities: (1)
Stock-based compensation	0.4		0.7		0.8

Denominator for diluted net income per share	58.1		58.5		58.6

Net income per share - Basic (2)	$	18.91	$	13.72	$	11.40
Net income per share - Diluted (2)	$	18.77	$	13.55	$	11.25

_______________________________

(2) Source data for calculations in thousands.

Income Taxes - Provision for Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current:
Federal	$ 349	$ 297	$ 209
State	55	40	31
Total current	404	337	240
Deferred:
Federal	(28)	(66)	(17)
State	(3)	0	(7)
Total deferred	(31)	(66)	(24)
Income tax expense	$ 373	$ 271	$ 216

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Condensed Financial Information of Registrant

12 Months Ended

Dec. 31, 2023

Condensed Financial Information Disclosure [Abstract]

Condensed Financial Information of Registrant

The condensed balance sheets as of December 31, 2023 and 2022, and the related condensed statements of income, comprehensive income and cash flows for each of the three years in the period ended December 31, 2023 for our parent company Molina Healthcare, Inc. (the “Registrant”), are presented below.

Condensed Balance Sheets


	December 31,
	2023		2022

	(In millions, except per-share data)
ASSETS
Current assets:
Cash and cash equivalents	$	694	$	329
Investments	48		46

Due from affiliates	174		143
Prepaid expenses and other current assets	133		106
Total current assets	1,049		624
Property, equipment, and capitalized software, net	234		224
Goodwill and intangible assets, net	825		731
Investments in subsidiaries	4,911		4,142
Deferred income taxes, net	57		37
Advances to related parties and other assets	94		78
Total assets	$	7,170	$	5,836
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable, accrued liabilities and other	$	527	$	448
Total current liabilities	527		448
Long-term debt	2,180		2,176
Finance lease liabilities	205		215
Other long-term liabilities	43		33
Total liabilities	2,955		2,872
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding: 58 million shares at each of December 31, 2023 and December 31, 2022	—		—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	—		—
Additional paid-in capital	410		328
Accumulated other comprehensive loss	(82)		(160)
Retained earnings	3,887		2,796
Total stockholders’ equity	4,215		2,964
Total liabilities and stockholders’ equity	$	7,170	$	5,836

See accompanying notes.

Condensed Statements of Income


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Revenue:
Administrative services fees	$	2,038	$	1,826	$	1,496
Investment income and other revenue	27		8		11
Total revenue	2,065		1,834		1,507
Expenses:
General and administrative expenses	1,952		1,721		1,424
Depreciation and amortization	131		141		98
Impairment	—		138		—
Other	20		—		5
Total operating expenses	2,103		2,000		1,527
Operating loss	(38)		(166)		(20)
Interest expense	109		110		120
Other expenses, net	—		—		25
Total other expenses, net	109		110		145
Loss before income tax benefit and equity in net earnings of subsidiaries	(147)		(276)		(165)
Income tax benefit	(7)		(42)		(21)
Net loss before equity in net earnings of subsidiaries	(140)		(234)		(144)
Equity in net earnings of subsidiaries	1,231		1,026		803
Net income	$	1,091	$	792	$	659

Condensed Statements of Comprehensive Income


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Net income	$	1,091	$	792	$	659
Other comprehensive income (loss):
Unrealized investment income (loss)	102		(204)		(55)
Less: effect of income taxes	24		(49)		(13)
Other comprehensive income (loss), net of tax	78		(155)		(42)
Comprehensive income	$	1,169	$	637	$	617

See accompanying notes.

Condensed Statements of Cash Flows


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Operating activities:
Net cash provided by operating activities	$	81	$	119	$	60
Investing activities:
Capital contributions to subsidiaries	(221)		(159)		(440)
Dividends received from subsidiaries	705		668		564
Purchases of investments	(2)		(29)		(27)
Proceeds from sales and maturities of investments	1		49		21
Purchases of property, equipment and capitalized software	(79)		(86)		(70)
Net cash paid in business combinations	(74)		—		(263)
Change in amounts due to/from affiliates	5		(69)		40
Other, net	7		3		(3)
Net cash provided by (used in) investing activities	342		377		(178)
Financing activities:
Common stock purchases	—		(400)		(128)
Common stock withheld to settle employee tax obligations	(60)		(54)		(53)
Contingent consideration liabilities settled	—		(20)		(20)
Proceeds from senior notes offering, net of issuance costs	—		—		740
Repayment of senior notes	—		—		(723)






Other, net	2		33		1
Net cash used in financing activities	(58)		(441)		(183)
Net increase (decrease) in cash and cash equivalents	365		55		(301)
Cash and cash equivalents at beginning of period	329		274		575
Cash and cash equivalents at end of period	$	694	$	329	$	274

Notes to Condensed Financial Information of Registrant

Note A - Basis of Presentation

The Registrant was incorporated in 2002. Prior to that date, Molina Healthcare of California (formerly known as Molina Medical Centers) operated as a California health plan and as the parent company for three other state health plans. In June 2003, the employees and operations of the corporate entity were transferred from Molina Healthcare of California to the Registrant.

The Registrant’s investment in subsidiaries is stated at cost plus equity in undistributed earnings of subsidiaries since the date of acquisition. The accompanying condensed financial information of the Registrant should be read in conjunction with the consolidated financial statements and accompanying notes.

Note B - Transactions with Subsidiaries

The Registrant provides certain centralized medical and administrative services to our subsidiaries pursuant to administrative services agreements that include, but are not limited to, information technology, product development and administration, underwriting, claims processing, customer service, certain care management services, human resources, marketing, purchasing, risk management, actuarial, finance, accounting, compliance, legal and public relations. Fees are based on the fair market value of services rendered and are recorded as operating revenue. Payment is subordinated to the subsidiaries’ ability to comply with minimum capital and other restrictive financial requirements of the states in which they operate. Charges in 2023, 2022, and 2021 for these services amounted to $2,038 million, $1,826 million, and $1,496 million, respectively, and are included in operating revenue.

The Registrant and its subsidiaries are included in the consolidated federal and state income tax returns filed by the Registrant. Income taxes are allocated to each subsidiary in accordance with an intercompany tax allocation agreement. The agreement allocates income taxes in an amount generally equivalent to the amount which would be expensed by the subsidiary if it filed a separate tax return. Net operating loss benefits are paid to the subsidiary by the Registrant to the extent such losses are utilized in the consolidated tax returns.

Note C - Dividends and Capital Contributions

When the Registrant receives dividends from its subsidiaries, such amounts are recorded as a reduction to the investments in the respective subsidiaries.

For all periods presented, the Registrant made capital contributions to certain subsidiaries primarily to comply with minimum net worth requirements and to fund business combinations. Such amounts have been recorded as an increase in investment in the respective subsidiaries.

Stockholders' Equity - Fair Value of Awards Granted and Vested (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares vested	$ 152	$ 139	$ 124
RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares vested	62	70	53
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares vested	$ 90	$ 69	$ 71

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Fair Value Measurements - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value recognized loss		$ 4
Passport Health Plan Inc
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration paid to seller included in financing and operating activities	$ 8

Organization and Basis of Presentation (Details) member in Millions	12 Months Ended
	Dec. 31, 2023 segment member state
Basis Of Presentation [Line Items]
Number of reportable segments \| segment	4
Health Plans
Basis Of Presentation [Line Items]
Number of members eligible for the health care programs \| member	5.0
Number of states with programs \| state	20
Medicaid \| Minimum
Basis Of Presentation [Line Items]
Contract term	3 years
Medicaid \| Maximum
Basis Of Presentation [Line Items]
Contract term	5 years
Medicare \| Minimum
Basis Of Presentation [Line Items]
Contract term	1 year
Medicare \| Maximum
Basis Of Presentation [Line Items]
Contract term	3 years

Medical Claims and Benefits Payable (Tables)

12 Months Ended

Dec. 31, 2023

Insurance [Abstract]

Schedule of Liability for Unpaid Claims and Claims Adjustment Expense

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


	December 31,
	2023		2022		2021

	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	2,901	$	2,597	$	2,486
Pharmacy payable	202		206		219
Capitation payable	100		94		82
Other	1,001		631		576
Total	$	4,204	$	3,528	$	3,363

Schedule of Components of The Change in Medical Claims and Benefits Payable

The following tables present the components of the change in our medical claims and benefits payable for the periods indicated.


	Year Ended December 31, 2023
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,815	$	452	$	261	$	3,528
Components of medical care costs related to:
Current year	23,749		3,802		1,545		29,096
Prior years	(395)		(11)		(21)		(427)
Total medical care costs	23,354		3,791		1,524		28,669
Payments for medical care costs related to:
Current year	20,999		3,293		1,323		25,615
Prior years	2,069		431		234		2,734
Total paid	23,068		3,724		1,557		28,349
Acquired balances, net of post-acquisition adjustments	82		14		—		96
Change in non-risk and other provider payables	261		(1)		—		260
Medical claims and benefits payable, ending balance	$	3,444	$	532	$	228	$	4,204


	Year Ended December 31, 2022
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,580	$	404	$	379	$	3,363
Components of medical care costs related to:
Current year	22,097		3,390		1,972		27,459
Prior years	(251)		(32)		(1)		(284)
Total medical care costs	21,846		3,358		1,971		27,175
Payments for medical care costs related to:
Current year	19,655		2,944		1,746		24,345
Prior years	1,966		361		343		2,670
Total paid	21,621		3,305		2,089		27,015
Acquired balances, net of post-acquisition adjustments	12		—		—		12
Change in non-risk and other provider payables	(2)		(5)		—		(7)
Medical claims and benefits payable, ending balance	$	2,815	$	452	$	261	$	3,528


	Year Ended December 31, 2021
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,129	$	392	$	175	$	2,696
Components of medical care costs related to:
Current year	18,321		2,970		2,652		23,943
Prior years	(182)		(39)		(18)		(239)
Total medical care costs	18,139		2,931		2,634		23,704
Payments for medical care costs related to:
Current year	16,284		2,573		2,291		21,148
Prior years	1,601		340		139		2,080
Total paid	17,885		2,913		2,430		23,228
Acquired balances, net of post-acquisition adjustments	205		(8)		—		197
Change in non-risk and other provider payables	(8)		2		—		(6)
Medical claims and benefits payable, ending balance	$	2,580	$	404	$	379	$	3,363

Schedule of Incurred and Paid Claims Development


Incurred Claims and Allocated Claims Adjustment Expenses							Total IBNP		Cumulative number of reported claims
Benefit Year	2021		2022		2023

	(Unaudited)		(Unaudited)
	(In millions)
2021	$	24,167	$	23,979	$	23,912	$	18	133
2022			27,459		27,128		77		163
2023					29,096		2,803		153
					$	80,136	$	2,898


Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year	2021		2022		2023

	(Unaudited)		(Unaudited)
	(In millions)
2021	$	21,148	$	23,871	$	23,894
2022			24,345		27,051
2023					25,615
					$	76,560

Schedule of Reconciliation of Claims Development to Liability

The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.


	2023

	(In millions)
Incurred claims and allocated claims adjustment expenses	$	80,136
Less: cumulative paid claims and allocated claims adjustment expenses	(76,560)
All outstanding liabilities before 2021	3
Acquired balances	96
Non-risk and other provider payables	529
Medical claims and benefits payable	$	4,204

Condensed Financial Information of Registrant - Condensed Balance Sheets - Additional Information (Details) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Condensed Financial Statements, Captions [Line Items]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares, outstanding (in shares)	58,000,000	58,000,000
Preferred stock, par value (in dollars 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
Parent Company
Condensed Financial Statements, Captions [Line Items]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares, outstanding (in shares)	58,000,000	58,000,000
Preferred stock, par value (in dollars 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

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	$ 4,259	$ 3,499
Total assets	4,259	3,499
Contingent consideration liabilities		8
Total liabilities		8
Corporate debt securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	2,732	2,184
Mortgage-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	911	731
Asset-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	365	288
Municipal securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	166	149
U.S. Treasury notes
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	40	105
Other
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	45	42
Level 1
Fair value of assets measured on recurring basis
Total assets	0	0
Contingent consideration liabilities		0
Total liabilities		0
Level 1 \| Corporate debt securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 1 \| Mortgage-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 1 \| Asset-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 1 \| Municipal securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 1 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 1 \| Other
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 2
Fair value of assets measured on recurring basis
Total assets	4,259	3,499
Contingent consideration liabilities		0
Total liabilities		0
Level 2 \| Corporate debt securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	2,732	2,184
Level 2 \| Mortgage-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	911	731
Level 2 \| Asset-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	365	288
Level 2 \| Municipal securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	166	149
Level 2 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	40	105
Level 2 \| Other
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	45	42
Level 3
Fair value of assets measured on recurring basis
Total assets	0	0
Contingent consideration liabilities		8
Total liabilities		8
Level 3 \| Corporate debt securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 3 \| Mortgage-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 3 \| Asset-backed securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 3 \| Municipal securities
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 3 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	0	0
Level 3 \| Other
Fair value of assets measured on recurring basis
Debt securities, available-for-sale	$ 0	$ 0

Pay vs Performance Disclosure - USD ($) $ in Millions	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income	$ 1,091	$ 792	$ 659

- Definition

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

+ References

+ Details

Income Taxes - Reconciliation of the U.S. Federal Statutory Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Statutory federal tax (benefit) rate	21.00%	21.00%	21.00%
State income provision (benefit), net of federal benefit	2.80%	3.00%	2.20%
Nondeductible compensation	1.40%	1.80%	1.50%
Other	0.30%	(0.30%)	0.00%
Effective tax expense rate	25.50%	25.50%	24.70%

Business Combinations - Schedule of The Provisional Fair Values Assigned To Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	Dec. 31, 2023	Sep. 01, 2023	Dec. 31, 2022	Dec. 31, 2021
Assets acquired:
Goodwill	$ 1,241		$ 1,115	$ 982
My Choice Wisconsin
Assets acquired:
Current assets		$ 96
Goodwill		126
Intangible assets		18
Other long-term assets		7
Liabilities assumed:
Medical claims and benefits payable		(96)
Amounts due government agencies		(19)
Accounts payable, accrued and other long-term liabilities		(58)
Net consideration transferred		$ 74

Debt - Senior Notes (Details) - Senior Notes	Dec. 31, 2023 USD ($)
4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Aggregate principal amount of notes outstanding	$ 800,000,000
3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Aggregate principal amount of notes outstanding	$ 650,000,000
3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Aggregate principal amount of notes outstanding	$ 750,000,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
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+ Details

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Schedule of Cash and Cash Equivalents

The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.


	December 31,
	2023		2022		2021

	(In millions)
Cash and cash equivalents	$	4,848	$	4,006	$	4,438
Restricted cash and cash equivalents	60		42		68
Total cash and cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,908	$	4,048	$	4,506

Schedule of Restricted Cash and Cash Equivalents

The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.


	December 31,
	2023		2022		2021

	(In millions)
Cash and cash equivalents	$	4,848	$	4,006	$	4,438
Restricted cash and cash equivalents	60		42		68
Total cash and cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,908	$	4,048	$	4,506

Schedule of Receivables


	December 31,
	2023		2022

	(In millions)
Government receivables	$	2,354	$	1,702
Pharmacy rebate receivables	330		291

Other	420		309
Total receivables	$	3,104	$	2,302

Leases - Components of Lease Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Operating lease expense	$ 15	$ 31	$ 34
Finance lease expense:
Amortization of ROU assets	18	28	25
Interest on lease liabilities	15	15	15
Total finance lease expense	$ 33	$ 43	$ 40

Stockholders' Equity - Components of Share-based Compensation (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax Charges	$ 115	$ 103	$ 72
Net-of-Tax Amount	109	96	68
RSAs and PSUs (defined below)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax Charges	108	97	66
Net-of-Tax Amount	102	90	62
Employee stock purchase plan and stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Pretax Charges	7	6	6
Net-of-Tax Amount	$ 7	$ 6	$ 6

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Unrecognized tax benefits roll forward
Gross unrecognized tax benefits at beginning of period	$ (5)	$ (15)	$ (20)
Settlements	0	0	5
Lapse in statute of limitations	0	10	0
Gross unrecognized tax benefits at end of period	$ (5)	$ (5)	$ (15)

Stockholders' Equity - Stock Option Activity (Details) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares shares
Number of Shares
Beginning balance, outstanding (in shares) \| shares	5,000
Exercised (in shares) \| shares	(5,000)
Ending balance, outstanding (in shares) \| shares	0
Weighted Average Exercise Price
Beginning balance, outstanding (in dollars per share) \| $ / shares	$ 33.02
Exercised (in dollars per share) \| $ / shares	33.02
Ending balance, outstanding (in dollars per share) \| $ / shares	$ 0
Outstanding, Aggregate Intrinsic Value \| $	$ 0
Outstanding, Weighted Average Remaining Contractual term	0 years

Investments (Tables)

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Schedule of Investments

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


	December 31, 2023
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	2,781	$	16	$	65	$	2,732
Mortgage-backed securities	951		4		44		911
Asset-backed securities	376		1		12		365
Municipal securities	172		—		6		166
U.S. Treasury notes	40		—		—		40


Other	47		—		2		45
Total	$	4,367	$	21	$	129	$	4,259


	December 31, 2022
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	2,303	$	2	$	121	$	2,184
Mortgage-backed securities	787		—		56		731
Asset-backed securities	308		—		20		288
Municipal securities	160		—		11		149
U.S. Treasury notes	106		—		1		105


Other	45		—		3		42
Total	$	3,709	$	2	$	212	$	3,499

Schedule of Contractual Maturities of Investments

The contractual maturities of our current investments as of December 31, 2023 are summarized below:


	Amortized Cost		Estimated Fair Value

	(In millions)
Due in one year or less	$	538	$	530
Due after one year through five years	2,437		2,384
Due after five years through ten years	406		405
Due after ten years	986		940
Total	$	4,367	$	4,259

Schedule of Available-for-Sale Investments


	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	$	263	$	1	160	$	1,553	$	64	754
Mortgage-backed securities	123		2		98	549		42		283
Asset-backed securities	—		—		—	195		12		91
Municipal securities	—		—		—	117		6		116


Other	—		—		—	17		2		17

Total	$	386	$	3	258	$	2,431	$	126	1,261


	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	$	1,124	$	45	683	$	887	$	76	371
Mortgage-backed securities	395		20		220	319		36		131
Asset-backed securities	161		6		108	118		14		59
Municipal securities	75		4		83	57		7		57
U.S. Treasury notes	88		1		6	—		—		—

Other	15		1		16	17		2		6

Total	$	1,858	$	77	1,116	$	1,398	$	135	624

Schedule of Balances of Restricted Investments

The following table presents the balances of restricted investments:


	December 31,
	2023		2022

	(In millions)
Cash and cash equivalents	$	60	$	42
U.S. Treasury notes	167		159
Corporate debt securities	34		37
Total restricted investments	$	261	$	238

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2023
Postemployment Benefits [Abstract]
Employee Benefit Plans	Employee Benefit Plans We sponsor defined contribution 401(k) plans that cover substantially all employees of our company and its subsidiaries. Eligible employees are permitted to contribute up to the maximum amount allowed by law. We match up to the first 4% of compensation contributed by employees. Expense recognized in connection with our contributions to the 401(k) plans amounted to $54 million, $45 million, and $41 million in the years ended December 31, 2023, 2022, and 2021, respectively. We also have a non-qualified deferred compensation plan for certain key employees. Under this plan, eligible participants may defer portions of their base salary and bonus to provide tax-deferred growth. The deferrals are distributable based upon termination of employment or other periods, as elected under the plan and were $39 million and $26 million as of December 31, 2023 and 2022, respectively.

Condensed Financial Information of Registrant - Condensed Statements of Comprehensive Income (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Condensed Financial Statements, Captions [Line Items]
Net income	$ 1,091	$ 792	$ 659
Other comprehensive income (loss):
Unrealized investment income (loss)	102	(204)	(55)
Less: effect of income taxes	24	(49)	(13)
Other comprehensive income (loss), net of tax	78	(155)	(42)
Comprehensive income	1,169	637	617
Parent Company
Condensed Financial Statements, Captions [Line Items]
Net income	1,091	792	659
Other comprehensive income (loss):
Unrealized investment income (loss)	102	(204)	(55)
Less: effect of income taxes	24	(49)	(13)
Other comprehensive income (loss), net of tax	78	(155)	(42)
Comprehensive income	$ 1,169	$ 637	$ 617

- Definition

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

+ References

+ Details

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Accrued expenses and reserve liabilities	$ 94	$ 77
Other accrued medical costs	26	24
Net operating losses	7	9
Unearned premiums	19	16
Lease liabilities	87	88
Unrealized losses	26	49
Fixed assets and intangibles	24	9
Tax credit carryover	5	5
Other	6	5
Valuation allowance	(24)	(18)
Total deferred income tax assets, net of valuation allowance	270	264
Right-of-use assets	(29)	(29)
Prepaid expenses	(14)	(15)
Total deferred income tax liabilities	(43)	(44)
Net deferred income tax asset	$ 227	$ 220

Segments - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Revenues	$ 34,072	$ 31,974	$ 27,771
Medicaid
Segment Reporting Information [Line Items]
Revenues	27,707	25,783	21,231
Medicare
Segment Reporting Information [Line Items]
Revenues	4,227	3,824	3,379
Marketplace
Segment Reporting Information [Line Items]
Revenues	2,062	2,296	3,091
Other
Segment Reporting Information [Line Items]
Revenues	$ 76	$ 71	$ 70

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

+ Details

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating Loss Carryforwards [Line Items]
Deferred tax assets	$ 24
Increased in deferred tax asset valuation allowance	6
Valuation allowance	24	$ 18
Impact on effective tax rate if tax benefits are recognized	5	$ 5	$ 15
Liability for unrecognized tax benefits, potential decrease	5
State
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	53
Foreign
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	11
Tax credit carryovers	$ 5

Segments

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Segments

We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.

The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes long-term services and supports consultative services in Wisconsin.

The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment since this is not a metric used to assess segment performance or allocate resources.

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


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Total revenue:
Medicaid	$	27,707	$	25,783	$	21,231
Medicare	4,227		3,824		3,379
Marketplace	2,062		2,296		3,091
Other	76		71		70
Consolidated	$	34,072	$	31,974	$	27,771

The following table reconciles margin by segment to consolidated income before income tax expense:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Margin:
Medicaid	$	2,973	$	2,981	$	2,322
Medicare	388		437		430
Marketplace	499		290		399
Other	9		11		14
Total margin	3,869		3,719		3,165
Add: other operating revenues (1)	1,467		1,020		846
Less: other operating expenses (2)	(3,763)		(3,566)		(2,991)
Operating income	1,573		1,173		1,020
Less: other expenses, net (3)	109		110		145
Income before income tax expense	$	1,464	$	1,063	$	875

______________________

(1)Other operating revenues include premium tax revenue, investment income and certain other revenue.

(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, impairment, and certain other operating expenses.

(3)Other expenses, net include interest expense and non-operating other expenses.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

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+ Details

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares, outstanding (in shares)	58,000,000	58,000,000
Preferred stock, par value (in dollars 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

Goodwill and Intangible Assets, Net - Additional Information (Details) $ in Millions	Dec. 31, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Future amortization expense, 2024	$ 71
Future amortization expense, 2025	67
Future amortization expense, 2026	27
Future amortization expense, 2027	15
Future amortization expense, 2028	$ 8

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue:
Premium revenue	$ 32,529	$ 30,883	$ 26,855
Premium tax revenue	1,069	873	787
Investment income	394	143	52
Other revenue	80	75	77
Total revenue	34,072	31,974	27,771
Operating expenses:
Medical care costs	28,669	27,175	23,704
General and administrative expenses	2,462	2,311	2,068
Premium tax expenses	1,069	873	787
Depreciation and amortization	171	176	131
Impairment	0	208	0
Other	128	58	61
Total operating expenses	32,499	30,801	26,751
Operating income	1,573	1,173	1,020
Other expenses, net:
Interest expense	109	110	120
Other expenses, net	0	0	25
Total other expenses, net	109	110	145
Income before income tax expense	1,464	1,063	875
Income tax expense	373	271	216
Net income	$ 1,091	$ 792	$ 659
Net income per share:
Basic (in dollars per share)	$ 18.91	$ 13.72	$ 11.40
Diluted (in dollars per share)	$ 18.77	$ 13.55	$ 11.25
Weighted average shares outstanding:
Basic (in shares)	57.7	57.8	57.8
Diluted (in shares)	58.1	58.5	58.6

Debt

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Debt

Contractual maturities of debt, as of December 31, 2023, are illustrated in the following table. All amounts represent the principal amounts of the debt instruments outstanding.


	Total		2024		2025		2026		2027		2028		Thereafter

	(In millions)
4.375% Notes due 2028	$	800	$	—	$	—	$	—	$	—	$	800	$	—
3.875% Notes due 2030	650		—		—		—		—		—		650
3.875% Notes due 2032	750		—		—		—		—		—		750
Total	$	2,200	$	—	$	—	$	—	$	—	$	800	$	1,400

The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below:


	December 31,
	2023		2022

	(In millions)




Non-current long-term debt:
4.375% Notes due 2028	$	800	$	800
3.875% Notes due 2030	650		650
3.875% Notes due 2032	750		750
Less: unamortized debt issuance costs	(20)		(24)
Total	$	2,180	$	2,176

Credit Agreement

We are party to a credit agreement (the “Credit Agreement”) which includes a revolving credit facility (“Credit Facility”) of $1.0 billion, among other provisions. The Credit Agreement has a term of five years, and all amounts outstanding will be due and payable on June 8, 2025. 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.

Effective April 26, 2023, we amended the Credit Agreement to transition from the use of the London Interbank Offered Rate, or LIBOR, to the Secured Overnight Financing Rate, or SOFR, as a benchmark interest rate used in the Credit Agreement.

We have other relationships, including financial advisory and banking, with some parties to the Credit Agreement.

The Credit Agreement contains customary non-financial and financial covenants. As of December 31, 2023, we were in compliance with all financial and non-financial covenants under the Credit Agreement. As of December 31, 2023, no amounts were outstanding under the Credit Facility.

Senior Notes

Our senior notes are described below. Each of these notes are senior unsecured obligations of the Parent corporation, Molina Healthcare, Inc., and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina Healthcare, Inc. In addition, each of the indentures governing the senior notes contain customary non-financial covenants and change of control provisions. As of December 31, 2023, we were in compliance with all non-financial covenants in the indentures governing the senior notes.

The indentures governing the senior 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.

4.375% Notes due 2028. We have $800 million aggregate principal amount of senior notes (the “4.375% Notes”) outstanding as of December 31, 2023, which are due June 15, 2028, unless earlier redeemed. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15.

3.875% Notes due 2030. We have $650 million aggregate principal amount of senior notes (the “3.875% Notes due 2030”) outstanding as of December 31, 2023, which are due November 15, 2030, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15.

3.875% Notes due 2032. We have $750 million aggregate principal amount of senior notes (the “3.875% Notes due 2032”) outstanding as of December 31, 2023, which are due May 15, 2032, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15.

Commitments and Contingencies (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statutory Accounting Practices [Line Items]
Performance bond	$ 35
Net assets of subsidiaries subject to restrictions	3,700
Aggregate statutory capital and surplus	4,100
Required minimum statutory capital surplus	2,300
Parent Company
Statutory Accounting Practices [Line Items]
Cash, cash equivalents, and investments	$ 742	$ 375

Property, Equipment, and Capitalized Software, Net

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property, Equipment, and Capitalized Software, Net

Property and equipment are stated at historical cost. Replacements and major improvements are capitalized, and repairs and maintenance are charged to expense as incurred. Software developed for internal use is capitalized. Property and equipment are generally depreciated using the straight-line method over estimated useful lives ranging from three to seven years. Software is generally amortized over its estimated useful life of three years. Leasehold improvements are amortized over the term of the lease, or over their useful lives from five to 10 years, whichever is shorter. Buildings are depreciated over their estimated useful lives of 31.5 to 40 years.

The Company recognized an impairment on property and equipment of $16 million associated with our reduction in leased space used in our business operations in the year ended December 31, 2022.

A summary of property, equipment, and capitalized software is as follows:


	December 31,
	2023		2022

	(In millions)
Capitalized software	$	687	$	615
Property and equipment	199		221
Building and improvements	41		41
Land	5		5

Total cost	932		882
Less: accumulated amortization - capitalized software	(537)		(482)
Less: accumulated depreciation and amortization - property, equipment, building, and improvements	(192)		(213)
Total accumulated depreciation and amortization	(729)		(695)
ROU assets - finance leases	67		72
Property, equipment, and capitalized software, net	$	270	$	259

The following table presents all depreciation and amortization recognized in our consolidated statements of income:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Recorded in depreciation and amortization:
Amortization of intangible assets	$	85	$	77	$	49
Amortization of capitalized software	58		54		41
Amortization of finance leases	18		28		25
Depreciation and amortization of property, equipment, building, and improvements	10		17		16
Total depreciation and amortization recognized	$	171	$	176	$	131

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	Ernst & Young LLP
Auditor Location	Los Angeles, California
Auditor Firm ID	42

Medical Claims and Benefits Payable - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Insurance [Abstract]
Non-risk provide payables	$ 481	$ 228	$ 226
Prior period claims, favorable development	$ 427	$ 284	$ 239

Business Combinations - Intangible Assets (Details) - My Choice Wisconsin $ in Millions	Sep. 01, 2023 USD ($)
Acquired Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 18
Contract rights - member list
Acquired Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 13
Useful life	7 years
Trade names
Acquired Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 3
Useful life	2 years
Provider network
Acquired Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 2
Useful life	10 years

Investments - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
Investments - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Investments, Debt and Equity Securities [Abstract]
Available-for-sale, securities maturities and redemptions	$ 513	$ 1,069	$ 948
Debt securities, sale	259	329	381
Gross realized investment gains	1	1	10
Gross realized investment loss	11	$ 7	$ 0
Amortized Cost, Due in one year or less	190
Amortized Cost, Due one year through five years	65
Amortized cost, due after five years	$ 6

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Less: unamortized debt issuance costs	$ (20)	$ (24)
Total	$ 2,180	2,176
Senior Notes \| 4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.375%
Non-current portion of long-term debt	$ 800	800
Senior Notes \| 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate	3.875%
Non-current portion of long-term debt	$ 650	650
Senior Notes \| 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate	3.875%
Non-current portion of long-term debt	$ 750	$ 750

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statutory Accounting Practices [Line Items]
Total receivables	$ 3,104	$ 2,302
Government receivables
Statutory Accounting Practices [Line Items]
Total receivables	2,354	1,702
Pharmacy rebate receivables
Statutory Accounting Practices [Line Items]
Total receivables	330	291
Other
Statutory Accounting Practices [Line Items]
Total receivables	$ 420	$ 309

Business Combinations

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Business Combinations

In 2023, we closed on one business combination in the Medicaid and Medicare segments, consistent with our growth strategy. For this transaction, we applied the acquisition method of accounting, where the total purchase price was allocated to the tangible and intangible assets acquired and liabilities assumed, based on their fair values as of the acquisition date. The pro forma effects of this acquisition for prior periods were not material to our consolidated results of operations. Costs to complete acquisitions amounted to $4 million in the aggregate for the year ended December 31, 2023, and were recorded as “General and administrative expenses” in the accompanying consolidated statements of income.

My Choice. On September 1, 2023, we closed on our acquisition of My Choice Wisconsin for preliminary purchase consideration of approximately $74 million. Finalization of purchase price adjustments, as provided in the definitive asset purchase agreement governing the transaction, is expected to occur in the first half of 2024.

Goodwill is calculated as the excess of the consideration transferred over the net assets recognized and represents the estimated future economic benefits arising from other assets acquired that could not be individually identified and separately recognized. Such assets include synergies we expect to achieve as a result of the transaction, such as the use of our existing infrastructure to support the added membership, and future economic benefits arising from the assembled workforce. We allocated goodwill in the amounts of $95 million to the Medicaid segment and $31 million to the Medicare segment. The goodwill is entirely deductible for income tax purposes. The following table summarizes the provisional fair values assigned to assets acquired and liabilities assumed, in millions.


Assets acquired:
Current assets	$	96
Goodwill	126
Intangible assets	18
Other long-term assets	7
Liabilities assumed:
Medical claims and benefits payable	(96)
Amounts due government agencies	(19)
Accounts payable, accrued and other long-term liabilities	(58)
Net consideration transferred	$	74

The table below presents intangible assets acquired, by major class, for the My Choice acquisition. The weighted-average amortization period, in the aggregate, is 6.5 years.


	Fair Value		Life

	(In millions)		(Years)
Contract rights - member list	$	13	7
Trade Name	3		2
Provider network	2		10
	$	18

Bright Health Medicare. We closed on this acquisition effective January 1, 2024 for $441 million, which will be part of our Medicare segment. The initial accounting for this transaction is incomplete.

Organization and Basis of Presentation	12 Months Ended
Organization and Basis of Presentation	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	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”). Molina was founded in 1980 as a provider organization serving low-income families in Southern California and reincorporated in Delaware in 2002. We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. As of December 31, 2023, we served approximately 5.0 million members eligible for government-sponsored healthcare programs, located across 20 states. 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 (“RFP”) 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 (“ABD”); and regions or service areas. In Medicare, we enter into Medicare Advantage-Part D contracts with the Centers for Medicare and Medicaid Services (“CMS”) annually, and for dual-eligible programs, we enter into contracts with CMS, in partnership with each state’s department of health and human services. Such contracts typically have terms of one to three years. In Marketplace, we enter into contracts with CMS, which end on December 31 of each year, and must be renewed annually. Consolidation and Presentation The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. All significant inter-company balances and transactions have been eliminated in consolidation. Financial information related to subsidiaries acquired during any year is included only for periods subsequent to their acquisition. We have reclassified certain 2022 amounts in the deferred tax asset and liabilities table in Note 12, “Income Taxes,” to conform to the 2023 presentation. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the periods presented have been included; such adjustments consist of normal recurring adjustments. 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.

Debt - Maturities (Details) $ in Millions	Dec. 31, 2023 USD ($)
Debt Instrument [Line Items]
Total	$ 2,200
2024	0
2025	0
2026	0
2027	0
2028	800
Thereafter	$ 1,400
Senior Notes \| 4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.375%
Total	$ 800
2024	0
2025	0
2026	0
2027	0
2028	800
Thereafter	$ 0
Senior Notes \| 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate	3.875%
2024	$ 0
2025	0
2026	0
2027	0
2028	0
Thereafter	$ 650
Senior Notes \| 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate	3.875%
Total	$ 750
2024	0
2025	0
2026	0
2027	0
2028	0
Thereafter	$ 750

Stockholders' Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Stockholders' Equity

Stock Purchase Programs

In September 2023, our board of directors authorized the purchase of up to $750 million of our common stock. This new program supersedes the stock purchase program previously approved by our board of directors in November 2022 and extends through December 31, 2024. The exact timing and amount of any repurchase is determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. No shares were purchased in 2023 and through February 9, 2024.

Share-Based Compensation

In connection with our employee stock plans, approximately 442,000 shares and 755,000 shares of common stock were issued, net of shares used to settle employees’ income tax obligations, during the years ended December 31, 2023, and 2022, respectively. Total share-based compensation expense is reported in “General and administrative expenses” in the accompanying consolidated statements of income, and summarized below.


	Year Ended December 31,
	2023				2022				2021

	(In millions)
	Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount
RSAs and PSUs (defined below)	$	108	$	102	$	97	$	90	$	66	$	62
Employee stock purchase plan and stock options	7		7		6		6		6		6
Total	$	115	$	109	$	103	$	96	$	72	$	68

Equity Incentive Plan

At December 31, 2023, we had employee equity incentives outstanding under our 2019 Equity Incentive Plan (the “2019 EIP”). The 2019 EIP provides for awards, in the form of restricted stock awards (“RSAs”), performance units (“PSUs”), stock options, and other stock– or cash–based awards, to eligible persons who perform services for us. The 2019 EIP provides for the issuance of up to 2.9 million shares of our common stock.

Stock-based awards. RSAs and PSUs are granted with a fair value equal to the market price of our common stock on the date of grant, and generally vest in equal annual installments over periods up to four years from the date of grant. PSUs vest in their entirety at the end of three-year performance periods, if their performance conditions are met. We generally recognize expense for RSAs and PSUs on a straight-line basis. The weighted-average grant date fair value of our RSAs was $277.37 in 2023, $312.27 in 2022, and $224.63 in 2021. The weighted-average grant date fair value of our PSUs was $233.50 in 2023, $214.94 in 2022, and $74.52 in 2021. Activity for stock-based awards in the year ended December 31, 2023, is summarized below.


	RSAs	Weighted Average Grant Date Fair Value		PSUs	Weighted Average Grant Date Fair Value
Unvested balance, December 31, 2022	511,105	$	237.10	312,830	$	193.09
Granted	294,604	277.37		470,284	233.50
Vested	(224,269)	210.22		(328,998)	124.98
Forfeited	(45,993)	261.71		(43,742)	261.01
Unvested balance, December 31, 2023	535,447	$	268.41	410,374	$	286.77

As of December 31, 2023, total unrecognized compensation expense related to unvested RSAs and PSUs was $88 million, and $52 million, respectively, which we expect to recognize over a remaining weighted-average period of 2.1 years, and 1.1 years, respectively. This unrecognized compensation cost assumes an estimated forfeiture rate of 8% for non-executive employees as of December 31, 2023, based on actual forfeitures over the last 4 years.

The total fair value of awards vested is presented in the following table.


	Year Ended December 31,
	2023		2022		2021

	(In millions)





RSAs	$	62	$	70	$	53
PSUs	90		69		71
Total vested	$	152	$	139	$	124

Stock Options. Stock option awards generally have an exercise price equal to the fair market value of our common stock on the date of grant, vest in equal annual installments over periods up to four years from the date of grant, and have a maximum term of ten years from the date of grant. Stock option activity for the year ended December 31, 2023, is summarized below.


	Number of Shares	Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual term

		(Per share)		(In millions)		(Years)
Stock options outstanding as of December 31, 2022	5,000	$	33.02
Exercised	(5,000)	33.02
Stock options outstanding, vested, and exercisable as of December 31, 2023	—	—		$	—	0.0

No stock options were granted in 2023, 2022, or 2021. As of December 31, 2023, there was no unrecognized compensation expense related to unvested stock options.

Employee Stock Purchase Plans (“ESPP”)

Under our ESPP, eligible employees may purchase common shares at 85% of the lower of the fair market value of our common stock on either the first or last trading day of each six-month offering period. Each participant is limited to a maximum purchase of $25,000 (as measured by the fair value of the stock acquired) per year through payroll deductions. We estimate the fair value of the stock issued using a standard option pricing model. For the years ended December 31, 2023, 2022, and 2021, the inputs to this model were as follows: risk-free interest rates of approximately 0.1% to 5.4%; expected volatility of approximately 28% to 54%, dividend yields of 0%, and an average expected life of 0.5 years.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 4,848	$ 4,006	$ 4,438
Restricted cash and cash equivalents	60	42	68
Total cash and cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 4,908	$ 4,048	$ 4,506	$ 4,223

Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Numerator:
Net income	$ 1,091	$ 792	$ 659
Denominator:
Shares outstanding at the beginning of the period (in shares)		57.4	57.9	58.0
Weighted-average number of shares issued:
Stock purchases (in shares)	0.0	(0.5)	(0.5)
Stock-based compensation (in shares)	0.3	0.4	0.3
Denominator for basic net income per share (in shares)	57.7	57.8	57.8
Effect of dilutive securities:
Stock-based compensation (in shares)	0.4	0.7	0.8
Denominator for diluted net income per share (in shares)	58.1	58.5	58.6
Net income per share:
Net income per share - Basic (in dollars per share)	$ 18.91	$ 13.72	$ 11.40
Net income per share - Diluted (in dollars per share)	$ 18.77	$ 13.55	$ 11.25

Medical Claims and Benefits Payable - Components of the Change (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and benefits payable, beginning balance	$ 3,528	$ 3,363	$ 2,696
Components of medical care costs related to:
Current year	29,096	27,459	23,943
Prior years	(427)	(284)	(239)
Incurred Claims and Allocated Claims Adjustment Expenses	28,669	27,175	23,704
Payments for medical care costs related to:
Current year	25,615	24,345	21,148
Prior years	2,734	2,670	2,080
Total paid	28,349	27,015	23,228
Acquired balances, net of post-acquisition adjustments	96	12	197
Change in non-risk and other provider payables	260	(7)	(6)
Medical claims and benefits payable, ending balance	4,204	3,528	3,363
Medicaid
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and benefits payable, beginning balance	2,815	2,580	2,129
Components of medical care costs related to:
Current year	23,749	22,097	18,321
Prior years	(395)	(251)	(182)
Incurred Claims and Allocated Claims Adjustment Expenses	23,354	21,846	18,139
Payments for medical care costs related to:
Current year	20,999	19,655	16,284
Prior years	2,069	1,966	1,601
Total paid	23,068	21,621	17,885
Acquired balances, net of post-acquisition adjustments	82	12	205
Change in non-risk and other provider payables	261	(2)	(8)
Medical claims and benefits payable, ending balance	3,444	2,815	2,580
Medicare
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and benefits payable, beginning balance	452	404	392
Components of medical care costs related to:
Current year	3,802	3,390	2,970
Prior years	(11)	(32)	(39)
Incurred Claims and Allocated Claims Adjustment Expenses	3,791	3,358	2,931
Payments for medical care costs related to:
Current year	3,293	2,944	2,573
Prior years	431	361	340
Total paid	3,724	3,305	2,913
Acquired balances, net of post-acquisition adjustments	14	0	(8)
Change in non-risk and other provider payables	(1)	(5)	2
Medical claims and benefits payable, ending balance	532	452	404
Marketplace
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and benefits payable, beginning balance	261	379	175
Components of medical care costs related to:
Current year	1,545	1,972	2,652
Prior years	(21)	(1)	(18)
Incurred Claims and Allocated Claims Adjustment Expenses	1,524	1,971	2,634
Payments for medical care costs related to:
Current year	1,323	1,746	2,291
Prior years	234	343	139
Total paid	1,557	2,089	2,430
Acquired balances, net of post-acquisition adjustments	0	0	0
Change in non-risk and other provider payables	0	0	0
Medical claims and benefits payable, ending balance	$ 228	$ 261	$ 379

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Less: Other operating expenses	$ (32,499)	$ (30,801)	$ (26,751)
Operating income	1,573	1,173	1,020
Less: other expenses, net	109	110	145
Income before income tax expense	1,464	1,063	875
Medicaid
Segment Reporting Information [Line Items]
Total margin	2,973	2,981	2,322
Medicare
Segment Reporting Information [Line Items]
Total margin	388	437	430
Marketplace
Segment Reporting Information [Line Items]
Total margin	499	290	399
Other
Segment Reporting Information [Line Items]
Total margin	9	11	14
Operating Segments
Segment Reporting Information [Line Items]
Total margin	3,869	3,719	3,165
Other Operating
Segment Reporting Information [Line Items]
Add: Other operating revenues	1,467	1,020	846
Less: Other operating expenses	$ (3,763)	$ (3,566)	$ (2,991)

CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive (Loss) Income	Retained Earnings
Beginning Balance (in shares) at Dec. 31, 2020		59
Beginning Balance at Dec. 31, 2020	$ 2,096	$ 0	$ 199	$ 37	$ 1,860
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	659				659
Common stock purchases (in shares)		(1)
Common stock purchases	(122)		(2)		(120)
Other comprehensive income (loss), net	(42)			(42)
Share-based compensation	39		39
Ending Balance (in shares) at Dec. 31, 2021		58
Ending Balance at Dec. 31, 2021	2,630	$ 0	236	(5)	2,399
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	792				792
Common stock purchases (in shares)		(1)
Common stock purchases	(400)		(5)		(395)
Other comprehensive income (loss), net	(155)			(155)
Share-based compensation (in shares)		1
Share-based compensation	$ 97		97
Ending Balance (in shares) at Dec. 31, 2022	58	58
Ending Balance at Dec. 31, 2022	$ 2,964	$ 0	328	(160)	2,796
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	1,091				1,091
Other comprehensive income (loss), net	78			78
Share-based compensation	$ 82		82
Ending Balance (in shares) at Dec. 31, 2023	58	58
Ending Balance at Dec. 31, 2023	$ 4,215	$ 0	$ 410	$ (82)	$ 3,887

- Definition

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

+ References

+ Details

- Definition

Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

- Definition

Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

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+ Details

Condensed Financial Information of Registrant - Notes to Condensed Financial Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Related Party Transaction [Line Items]
Medicaid	$ 34,072	$ 31,974	$ 27,771
Parent Company
Related Party Transaction [Line Items]
Medicaid	2,065	1,834	1,507
Parent Company \| Affiliated Entity
Related Party Transaction [Line Items]
Medicaid	$ 2,038	$ 1,826	$ 1,496

- Definition

+ References

+ Details

Business Combinations (Tables)

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following table summarizes the provisional fair values assigned to assets acquired and liabilities assumed, in millions.


Assets acquired:
Current assets	$	96
Goodwill	126
Intangible assets	18
Other long-term assets	7
Liabilities assumed:
Medical claims and benefits payable	(96)
Amounts due government agencies	(19)
Accounts payable, accrued and other long-term liabilities	(58)
Net consideration transferred	$	74

Schedule of Intangible Assets


	Fair Value		Life

	(In millions)		(Years)
Contract rights - member list	$	13	7
Trade Name	3		2
Provider network	2		10
	$	18

Property, Equipment, and Capitalized Software, Net - Depreciation and Amortization (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Recorded in depreciation and amortization:
Amortization of intangible assets	$ 85	$ 77	$ 49
Amortization of capitalized software	58	54	41
Amortization of finance leases	18	28	25
Depreciation and amortization of property, equipment, building, and improvements	10	17	16
Total depreciation and amortization recognized	$ 171	$ 176	$ 131

Investments - Balances of Restricted Investments (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Schedule of Held-to-maturity Securities [Line Items]
Restricted investments	$ 261	$ 238
Cash and cash equivalents
Schedule of Held-to-maturity Securities [Line Items]
Restricted investments	60	42
U.S. Treasury notes
Schedule of Held-to-maturity Securities [Line Items]
Restricted investments	167	159
Corporate debt securities
Schedule of Held-to-maturity Securities [Line Items]
Restricted investments	$ 34	$ 37

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Income tax expense for continuing operations consisted of the following:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Current:
Federal	$	349	$	297	$	209
State	55		40		31

Total current	404		337		240
Deferred:
Federal	(28)		(66)		(17)
State	(3)		—		(7)

Total deferred	(31)		(66)		(24)
Income tax expense	$	373	$	271	$	216

A reconciliation of the U.S. federal statutory income tax rate to the combined effective income tax rate for continuing operations is as follows:


	Year Ended December 31,
	2023		2022		2021
Statutory federal tax (benefit) rate	21.0	%	21.0	%	21.0	%
State income provision (benefit), net of federal benefit	2.8		3.0		2.2


Nondeductible compensation	1.4		1.8		1.5

Other	0.3		(0.3)		—
Effective tax expense rate	25.5	%	25.5	%	24.7	%

Our effective tax rate is based on expected income, statutory tax rates, and tax planning opportunities available to us in the various jurisdictions in which we operate. Management estimates and judgments are required in determining our effective tax rate. We are routinely under audit by federal, state, or local authorities regarding the timing and amount of deductions, nexus of income among various tax jurisdictions, and compliance with federal, state, foreign, and local tax laws.

Deferred tax assets and liabilities are classified as non-current. Significant components of our deferred tax assets and liabilities as of December 31, 2023 and 2022 were as follows:


	December 31,
	2023		2022

	(In millions)
Accrued expenses and reserve liabilities	$	94	$	77
Other accrued medical costs	26		24
Net operating losses	7		9
Unearned premiums	19		16
Lease liabilities	87		88
Unrealized losses	26		49
Fixed assets and intangibles	24		9
Tax credit carryover	5		5
Other	6		5
Valuation allowance	(24)		(18)
Total deferred income tax assets, net of valuation allowance	270		264

Right-of-use assets	(29)		(29)
Prepaid expenses	(14)		(15)


Total deferred income tax liabilities	(43)		(44)
Net deferred income tax asset	$	227	$	220

At December 31, 2023, we had state net operating loss carryforwards of $53 million, which begin expiring in 2036.

At December 31, 2023, we had foreign net operating loss carryforwards of $11 million, which begin expiring in 2031.

At December 31, 2023, we had foreign tax credit carryovers of $5 million, which expire in 2030.

We evaluate the need for a valuation allowance taking into consideration the ability to carry back and carry forward tax credits and losses, available tax planning strategies and future income, including reversal of temporary differences. We have determined that as of December 31, 2023, $24 million of deferred tax assets did not satisfy the recognition criteria. Therefore, we increased our valuation allowance by $6 million, from $18 million at December 31, 2022, to $24 million as of December 31, 2023.

We recognize tax benefits only if the tax position is more likely than not to be sustained. We are subject to income taxes in the United States, Puerto Rico, and numerous state jurisdictions. Significant judgment is required in evaluating our tax positions and determining our provision for income taxes. During the ordinary course of business, there are many transactions and calculations for which the ultimate tax determination is uncertain. We establish reserves for tax-related uncertainties based on estimates of whether, and the extent to which, additional taxes will be due. These reserves are established when we believe that certain positions might be challenged despite our belief that our tax return positions are fully supportable. We adjust these reserves in light of changing facts and circumstances, such as the outcome of tax audits. The provision for income taxes includes the impact of reserve provisions and changes to reserves that are considered appropriate.

The roll forward of our unrecognized tax benefits is as follows:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Gross unrecognized tax benefits at beginning of period	$	(5)	$	(15)	$	(20)




Settlements	—		—		5
Lapse in statute of limitations	—		10		—
Gross unrecognized tax benefits at end of period	$	(5)	$	(5)	$	(15)

The total amount of unrecognized tax benefits at December 31, 2023, 2022 and 2021 that, if recognized, would affect the effective tax rates is $5 million, $5 million, and $15 million, respectively. We expect that during the next 12 months it is reasonably possible that unrecognized tax benefit liabilities may decrease by $5 million due to

resolution of a state refund claim. The state refund claim will not result in a cash payment for income taxes if our claim is denied.

Our continuing practice is to recognize interest and/or penalties related to unrecognized tax benefits in income tax expense. Amounts accrued for the payment of interest and penalties as of December 31, 2023, 2022 and 2021 were insignificant.

We may be subject to examination by the IRS for calendar years after 2019. With a few exceptions, which are immaterial in the aggregate, we no longer are subject to state, local, and Puerto Rico tax examinations for years before 2019.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

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-Topic 946
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-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Investments - Available-for-Sale (Details) $ in Millions	Dec. 31, 2023 USD ($) position	Dec. 31, 2022 USD ($) position
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 386	$ 1,858
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 3	$ 77
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	258	1,116
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 2,431	$ 1,398
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 126	$ 135
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	1,261	624
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 263	$ 1,124
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 1	$ 45
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	160	683
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 1,553	$ 887
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 64	$ 76
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	754	371
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 123	$ 395
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 2	$ 20
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	98	220
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 549	$ 319
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 42	$ 36
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	283	131
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0	$ 161
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 0	$ 6
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	0	108
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 195	$ 118
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 12	$ 14
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	91	59
Municipal securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0	$ 75
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 0	$ 4
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	0	83
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 117	$ 57
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 6	$ 7
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	116	57
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value		$ 88
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses		$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position		6
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value		$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses		$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position		0
Other
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0	$ 15
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 0	$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions \| position	0	16
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 17	$ 17
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 2	$ 2
In a Continuous Loss Position for 12 Months or More, Total Number of Positions \| position	17	6

Debt (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Schedule of Maturities of Long-Term Debt

Contractual maturities of debt, as of December 31, 2023, are illustrated in the following table. All amounts represent the principal amounts of the debt instruments outstanding.


	Total		2024		2025		2026		2027		2028		Thereafter

	(In millions)
4.375% Notes due 2028	$	800	$	—	$	—	$	—	$	—	$	800	$	—
3.875% Notes due 2030	650		—		—		—		—		—		650
3.875% Notes due 2032	750		—		—		—		—		—		750
Total	$	2,200	$	—	$	—	$	—	$	—	$	800	$	1,400

Schedule of Long Term Debt

The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below:


	December 31,
	2023		2022

	(In millions)




Non-current long-term debt:
4.375% Notes due 2028	$	800	$	800
3.875% Notes due 2030	650		650
3.875% Notes due 2032	750		750
Less: unamortized debt issuance costs	(20)		(24)
Total	$	2,180	$	2,176

- 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://www.xbrl.org/2003/role/exampleRef
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+ Details

Leases - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
Leases - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2023
Leases [Abstract]
Operating lease, remaining lease term		12 years
Operating lease renewal term		10 years
Operating leases, weighted average remaining lease term		8 years
Finance lease, remaining lease term		15 years
Finance lease renewal term		25 years
Finance leases, weighted average remaining lease term		12 years
ROU assets impairments	$ 192
Operating leases, weighted average discount rate		4.80%
Finance leases, weighted average discount rate		6.40%

Goodwill and Intangible Assets, Net - Balances of Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Goodwill [Roll Forward]
Beginning balance	$ 1,115	$ 982
Acquisitions and measurement period adjustments	126	133
Ending balance	1,241	1,115
Medicaid
Goodwill [Roll Forward]
Beginning balance	899	769
Acquisitions and measurement period adjustments	95	130
Ending balance	994	899
Medicare
Goodwill [Roll Forward]
Beginning balance	172	169
Acquisitions and measurement period adjustments	31	3
Ending balance	203	172
Other
Goodwill [Roll Forward]
Beginning balance	44	44
Acquisitions and measurement period adjustments	0	0
Ending balance	$ 44	$ 44

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Goodwill and Intangible Assets, Net (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The following table presents the changes in the carrying amounts of goodwill by segment, for the periods presented.


	Medicaid		Medicare		Other		Consolidated

	(In millions)
Balance, December 31, 2021	$	769	$	169	$	44	$	982
Acquisitions and measurement period adjustments	130		3		—		133


Balance, December 31, 2022	899		172		44		1,115




Acquisitions and measurement period adjustments	95		31		—		126


Balance, December 31, 2023	$	994	$	203	$	44	$	1,241

Schedule of Identified Intangible Assets, by Major Class

The following table provides the details of identified intangible assets, by major class, for the periods presented.


	December 31, 2023						December 31, 2022
	Cost		Accumulated Amortization		Carrying Amount		Cost		Accumulated Amortization		Carrying Amount

	(In millions)
Contract rights and licenses	$	520	$	357	$	163	$	507	$	279	$	228
Provider networks	59		29		30		57		24		33
Trade names	22		7		15		19		5		14
Total	$	601	$	393	$	208	$	583	$	308	$	275

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
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+ Details

Condensed Financial Information of Registrant - Condensed Statements of Operations (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue:
Revenues	$ 34,072	$ 31,974	$ 27,771
Expenses:
General and administrative expenses	2,462	2,311	2,068
Depreciation and amortization	171	176	131
Impairment	0	208	0
Total operating expenses	32,499	30,801	26,751
Operating income	1,573	1,173	1,020
Interest expense	109	110	120
Other expenses, net	0	0	25
Income tax benefit	373	271	216
Net income	1,091	792	659
Parent Company
Revenue:
Administrative services fees	2,038	1,826	1,496
Investment income and other revenue	27	8	11
Revenues	2,065	1,834	1,507
Expenses:
General and administrative expenses	1,952	1,721	1,424
Depreciation and amortization	131	141	98
Impairment	0	138	0
Other	20	0	5
Total operating expenses	2,103	2,000	1,527
Operating income	(38)	(166)	(20)
Interest expense	109	110	120
Other expenses, net	0	0	25
Total other expenses, net	109	110	145
Loss before income tax benefit and equity in net earnings of subsidiaries	(147)	(276)	(165)
Income tax benefit	(7)	(42)	(21)
Net loss before equity in net earnings of subsidiaries	(140)	(234)	(144)
Equity in net earnings of subsidiaries	1,231	1,026	803
Net income	1,091	792	659
Parent Company \| Affiliated Entity
Revenue:
Revenues	$ 2,038	$ 1,826	$ 1,496

Medical Claims and Benefits Payable - Medical Claims and Future Benefits (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Insurance [Abstract]
Fee-for-service claims incurred but not paid (“IBNP”)	$ 2,901	$ 2,597	$ 2,486
Pharmacy payable	202	206	219
Capitation payable	100	94	82
Other	1,001	631	576
Medical claims and benefits payable	$ 4,204	$ 3,528	$ 3,363	$ 2,696

Medical Claims and Benefits Payable - Reconciliation of Claims Development (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Insurance [Abstract]
Incurred claims and allocated claims adjustment expenses	$ 80,136
Less: cumulative paid claims and allocated claims adjustment expenses	(76,560)
All outstanding liabilities before 2021	3
Acquired balances	96
Non-risk and other provider payables	529
Medical claims and benefits payable	$ 4,204	$ 3,528	$ 3,363	$ 2,696

Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,180	$ 2,176
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 1,994	1,912
Senior Notes \| 4.375% Notes due 2028
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	4.375%
Senior Notes \| 4.375% Notes due 2028 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 794	792
Senior Notes \| 4.375% Notes due 2028 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 757	729
Senior Notes \| 3.875% Notes due 2030
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes \| 3.875% Notes due 2030 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 644	643
Senior Notes \| 3.875% Notes due 2030 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 583	554
Senior Notes \| 3.875% Notes due 2032
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes \| 3.875% Notes due 2032 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 742	741
Senior Notes \| 3.875% Notes due 2032 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 654	$ 629

Property, Equipment, and Capitalized Software, Net (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment and Depreciation and Amortization Recognized

A summary of property, equipment, and capitalized software is as follows:


	December 31,
	2023		2022

	(In millions)
Capitalized software	$	687	$	615
Property and equipment	199		221
Building and improvements	41		41
Land	5		5

Total cost	932		882
Less: accumulated amortization - capitalized software	(537)		(482)
Less: accumulated depreciation and amortization - property, equipment, building, and improvements	(192)		(213)
Total accumulated depreciation and amortization	(729)		(695)
ROU assets - finance leases	67		72
Property, equipment, and capitalized software, net	$	270	$	259

The following table presents all depreciation and amortization recognized in our consolidated statements of income:


	Year Ended December 31,
	2023		2022		2021

	(In millions)
Recorded in depreciation and amortization:
Amortization of intangible assets	$	85	$	77	$	49
Amortization of capitalized software	58		54		41
Amortization of finance leases	18		28		25
Depreciation and amortization of property, equipment, building, and improvements	10		17		16
Total depreciation and amortization recognized	$	171	$	176	$	131

Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Maturity period (less than)	15 years
Interest receivable	$ 53	$ 35
Minimum MLR, medical cost corridors and profit sharing liability	1,344	1,145
Government agencies liability	64	84
Risk adjustments liability	66	76
Risk adjustment payable	201	230
Risk adjustment receivable	241	135
Risk adjustment, net receivable	40
Risk adjustment, credit loss allowances	41
Risk adjustment, net payable		95
Prepaid reinsurance premiums	11	2	$ 2
Reinsurance recoveries	21	35	$ 33
Reinsurance recoverable	$ 28	$ 27
NEW YORK
Property, Plant and Equipment [Line Items]
Premium revenue percentage	11.40%
TEXAS
Property, Plant and Equipment [Line Items]
Premium revenue percentage	13.90%
WASHINGTON
Property, Plant and Equipment [Line Items]
Premium revenue percentage	14.00%
Minimum
Property, Plant and Equipment [Line Items]
Useful life	5 years
Minimum \| Premium revenue
Property, Plant and Equipment [Line Items]
Revenue ranging	1.00%
Maximum
Property, Plant and Equipment [Line Items]
Useful life	16 years
Maximum \| Premium revenue
Property, Plant and Equipment [Line Items]
Revenue ranging	4.00%
Structured Securities
Property, Plant and Equipment [Line Items]
Average maturity period (less than)	15 years