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Document and Entity Information - USD ($) $ in Millions	12 Months Ended
Document and Entity Information - USD ($) $ in Millions	Dec. 31, 2018	Feb. 15, 2019	Jun. 30, 2018
Document and Entity Information [Abstract]
Entity Registrant Name	MOLINA HEALTHCARE INC
Entity Central Index Key	0001179929
Document Type	10-K
Document Period End Date	Dec. 31, 2018
Amendment Flag	false
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Shell Company	false
Entity Filer Category	Large Accelerated Filer
Entity Public Float			$ 6,018.8
Entity Common Stock, Shares Outstanding		62,460,000

Consolidated Statements of Operations - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Premium revenue	$ 17,612	$ 18,854	$ 16,445
Service revenue	407	521	539
Premium tax revenue	417	438	468
Health insurer fees reimbursed	329	0	292
Investment income and other revenue	125	70	38
Total revenue	18,890	19,883	17,782
Operating expenses:
General and administrative expenses	1,333	1,594	1,393
Premium tax expenses	417	438	468
Health insurer fees	348	0	217
Depreciation and amortization	99	137	139
Restructuring and separation costs	46	234	0
Impairment losses	0	470	0
Total operating expenses	17,744	20,438	17,476
Loss on sales of subsidiaries, net of gain	(15)	0	0
Operating income (loss)	1,131	(555)	306
Interest expense	115	118	101
Other expenses (income), net	17	(61)	0
Total other expenses, net	132	57	101
Income (loss) before income tax expense (benefit)	999	(612)	205
Income tax expense (benefit)	292	(100)	153
Net income (loss)	$ 707	$ (512)	$ 52
Net income (loss) per share:
Basic (in dollars per share)	$ 11.57	$ (9.07)	$ 0.93
Diluted (in dollars per share)	$ 10.61	$ (9.07)	$ 0.92
Weighted average shares outstanding:
Basic (in shares)	61.1	56.4	55.4
Diluted (in shares)	66.6	56.4	56.2
Medical care costs
Operating expenses:
Cost of revenue	$ 15,137	$ 17,073	$ 14,774
Cost of service revenue
Operating expenses:
Cost of revenue	$ 364	$ 492	$ 485

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	$ 707	$ (512)	$ 52
Other comprehensive (loss) income:
Unrealized investment (loss) gain									(3)	(5)	3
Less: effect of income taxes									(1)	(2)	1
Other comprehensive (loss) income, net of tax									(2)	(3)	2
Comprehensive income (loss)									$ 705	$ (515)	$ 54

- Definition

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

+ References + Details

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 2,826	$ 3,186	$ 2,819
Investments	1,681	2,524
Restricted investments	0	169
Receivables	1,330	871
Prepaid expenses and other current assets	149	239
Derivative asset	476	522
Total current assets	6,462	7,511
Property, equipment, and capitalized software, net	241	342
Goodwill and intangible assets, net	190	255	760
Restricted investments	120	119
Deferred income taxes	117	103
Other assets	24	141
Total assets	7,154	8,471	7,449
Current liabilities:
Medical claims and benefits payable	1,961	2,192	$ 1,929	$ 1,685
Amounts due government agencies	967	1,542
Accounts payable and accrued liabilities	390	366
Deferred revenue	211	282
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	4,246	5,557
Long-term debt	1,020	1,318
Lease financing obligations	197	198
Other long-term liabilities	44	61
Total liabilities	5,507	7,134
Stockholders’ equity:
Common stock, $0.001 par value per share; 150 million shares authorized; outstanding: 62 million shares at December 31, 2018 and 60 million shares at December 31, 2017	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	643	1,044
Accumulated other comprehensive loss	(8)	(5)
Retained earnings	1,012	298
Total stockholders’ equity	1,647	1,337
Total liabilities and stockholders' equity	$ 7,154	$ 8,471

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Common stock, par value (dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares outstanding	62,000,000	60,000,000
Preferred stock, par value (dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	20,000,000	20,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

Consolidated Statements of Stockholders' Equity - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings
Beginning Balance, shares at Dec. 31, 2015	55.1	56.0
Beginning Balance at Dec. 31, 2015	$ 1,557	$ 0	$ 803	$ (4)	$ 758
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	52				52
Other comprehensive income (loss), net	2			2
Share-based compensation, shares		1.0
Share-based compensation	36		36
Tax benefit from share-based compensation	2		2
Exchange of 1.625% Convertible Notes	$ 0
Ending Balance, shares at Dec. 31, 2016	55.8	57.0
Ending Balance at Dec. 31, 2016	$ 1,649	$ 0	841	(2)	810
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(512)				(512)
Other comprehensive income (loss), net	(3)			(3)
Share-based compensation	42		42
Exchange of 1.625% Convertible Notes, shares		3.0
Exchange of 1.625% Convertible Notes	$ 161		161
Ending Balance, shares at Dec. 31, 2017	59.3	60.0
Ending Balance at Dec. 31, 2017	$ 1,337	$ 0	1,044	(5)	298
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Adoption of ASU \| Adoption of Topic 606	6				6
Adoption of ASU \| Adoption of ASU 2018-02	0			(1)	1
Net income (loss)	707
Other comprehensive income (loss), net	(2)			(2)
Share-based compensation	37		37
Exchange of 1.625% Convertible Notes, shares		2.0
Exchange of 1.625% Convertible Notes	108		108
Partial termination of 1.125% Warrants	(550)		(550)
Conversion of 1.625% Convertible Notes	4		4
Ending Balance, shares at Dec. 31, 2018		62.0
Ending Balance at Dec. 31, 2018	$ 1,647	$ 0	$ 643	$ (8)	$ 1,012

Consolidated Statements of Stockholders' Equity (Parenthetical)	Dec. 31, 2018
1.625% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.625%
Convertible Debt \| 1.625% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.625%
1.125% Warrants
Debt Instrument [Line Items]
Stated interest rate	1.125%

Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating activities:
Net income (loss)	$ 707	$ (512)	$ 52
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:
Depreciation and amortization	127	178	182
Deferred income taxes	(6)	(94)	22
Share-based compensation	27	46	26
Non-cash restructuring charges	17	60	0
Amortization of convertible senior notes and lease financing obligations	22	32	31
Loss on sales of subsidiaries, net of gain	15	0	0
Loss on debt extinguishment	22	14	0
Impairment losses	0	470	0
Other, net	4	21	16
Changes in operating assets and liabilities:
Receivables	(530)	103	(348)
Prepaid expenses and other current assets	6	(56)	(69)
Medical claims and benefits payable	(226)	263	226
Amounts due government agencies	(574)	341	473
Accounts payable and accrued liabilities	45	(12)	(4)
Deferred revenue	(21)	(34)	92
Income taxes	51	(16)	(26)
Net cash (used in) provided by operating activities	(314)	804	673
Investing activities:
Purchases of investments	(1,444)	(2,697)	(1,929)
Proceeds from sales and maturities of investments	2,445	1,759	1,966
Purchases of property, equipment and capitalized software	(30)	(86)	(176)
Net cash received from sale of subsidiaries	190	0	0
Net cash paid in business combinations	0	0	(48)
Other, net	(18)	(38)	(19)
Net cash provided by (used in) investing activities	(1,143)	1,062	206
Financing activities:
Repayment of credit facility	(300)	0	0
Cash paid for partial settlement of 1.125% Conversion Option	(623)	0	0
Cash received for partial settlement of 1.125% Call Option	623	0	0
Cash paid for partial termination of 1.125% Warrants	(549)	0	0
Proceeds from senior notes offerings, net of issuance costs	0	325	0
Proceeds from borrowings under credit facility	0	300	0
Other, net	18	11	19
Net cash (used in) provided by financing activities	(1,193)	636	19
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(364)	378	486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	3,290	2,912	2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	3,290	2,912	2,426
Supplemental cash flow information:
Income taxes	240	7	153
Interest	93	78	66
Schedule of non-cash investing and financing activities:
Common stock issued in exchange for 1.625% Convertible Notes	131	193	0
Component of 1.625% Convertible Notes allocated to additional paid-in capital, net of income taxes	(23)	(32)	0
Net increase to additional paid-in capital	108	161	0
Common stock used for stock-based compensation	(6)	(22)	(8)
Details of sales of subsidiaries:
Decrease in carrying amount of assets	(327)	0	0
Decrease in carrying amount of liabilities	85	0	0
Transaction costs	(15)	0	0
Cash received from buyers	242	0	0
Loss on sales of subsidiaries, net of gain	(15)	0	0
Details of business combinations:
Fair value of assets acquired	0	0	(186)
Fair value of liabilities assumed	0	0	28
Payable to seller	0	0	8
Amounts advanced for acquisitions	0	0	102
Net cash paid in business combinations	0	0	(48)
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	0	0	0
1.125% Call Option
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	577	255	(107)
1.125% Conversion Option
Details of change in fair value of derivatives, net:
Change in fair value of derivatives, net	(577)	(255)	107
1.125% Notes
Financing activities:
Repayment of principal amount of Notes	(298)	0	0
1.625% Notes
Financing activities:
Repayment of principal amount of Notes	$ (64)	$ 0	$ 0

Consolidated Statements of Cash Flows (Parenthetical)	Dec. 31, 2018
1.125% Call Option
Fixed interest rate on derivative	1.125%
1.125% Conversion Option
Fixed interest rate on derivative	1.125%
1.625% Convertible Notes
Percentage of contractual interest rate	1.625%
Convertible Debt \| 1.625% Convertible Notes
Percentage of contractual interest rate	1.625%

Organization and Basis of Presentation

12 Months Ended

Dec. 31, 2018

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Basis of Presentation

Organization and Operations

Molina Healthcare, Inc. provides managed health care services under the Medicaid and Medicare programs and through the state insurance marketplaces (the “Marketplace”). We currently have two reportable segments: our Health Plans segment and our Other segment. We manage the vast majority of our operations through our Health Plans segment. Our Other segment includes the historical results of the Pathways behavioral health subsidiary, which we sold in the fourth quarter of 2018, and certain corporate amounts not allocated to the Health Plans segment. Effective in the fourth quarter of 2018, we reclassified the historical results relating to our Molina Medicaid Solutions (“MMS”) segment, which we sold in the third quarter of 2018, to the Other segment. Previously, results for MMS were reported in a stand-alone segment.

We operate health plans in 14 states and the Commonwealth of Puerto Rico. As of December 31, 2018, these health plans served approximately 3.8 million members eligible for Medicaid, Medicare, and other government-sponsored health care programs for low-income families and individuals. This membership includes Affordable Care Act Marketplace members, most of whom receive government premium subsidies. The health plans are operated by our respective wholly owned subsidiaries in those states, each of which is licensed as a health maintenance organization (“HMO”).

Our state Medicaid contracts generally have terms of three to five years. These contracts typically 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; and regions or service areas.

Recent Developments – Health Plans Segment

Mississippi Health Plan. Our Mississippi health plan commenced operations on October 1, 2018 and served approximately 26,000 Medicaid members as of December 31, 2018. In December 2018, our Mississippi health plan was awarded a contract by the Mississippi Division of Medicaid for the Children’s Health Insurance Program (“CHIP”). Services under the new three-year contract were initially set to begin July 1, 2019; however, the start date is now pending the outcome of a protest of the contract awards.

Puerto Rico Health Plan. In July 2018, our Puerto Rico health plan was selected by the Puerto Rico Health Insurance Administration to be one of the organizations to administer the Commonwealth’s new Medicaid Managed Care contract. As of December 31, 2018, we served approximately 252,000 members under the new contract, which represents a reduction in membership compared with 320,000 members served as of September 30, 2018. The new contract commenced on November 1, 2018 and has a three-year term with an optional one year extension. The Puerto Rico health plan’s premium revenue amounted to $696 million in the year ended December 31, 2018.

Florida Health Plan. In June 2018, our Florida health plan was awarded comprehensive Medicaid Managed Care contracts by the Florida Agency for Health Care Administration in Regions 8 and 11 of the Florida Statewide Medicaid Managed Care Invitation to Negotiate. Under the new contracts, effective January 1, 2019, we serve approximately 98,000 Medicaid members in those regions, which represented premium revenue of approximately $462 million in the year ended December 31, 2018. As of December 31, 2018, we served a total of 272,000 Medicaid members in Florida, which represented premium revenue of approximately $1,479 million in the year ended December 31, 2018.

Washington Health Plan. In May 2018, our Washington health plan was selected by the Washington State Health Care Authority to enter into a managed care contract for the eight remaining regions of the state’s Apple Health Integrated Managed Care program, in addition to the two regions previously awarded to us. As of December 31, 2018, we served approximately 751,000 Medicaid members in Washington, which represented premium revenue of approximately $2,035 million in the year ended December 31, 2018.

New Mexico Health Plan. In January 2018, we were notified by the New Mexico Medicaid agency that we had not been selected for a tentative award of a 2019 Medicaid contract. A hearing was held on our judicial protest on October 17, 2018, and our protest was rejected. We filed an appeal with the New Mexico Court of Appeals on January 28, 2019. We are continuing to manage the business in run-off until the determination of these further appeals or our decision not to pursue our appeal rights. As of December 31, 2018, we served approximately 196,000 Medicaid members in New Mexico, and Medicaid premium revenue amounted to $1,181 million in the year ended December 31, 2018. Our New Mexico health plan continues to serve Medicare and Marketplace members, but, effective January 1, 2019, no longer has Medicaid members.

Recent Developments – Other

Molina Medicaid Solutions. We closed on the sale of Molina Medicaid Solutions (“MMS”) to DXC Technology Company on September 30, 2018. The net cash selling price for the equity interests of MMS was $233 million. As a result of this transaction, we recognized a pretax gain, net of transaction costs, of $37 million. The gain, net of income tax expense, was $28 million.

Pathways. We closed on the sale of our Pathways behavioral health subsidiary to Pyramid Health Holdings, LLC on October 19, 2018, for a nominal purchase price. As a result of this transaction, we recognized a pretax loss of $52 million. The loss, net of income tax benefit, was $32 million.

Presentation and Reclassification

We have reclassified certain amounts in the 2017 and 2016 consolidated statements of cash flows to conform to the 2018 presentation, relating to the presentation of restricted cash and cash equivalents. The reclassification is a result of our adoption of Accounting Standards Update (“ASU”) 2016-18, Restricted Cash effective January 1, 2018. See Note 2, “Significant Accounting Policies,” for further information, including the amount reclassified.

We have combined certain line items in the accompanying consolidated balance sheets. For all periods presented, we have combined the presentation of:


•	Income taxes refundable with “Prepaid expenses and other current assets;”


•	Income taxes payable with “Accounts payable and accrued liabilities;” and


•	Goodwill, and intangible assets, net to a single line.

Consolidation

The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. As of December 31, 2018, we were no longer a party to any variable interest entities following the termination of certain agreements earlier in the year and in the fourth quarter of 2018. Such variable interest entities were insignificant. 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. 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 generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include:


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


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


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


•	Settlements under risk or savings sharing programs;


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


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


•	The determination of reserves for the outcome of litigation;


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


•	The determination of unrecognized tax benefits.

Significant Accounting Policies

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Significant Accounting Policies

Certain of our significant accounting policies are discussed within the note to which they specifically relate.

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.



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Cash and cash equivalents	$	2,826	$	3,186	$	2,819
Restricted cash and cash equivalents, non-current	100		95		93
Restricted cash and cash equivalents, current	—		9		—
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,926	$	3,290	$	2,912

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 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 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 judged to be other than temporary with respect to available-for-sale and held-to-maturity securities are included in the determination of net income (loss). 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 10 years or less (excluding variable rate securities where interest rates may be periodically reset), and that the average maturity be three years or less. 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 available-for-sale 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 other-than-temporary impairment. For comprehensive discussions of the fair value and classification of our investments, see Note 4, “Fair Value Measurements,” Note 5, “Investments,” and Note 9, “Restricted Investments.”

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. 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 15 years.

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 8, “Goodwill and Intangible Assets, Net”, for further details.

Goodwill and Business Combinations

Goodwill represents the excess of the purchase price 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. Such events or circumstances 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 the 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. Our reporting units consist of our individual health plans.

During the fourth quarter of 2018, we changed the date of our annual impairment testing of goodwill from December 31 to October 1. When testing goodwill for impairment, we may first assess qualitative factors, such as industry and market factors, cost factors, and changes in overall performance, to determine if it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value. 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. The dynamic economic and political environments in which we operate may necessitate the performance of a quantitative test to prove that goodwill is not impaired. If performing a quantitative assessment, we generally estimate the fair values of our reporting units by applying the income approach, using discounted cash flows. For the annual impairment test, the base year in the reporting units’ discounted cash flows is derived from the annual financial budgeting cycle, for which the planning process commences in the fourth quarter of the year. When computing discounted cash flows, we make assumptions about a wide variety of internal and external factors, and consider what the reporting unit’s selling price would be in an orderly transaction between market participants at the measurement date. Significant assumptions include financial projections of free cash flow (including significant assumptions about membership, premium rates, health care and operating cost trends, contract renewal and the procurement of new contracts, capital requirements and income taxes), long-term growth rates for determining terminal value beyond the discretely forecasted periods, and discount rates. When determining the discount rate, we consider the overall level of inherent risk of the reporting unit, and the expected rate an outside investor would expect to earn. 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.

Accounting for acquisitions requires us to recognize separately from goodwill the assets acquired and the liabilities assumed at their acquisition date fair values. 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. 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 statements of operations. Refer to Note 8, “Goodwill and Intangible Assets, Net”, for further details.

Revenue Recognition

We adopted ASU 2014-09, Revenue from Contracts with Customers (Topic 606) effective January 1, 2018, using the modified retrospective approach. The insurance contracts of our Health Plans segment are excluded from the scope of Topic 606 because the recognition of revenue under these contracts is dictated by other accounting standards governing insurance contracts. The cumulative effect of initially applying the guidance, relating entirely to the contracts of our recently divested MMS subsidiary, resulted in an immaterial impact to beginning retained earnings as of January 1, 2018. Such impact is presented in the accompanying consolidated statement of stockholders’ equity.

Premium Revenue

Premium revenue is generated from our Health Plans segment contracts, including agreements with other managed care organizations for which we operate as a subcontractor. 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 health care services, and premiums collected in advance are deferred. The state Medicaid programs and the federal Medicare program periodically adjust premiums. Additionally, many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions.

The following table summarizes premium revenue by geography for the periods indicated:



	Year Ended December 31,
	2018				2017				2016
	Amount		% of Total		Amount		% of Total		Amount		% of Total
	(Dollars in millions)
California	$	2,150	12.2	%	$	2,701	14.3	%	$	2,378	14.4	%
Florida	1,790		10.2		2,568		13.6		1,938		11.8
Illinois	793		4.5		593		3.1		603		3.7
Michigan	1,601		9.1		1,596		8.5		1,527		9.3
New Mexico	1,356		7.7		1,368		7.3		1,305		7.9
Ohio	2,388		13.6		2,216		11.8		1,967		12.0
Puerto Rico	696		3.9		732		3.9		726		4.4
South Carolina	495		2.8		445		2.4		378		2.3
Texas	3,244		18.4		2,813		14.9		2,461		15.0
Washington	2,361		13.4		2,608		13.8		2,222		13.5
Other ⁽¹⁾	738		4.2		1,214		6.4		940		5.7
	$	17,612	100.0	%	$	18,854	100.0	%	$	16,445	100.0	%

_______________________


(1)	“Other” includes the Idaho, Mississippi, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

Certain components of premium revenue are subject to accounting estimates and fall into the following categories:

Contractual Provisions That May Adjust or Limit Revenue or Profit

Medicaid Program

Medical Cost Floors (Minimums), and Medical Cost Corridors. A portion of our premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs. In the aggregate, we recorded a liability under the terms of such contract provisions of $103 million and $135 million at December 31, 2018 and December 31, 2017, respectively, to amounts due government agencies. Approximately $87 million and $96 million of the liability accrued at December 31, 2018 and December 31, 2017, respectively, relates to our participation in Medicaid Expansion programs.

In the third and fourth quarters of 2018, we recognized adjustments of $57 million and $24 million, respectively, mainly related to the retroactive reinstatement of the Medicaid Expansion risk corridor requirement by the California Department of Health Care Services, mainly for the state fiscal years ended June 2017 and 2018. The risk corridor provision mandates a minimum loss ratio (“MLR”) of 85% and a maximum MLR of 95%. The total impact of these adjustments resulted in a reduction to premium revenue totaling approximately $81 million in the year ended December 31, 2018.

In certain circumstances, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined maximum threshold. Receivables relating to such provisions were insignificant at December 31, 2018 and December 31, 2017.

Profit Sharing and Profit Ceiling. Our contracts with certain states contain profit-sharing or profit ceiling provisions under which we refund amounts to the states if our health plans generate profit above a certain specified percentage. In some cases, we are limited in the amount of administrative costs that we may deduct in calculating the refund, if any. Liabilities for profits in excess of the amount we are allowed to retain under these provisions were insignificant at December 31, 2018 and December 31, 2017.

Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we must adjust our premium revenue in the period in which we learn of the adjustment, rather than in the months of service to which the retroactive adjustment applies.

Medicare Program

Risk Adjusted Premiums: Our Medicare premiums are subject to retroactive increase or decrease based on the health status of our Medicare members (as measured by member risk score). We estimate our members’ risk scores and the related amount of Medicare revenue that will ultimately be realized for the periods presented based on our knowledge of our members’ health status, risk scores and CMS practices. Consolidated balance sheet amounts related to anticipated Medicare risk adjusted premiums and Medicare Part D settlements were insignificant at December 31, 2018 and December 31, 2017.

Minimum MLR: Additionally, federal regulations have established a minimum annual medical loss ratio (Minimum MLR) of 85% for Medicare. The medical loss ratio represents medical costs as a percentage of premium revenue. Federal regulations define what constitutes medical costs and premium revenue. If the Minimum MLR is not met, we may be required to pay rebates to the federal government. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of operations. Aggregate balance sheet amounts related to the Medicare Minimum MLR were insignificant at December 31, 2018 and December 31, 2017.

Marketplace Program

Risk adjustment: Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score, and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score. 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 operations. As of December 31, 2018, and December 31, 2017, the Marketplace risk adjustment payable amounted to $466 million and $917 million, respectively.

Minimum MLR: The ACA has established a Minimum MLR of 80% for the Marketplace. If the Minimum MLR is not met, we may be required to pay rebates to our Marketplace policyholders. The Marketplace risk adjustment program is taken into consideration when computing the Minimum MLR. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of operations. Aggregate balance sheet amounts related to the Marketplace Minimum MLR were insignificant at December 31, 2018 and December 31, 2017.

Quality Incentives

At many of our health plans, revenue ranging from approximately 1% to 3% of certain health plan premiums is earned only if certain performance measures are met.

The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the periods presented and prior periods. Although the reasonably possible effects of a change in estimate related to quality incentive premium revenue as of December 31, 2018 are not known, we have no reason to believe that the adjustments to prior periods noted below are not indicative of the potential future changes in our estimates as of December 31, 2018.



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Maximum available quality incentive premium - current period	$	182		$	150		$	147

Amount of quality incentive premium revenue recognized in current period:
Earned current period	$	133		$	97		$	104
Earned prior periods	31			10			47
Total	$	164		$	107		$	151

Quality incentive premium revenue recognized as a percentage of total premium revenue	0.9		%	0.6		%	0.9		%

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



	December 31,
	2018		2017
	(In millions)
Medicaid program:
Medical cost floors and corridors	$	103	$	135
Other amounts due to states	81		71
Marketplace program:
Risk adjustment	466		917
Cost sharing reduction	183		275
Other	134		144
	$	967	$	1,542

Medical Care Costs and Medical Claims and Benefits Payable

Medical care costs are recognized in the period in which services are provided and include amounts that have been paid by us through the reporting date, as well as estimated medical claims and benefits payable for costs that have been incurred but not paid by us as of the reporting date. Medical care costs include, among other items, fee-for-service claims, pharmacy benefits, capitation payments to providers, and various other medically-related costs. We use judgment to determine the appropriate assumptions for determining the required estimates.

Under fee-for-service claims arrangements, we retain the financial responsibility for medical care provided and incur costs based on actual utilization of hospital and physician services. Pharmacy benefits represent payments for members' prescription drug costs, net of rebates from drug manufacturers. We estimate pharmacy rebates earned based on historical and current utilization of prescription drugs and contract terms. Capitation payments represent monthly contractual fees paid to physicians and other providers on a per-member, per-month basis, 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. Due to insolvency or other circumstances, such providers may be unable to pay claims they have incurred with third parties in connection with referral services provided to our members. Depending on states’ laws, we may be held liable for such unpaid referral claims even though the delegated provider has contractually assumed such risk. Based on our current assessment, such losses have not been and are not expected to be significant. Other medical care costs include all medically-related administrative costs, certain provider incentive costs, provider claims, and other health care expenses. See further discussion of provider claims in Note 17, “Commitments and Contingencies.” Medically related administrative costs include, for example, expenses relating to health education, quality assurance, case management, care coordination, disease management, and 24-hour on-call nurses. Salary and benefit costs are a substantial portion of these expenses. Additionally, we include an estimate for the cost of settling claims incurred through the reporting date in our medical claims and benefits payable liability.

The following table provides the details of our consolidated medical care costs for the periods indicated:



	Year Ended December 31,
	2018						2017						2016
	Amount		PMPM		% of Total		Amount		PMPM		% of Total		Amount		PMPM		% of Total
	(In millions, except PMPM amounts)
Fee-for-service	$	11,278	$	232.15	74.5	%	$	12,682	$	229.63	74.3	%	$	10,993	$	217.84	74.4	%
Pharmacy	2,138		44.01		14.1		2,563		46.40		15.0		2,213		43.84		15.0
Capitation	1,184		24.38		7.8		1,360		24.63		8.0		1,218		24.13		8.2
Other	537		11.05		3.6		468		8.48		2.7		350		6.94		2.4
Total	$	15,137	$	311.59	100.0	%	$	17,073	$	309.14	100.0	%	$	14,774	$	292.75	100.0	%

The determination of our liability for fee-for-service claims incurred but not paid (“IBNP”) is particularly important to the determination of our financial position and results of operations in any given period and requires the application of a significant degree of judgment by our management.

As a result, the determination of IBNP is subject to an inherent degree of uncertainty. Our IBNP claims reserve represents our best estimate of the total amount we will ultimately pay with respect to claims incurred as of the balance sheet date. We estimate our IBNP monthly using actuarial methods based on several factors. The factors we consider when estimating our IBNP include, without limitation:


•	claims receipt and payment experience (and variations in that experience),


•	changes in membership,


•	provider billing practices,


•	health care service utilization trends,


•	cost trends,


•	product mix,


•	seasonality,


•	prior authorization of medical services,


•	benefit changes,


•	known outbreaks of disease or increased incidence of illness such as influenza,


•	provider contract changes,


•	changes to Medicaid fee schedules, and


•	the incidence of high dollar or catastrophic claims.

Our assessment of these factors is then translated into an estimate of our IBNP liability at the relevant measuring point through the calculation of a base estimate of IBNP, a further provision for adverse claims development, and an estimate of the administrative costs of settling all claims incurred through the reporting date. The base estimate of IBNP is derived through application of claims payment completion factors and trended PMPM cost estimates.

For the fourth month of service prior to the reporting date and earlier, we estimate our outstanding claims liability based on actual claims paid, adjusted for estimated completion factors. Completion factors seek to measure the cumulative percentage of claims expense that will have been paid for a given month of service as of the reporting date, based on historical payment patterns.

For the three months of service immediately prior to the reporting date, actual claims paid are a less reliable measure of our ultimate liability, given the inherent delay between the patient/physician encounter and the actual submission of a claim for payment. For these months of service, we estimate our claims liability based on a blend of estimated completion factors and trended PMPM cost estimates. The PMPM costs estimates are designed to reflect recent trends in payments and expense, utilization patterns, authorized services, pharmacy utilization and other relevant factors.

After we have established our base IBNP reserve through the application of completion factors and trended PMPM cost estimates, we then compute an additional liability, once again using actuarial techniques, to account for adverse development in our claim payments for which the base actuarial model is not intended to and does not account. We refer to this additional liability as the provision for adverse claims development. The provision for adverse claims development is a component of our overall determination of the adequacy of our IBNP, and averages between 8% to 10% of IBNP. It is intended to capture the potential inadequacy of our IBNP estimate as a result of our inability to adequately assess the impact of factors such as changes in the speed of claims receipt and payment, the relative magnitude or severity of claims, known outbreaks of disease such as influenza, our entry into new geographical markets, our provision of services to new populations such as the aged, blind or disabled, changes to state-controlled fee schedules upon which a large proportion of our provider payments are based, modifications and upgrades to our claims processing systems and practices, and increasing medical costs. Because of the complexity of our business, the number of states in which we operate, and the need to account for different health care benefit packages among those states, we make an overall assessment of IBNP after considering the base actuarial model reserves and the provision for adverse claims development.

The development of our IBNP estimate is a continuous process that we monitor and update monthly as additional claims payment information becomes available. As additional information becomes known to us, we adjust our actuarial model accordingly. Any adjustments, if appropriate, are reflected in the period known. While we believe our current estimates are adequate, we have in the past been required to increase significantly our claims reserves for periods previously reported and may be required to do so again in the future. Any significant increases to prior period claim reserves would materially decrease reported earnings for the period in which the adjustment is made.

There are many related factors working in conjunction with one another that determine the accuracy of our estimates, some of which are qualitative in nature rather than quantitative. Therefore, we are seldom able to quantify the impact that any single factor has on a change in estimate. Given the variability inherent in the reserving process, we will only be able to identify specific factors if they represent a significant departure from expectations. As a result, we do not expect to be able to fully quantify the impact of individual factors on changes in estimates.

We limit our risk of catastrophic losses by maintaining high deductible reinsurance coverage. Such reinsurance coverage does not relieve us of our primary obligation to our policyholders. We report reinsurance premiums as a reduction to premium revenue, while related reinsurance recoveries are reported as a reduction to medical care costs. Reinsurance premiums amounted to $16 million, $20 million and $30 million for the years ended December 31, 2018, 2017, and 2016, respectively. Reinsurance recoveries amounted to $33 million, $24 million and $65 million for the years ended December 31, 2018, 2017, and 2016, respectively. Reinsurance recoverable of $31 million, $16 million, and $61 million, as of December 31, 2018, 2017, and 2016, respectively, is included in “Receivables” in the accompanying consolidated balance sheets.

Marketplace Cost Share Reduction (“CSR”)

In the year ended December 31, 2018, we recognized a benefit of approximately $81 million in reduced medical care costs related to 2017 dates of service, as a result of the federal government’s confirmation that the reconciliation of 2017 Marketplace CSR subsidies would be performed on an annual basis. In the fourth quarter of 2017, we had assumed a nine-month reconciliation of this item pending confirmation of the time period to which the 2017 reconciliation would be applied.

Premium Deficiency Reserves on Loss Contracts

We assess the profitability of our medical care policies to identify groups of contracts where current operating results or forecasts indicate probable future losses. If anticipated future variable costs exceed anticipated future premiums and investment income, a premium deficiency reserve is recognized. No premium deficiency reserves were recorded as of December 31, 2018 and 2017.

Taxes Based on Premiums

Health Insurer Fee (“HIF”). The federal government under the ACA imposes an annual fee, or excise tax, on health insurers for each calendar year. The HIF is based on a company’s share of the industry’s net premiums written during the preceding calendar year and is non-deductible for income tax purposes. We recognize expense for the HIF over the year on a straight-line basis. Within our Medicaid program, we must secure additional reimbursement from our state partners for this added cost. We recognize the related revenue when we have obtained a contractual commitment or payment from a state to reimburse us for the HIF, and such HIF revenue is recognized ratably throughout the year. The Consolidated Appropriations Act of 2016 provided for a HIF moratorium in 2017. Therefore, there were no health insurer fees reimbursed, nor health insurer fees incurred, in 2017.

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 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 operations.

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 a maximum maturity of 10 years and an average duration of three years or less. Restricted investments are invested principally in certificates of deposit and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the 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 health care 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 (or Commonwealth), 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 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. 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 Adopted

Revenue Recognition (Topic 606). See discussion above, in “Revenue Recognition.”

Comprehensive Income. In February 2018, the Financial Accounting Standards Board (“FASB”) issued ASU 2018-02, Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income. ASU 2018-02 allows a reclassification from accumulated other comprehensive income to retained earnings for stranded tax effects resulting from the Tax Cuts and Jobs Act (“TCJA”), which was enacted on December 22, 2017. ASU 2018-02 is effective beginning January 1, 2019; we early adopted this ASU effective January 1, 2018. The effect of applying the guidance resulted in an immaterial impact to beginning retained earnings, as presented in the accompanying consolidated statements of stockholders’ equity.

Restricted Cash. In November 2016, the FASB issued ASU 2016-18, Restricted Cash, which requires us to include in our consolidated statements of cash flows the changes in the balances of cash, cash equivalents, restricted cash and restricted cash equivalents. We adopted ASU 2016-18 on January 1, 2018. We have applied the guidance retrospectively to all periods presented. Such retrospective adoption resulted in a $104 million and $93 million reclassification of restricted cash and cash equivalents from “Investing activities,” to the beginning and ending balances of cash and cash equivalents in our consolidated statements of cash flows for the years ended December 31, 2017 and 2016, respectively. There was no impact to our consolidated statements of operations, balance sheets, or stockholders’ equity. The reconciliation of cash and cash equivalents to cash, cash equivalents, and restricted cash and cash equivalents is presented at the beginning of this note.

Recent Accounting Pronouncements Not Yet Adopted

Software Licenses. In August 2018, the FASB issued ASU 2018-15, Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract, which aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. ASU 2018-15 is effective beginning January 1, 2020 and can be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption; early adoption is permitted. We are evaluating the effect of this guidance.

Credit Losses. In June 2016, the FASB issued ASU 2016-13, Measurement of Credit Losses on Financial Instruments. Rather than generally recognizing credit losses when it is probable that the loss has been incurred, the revised guidance requires companies to recognize an allowance for credit losses for the difference between the amortized cost basis of a financial instrument and the amount of amortized cost that the company expects to collect over the instrument’s contractual life. ASU 2016-13 is effective beginning January 1, 2020 and must be adopted as a cumulative effect adjustment to retained earnings; early adoption is permitted. We are in the early stages of evaluating the effect of this guidance.

Leases. In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842), as modified by:


•	ASU 2017-03, Transition and Open Effective Date Information;


•	ASU 2018-01, Leases (Topic 842): Land Easement Practical Expedient for Transition to Topic 842;


•	ASU 2018-10, Codification Improvements to Topic 842, Leases; and


•	ASU 2018-11, Leases (Topic 842): Targeted Improvements.

Under Topic 842, an entity will be required to recognize assets and liabilities for the rights and obligations created by leases on the entity’s balance sheet for both financing and operating leases. Topic 842 also requires new disclosures that depict the amount, timing, and uncertainty of cash flows pertaining to an entity’s leases. We will adopt Topic 842 effective January 1, 2019, using the modified retrospective method. Under this method, we will recognize the cumulative effect of initially applying the standard as an adjustment to the opening balance of retained earnings on January 1, 2019. In addition, we have elected the transition option provided under ASU 2018-11, which allows entities to continue to apply the legacy guidance in Topic 840, Leases, including its disclosure requirements, in the comparative periods presented in the year of adoption.

Under Topic 842, we will record right-of-use assets and liabilities relating primarily to leases of office space for administrative and health plan operations. Specifically, on January 1, 2019, we expect to record operating lease right-of-use assets of approximately $80 million to $90 million, and operating lease liabilities of approximately $90 million to $100 million. In addition, in connection with the transition provisions relating to failed sale-leaseback transactions, we expect to record finance lease right-of-use assets of approximately $230 million to $240 million; record finance lease liabilities of approximately $230 million to $240 million; reduce property, equipment, and capitalized software net, by approximately $75 million to $95 million; reduce lease financing obligations by approximately $195 million to $205 million; and record an increase of approximately $80 million to $100 million to opening retained earnings.

Net Income (Loss) Per Share

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Net Income (Loss) Per Share

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



	Year Ended December 31,
	2018		2017			2016
	(In millions, except net income (loss) per share)
Numerator:
Net income (loss)	$	707	$	(512	)	$	52
Denominator:
Shares outstanding at the beginning of the period	59.3		55.8			55.1
Weighted-average number of shares issued:
Exchange of 1.625% Convertible Notes ⁽¹⁾	1.4		0.1			—
Conversion of 1.625% Convertible Notes ⁽¹⁾	0.2		—			—
Stock-based compensation	0.2		0.5			0.3
Denominator for basic net income (loss) per share	61.1		56.4			55.4
Effect of dilutive securities:
1.125% Warrants ⁽¹⁾	4.8		—			0.5
1.625% Convertible Notes⁽¹⁾	0.4		—			—
Stock-based compensation	0.3		—			0.3
Denominator for diluted net income (loss) per share	66.6		56.4			56.2

Net income (loss) per share: ⁽²⁾
Basic	$	11.57	$	(9.07	)	$	0.93
Diluted	$	10.61	$	(9.07	)	$	0.92

Potentially dilutive common shares excluded from calculations: ⁽¹⁾
1.125% Warrants ⁽¹⁾	—		1.9			—
1.625% Convertible Notes⁽¹⁾	—		0.4			—
Stock-based compensation	—		0.3			—

_______________________________

(1)

For more information regarding the 1.625% Convertible Notes, refer to Note 11, “Debt.” For more information and definitions regarding the 1.125% Warrants, refer to Note 14, “Stockholders' Equity.” 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 (loss) per share because to do so would have been anti-dilutive.


(2)	Source data for calculations in thousands.

Fair Value Measurements

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Fair Value Measurements

We consider the carrying amounts of current assets and current liabilities (not including derivatives and the current portion of long-term debt) to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to 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. Our Level 3 financial instruments consist primarily of derivative financial instruments.

The derivatives include the 1.125% Call Option derivative asset and the 1.125% Conversion Option derivative liability. These derivatives are not actively traded and are valued based on an option pricing model that uses observable and unobservable market data for inputs. Significant market data inputs used to determine fair value as of December 31, 2018, included the price of our common stock, the time to maturity of the derivative instruments, the risk-free interest rate, and the implied volatility of our common stock. As described further in Note 12, “Derivatives,” the 1.125% Call Option asset and the 1.125% Conversion Option liability were designed such that changes in their fair values offset, with minimal impact to the consolidated statements of operations. Therefore, the sensitivity of changes in the unobservable inputs to the option pricing model for such instruments is mitigated.

The net changes in fair value of Level 3 financial instruments were insignificant to our results of operations for the years ended December 31, 2018, and 2017.

Our financial instruments measured at fair value on a recurring basis at December 31, 2018, were as follows:



	Total		Level 1		Level 2		Level 3
	(In millions)
Corporate debt securities	$	1,123	$	—	$	1,123	$	—
U.S. Treasury notes	181		—		181		—
Government-sponsored enterprise securities (GSEs)	163		—		163		—
Municipal securities	114		—		114		—
Asset-backed securities	82		—		82		—
Certificates of deposit	14		—		14		—
Other	4		—		4		—
Subtotal - current investments	1,681		—		1,681		—
1.125% Call Option derivative asset	476		—		—		476
Total assets	$	2,157	$	—	$	1,681	$	476

1.125% Conversion Option derivative liability	$	476	$	—	$	—	$	476
Total liabilities	$	476	$	—	$	—	$	476

Our financial instruments measured at fair value on a recurring basis at December 31, 2017, were as follows:



	Total		Level 1		Level 2		Level 3
	(In millions)
Corporate debt securities	$	1,588	$	—	$	1,588	$	—
U.S. Treasury notes	388		—		388		—
GSEs	253		—		253		—
Municipal securities	141		—		141		—
Asset-backed securities	117		—		117		—
Certificates of deposit	37		—		37		—
Subtotal - current investments	2,524		—		2,524		—
Corporate debt securities	101		—		101		—
U.S. Treasury notes	68		—		68		—
Subtotal - current restricted investments	169		—		169		—
1.125% Call Option derivative asset	522		—		—		522
Total assets	$	3,215	$	—	$	2,693	$	522

1.125% Conversion Option derivative liability	$	522	$	—	$	—	$	522
Total liabilities	$	522	$	—	$	—	$	522

Fair Value Measurements – Disclosure Only

The carrying amounts and estimated fair values of our senior notes 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, 2018				December 31, 2017
	Carrying		Fair Value		Carrying		Fair Value
	Amount		Fair Value		Amount		Fair Value
	(In millions)
5.375% Notes	$	694	$	674	$	692	$	730
4.875% Notes	326		301		325		329
1.125% Convertible Notes ^(1),(2)	240		732		496		1,052
Credit Facility ⁽²⁾	—		—		300		300
1.625% Convertible Notes ⁽²⁾	—		—		157		220
	$	1,260	$	1,707	$	1,970	$	2,631

_______________________________


(1)	The fair value of the 1.125% Conversion Option derivative liability (the embedded cash conversion option), which is included in the fair value amounts presented above, amounted to $476 million and $522 million as of December 31, 2018 and 2017, respectively. See further discussion at Note 11, “Debt,” and Note 12, “Derivatives.”


(2)	For more information on debt repayments in the year ended December 31, 2018, refer to Note 11, “Debt.”

- Definition

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

+ References + Details

Investments

12 Months Ended

Dec. 31, 2018

Investments, Debt and Equity Securities [Abstract]

Investments

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, 2018
	Amortized		Gross Unrealized				Estimated
	Cost		Gains		Losses		Fair Value
	(In millions)
Corporate debt securities	$	1,131	$	—	$	8	$	1,123
U.S. Treasury notes	181		—		—		181
GSEs	164		—		1		163
Municipal securities	115		—		1		114
Asset-backed securities	83		—		1		82
Certificates of deposit	14		—		—		14
Other	4		—		—		4
Total current investments	$	1,692	$	—	$	11	$	1,681



	December 31, 2017
	Amortized Cost		Gross Unrealized				Estimated Fair Value
	Amortized Cost		Gains		Losses		Estimated Fair Value
	(In millions)
Corporate debt securities	$	1,591	$	1	$	4	$	1,588
U.S. Treasury notes	389		—		1		388
GSEs	255		—		2		253
Municipal securities	142		—		1		141
Asset-backed securities	117		—		—		117
Certificates of deposit	37		—		—		37
Subtotal - current investments	2,531		1		8		2,524
Corporate debt securities	101		—		—		101
U.S. Treasury notes	68		—		—		68
Subtotal - current restricted investments	169		—		—		169
	$	2,700	$	1	$	8	$	2,693

The contractual maturities of our current investments as of December 31, 2018 are summarized below:



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	1,000	$	997
Due after one year through five years	692		684
	$	1,692	$	1,681

As discussed further in Note 11, “Debt,” the 4.875% Notes’ indenture required us to hold a portion of the net proceeds from their issuance in a segregated account to be used to settle the conversion of the 1.625% Convertible Notes. Prior to September 30, 2018, this account was reported as a current asset, entitled “Restricted investments,” in the accompanying consolidated balance sheets. Because this account was used to settle the conversion of the 1.625% Convertible Notes in the third quarter of 2018, current restricted investments, as of December 31, 2018, was reduced to zero.

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 and losses for the years ended December 31, 2018, 2017 and 2016 were insignificant.

We have determined that unrealized losses at December 31, 2018 and 2017 are temporary in nature, because the change in market value for these securities resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant.

The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2018.



	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	$	509	$	3	285	$	412	$	5	298
GSEs	—		—		—	127		1		76
Municipal securities	—		—		—	87		1		90
Asset backed securities	—		—		—	68		1		52
	$	509	$	3	285	$	694	$	8	516



	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	$	1,297	$	3	561	$	94	$	1	69
U.S. Treasury notes	470		1		89	—		—		—
GSEs	173		1		69	95		1		47
Municipal securities	—		—		—	38		1		48
	$	1,940	$	5	719	$	227	$	3	164

Receivables

12 Months Ended

Dec. 31, 2018

Receivables [Abstract]

Receivables

Receivables consist primarily of amounts due from government agencies, which may be subject to potential retroactive adjustments. Because all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for doubtful accounts is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.



	December 31,
	2018		2017
	(In millions)
Premiums and other receivables	855		695
Pharmacy administrative services receivables	179		—
Pharmacy rebate receivables	155		154
Health insurer fee reimbursement receivables	141		22
	$	1,330	$	871

- Definition

The entire disclosure for claims held for amounts due a entity, excluding financing receivables. Examples include, but are not limited to, trade accounts receivables, notes receivables, loans receivables. Includes disclosure for allowance for credit losses.

+ References + Details

Property, Equipment, and Capitalized Software, Net

12 Months Ended

Dec. 31, 2018

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. Furniture and equipment are generally depreciated using the straight-line method over estimated useful lives ranging from three to seven years. Software developed for internal use is capitalized. 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.

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



	December 31,
	2018			2017
	(In millions)
Capitalized software	$	373		$	417
Furniture and equipment	231			289
Building and improvements	154			161
Land	16			16
Total cost	774			883
Less: accumulated amortization - capitalized software	(320		)	(308		)
Less: accumulated depreciation and amortization - building and improvements, furniture and equipment	(213		)	(233		)
Total accumulated depreciation and amortization	(533		)	(541		)
Property, equipment, and capitalized software, net	$	241		$	342

The following table presents all depreciation and amortization recognized in our consolidated statements of operations, whether the item appears as depreciation and amortization, or as cost of service revenue.



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Recorded in depreciation and amortization:
Amortization of capitalized software	$	42	$	64	$	62
Depreciation of property and equipment	36		42		45
Amortization of intangible assets	21		31		32
Subtotal	99		137		139
Recorded in cost of service revenue:
Amortization of capitalized software	19		28		22
Amortization of deferred contract costs	9		13		21
Subtotal	28		41		43
Total depreciation and amortization recognized	$	127	$	178	$	182

Goodwill and Intangible Assets, Net

12 Months Ended

Dec. 31, 2018

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 year ended December 31, 2018. The 2017 goodwill impairment losses were reported as “Impairment losses” in the accompanying consolidated statements of operations. See Note 18, “Segments,” for a discussion of the change in our reportable segments in 2018.



	Health Plans			Other			Total
	(In millions)
Historical goodwill, gross	$	445		$	233		$	678
Accumulated impairment losses at December 31, 2017	(302		)	(190		)	(492		)
Balance, December 31, 2017	143			43			186
Sale of subsidiary	—			(43		)	(43		)
Balance, December 31, 2018	$	143		$	—		$	143

Accumulated impairment losses at December 31, 2018	$	302		$	190		$	492

Impairment Analysis Results

2018. We performed a qualitative goodwill assessment of our reporting units, which resulted in no goodwill impairment losses in the year ended December 31, 2018.

2017 – Health Plans Segment. We performed quantitative goodwill assessments using the discounted cash flows and asset liquidation methods, which resulted in Health Plans segment goodwill impairment losses of $244 million in the year ended December 31, 2017, primarily due to the following:


•	Medicaid contract terminations announced in early 2018 at our Florida and New Mexico health plans; and


•	Future cash flow projections insufficient to produce an estimated fair value in excess of the Illinois health plan’s carrying amount.

2017 – Other Segment. Our recently divested Molina Medicaid Solutions and Pathways businesses are reported in the Other segment. The quantitative goodwill assessments of these reporting units, using the discounted cash flows method, resulted in goodwill impairment losses of $190 million in the year ended December 31, 2017, primarily due to the following:


•	Management’s conclusion that Molina Medicaid Solutions would provide fewer future benefits for its support of the Health Plans segment; and


•	Management’s conclusion that Pathways would not provide future benefits relating to the integration of its operations with the Health Plans segment to the extent previously expected.

2016. We performed a quantitative goodwill assessment of our reporting units using the discounted cash flows method, which resulted in no impairment losses in the year ended December 31, 2016.

Intangible Assets, Net

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



	Cost		Accumulated Amortization		Carrying Amount
	(In millions)
Intangible assets:
Contract rights and licenses	$	201	$	162	$	39
Provider networks	20		12		8
Balance at December 31, 2018	$	221	$	174	$	47
Intangible assets:
Contract rights and licenses	$	201	$	141	$	60
Provider networks	20		11		9
Balance at December 31, 2017	$	221	$	152	$	69

Based on the balances of our identifiable intangible assets as of December 31, 2018, we estimate that our intangible asset amortization will be approximately $18 million in 2019, $14 million in 2020, $5 million in 2021, and $3 million in 2022 and 2023. For a presentation of our intangible assets by reportable segment, refer to Note 18, “Segments.”

Impairment Analysis Results

2018. No impairment charges relating to intangible assets were recorded in the year ended December 31, 2018. See Note 15, “Restructuring and Separation Costs,” for a description of certain long-lived assets written off in 2018, in connection with our 2017 Restructuring Plan.

2017 – Health Plans Segment. As a result of the impairment indicators described above for the Florida and New Mexico reporting units of the Health Plans segment in 2017, we performed undiscounted cash flows analyses of the reporting units, which resulted in Health Plans segment intangible asset impairment losses of $25 million in the year ended December 31, 2017.

2017 – Other Segment. As a result of management’s conclusion that Pathways would not provide future benefits relating to the integration of its operations with the Health Plans segment to the extent previously expected, we computed an undiscounted cash flows analysis of reporting units, which resulted in Other segment intangible asset impairment losses of $11 million.

2016. No significant impairment charges relating to long-lived assets, including intangible assets, were recorded in the year ended December 31, 2016.

Restricted Investments

12 Months Ended

Dec. 31, 2018

Investments, Debt and Equity Securities [Abstract]

Restricted Investments

Pursuant to the regulations governing our Health Plans segment subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in certificates of deposit and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulation 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. The following table presents the balances of restricted investments:



	December 31,
	2018		2017
	(In millions)
Florida	$	32	$	31
New Mexico	43		43
Ohio	12		12
Puerto Rico	10		10
Other	23		23
Total Health Plans segment	$	120	$	119

The contractual maturities of our held-to-maturity restricted investments, which are carried at amortized cost, which approximates fair value, as of December 31, 2018 are summarized below.



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	105	$	105
Due after one year through five years	15		15
	$	120	$	120

Medical Claims and Benefits Payable

12 Months Ended

Dec. 31, 2018

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,
	2018		2017		2016
	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	1,562	$	1,717	$	1,352
Pharmacy payable	115		112		112
Capitation payable	52		67		37
Other	232		296		428
	$	1,961	$	2,192	$	1,929

“Other” medical claims and benefits payable include 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 operations. Non-risk provider payables amounted to $107 million, $122 million and $225 million, as of December 31, 2018, 2017, and 2016, respectively.

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



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Medical claims and benefits payable, beginning balance	$	2,192		$	1,929		$	1,685
Components of medical care costs related to:
Current period	15,478			17,037			14,966
Prior periods ⁽¹⁾	(341		)	36			(192		)
Total medical care costs	15,137			17,073			14,774

Change in non-risk provider payables	13			(106		)	58

Payments for medical care costs related to:
Current period	13,671			15,130			13,304
Prior periods	1,710			1,574			1,284
Total paid	15,381			16,704			14,588
Medical claims and benefits payable, ending balance	$	1,961		$	2,192		$	1,929

________________


(1)	Includes the 2018 benefit of the 2017 Marketplace CSR reimbursement of $81 million.

The following tables provide information about incurred and paid claims development as of December 31, 2018, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. 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	2016		2017		2018		Total IBNP		Cumulative number of reported claims

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	15,064	$	15,093	$	15,057	$	18	105
2017			17,037		16,728		57		119
2018					15,478		1,477		105
					$	47,263	$	1,552



Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year	2016		2017		2018

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	13,403	$	14,952	$	15,039
2017			15,130		16,752
2018					13,671
					$	45,462

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



	2018
	(In millions)
Incurred claims and allocated claims adjustment expenses	$	47,263
Less: cumulative paid clams and allocated claims adjustment expenses	(45,462		)
All outstanding liabilities before 2016	10
Non-risk provider payables and other	150
Medical claims and benefits payable	$	1,961

Our estimates of medical claims and benefits payable recorded at December 31, 2017, 2016 and 2015 developed favorably (unfavorably) by approximately $341 million, $(36) million and $192 million in 2018, 2017 and 2016, respectively.

The favorable prior year development recognized in 2018 includes a benefit of approximately $81 million in reduced medical care costs relating to Marketplace CSR subsidies for 2017 dates of service. The remainder of the favorable prior period development was primarily due to lower than expected utilization of medical services by our Medicaid and Marketplace members and improved operating performance. The differences between our original estimates in 2017 and the ultimate costs in 2018 were not discernable until additional information was provided to us in 2018 and the effect became clearer over time as claim payments were processed.

The unfavorable prior year development in 2017 was primarily due to higher than expected costs for settling certain claims with certain providers in states where we had recently commenced operations, such as in Illinois and Puerto Rico, or had instituted significant changes due to provider contract changes, such as in Florida and New Mexico. The differences between our original estimates in 2016 and the ultimate costs in 2017 were not discernable until additional information was provided to us in 2017 and the effect became clearer over time as claim payments were processed.

The favorable prior year development we recognized in 2016 was primarily due to reprocessing a significant number of claims in 2016 for provider submission of claims that were not compliant with new diagnostic coding requirements instituted in late 2015; several high-dollar claims at our New Mexico health plan that were settled for amounts lower than we initially estimated; recoveries on certain outpatient facility claims at our Washington health plan; and lower than expected claims costs for Medicaid Expansion members that were new to our California health plan in 2015. The differences between our original estimates in 2015 and the ultimate costs in 2016 were not discernable until additional information was provided to us in 2016 and the effect became clearer over time as claim payments were processed.

Debt

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Debt

As of December 31, 2018, contractual maturities of debt for the years ending December 31 were as follows. All amounts represent the principal amounts of the debt instruments outstanding.



	Total		2019		2020		2021		2022		2023		Thereafter

	(In millions)
5.375% Notes	$	700	$	—	$	—	$	—	$	700	$	—	$	—
4.875% Notes	330		—		—		—		—		—		330
1.125% Convertible Notes	252		—		252		—		—		—		—
	$	1,282	$	—	$	252	$	—	$	700	$	—	$	330

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



	December 31,
	2018			2017
	(In millions)
Current portion of long-term debt:
1.125% Convertible Notes, net of unamortized discount	$	241		$	499
1.625% Convertible Notes, net of unamortized discount	—			157
Lease financing obligations	1			1
Debt issuance costs	(1		)	(4		)
	241			653
Non-current portion of long-term debt:
5.375% Notes	700			700
4.875% Notes	330			330
Credit Facility	—			300
Debt issuance costs	(10		)	(12		)
	1,020			1,318
Lease financing obligations	197			198
	$	1,458		$	2,169

Interest cost recognized relating to our convertible senior notes, the 1.125% Convertible Notes and the 1.625% Convertible Notes, was as follows:



	Years Ended December 31,
	2018		2017		2016
	(In millions)
Contractual interest at coupon rate	$	6	$	11	$	11
Amortization of the discount	21		32		30
	$	27	$	43	$	41

Credit Agreement

In January 2017, we entered into an amended Credit Agreement, which provides for an unsecured $500 million revolving credit facility (the “Credit Facility”). The Credit Facility has a term of five years and all amounts outstanding (other than the Term Loan, as described below) will be due and payable on January 31, 2022. In May 2018, we repaid the $300 million outstanding borrowings under the Credit Facility. As of December 31, 2018, no amounts were outstanding under the Credit Facility, and outstanding letters of credit amounting to $7 million reduced our remaining borrowing capacity under the Credit Facility to $493 million.

Borrowings under our Credit Agreement, including both the Credit Facility and the Term Loan, 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.

Subsequent Event

On January 31, 2019, we entered into a Sixth Amendment to the Credit Agreement that provides for the following:

•

A delayed draw term loan facility in an aggregate principal amount of $600 million (the “Term Loan”), under which we may request up to ten advances, each in a minimum principal amount of $50 million, until 18 months after January 31, 2019 (“Delayed Draw Commitment Period”). The Term Loan will amortize in quarterly installments, commencing on the last day of the first fiscal quarter after the Delayed Draw Commitment Period, equal to the principal amount of the Term Loan outstanding on the last day of the Delayed Draw Commitment Period multiplied by an amortization payment percentage ranging from 1.25% to 2.50% (depending on the applicable fiscal quarter) for each fiscal quarter. We will pay a delayed draw ticking fee in an amount equal to 37.5 basis points (0.375%) per annum of the undrawn amount of the Term Loan commencing on January 31, 2019, and continuing until the last day of the Delayed Draw Commitment Period, payable quarterly. All amounts outstanding under the Term Loan will be due and payable on January 31, 2024;


•	Addition of definitions for various terms that apply to the Term Loan; and


•	Various other amendments relating to the administration of the Credit Agreement.

In addition, effective as of January 31, 2019, Molina Pathways, LLC was automatically and unconditionally released as a guarantor under the Credit Agreement. As a result, as of January 31, 2019, no guarantors were parties to the Credit Agreement.

The Credit Agreement contains customary non-financial and financial covenants, including a net leverage ratio and an interest coverage ratio. As of December 31, 2018, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt.

5.375% Notes due 2022

We have $700 million aggregate principal amount of senior notes (the “5.375% Notes”) outstanding as of December 31, 2018, which are due November 15, 2022, unless earlier redeemed. Interest on the 5.375% Notes is payable semiannually in arrears on May 15 and November 15. As noted above, effective January 31, 2019, none of our subsidiaries is a guarantor of the 5.375% Notes.

The 5.375% Notes are senior unsecured obligations of Molina 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. The 5.375% Notes contain customary non-financial covenants and change in control provisions.

4.875% Notes due 2025

We have $330 million aggregate principal amount of senior notes (the “4.875% Notes”) outstanding as of December 31, 2018, which are due June 15, 2025, unless earlier redeemed. Interest on the 4.875% Notes is payable semiannually in arrears on June 15 and December 15. As noted above, effective January 31, 2019, none of our subsidiaries is a guarantor of the 4.875% Notes.

The 4.875% Notes are senior unsecured obligations of Molina, respectively, 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. The 4.875% Notes contain customary non-financial covenants and change of control provisions.

1.125% Cash Convertible Senior Notes due 2020

In the second, third and fourth quarters of 2018, we entered into privately negotiated note purchase agreements with certain holders of our outstanding 1.125% cash convertible senior notes due January 15, 2020 (the “1.125% Convertible Notes”). In each case, the difference between the principal amount extinguished and our cash payments primarily represented the settlement of the 1.125% Convertible Notes’ embedded cash conversion option feature at fair value (which is a derivative liability we refer to as the 1.125% Conversion Option). Activity during the year was as follows:


•	In the fourth quarter of 2018, we repaid $62 million aggregate principal amount of the 1.125% Convertible Notes, plus accrued interest, for a total cash payment of $202 million.


•	In the third quarter of 2018, we repaid $140 million aggregate principal amount of the 1.125% Convertible Notes, plus accrued interest, for a total cash payment of $483 million.


•	In the second quarter of 2018, we repaid $96 million aggregate principal amount of the 1.125% Convertible Notes, plus accrued interest, for a total cash payment of $228 million.

In the year ended December 31, 2018, we have recorded an aggregate net loss on debt extinguishment of $12 million for the 1.125% Convertible Notes purchases, primarily relating to the acceleration of the debt discount. This loss is reported in “Other expenses (income), net” in the accompanying consolidated statements of operations. No common shares were issued in connection with these transactions.

In connection with each of the 1.125% Convertible Notes purchases, we also entered into privately negotiated termination agreements with each of the counterparties in 2018, to partially terminate the Call Spread Overlay, defined and further discussed in Notes 12, “Derivatives,” and 14, “Stockholders' Equity.” The net cash proceeds from the Call Spread Overlay partial termination transactions partially offset the cash paid to settle the 1.125% Convertible Notes.

Following the transactions described above, we have $252 million aggregate principal amount of 1.125% Convertible Notes outstanding at December 31, 2018. Interest is payable semiannually in arrears on January 15 and July 15. The 1.125% Convertible Notes are senior unsecured obligations and rank senior in right of payment to any of our indebtedness that is expressly subordinated in right of payment to the 1.125% Convertible Notes; equal in right of payment to any of our unsecured indebtedness that is not subordinated; effectively junior in right of payment to any of our secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities of our subsidiaries.

The 1.125% Convertible Notes are convertible only into cash, and not into shares of our common stock or any other securities. The initial conversion rate for the 1.125% Convertible Notes is 24.5277 shares of our common stock per $1,000 principal amount, or approximately $40.77 per share of our common stock. Upon conversion, in lieu of receiving shares of our common stock, a holder will receive an amount in cash, per $1,000 principal amount of 1.125% Convertible Notes, equal to the settlement amount, determined in the manner set forth in the indenture. We may not redeem the 1.125% Convertible Notes prior to the maturity date. Holders may convert their 1.125% Convertible Notes only under the following circumstances:

•

During any calendar quarter commencing after the calendar quarter ending on June 30, 2013 (and only during such calendar quarter), if the last reported sale price of the common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day;


•	During the five business day period immediately after any five consecutive trading day period (the measurement period) in which the trading price per $1,000 principal amount of 1.125% Convertible Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day;


•	Upon the occurrence of specified corporate events; or


•	At any time on or after July 15, 2019 until the close of business on the second scheduled trading day immediately preceding the maturity date.

The 1.125% Convertible Notes are convertible by the holders within one year of December 31, 2018, until they mature; therefore, they are reported in current portion of long-term debt.

Concurrent with the issuance of the 1.125% Convertible Notes, the 1.125% Conversion Option was separated from the 1.125% Convertible Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations until the 1.125% Conversion Option settles or expires. This initial liability simultaneously reduced the carrying value of the 1.125% Convertible Notes’ principal amount (effectively an original issuance discount), which is amortized to the principal amount through the recognition of non-cash interest expense over the expected life of the debt. The effective interest rate approximating what we would have incurred had nonconvertible debt with otherwise similar terms been issued is approximately 6%. As of December 31, 2018, the 1.125% Convertible Notes have a remaining amortization period of one year, and their ‘if-converted’ value exceeded their principal amount by approximately $581 million and $406 million as of December 31, 2018 and 2017, respectively.

1.625% Convertible Senior Notes due 2044

Conversion. On July 11, 2018, we announced notice of our election to redeem the remaining $64 million aggregate principal amount of the 1.625% convertible senior notes due 2044 (the “1.625% Convertible Notes”) on August 20, 2018 (the “Redemption Date”), pursuant to the terms of the indenture. Also pursuant to the indenture, the 1.625% Convertible Notes were convertible until August 17, 2018, at a conversion rate of 17.2157 shares of our common stock per $1,000 principal amount equal to the settlement amount (as defined in the related indenture), or approximately $58.09 per share of our common stock. At December 31, 2017, the equity component of the 1.625% Convertible Notes, including the impact of deferred taxes, was $12 million.

Through August 17, 2018, we received conversion notices from substantially all of the remaining holders of the 1.625% Convertible Notes outstanding. Under the conversions, we paid cash for the remaining $64 million aggregate principal amount and delivered 0.6 million shares of our common stock to the converting holders on the settlement dates in September 2018.

Exchange. In March 2018, we entered into separate, privately negotiated, synthetic exchange agreements with certain holders of our outstanding 1.625% Convertible Notes, under which we exchanged $97 million aggregate principal amount and accrued interest for 1.8 million shares of our common stock. We recorded a loss on debt extinguishment, including transaction fees, of $10 million, primarily relating to the inducement premium paid to the bondholders, which is recorded in “Other expenses (income), net” in the accompanying consolidated statements of operations. We did not receive any proceeds from the transaction.

In December 2017, we entered into separate, privately negotiated, synthetic exchange agreements with certain holders of our outstanding 1.625% Convertible Notes, under which we exchanged $141 million aggregate principal amount and accrued interest for 2.6 million shares of our common stock. We recorded a loss on debt extinguishment, including transaction fees, of $14 million, primarily relating to the inducement premium paid to the bondholders, which is recorded in “Other expenses (income), net” in the accompanying consolidated statements of operations. We did not receive any proceeds from the transaction.

Cross-Default Provisions

The indentures governing the 4.875% Notes, the 5.375% Notes and the 1.125% Convertible 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.

Bridge Credit Agreement

In January 2018, we entered into a bridge credit agreement with several banks, which was subsequently terminated in August 2018.

Lease Financing Obligations

Molina Center and Ohio Exchange. In 2013, we entered into a sale-leaseback transaction for the Molina Center and our Ohio health plan office building located in Columbus, Ohio, also known as the Ohio Exchange. Based on certain lease terms, we retained continuing involvement with these leased properties. Rent increases 3% per year through the initial term, which expires in 2038. The lease provides for six five-year renewal options, with renewal rent to be the higher of the 3% annual escalator or the then-fair market value.

6th and Pine. Also in 2013, we entered into a construction and lease transaction for two office buildings in Long Beach, California (“6th and Pine”). Due to our participation in the construction project, we retained continuing involvement in the properties. Rent increases 3.4% per year through the initial term, which expires in 2029. The lease provides for two five-year renewal options, with renewal rent to be determined based on the then-fair market value.

Because of our continuing involvement in the leasing transactions, as noted above, the sale of these properties did not qualify for sales recognition and we remain the owner of the properties under these leases for accounting purposes as of December 31, 2018. The assets are therefore included in our consolidated balance sheets, and are depreciated over their remaining useful lives. The lease financing obligations are amortized over the initial lease terms, such that there will be no gain or loss recorded if the leases are not extended beyond their expiration dates. Payments under the leases adjust the lease financing obligations, and the imputed interest is recorded to interest expense in our consolidated statements of operations. Aggregate interest expense under these leases amounted to $17 million in each of the years ended December 31, 2018, 2017 and 2016. For information regarding the future minimum lease obligations, refer to Note 17, “Commitments and Contingencies” and Note 2, “Significant Accounting Policies,” Recent Accounting Pronouncements Not Yet Adopted, Leases.

Derivatives

12 Months Ended

Dec. 31, 2018

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivatives

The following table summarizes the fair values and the presentation of our derivative financial instruments (defined and discussed individually below) in the consolidated balance sheets:



		December 31,
	Balance Sheet Location	2018		2017
		(In millions)
Derivative asset:
1.125% Call Option	Current assets: Derivative asset	$	476	$	522

Derivative liability:
1.125% Conversion Option	Current liabilities: Derivative liability	$	476	$	522

Our derivative financial instruments do not qualify for hedge treatment; therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of operations, and reported in “Other expenses (income), net.” Gains and losses for our derivative financial instruments are presented individually in the accompanying consolidated statements of cash flows, “Supplemental cash flow information.”

1.125% Convertible Notes Call Spread Overlay. Concurrent with the issuance of the 1.125% Convertible Notes in 2013, we entered into privately negotiated hedge transactions (collectively, the “1.125% Call Option”) and warrant transactions (collectively, the “1.125% Warrants”), with certain of the initial purchasers of the 1.125% Convertible Notes (the “Counterparties”). We refer to these transactions collectively as the Call Spread Overlay. Under the Call Spread Overlay, the cost of the 1.125% Call Option we purchased to cover the cash outlay upon conversion of the 1.125% Convertible Notes was reduced by proceeds from the sale of the 1.125% Warrants. Assuming full performance by the Counterparties (and 1.125% Warrants strike prices in excess of the conversion price of the 1.125% Convertible Notes), these transactions are intended to offset cash payments in excess of the principal amount of the 1.125% Convertible Notes due upon any conversion of such notes.

In the second, third and fourth quarters of 2018, in connection with the 1.125% Convertible Notes purchases (described in Note 11, “Debt”), we entered into privately negotiated termination agreements with each of the Counterparties to partially terminate the Call Spread Overlay, in notional amounts corresponding to the aggregate principal amount of the 1.125% Convertible Notes purchased.


•	In the fourth quarter of 2018, this resulted in our receipt of $146 million for the settlement of the 1.125% Call Option (which is a derivative asset), and the payment of $130 million for the partial termination of the 1.125% Warrants, for an aggregate net cash receipt of $16 million from the Counterparties.


•	In the third quarter of 2018, this resulted in our receipt of $343 million for the settlement of the 1.125% Call Option, and the payment of $306 million for the partial termination of the 1.125% Warrants, for an aggregate net cash receipt of $37 million from the Counterparties.


•	In the second quarter of 2018, this resulted in our receipt of $134 million for the settlement of the 1.125% Call Option, and the payment of $113 million for the partial termination of the 1.125% Warrants, for an aggregate net cash receipt of $21 million from the Counterparties.

1.125% Call Option. The 1.125% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment due to cash settlement features until the 1.125% Call Option settles or expires. For further discussion of the inputs used to determine the fair value of the 1.125% Call Option, refer to Note 4, “Fair Value Measurements.”

1.125% Conversion Option. The embedded cash conversion option within the 1.125% Convertible Notes is accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations until the cash conversion option settles or expires. For further discussion of the inputs used to determine the fair value of the 1.125% Conversion Option, refer to Note 4, “Fair Value Measurements.”

As of December 31, 2018, the 1.125% Call Option and the 1.125% Conversion Option were classified as a current asset and current liability, respectively, because the 1.125% Convertible Notes may be converted within twelve months of December 31, 2018, as described in Note 11, “Debt.”

Income Taxes

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Income Taxes

Income tax expense (benefit) is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of state taxes, nondeductible expenses such as the HIF, goodwill impairment, certain compensation, and other general and administrative expenses. The effective tax rate was not impacted by the HIF in 2017, given the 2017 HIF moratorium. The effective tax rate may be subject to fluctuations during the year, particularly as a result of the level of pretax earnings, and also as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including factors such as the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.

The TCJA, in part, reduced the U.S. federal corporate tax rate from 35% to 21% effective January 1, 2018. TCJA’s change in the federal rate required that we revalue deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally the new 21% federal corporate tax rate plus applicable state tax rate. We applied the guidance in SEC Staff Accounting Bulletin No. 118 when accounting for the enactment-date effects of the TCJA in 2017 and throughout 2018.

As of December 31, 2017, we recorded a provisional amount of $54 million for the revaluation of deferred tax assets and liabilities because we had not yet completed our accounting for all of the enactment-date income tax effects of the TJCA under ASC 740, Income Taxes. Upon further analysis of certain aspects of the TCJA and refinement of our calculations in the year ended December 31, 2018, we reduced this provisional amount by $4 million, which is included as a component of income tax expense in the accompanying consolidated statement of operations. As of December 31, 2018, the accounting for all of the enactment-date income tax effects of the TCJA is complete.

Income tax expense (benefit) consisted of the following:



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Current:
Federal	$	272		$	(9	)	$	134
State	18			3			3
Foreign	8			—			(6		)
Total current	298			(6		)	131
Deferred:
Federal	(3		)	(85		)	19
State	(3		)	(9		)	2
Foreign	—			—			1
Total deferred	(6		)	(94		)	22
Income tax expense (benefit)	$	292		$	(100	)	$	153

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



	Year Ended December 31,
	2018		2017		2016
Statutory federal tax (benefit) rate	21.0	%	(35.0	)%	35.0	%
State income provision (benefit), net of federal	1.2		(0.7	)	1.6
Nondeductible health insurer fee (“HIF”)	7.3		—		37.0
Nondeductible compensation	0.7		2.8		3.1
Nondeductible goodwill impairment	—		6.6		—
Worthless stock deduction	(1.0	)	—		—
Revaluation of net deferred tax assets	(0.4	)	8.8		—
Change in purchase agreement that increased tax basis in assets	—		—		(2.2	)
Other	0.4		1.1		0.3
Effective tax (benefit) rate	29.2	%	(16.4	)%	74.8	%

Our effective tax rate is based on expected income (loss), statutory tax rates, and tax planning opportunities available to us in the various jurisdictions in which we operate. Significant 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, 2018 and 2017 were as follows:



	December 31,
	2018			2017
	(In millions)
Accrued expenses	$	32		$	15
Reserve liabilities	7			11
Other accrued medical costs	12			16
Net operating losses	16			27
Fixed assets and intangibles	30			23
Unearned premiums	9			19
Lease financing obligation	30			30
Tax credit carryover	12			15
Other	3			3
Valuation allowance	(28		)	(41		)
Total deferred income tax assets, net of valuation allowance	123			118
Prepaid expenses	(6		)	(6		)
Basis in debt	—			(9		)
Total deferred income tax liabilities	(6		)	(15		)
Net deferred income tax asset	$	117		$	103

At December 31, 2018, we had state net operating loss carryforwards of $332 million, which begin expiring in 2027.

At December 31, 2018, we had California research and development and enterprise zone tax credit carryovers of $14 million, which will begin to expire in 2024.

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, 2018, $28 million of deferred tax assets did not satisfy the recognition criteria. Therefore, we decreased our valuation allowance by $13 million, from $41 million at December 31, 2017, to $28 million as of December 31, 2018.

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,
	2018			2017			2016
	(In millions)
Gross unrecognized tax benefits at beginning of period	$	(13	)	$	(11	)	$	(9	)
Increases in tax positions for current year	(9		)	(1		)	(1		)
Increases in tax positions for prior years	—			(4		)	(1		)
Decreases in tax positions for prior years	—			3			—
Lapse in statute of limitations	2			—			—
Gross unrecognized tax benefits at end of period	$	(20	)	$	(13	)	$	(11	)

The total amount of unrecognized tax benefits at December 31, 2018, 2017 and 2016 that, if recognized, would affect the effective tax rates is $18 million, $12 million, and $9 million, respectively. We expect that during the next 12 months it is reasonably possible that unrecognized tax benefit liabilities may decrease by as much as $3 million due to the expiration of statutes of limitation.

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, 2018, 2017 and 2016 were insignificant.

We may be subject to federal examination for calendar years 2015 through 2017. 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 2014. We are not aware of any material adjustments that may be proposed.

Stockholders' Equity

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Stockholders' Equity

1.625% Convertible Notes

Conversion. As described in Note 11, “Debt,” we issued 0.6 million shares of our common stock in connection with the conversion of the 1.625% Convertible Notes in the third quarter of 2018.

Exchange. As described in Note 11, “Debt,” we issued 1.8 million shares and 2.6 million shares of our common stock in connection with the exchange of the 1.625% Convertible Notes in March 2018 and December 2017, respectively.

1.125% Warrants

In connection with the Call Spread Overlay transaction described in Note 12, “Derivatives,” in 2013, we issued 13.5 million warrants with a strike price of $53.8475 per share. Under certain circumstances, beginning in April 2020, if the price of our common stock exceeds the strike price of the 1.125% Warrants, we will be obligated to issue shares of our common stock subject to a share delivery cap. The 1.125% Warrants could separately have a dilutive effect to the extent that the market value per share of our common stock exceeds the applicable strike price of the 1.125% Warrants. Refer to Note 3, “Net Income (Loss) Per Share,” for dilution information for the periods presented. We will not receive any additional proceeds if the 1.125% Warrants are exercised. Following the transactions described below, 6.2 million of the 1.125% Warrants remain outstanding.

As described in Note 12, “Derivatives,” in the second, third and fourth quarters of 2018, we entered into privately negotiated termination agreements with each of the Counterparties to terminate the respective portion of the Call Spread Overlay, in notional amounts corresponding to the aggregate principal amount of the 1.125% Convertible Notes repaid. In each case, additional paid-in capital was reduced for the same amount paid to the Counterparties for the termination of the 1.125% Warrants.


•	In the fourth quarter of 2018, we paid $130 million to the Counterparties for the termination of 1.5 million of the 1.125% Warrants outstanding.


•	In the third quarter of 2018, we paid $306 million to the Counterparties for the termination of 3.4 million of the 1.125% Warrants outstanding.


•	In the second quarter of 2018, we paid $113 million to the Counterparties for the termination of 2.4 million of the 1.125% Warrants outstanding.

Share-Based Compensation

At December 31, 2018, we had employee equity incentives outstanding under our 2011 Equity Incentive Plan (“2011 Plan”). The 2011 Plan provides for the award of restricted stock (“RSAs”), performance stock (“PSAs”), performance stock units (“PSUs”), stock options and stock bonuses to the company’s officers, employees, directors, consultants, advisers, and other service providers. The 2011 Plan provides for the issuance of up to 4.5 million shares of common stock.

In connection with the 2011 Plan and employee stock purchase plan, approximately 365,000 shares and 857,000 shares of common stock were purchased or vested, net of shares used to settle employees’ income tax obligations, during the years ended December 31, 2018, and 2017, respectively.

Except as noted below, we record share-based compensation as “General and administrative expenses” in the accompanying consolidated statements of operations. Total share-based compensation expense was as follows:



	Year Ended December 31,
	2018				2017				2016
	(In millions)
	Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount
RSAs, PSAs and PSUs	$	17	$	17	$	39	$	35	$	20	$	17
Employee stock purchase plan and stock options	10		9		7		5		6		5
	$	27	$	26	$	46	$	40	$	26	$	22

RSAs, PSAs 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. Certain PSUs may vest in their entirety at the end of three-year performance periods, if their performance conditions are met. We generally recognize expense for RSAs, PSAs and PSUs on a straight-line basis.

Activity for such awards in the year ended December 31, 2018 is summarized below:



	RSAs		PSAs		PSUs		Total Shares		Weighted Average Grant Date Fair Value
Unvested balance as of December 31, 2017	401,804		84,762		91,828		578,394		$	58.35
Granted	363,740		—		214,952		578,692		75.38
Vested	(192,609	)	(32,929	)	—		(225,538	)	59.08
Forfeited	(173,140	)	(48,701	)	(105,397	)	(327,238	)	63.69
Unvested balance as of December 31, 2018	399,795		3,132		201,383		604,310		$	71.50

As of December 31, 2018, there was $35 million of total unrecognized compensation expense related to unvested RSAs, PSAs and PSUs, which we expect to recognize over a remaining weighted-average period of 2.6 years, 0.2 years and 2.0 years, respectively. This unrecognized compensation cost assumed an estimated forfeiture rate of 16.1% for non-executive employees as of December 31, 2018, based on actual forfeitures over the last 4 years.

The total grant date fair value of awards granted and vested is presented in the following table:



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Granted:
RSAs	$	28	$	20	$	19
PSAs	—		—		15
PSUs	16		16		—
	$	44	$	36	$	34
Vested:
RSAs	$	15	$	23	$	22
PSAs	3		15		—
PSUs	—		9		—
	$	18	$	47	$	22

During the year ended December 31, 2017, the vesting of 133,957 RSAs, 153,574 PSAs and 139,272 PSUs was accelerated in connection with the termination of our former Chief Executive Officer and former Chief Financial Officer in May 2017. The incremental charge relating to this acceleration, or $23 million, is reported in “Restructuring and separation costs” in the accompanying consolidated statements of operations. This amount is included in the 2017 “Pretax Charges” in the table above.

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, 2018 is summarized below:



	Shares	Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual term
				(In millions)		(Years)
Stock options outstanding as of December 31, 2017	405,000	$	64.79
Granted	—	—
Exercised	—	—
Stock options outstanding as of December 31, 2018	405,000	64.79		$	21	8.5
Stock options exercisable and expected to vest as of December 31, 2018	405,000	64.79		$	21	8.5
Exercisable as of December 31, 2018	155,000	60.69		$	9	8.0

The weighted-average grant date fair value per share of stock options awarded in 2017 was $41.43. We estimate the fair value of each stock option award on the grant date using the Black-Scholes option pricing model. To determine the fair value of the stock options awarded in 2017 we applied a risk-free interest rate of 2.3%, expected volatility of 38.4%, dividend yield of 0% and expected life of 8.4 years. No stock options were granted in 2018 and 2016.

Also as of December 31, 2018, there was $9 million of total unrecognized compensation expense related to unvested stock options, which we expect to recognize over a weighted-average period of 1.8 years. The total intrinsic value of options exercised during the years ended December 31, 2017, and 2016 was $2 million, and $1 million, respectively. No stock options were exercised in 2018. The following is a summary of information about stock options outstanding and exercisable at December 31, 2018:



	Options Outstanding				Options Exercisable
	Number Outstanding	Weighted Average Remaining Contractual Life (Years)	Weighted-Average Exercise Price		Number Exercisable	Weighted-Average Exercise Price
Range of Exercise Prices
$33.02	30,000	4.2	$	33.02	30,000	$	33.02
$67.33	375,000	8.9	67.33		125,000	67.33
	405,000				155,000

Employee Stock Purchase Plan. Under our employee stock purchase plan (“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 the Black-Scholes option pricing model. For the years ended December 31, 2018, 2017, and 2016, the inputs to this model were as follows: risk-free interest rates of approximately 0.4% to 1.9%; expected volatilities ranging from approximately 31% to 44%, dividend yields of 0%, and an average expected life of 0.5 years. We issued approximately 216,000, 351,000 and 410,000 shares of our common stock under the ESPP during the years ended December 31, 2018, 2017, and 2016, respectively. The 2011 ESPP provides for the issuance of up to three million shares of common stock.

Restructuring and Separation Costs

12 Months Ended

Dec. 31, 2018

Restructuring and Related Activities [Abstract]

Restructuring and Separation Costs

Restructuring and separation costs are reported by the same name in the accompanying consolidated statements of operations.

IT Restructuring Plan

Following the 2017 Restructuring Plan noted below, our new executive team has focused on a margin recovery plan that includes identification and implementation of various profit improvement initiatives. To that end, we began the implementation of a plan to restructure our information technology department (the “IT Restructuring Plan”) in the third quarter of 2018. On February 4, 2019, we entered into a master services agreement with Infosys Limited pursuant to which Infosys will manage certain of our information technology infrastructure services including, among other things, our information technology operations, end-user services, and data centers.

Expected Costs

In addition to $9 million incurred in the last half of 2018, we expect to incur approximately $11 million for the IT Restructuring Plan in 2019. We expect such costs to consist primarily of one-time termination benefits and other costs in the Other segment. We expect the IT Restructuring Plan to be completed by the end of 2019.

Costs Incurred

We have incurred expenses under the IT Restructuring Plan as follows:



	Year Ended December 31, 2018
	One-Time Termination Benefits		Other Restructuring Costs		Total
	One-Time Termination Benefits		Consulting Fees		Total
	(In millions)
Other	$	7	$	2	$	9

Reconciliation of Liability

For those restructuring costs that require cash settlement (such as one-time termination benefits and consulting fees), the following table presents a roll-forward of the accrued liability, which is reported in “Accounts payable and accrued liabilities” in the accompanying consolidated balance sheets.



	One-Time Termination Benefits			Other Restructuring Costs			Total
	(In millions)
Accrued as of December 31, 2017	$	—		$	—		$	—
Charges	7			2			9
Cash payments	(2		)	(1		)	(3		)
Accrued as of December 31, 2018	$	5		$	1		$	6

2017 Restructuring Plan

Following a management-initiated, broad operational assessment in early 2017, our board of directors approved, and we committed to, a comprehensive restructuring and profitability improvement plan in June 2017 (the “2017 Restructuring Plan”). Key activities under this plan to date have included:


•	Streamlining of our organizational structure to eliminate redundant layers of management, consolidate regional support services, and other staff reductions to improve efficiency and the speed and quality of decision making;


•	Re-design of core operating processes such as provider payment, utilization management, quality monitoring and improvement, and information technology, to achieve more effective and cost-efficient outcomes;


•	Remediation of high-cost provider contracts and enhancement of high quality, cost-effective networks;


•	Restructuring, including selective exits, of direct delivery operations; and


•	Partnering with the lowest-cost, most effective vendors.

Costs Incurred

In our 2017 Annual Report on Form 10-K, we reported that we had incurred approximately $234 million of costs associated with the 2017 Restructuring Plan in 2017. In the year ended December 31, 2018, we incurred an additional $37 million in such costs, primarily resulting from a write-off of costs associated with a terminated utilization and care management project that was inconsistent with the goals of the 2017 Restructuring Plan. We also recorded nominal amounts for one-time termination benefits, and true-ups of certain lease contract termination costs recorded in 2017. As of December 31, 2018, we had incurred $271 million in total costs under the 2017 Restructuring Plan. We completed all activities under the 2017 Restructuring Plan in 2018, with the exception of the cash settlement of lease termination liabilities. We expect to continue to settle those liabilities through 2025, unless the leases are terminated sooner.

The following table presents the major types of such costs by segment. Current and long-lived assets include current and non-current capitalized project costs, and capitalized software determined to be unrecoverable.



	Year Ended December 31, 2018
	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs							Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Current and Long-lived Assets			Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	—	$	(1	)	$	—	$	12	$	11
Other	—		5		20			1		—		26
	$	—	$	5	$	19		$	1	$	12	$	37



	Year Ended December 31, 2017
	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs						Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Long-lived Assets		Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	33	$	16	$	—	$	24	$	73
Other	36		34		45		44		2		161
	$	36	$	67	$	61	$	44	$	26	$	234

As of December 31, 2018, we had incurred cumulative restructuring costs under the 2017 Restructuring Plan as follows:



	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs						Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Current and Long-lived Assets		Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	33	$	15	$	—	$	36	$	84
Other	36		39		65		45		2		187
	$	36	$	72	$	80	$	45	$	38	$	271

Reconciliation of Liability

For those restructuring and separation costs that require cash settlement (primarily separation costs not including equity incentives, termination benefits, consulting fees and contract termination costs), the following table presents a roll-forward of the accrued liability, which is reported primarily in “Accounts payable and accrued liabilities” in the accompanying consolidated balance sheets. Certain contract termination cost accruals are non-current, recorded in “Other long-term liabilities.”



	Separation Costs - Former Executives			One-Time Termination Benefits			Other Restructuring Costs			Total
	(In millions)
Accrued as of December 31, 2017	$	2		$	11		$	35		$	48
Adjustments	—			(1		)	11			10
Charges	—			6			2			8
Cash payments	(2		)	(15		)	(31		)	(48		)
Accrued as of December 31, 2018	$	—		$	1		$	17		$	18

Employee Benefits	12 Months Ended
Employee Benefits	Dec. 31, 2018
Postemployment Benefits [Abstract]
Employee Benefits	Employee Benefits 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 generally 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 $36 million, $43 million, and $36 million in the years ended December 31, 2018, 2017, and 2016, respectively. We also have a non-qualified deferred compensation plan for certain key employees. Under this plan, eligible participants may defer up to 100% of their base salary and 100% of their bonus to provide tax-deferred growth for retirement. The funds deferred are invested in corporate-owned life insurance, under a rabbi trust.

Commitments and Contingencies

12 Months Ended

Dec. 31, 2018

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Regulatory Capital Requirements and Dividend Restrictions

Our health plans, which are operated by our respective wholly owned subsidiaries in those states, 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 rules which, if implemented by the states, set minimum capitalization requirements for insurance companies, HMOs, and other entities bearing risk for health care coverage. The requirements take the form of risk-based capital (“RBC”) rules which may vary from state to state. All of the states in which our health plans operate, except California, Florida and New York, have adopted these rules. Such requirements, if adopted by California, Florida and New York, may increase the minimum capital required for those states. 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. As of December 31, 2018, our health plans had aggregate statutory capital and surplus of approximately $2,388 million compared with the required minimum aggregate statutory capital and surplus of approximately $1,040 million. All of our health plans were in compliance with the minimum capital requirements at December 31, 2018. 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 continue to meet regulatory requirements.

Such 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 (after intercompany eliminations) which may not be transferable to us in the form of loans, advances, or cash dividends was approximately $2,262 million at December 31, 2018, and $1,691 million at December 31, 2017. 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 $170 million and $696 million as of December 31, 2018 and 2017, respectively.

Legal Proceedings

The health care industry is subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, and the repayment of previously billed and collected revenues.

We are involved in legal actions in the ordinary course of business, some of which seek monetary damages, including claims for punitive damages, which are not covered by insurance. We have accrued liabilities for certain matters for which we deem the loss to be both probable and estimable. Although we believe that our estimates of such losses are reasonable, these estimates could change as a result of further developments of these matters. The outcome of legal actions is inherently uncertain and such pending matters for which accruals have not been established have not progressed sufficiently through discovery and/or development of important factual information and legal issues to enable us to estimate a range of possible loss, if any. While it is not possible to accurately predict or determine the eventual outcomes of these items, 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.

Steamfitters Local 449 Pension Plan v. Molina Healthcare, Inc., et al. On October 5, 2018, the Steamfitters Local 449 Pension Plan filed its first amended class action securities complaint in the Central District Court of California against the Company and its former executive officers, J. Mario Molina, John C. Molina, Terry P. Bayer, and Rick Hopfer, Case 2:18-cv-03579. The amended complaint purports to seek recovery on behalf of all persons or entities who purchased Molina common stock between October 31, 2014, and August 2, 2017, for alleged violations under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, as amended, and Rule 10b-5 promulgated thereunder. The plaintiff alleges the defendants misled investors regarding the scalability of the Company’s administrative infrastructure during the identified class period. On December 13, 2018, the Court granted the Company’s motion to dismiss in its entirety and closed the case. On January 9, 2019, plaintiffs appealed to the United States Court of Appeals for the Ninth Circuit. Plaintiff’s opening brief is due April 10, 2019, the Company’s response is due May 10, 2019, and Plaintiff’s reply is due May 31, 2019. Oral argument will likely occur within 9-12 months after the briefing is completed. The Company believes it has meritorious defenses to the alleged claims and intends to defend the matter vigorously. At this time, we are not able to estimate a possible loss or range of loss that may result from this matter or to determine whether such loss, if any, would have a material adverse effect on our financial condition, results of operations, or cash flows.

States’ Budgets

Nearly all of our premium revenues come from the joint federal and state funding of the Medicaid, Medicare, and CHIP programs. The states in which we operate our health plans regularly face significant budgetary pressures.

Lease Obligations

We lease administrative facilities and certain equipment under non-cancelable operating leases expiring at various dates through 2026. Facility lease terms generally range from five to 10 years with one to two renewal options for extended terms. In most cases, we are required to make additional payments under facility operating leases for taxes, insurance and other operating expenses incurred during the lease period. Certain of our leases contain rent escalation clauses or lease incentives, including rent abatements and tenant improvement allowances. Rent escalation clauses and lease incentives are taken into account in determining total rent expense to be recognized during the lease term.

Future minimum lease payments by year and in the aggregate under operating leases and lease financing obligations consist of the following amounts:



	Lease Financing Obligations		Operating Leases		Total
	(In millions)
2019	$	19	$	46	$	65
2020	19		34		53
2021	20		24		44
2022	21		16		37
2023	21		12		33
Thereafter	311		15		326
	$	411	$	147	$	558

Rental expense related to operating leases amounted to $62 million, $75 million, and $64 million for the years ended December 31, 2018, 2017, and 2016, respectively. The amounts reported in “Lease Financing Obligations” above represent our contractual lease commitments for the properties described in Note 11, “Debt” under the subheading “Lease Financing Obligations.”

Professional Liability Insurance

We carry medical professional liability insurance for health care services rendered in the primary care institutions that we manage. In addition, we also carry errors and omissions insurance for all Molina entities.

Provider Claims

Many of our medical contracts are complex in nature and may be subject to differing interpretations regarding amounts due for the provision of various services. Such differing interpretations have led certain medical providers to pursue us for additional compensation. The claims made by providers in such circumstances often involve issues of contract compliance, interpretation, payment methodology, and intent. These claims often extend to services provided by the providers over a number of years.

Various providers have contacted us seeking additional compensation for claims that we believe to have been settled. These matters, when finally concluded and determined, will not, in our opinion, have a material adverse effect on our business, consolidated financial position, results of operations, or cash flows.

Segment Information

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Segment Information

Segments

We currently have two reportable segments: our Health Plans segment and our Other segment. We manage the vast majority of our operations through our Health Plans segment. Our Other segment includes the historical results of the Pathways behavioral health subsidiary, which we sold in the fourth quarter of 2018, and certain corporate amounts not allocated to the Health Plans segment. Effective in the fourth quarter of 2018, we reclassified the historical results relating to our Molina Medicaid Solutions (“MMS”) segment, which we sold in the third quarter of 2018, to the Other segment. Previously, results for MMS were reported in a stand-alone segment.

Refer to Note 1, “Organization and Basis of Presentation,” for further details on the sales of Pathways and MMS.

We regularly evaluate the appropriateness of our reportable segments, particularly in light of organizational changes, acquisition and divestiture activity, and changing laws and regulations. Therefore, these reportable segments may change in the future.

Description of Earnings Measures for Reportable Segments

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

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



	Health Plans		Other		Consolidated
	(In millions)
2018
Total revenue	$	18,471	$	419	18,890
Margin	2,475		43		2,518
Goodwill, and intangible assets, net	190		—		190
Total assets	6,165		989		7,154
2017
Total revenue	$	19,352	$	531	$	19,883
Margin	1,781		29		1,810
Goodwill, and intangible assets, net	212		43		255
Total assets	6,347		2,124		8,471
2016
Total revenue	$	17,234	$	548	$	17,782
Margin	1,671		54		1,725
Goodwill, and intangible assets, net	513		247		760
Total assets	5,897		1,552		7,449

The following table reconciles margin by segment to consolidated income (loss) before income tax expense (benefit):



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Margin:
Health Plans	$	2,475		$	1,781		$	1,671
Other	43			29			54
Total margin	2,518			1,810			1,725
Add: other operating revenues ⁽¹⁾	871			508			798
Less: other operating expenses ⁽²⁾	(2,243		)	(2,873		)	(2,217		)
Less: loss on sales of subsidiaries, net of gain	(15		)	—			—
Operating income (loss)	1,131			(555		)	306
Less: other expenses, net	132			57			101
Income (loss) before income tax expense (benefit)	$	999		$	(612	)	$	205

______________________


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


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

Quarterly Results of Operations (Unaudited)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Results of Operations (Unaudited)

The following table summarizes quarterly unaudited results of operations for the years ended December 31, 2018 and 2017.



	For The Quarter Ended
	March 31, 2018		June 30, 2018		Sept. 30, 2018		December 31, 2018
	(In millions, except per-share data)
Total revenue	$	4,646	$	4,883	$	4,697	$	4,664
Margin	615		673		566		664
Gain (loss) on sales of subsidiaries	—		—		37		(52		)
Restructuring and separation costs	25		8		5		8
Net income	107		202		197		201

Net income per share ⁽¹⁾:
Basic	$	1.79	$	3.29	$	3.22	$	3.24
Diluted	$	1.64	$	3.02	$	2.90	$	3.01



	For The Quarter Ended
	March 31, 2017		June 30, 2017			Sept. 30, 2017			December 31, 2017
	(In millions, except per-share data)
Total revenue	$	4,904	$	4,999		$	5,031		$	4,949
Margin	546		254			564			446
Impairment losses	—		72			129			269
Restructuring and separation costs	—		43			118			73
Net income (loss)	77		(230		)	(97		)	(262		)

Net income (loss) per share ⁽¹⁾:
Basic	$	1.38	$	(4.10	)	$	(1.70	)	$	(4.59	)
Diluted	$	1.37	$	(4.10	)	$	(1.70	)	$	(4.59	)

_______________________________

(1)

The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method and is based on the weighted-average common share equivalents outstanding during each quarter. Accordingly, the sum of the quarterly net income (loss) per share may not agree to the total for the year. Certain potentially dilutive common shares issuable are not included in the computation of diluted net income (loss) per share because to do so would be anti-dilutive.

Condensed Financial Information of Registrant

12 Months Ended

Dec. 31, 2018

Condensed Financial Information Disclosure [Abstract]

Condensed Financial Information of Registrant

The condensed balance sheets as of December 31, 2018 and 2017, and the related condensed statements of operations, comprehensive income (loss) and cash flows for each of the three years in the period ended December 31, 2018 for our parent company Molina Healthcare, Inc. (the “Registrant”), are presented below.

Condensed Balance Sheets



	December 31,
	2018			2017
	(In millions, except share data)
ASSETS
Current assets:
Cash and cash equivalents	$	70		$	504
Investments	100			192
Restricted investments	—			169
Receivables	2			2
Due from affiliates	90			148
Prepaid expenses and other current assets	47			103
Derivative asset	476			522
Total current assets	785			1,640
Property, equipment, and capitalized software, net	176			223
Goodwill and intangible assets, net	13			15
Investments in subsidiaries	2,768			2,306
Deferred income taxes	39			17
Advances to related parties and other assets	40			32
	$	3,821		$	4,233
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4		$	3
Accounts payable and accrued liabilities	223			178
Current portion of long-term debt	241			653
Derivative liability	476			522
Total current liabilities	944			1,356
Long-term debt	1,020			1,318
Lease financing obligations	197			198
Other long-term liabilities	13			24
Total liabilities	2,174			2,896
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding:
62 million shares at December 31, 2018 and 60 million shares at December 31, 2017	—			—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	—			—
Additional paid-in capital	643			1,044
Accumulated other comprehensive loss	(8		)	(5		)
Retained earnings	1,012			298
Total stockholders’ equity	1,647			1,337
	$	3,821		$	4,233

See accompanying notes.

Condensed Statements of Operations



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Revenue:
Management fees	$	1,138		$	1,317		$	1,062
Investment income and other revenue	17			16			16
Total revenue	1,155			1,333			1,078
Expenses:
Medical care costs	8			16			73
General and administrative expenses	1,007			1,082			899
Depreciation and amortization	69			93			95
Restructuring and separation costs	35			153			—
Impairment losses	—			39			—
Total operating expenses	1,119			1,383			1,067
Gain on sale of subsidiary	37			—			—
Operating income (loss)	73			(50		)	11
Interest expense	114			117			101
Other expense (income)	17			(61		)	—
Loss before income tax (benefit) expense and equity in net earnings (losses) of subsidiaries	(58		)	(106		)	(90		)
Income tax (benefit) expense	(14		)	8			(24		)
Net loss before equity in net earnings (losses) of subsidiaries	(44		)	(114		)	(66		)
Equity in net earnings (losses) of subsidiaries	751			(398		)	118
Net income (loss)	$	707		$	(512	)	$	52

Condensed Statements of Comprehensive Income (Loss)



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Net income (loss)	$	707		$	(512	)	$	52
Other comprehensive (loss) income:
Unrealized investment (loss) gain	(3		)	(5		)	3
Less: effect of income taxes	(1		)	(2		)	1
Other comprehensive (loss) income, net of tax	(2		)	(3		)	2
Comprehensive income (loss)	$	705		$	(515	)	$	54

See accompanying notes.

Condensed Statements of Cash Flows



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Operating activities:
Net cash provided by operating activities	$	118		$	166		$	55
Investing activities:
Capital contributions to subsidiaries	(145		)	(370		)	(386		)
Dividends received from subsidiaries	298			286			101
Purchases of investments	(136		)	(331		)	(115		)
Proceeds from sales and maturities of investments	388			156			188
Purchases of property, equipment and capitalized software	(22		)	(67		)	(125		)
Net cash received from sale of subsidiaries	242			—			—
Change in amounts due to/from affiliates	6			(49		)	(18		)
Other, net	—			—			6
Net cash provided by (used in) investing activities	631			(375		)	(349		)
Financing activities:
Repayment of credit facility	(300		)	—			—
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—
Cash received for partial settlement of 1.125% Call Option	623			—			—
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—
Proceeds from senior notes offerings, net of issuance costs	—			325			—
Proceeds from borrowings under credit facility	—			300			—
Other, net	19			11			20
Net cash (used in) provided by financing activities	(1,192		)	636			20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	427			(274		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			86			360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	513		$	86

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, legal, marketing, purchasing, risk management, actuarial, underwriting, finance, accounting, 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 2018, 2017, and 2016 for these services amounted to $1,137 million, $1,317 million, and $1,062 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.

Supplemental Condensed Consolidating Financial Information

12 Months Ended

Dec. 31, 2018

Condensed Financial Information [Abstract]

Supplemental Condensed Consolidating Financial Information

On November 10, 2015, the Parent issued $700 million aggregate principal amount of the 5.375% Notes in a private placement to institutional investors. The 5.375% Notes were registered with the SEC in September 2016. Pursuant to the terms of the indenture governing the 5.375% Notes (the “Indenture”), the 5.375% Notes are required to be guaranteed by each of the Parent’s existing and future direct and indirect domestic restricted subsidiaries that guarantee the Parent’s Credit Agreement. At the time of issuance, there were two subsidiaries of the Parent that guaranteed the Notes: MMS and Molina Medical Management, Inc. (“MMM”).

On November 1, 2015, the Parent acquired all of the outstanding ownership interests of Pathways Health and Community Support LLC (“Pathways”). As a result of that acquisition, and pursuant to the terms of the Indenture, effective February 16, 2016, Pathways and 15 of its subsidiaries were added as guarantors of the 5.375% Notes. Subsequently, effective January 3, 2017, MMM and 14 Pathways subsidiaries were released as guarantors of the 5.375% Notes, leaving MMS, Pathways, and Molina Pathways, LLC as the only subsidiary guarantors. MMS and Pathways were released as guarantors effective September 30, 2018, and October 19, 2018, respectively, in connection with their divestitures. Accordingly, as of December 31, 2018, Molina Pathways, LLC was the sole wholly owned subsidiary guarantor of the 5.375% Notes, on a full and unconditional basis. As discussed in Note 11, “Debt,” effective as of January 31, 2019, Molina Pathways, LLC was released as a guarantor of the 5.375% Notes.

For all periods presented, the following condensed consolidating financial statements present Molina Healthcare, Inc. (as “Parent Issuer”), Molina Pathways, LLC (as “Other Guarantor”), the subsidiary non-guarantors (as “Non-Guarantors”) and “Eliminations,” according to the guarantor structure as assessed as of and for the year ended December 31, 2018.

CONDENSED CONSOLIDATING STATEMENTS OF OPERATIONS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,155		$	3		$	18,884	$	(1,152	)	$	18,890
Expenses:
Medical care costs	8			—			15,129		—			15,137
Cost of service revenue	—			—			364		—			364
General and administrative expenses	1,007			4			1,474		(1,152		)	1,333
Premium tax expenses	—			—			417		—			417
Health insurer fees	—			—			348		—			348
Depreciation and amortization	69			—			30		—			99
Restructuring and separation costs	35			—			11		—			46
Total operating expenses	1,119			4			17,773		(1,152		)	17,744
Gain (loss) on sales of subsidiaries	37			(52		)	—		—			(15		)
Operating income (loss)	73			(53		)	1,111		—			1,131
Interest expense	114			—			1		—			115
Other expense	17			—			—		—			17
(Loss) income before income tax (benefit) expense	(58		)	(53		)	1,110		—			999
Income tax (benefit) expense	(14		)	(11		)	317		—			292
Net (loss) income before equity in net earnings (losses) of subsidiaries	(44		)	(42		)	793		—			707
Equity in net earnings (losses) of subsidiaries	751			(5		)	—		(746		)	—
Net income (loss)	$	707		$	(47	)	$	793	$	(746	)	$	707



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,333		$	2		$	19,904		$	(1,356	)	$	19,883
Expenses:
Medical care costs	16			—			17,058			(1		)	17,073
Cost of service revenue	—			—			492			—			492
General and administrative expenses	1,082			2			1,865			(1,355		)	1,594
Premium tax expenses	—			—			438			—			438
Depreciation and amortization	93			—			44			—			137
Restructuring and separation costs	153			—			81			—			234
Impairment losses	39			—			431			—			470
Total operating expenses	1,383			2			20,409			(1,356		)	20,438
Operating loss	(50		)	—			(505		)	—			(555		)
Total other expenses, net	56			—			1			—			57
Loss before income taxes	(106		)	—			(506		)	—			(612		)
Income tax expense (benefit)	8			—			(108		)	—			(100		)
Net loss before equity in net (losses) earnings of subsidiaries	(114		)	—			(398		)	—			(512		)
Equity in net (losses) earnings of subsidiaries	(398		)	(164		)	8			554			—
Net loss	$	(512	)	$	(164	)	$	(390	)	$	554		$	(512	)



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,078		$	—		$	17,786	$	(1,082	)	$	17,782
Expenses:
Medical care costs	73			—			14,702		(1		)	14,774
Cost of service revenue	—			—			485		—			485
General and administrative expenses	899			2			1,573		(1,081		)	1,393
Premium tax expenses	—			—			468		—			468
Health insurer fees	—			—			217		—			217
Depreciation and amortization	95			—			44		—			139
Total operating expenses	1,067			2			17,489		(1,082		)	17,476
Operating income (loss)	11			(2		)	297		—			306
Total other expenses, net	101			—			—		—			101
(Loss) income before income taxes	(90		)	(2		)	297		—			205
Income tax (benefit) expense	(24		)	(1		)	178		—			153
Net (loss) income before equity in earnings of subsidiaries	(66		)	(1		)	119		—			52
Equity in net earnings of subsidiaries	118			2			—		(120		)	—
Net income	$	52		$	1		$	119	$	(120	)	$	52

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME (LOSS)



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations			Consolidated

	(In millions)
Net income (loss)	$	707		$	(47	)	$	793		$	(746	)	$	707
Other comprehensive loss, net of tax	(2		)	—			(2		)	2			(2		)
Comprehensive income (loss)	$	705		$	(47	)	$	791		$	(744	)	$	705



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated

	(In millions)
Net loss	$	(512	)	$	(164	)	$	(390	)	$	554	$	(512	)
Other comprehensive loss, net of tax	(3		)	—			(2		)	2		(3		)
Comprehensive loss	$	(515	)	$	(164	)	$	(392	)	$	556	$	(515	)



	Year Ended December 31, 2016
	Parent Issuer		Other Guarantor		Non-Guarantors		Eliminations			Consolidated

	(In millions)
Net income	$	52	$	1	$	119	$	(120	)	$	52
Other comprehensive income, net of tax	2		—		1		(1		)	2
Comprehensive income	$	54	$	1	$	120	$	(121	)	$	54

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2018
	Parent Issuer		Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	70	$	2		$	2,754		$	—		$	2,826
Investments	100		—			1,581			—			1,681
Receivables	2		—			1,328			—			1,330
Due from (to) affiliates	90		7			(97		)	—			—
Prepaid expenses and other current assets	47		29			73			—			149
Derivative asset	476		—			—			—			476
Total current assets	785		38			5,639			—			6,462
Property, equipment, and capitalized software, net	176		—			65			—			241
Goodwill and intangible assets, net	13		—			177			—			190
Restricted investments	—		—			120			—			120
Investment in subsidiaries, net	2,768		(5		)	—			(2,763		)	—
Deferred income taxes	39		—			78			—			117
Other assets	40		—			5			(21		)	24
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4	$	—		$	1,957		$	—		$	1,961
Amounts due government agencies	—		—			967			—			967
Accounts payable and accrued liabilities	223		—			167			—			390
Deferred revenue	—		—			211			—			211
Current portion of long-term debt	241		—			—			—			241
Derivative liability	476		—			—			—			476
Total current liabilities	944		—			3,302			—			4,246
Long-term debt and lease financing obligations	1,217		—			20			(20		)	1,217
Other long-term liabilities	13		—			32			(1		)	44
Total liabilities	2,174		—			3,354			(21		)	5,507
Total stockholders’ equity	1,647		33			2,730			(2,763		)	1,647
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2017
	Parent Issuer		Other Guarantor		Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	504	$	—	$	2,682		$	—		$	3,186
Investments	192		—		2,332			—			2,524
Restricted investments	169		—		—			—			169
Receivables	2		—		869			—			871
Due from (to) affiliates	148		2		(150		)	—			—
Prepaid expenses and other current assets	103		2		150			(16		)	239
Derivative asset	522		—		—			—			522
Total current assets	1,640		4		5,883			(16		)	7,511
Property, equipment, and capitalized software, net	223		—		119			—			342
Goodwill and intangible assets, net	15		—		240			—			255
Restricted investments	—		—		119			—			119
Investment in subsidiaries, net	2,306		75		—			(2,381		)	—
Deferred income taxes	17		—		101			(15		)	103
Other assets	32		—		110			(1		)	141
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	3	$	—	$	2,189		$	—		$	2,192
Amounts due government agencies	—		—		1,542			—			1,542
Accounts payable and accrued liabilities	178		1		188			(1		)	366
Deferred revenue	—		—		282			—			282
Current portion of long-term debt	653		—		16			(16		)	653
Derivative liability	522		—		—			—			522
Total current liabilities	1,356		1		4,217			(17		)	5,557
Long-term debt and lease financing obligations	1,516		—		—			—			1,516
Deferred income taxes	—		—		15			(15		)	—
Other long-term liabilities	24		—		37			—			61
Total liabilities	2,896		1		4,269			(32		)	7,134
Total stockholders’ equity	1,337		78		2,303			(2,381		)	1,337
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	118		(2		)	(430		)	—		$	(314	)
Investing activities:
Purchases of investments	(136		)	—			(1,308		)	—		(1,444		)
Proceeds from sales and maturities of investments	388			—			2,057			—		2,445
Purchases of property, equipment and capitalized software	(22		)	—			(8		)	—		(30		)
Net cash received from sales of subsidiaries	242			—			(52		)	—		190
Capital contributions to subsidiaries	(145		)	—			145			—		—
Dividends received from subsidiaries	298			—			(298		)	—		—
Change in amounts due to/from affiliates	6			4			(10		)	—		—
Other, net	—			—			(18		)	—		(18		)
Net cash provided by investing activities	631			4			508			—		1,143
Financing activities:
Repayment of credit facility	(300		)	—			—			—		(300		)
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—			—		(298		)
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—			—		(623		)
Cash received for partial settlement of 1.125% Call Option	623			—			—			—		623
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—			—		(549		)
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—			—		(64		)
Other, net	19			—			(1		)	—		18
Net cash used in financing activities	(1,192		)	—			(1		)	—		(1,193		)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	2			77			—		(364		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			—			2,777			—		3,290
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	2		$	2,854		$	—	$	2,926



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by operating activities	$	166		—			638			—		$	804
Investing activities:
Purchases of investments	(331		)	—			(2,366		)	—		(2,697		)
Proceeds from sales and maturities of investments	156			—			1,603			—		1,759
Purchases of property, equipment and capitalized software	(67		)	—			(19		)	—		(86		)
Capital contributions to subsidiaries	(370		)	2			368			—		—
Dividends received from subsidiaries	286			—			(286		)	—		—
Change in amounts due to/from affiliates	(49		)	(2		)	51			—		—
Other, net	—			—			(38		)	—		(38		)
Net cash used in investing activities	(375		)	—			(687		)	—		(1,062		)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs	325			—			—			—		325
Proceeds from borrowings under credit facility	300			—			—			—		300
Other, net	11			—			—			—		11
Net cash provided by financing activities	636			—			—			—		636
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	427			—			(49		)	—		378
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	86			—			2,826			—		2,912
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	513		$	—		$	2,777		$	—	$	3,290



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	55		(1		)	619			—		$	673
Investing activities:
Purchases of investments	(115		)	—			(1,814		)	—		(1,929		)
Proceeds from sales and maturities of investments	188			—			1,778			—		1,966
Purchases of property, equipment and capitalized software	(125		)	—			(51		)	—		(176		)
Net cash paid in business combinations	—			—			(48		)	—		(48		)
Capital contributions to subsidiaries	(386		)	7			379			—		—
Dividends received from subsidiaries	101			—			(101		)	—		—
Change in amounts due to/from affiliates	(18		)	(6		)	24			—		—
Other, net	6			—			(25		)	—		(19		)
Net cash (used in) provided by investing activities	(349		)	1			142			—		(206		)
Financing activities:
Other, net	20			—			(1		)	—		19
Net cash provided by (used in) financing activities	20			—			(1		)	—		19
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	(274		)	—			760			—		486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	360			—			2,066			—		2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	86		$	—		$	2,826		$	—	$	2,912

Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Consolidation and Presentation

Consolidation

Use of Estimates


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


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


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


•	Settlements under risk or savings sharing programs;


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


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


•	The determination of reserves for the outcome of litigation;


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


•	The determination of unrecognized tax benefits.

Cash and Cash Equivalents

Investments

Long-Lived Assets, Including Intangible Assets

Long-Lived Assets, including Intangible Assets

Business Combinations

Goodwill and Business Combinations

Premium Revenue - Health Plans

Premium Revenue

The following table summarizes premium revenue by geography for the periods indicated:



	Year Ended December 31,
	2018				2017				2016
	Amount		% of Total		Amount		% of Total		Amount		% of Total
	(Dollars in millions)
California	$	2,150	12.2	%	$	2,701	14.3	%	$	2,378	14.4	%
Florida	1,790		10.2		2,568		13.6		1,938		11.8
Illinois	793		4.5		593		3.1		603		3.7
Michigan	1,601		9.1		1,596		8.5		1,527		9.3
New Mexico	1,356		7.7		1,368		7.3		1,305		7.9
Ohio	2,388		13.6		2,216		11.8		1,967		12.0
Puerto Rico	696		3.9		732		3.9		726		4.4
South Carolina	495		2.8		445		2.4		378		2.3
Texas	3,244		18.4		2,813		14.9		2,461		15.0
Washington	2,361		13.4		2,608		13.8		2,222		13.5
Other ⁽¹⁾	738		4.2		1,214		6.4		940		5.7
	$	17,612	100.0	%	$	18,854	100.0	%	$	16,445	100.0	%

_______________________


(1)	“Other” includes the Idaho, Mississippi, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

Certain components of premium revenue are subject to accounting estimates and fall into the following categories:

Contractual Provisions That May Adjust or Limit Revenue or Profit

Medicaid Program

Medicare Program

Marketplace Program

Quality Incentives

At many of our health plans, revenue ranging from approximately 1% to 3% of certain health plan premiums is earned only if certain performance measures are met

Medical Care Costs - Health Plans

Medical Care Costs and Medical Claims and Benefits Payable

The following table provides the details of our consolidated medical care costs for the periods indicated:



	Year Ended December 31,
	2018						2017						2016
	Amount		PMPM		% of Total		Amount		PMPM		% of Total		Amount		PMPM		% of Total
	(In millions, except PMPM amounts)
Fee-for-service	$	11,278	$	232.15	74.5	%	$	12,682	$	229.63	74.3	%	$	10,993	$	217.84	74.4	%
Pharmacy	2,138		44.01		14.1		2,563		46.40		15.0		2,213		43.84		15.0
Capitation	1,184		24.38		7.8		1,360		24.63		8.0		1,218		24.13		8.2
Other	537		11.05		3.6		468		8.48		2.7		350		6.94		2.4
Total	$	15,137	$	311.59	100.0	%	$	17,073	$	309.14	100.0	%	$	14,774	$	292.75	100.0	%


•	claims receipt and payment experience (and variations in that experience),


•	changes in membership,


•	provider billing practices,


•	health care service utilization trends,


•	cost trends,


•	product mix,


•	seasonality,


•	prior authorization of medical services,


•	benefit changes,


•	known outbreaks of disease or increased incidence of illness such as influenza,


•	provider contract changes,


•	changes to Medicaid fee schedules, and


•	the incidence of high dollar or catastrophic claims.

Taxes Based on Premiums

Concentrations of Credit Risk

Risks and Uncertainties

Recent Accounting Pronouncements Not Yet Adopted and Recent Accounting Pronouncements Adopted

Recent Accounting Pronouncements Adopted

Revenue Recognition (Topic 606). See discussion above, in “Revenue Recognition.”

Recent Accounting Pronouncements Not Yet Adopted

Leases. In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842), as modified by:


•	ASU 2017-03, Transition and Open Effective Date Information;


•	ASU 2018-01, Leases (Topic 842): Land Easement Practical Expedient for Transition to Topic 842;


•	ASU 2018-10, Codification Improvements to Topic 842, Leases; and


•	ASU 2018-11, Leases (Topic 842): Targeted Improvements.

Receivables

Income Taxes

(benefit) is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of state taxes, nondeductible expenses such as the HIF, goodwill impairment, certain compensation, and other general and administrative expenses. The effective tax rate was not impacted by the HIF in 2017, given the 2017 HIF moratorium. The effective tax rate may be subject to fluctuations during the year, particularly as a result of the level of pretax earnings, and also as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including factors such as the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Restricted cash and cash equivalents

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



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Cash and cash equivalents	$	2,826	$	3,186	$	2,819
Restricted cash and cash equivalents, non-current	100		95		93
Restricted cash and cash equivalents, current	—		9		—
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	2,926	$	3,290	$	2,912

Summarized premium revenue

The following table summarizes premium revenue by geography for the periods indicated:



	Year Ended December 31,
	2018				2017				2016
	Amount		% of Total		Amount		% of Total		Amount		% of Total
	(Dollars in millions)
California	$	2,150	12.2	%	$	2,701	14.3	%	$	2,378	14.4	%
Florida	1,790		10.2		2,568		13.6		1,938		11.8
Illinois	793		4.5		593		3.1		603		3.7
Michigan	1,601		9.1		1,596		8.5		1,527		9.3
New Mexico	1,356		7.7		1,368		7.3		1,305		7.9
Ohio	2,388		13.6		2,216		11.8		1,967		12.0
Puerto Rico	696		3.9		732		3.9		726		4.4
South Carolina	495		2.8		445		2.4		378		2.3
Texas	3,244		18.4		2,813		14.9		2,461		15.0
Washington	2,361		13.4		2,608		13.8		2,222		13.5
Other ⁽¹⁾	738		4.2		1,214		6.4		940		5.7
	$	17,612	100.0	%	$	18,854	100.0	%	$	16,445	100.0	%

_______________________


(1)	“Other” includes the Idaho, Mississippi, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

Quality incentive premium revenue recognized



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Maximum available quality incentive premium - current period	$	182		$	150		$	147

Amount of quality incentive premium revenue recognized in current period:
Earned current period	$	133		$	97		$	104
Earned prior periods	31			10			47
Total	$	164		$	107		$	151

Quality incentive premium revenue recognized as a percentage of total premium revenue	0.9		%	0.6		%	0.9		%

Amounts due to government agencies

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



	December 31,
	2018		2017
	(In millions)
Medicaid program:
Medical cost floors and corridors	$	103	$	135
Other amounts due to states	81		71
Marketplace program:
Risk adjustment	466		917
Cost sharing reduction	183		275
Other	134		144
	$	967	$	1,542

Consolidated medical care costs

The following table provides the details of our consolidated medical care costs for the periods indicated:



	Year Ended December 31,
	2018						2017						2016
	Amount		PMPM		% of Total		Amount		PMPM		% of Total		Amount		PMPM		% of Total
	(In millions, except PMPM amounts)
Fee-for-service	$	11,278	$	232.15	74.5	%	$	12,682	$	229.63	74.3	%	$	10,993	$	217.84	74.4	%
Pharmacy	2,138		44.01		14.1		2,563		46.40		15.0		2,213		43.84		15.0
Capitation	1,184		24.38		7.8		1,360		24.63		8.0		1,218		24.13		8.2
Other	537		11.05		3.6		468		8.48		2.7		350		6.94		2.4
Total	$	15,137	$	311.59	100.0	%	$	17,073	$	309.14	100.0	%	$	14,774	$	292.75	100.0	%

Net Income (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Summary 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 (loss) per share:



	Year Ended December 31,
	2018		2017			2016
	(In millions, except net income (loss) per share)
Numerator:
Net income (loss)	$	707	$	(512	)	$	52
Denominator:
Shares outstanding at the beginning of the period	59.3		55.8			55.1
Weighted-average number of shares issued:
Exchange of 1.625% Convertible Notes ⁽¹⁾	1.4		0.1			—
Conversion of 1.625% Convertible Notes ⁽¹⁾	0.2		—			—
Stock-based compensation	0.2		0.5			0.3
Denominator for basic net income (loss) per share	61.1		56.4			55.4
Effect of dilutive securities:
1.125% Warrants ⁽¹⁾	4.8		—			0.5
1.625% Convertible Notes⁽¹⁾	0.4		—			—
Stock-based compensation	0.3		—			0.3
Denominator for diluted net income (loss) per share	66.6		56.4			56.2

Net income (loss) per share: ⁽²⁾
Basic	$	11.57	$	(9.07	)	$	0.93
Diluted	$	10.61	$	(9.07	)	$	0.92

Potentially dilutive common shares excluded from calculations: ⁽¹⁾
1.125% Warrants ⁽¹⁾	—		1.9			—
1.625% Convertible Notes⁽¹⁾	—		0.4			—
Stock-based compensation	—		0.3			—

_______________________________

(1)


(2)	Source data for calculations in thousands.

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

Fair value of assets measured on recurring basis

Our financial instruments measured at fair value on a recurring basis at December 31, 2018, were as follows:



	Total		Level 1		Level 2		Level 3
	(In millions)
Corporate debt securities	$	1,123	$	—	$	1,123	$	—
U.S. Treasury notes	181		—		181		—
Government-sponsored enterprise securities (GSEs)	163		—		163		—
Municipal securities	114		—		114		—
Asset-backed securities	82		—		82		—
Certificates of deposit	14		—		14		—
Other	4		—		4		—
Subtotal - current investments	1,681		—		1,681		—
1.125% Call Option derivative asset	476		—		—		476
Total assets	$	2,157	$	—	$	1,681	$	476

1.125% Conversion Option derivative liability	$	476	$	—	$	—	$	476
Total liabilities	$	476	$	—	$	—	$	476

Our financial instruments measured at fair value on a recurring basis at December 31, 2017, were as follows:



	Total		Level 1		Level 2		Level 3
	(In millions)
Corporate debt securities	$	1,588	$	—	$	1,588	$	—
U.S. Treasury notes	388		—		388		—
GSEs	253		—		253		—
Municipal securities	141		—		141		—
Asset-backed securities	117		—		117		—
Certificates of deposit	37		—		37		—
Subtotal - current investments	2,524		—		2,524		—
Corporate debt securities	101		—		101		—
U.S. Treasury notes	68		—		68		—
Subtotal - current restricted investments	169		—		169		—
1.125% Call Option derivative asset	522		—		—		522
Total assets	$	3,215	$	—	$	2,693	$	522

1.125% Conversion Option derivative liability	$	522	$	—	$	—	$	522
Total liabilities	$	522	$	—	$	—	$	522

Fair value measurements of senior notes



	December 31, 2018				December 31, 2017
	Carrying		Fair Value		Carrying		Fair Value
	Amount		Fair Value		Amount		Fair Value
	(In millions)
5.375% Notes	$	694	$	674	$	692	$	730
4.875% Notes	326		301		325		329
1.125% Convertible Notes ^(1),(2)	240		732		496		1,052
Credit Facility ⁽²⁾	—		—		300		300
1.625% Convertible Notes ⁽²⁾	—		—		157		220
	$	1,260	$	1,707	$	1,970	$	2,631

_______________________________


(1)	The fair value of the 1.125% Conversion Option derivative liability (the embedded cash conversion option), which is included in the fair value amounts presented above, amounted to $476 million and $522 million as of December 31, 2018 and 2017, respectively. See further discussion at Note 11, “Debt,” and Note 12, “Derivatives.”


(2)	For more information on debt repayments in the year ended December 31, 2018, refer to Note 11, “Debt.”

- Definition

Tabular disclosure of financial instruments measured at fair value, including those classified in shareholders' equity measured on a recurring or nonrecurring basis. Disclosures include, but are not limited to, fair value measurements recorded and the reasons for the measurements, level within the fair value hierarchy in which the fair value measurements are categorized and transfers between levels 1 and 2. Nonrecurring fair value measurements are those that are required or permitted in the statement of financial position in particular circumstances.

+ References + Details

Investments (Tables)

12 Months Ended

Dec. 31, 2018

Investments, Debt and Equity Securities [Abstract]

Investments

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



	December 31, 2018
	Amortized		Gross Unrealized				Estimated
	Cost		Gains		Losses		Fair Value
	(In millions)
Corporate debt securities	$	1,131	$	—	$	8	$	1,123
U.S. Treasury notes	181		—		—		181
GSEs	164		—		1		163
Municipal securities	115		—		1		114
Asset-backed securities	83		—		1		82
Certificates of deposit	14		—		—		14
Other	4		—		—		4
Total current investments	$	1,692	$	—	$	11	$	1,681



	December 31, 2017
	Amortized Cost		Gross Unrealized				Estimated Fair Value
	Amortized Cost		Gains		Losses		Estimated Fair Value
	(In millions)
Corporate debt securities	$	1,591	$	1	$	4	$	1,588
U.S. Treasury notes	389		—		1		388
GSEs	255		—		2		253
Municipal securities	142		—		1		141
Asset-backed securities	117		—		—		117
Certificates of deposit	37		—		—		37
Subtotal - current investments	2,531		1		8		2,524
Corporate debt securities	101		—		—		101
U.S. Treasury notes	68		—		—		68
Subtotal - current restricted investments	169		—		—		169
	$	2,700	$	1	$	8	$	2,693

Contractual maturities of investments

The contractual maturities of our current investments as of December 31, 2018 are summarized below:



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	1,000	$	997
Due after one year through five years	692		684
	$	1,692	$	1,681

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	$	509	$	3	285	$	412	$	5	298
GSEs	—		—		—	127		1		76
Municipal securities	—		—		—	87		1		90
Asset backed securities	—		—		—	68		1		52
	$	509	$	3	285	$	694	$	8	516



	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	$	1,297	$	3	561	$	94	$	1	69
U.S. Treasury notes	470		1		89	—		—		—
GSEs	173		1		69	95		1		47
Municipal securities	—		—		—	38		1		48
	$	1,940	$	5	719	$	227	$	3	164

Receivables (Tables)

12 Months Ended

Dec. 31, 2018

Receivables [Abstract]

Summary of accounts receivable



	December 31,
	2018		2017
	(In millions)
Premiums and other receivables	855		695
Pharmacy administrative services receivables	179		—
Pharmacy rebate receivables	155		154
Health insurer fee reimbursement receivables	141		22
	$	1,330	$	871

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

12 Months Ended

Dec. 31, 2018

Property, Plant and Equipment [Abstract]

Summary of property and equipment

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



	December 31,
	2018			2017
	(In millions)
Capitalized software	$	373		$	417
Furniture and equipment	231			289
Building and improvements	154			161
Land	16			16
Total cost	774			883
Less: accumulated amortization - capitalized software	(320		)	(308		)
Less: accumulated depreciation and amortization - building and improvements, furniture and equipment	(213		)	(233		)
Total accumulated depreciation and amortization	(533		)	(541		)
Property, equipment, and capitalized software, net	$	241		$	342

Depreciation and amortization



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Recorded in depreciation and amortization:
Amortization of capitalized software	$	42	$	64	$	62
Depreciation of property and equipment	36		42		45
Amortization of intangible assets	21		31		32
Subtotal	99		137		139
Recorded in cost of service revenue:
Amortization of capitalized software	19		28		22
Amortization of deferred contract costs	9		13		21
Subtotal	28		41		43
Total depreciation and amortization recognized	$	127	$	178	$	182

Goodwill and Intangible Assets, Net (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill



	Health Plans			Other			Total
	(In millions)
Historical goodwill, gross	$	445		$	233		$	678
Accumulated impairment losses at December 31, 2017	(302		)	(190		)	(492		)
Balance, December 31, 2017	143			43			186
Sale of subsidiary	—			(43		)	(43		)
Balance, December 31, 2018	$	143		$	—		$	143

Accumulated impairment losses at December 31, 2018	$	302		$	190		$	492

Summary of identified intangible assets, by major class

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



	Cost		Accumulated Amortization		Carrying Amount
	(In millions)
Intangible assets:
Contract rights and licenses	$	201	$	162	$	39
Provider networks	20		12		8
Balance at December 31, 2018	$	221	$	174	$	47
Intangible assets:
Contract rights and licenses	$	201	$	141	$	60
Provider networks	20		11		9
Balance at December 31, 2017	$	221	$	152	$	69

Restricted Investments (Tables)

12 Months Ended

Dec. 31, 2018

Investments, Debt and Equity Securities [Abstract]

Summary of restricted investments by health plan

The following table presents the balances of restricted investments:



	December 31,
	2018		2017
	(In millions)
Florida	$	32	$	31
New Mexico	43		43
Ohio	12		12
Puerto Rico	10		10
Other	23		23
Total Health Plans segment	$	120	$	119

Contractual maturities of our held-to-maturity restricted investments

The contractual maturities of our held-to-maturity restricted investments, which are carried at amortized cost, which approximates fair value, as of December 31, 2018 are summarized below.



	Amortized Cost		Estimated Fair Value
	(In millions)
Due in one year or less	$	105	$	105
Due after one year through five years	15		15
	$	120	$	120

Medical Claims and Benefits Payable (Tables)

12 Months Ended

Dec. 31, 2018

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,
	2018		2017		2016
	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	1,562	$	1,717	$	1,352
Pharmacy payable	115		112		112
Capitation payable	52		67		37
Other	232		296		428
	$	1,961	$	2,192	$	1,929

Components of the change in medical claims and benefits payable



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Medical claims and benefits payable, beginning balance	$	2,192		$	1,929		$	1,685
Components of medical care costs related to:
Current period	15,478			17,037			14,966
Prior periods ⁽¹⁾	(341		)	36			(192		)
Total medical care costs	15,137			17,073			14,774

Change in non-risk provider payables	13			(106		)	58

Payments for medical care costs related to:
Current period	13,671			15,130			13,304
Prior periods	1,710			1,574			1,284
Total paid	15,381			16,704			14,588
Medical claims and benefits payable, ending balance	$	1,961		$	2,192		$	1,929

Incurred and paid claims development



Incurred Claims and Allocated Claims Adjustment Expenses							Total IBNP		Cumulative number of reported claims
Benefit Year	2016		2017		2018		Total IBNP		Cumulative number of reported claims

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	15,064	$	15,093	$	15,057	$	18	105
2017			17,037		16,728		57		119
2018					15,478		1,477		105
					$	47,263	$	1,552



Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year	2016		2017		2018

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	13,403	$	14,952	$	15,039
2017			15,130		16,752
2018					13,671
					$	45,462

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.



	2018
	(In millions)
Incurred claims and allocated claims adjustment expenses	$	47,263
Less: cumulative paid clams and allocated claims adjustment expenses	(45,462		)
All outstanding liabilities before 2016	10
Non-risk provider payables and other	150
Medical claims and benefits payable	$	1,961

Debt (Tables)

12 Months Ended

Dec. 31, 2018

Debt Disclosure [Abstract]

Maturities of long-term debt

As of December 31, 2018, contractual maturities of debt for the years ending December 31 were as follows. All amounts represent the principal amounts of the debt instruments outstanding.



	Total		2019		2020		2021		2022		2023		Thereafter

	(In millions)
5.375% Notes	$	700	$	—	$	—	$	—	$	700	$	—	$	—
4.875% Notes	330		—		—		—		—		—		330
1.125% Convertible Notes	252		—		252		—		—		—		—
	$	1,282	$	—	$	252	$	—	$	700	$	—	$	330

Long term debt

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



	December 31,
	2018			2017
	(In millions)
Current portion of long-term debt:
1.125% Convertible Notes, net of unamortized discount	$	241		$	499
1.625% Convertible Notes, net of unamortized discount	—			157
Lease financing obligations	1			1
Debt issuance costs	(1		)	(4		)
	241			653
Non-current portion of long-term debt:
5.375% Notes	700			700
4.875% Notes	330			330
Credit Facility	—			300
Debt issuance costs	(10		)	(12		)
	1,020			1,318
Lease financing obligations	197			198
	$	1,458		$	2,169

Debt instruments interest cost recognized

Interest cost recognized relating to our convertible senior notes, the 1.125% Convertible Notes and the 1.625% Convertible Notes, was as follows:



	Years Ended December 31,
	2018		2017		2016
	(In millions)
Contractual interest at coupon rate	$	6	$	11	$	11
Amortization of the discount	21		32		30
	$	27	$	43	$	41

- Definition

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

+ References

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

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

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

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

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 835
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
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-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

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

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

+ Details

Derivatives (Tables)

12 Months Ended

Dec. 31, 2018

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Fair Values of Derivative Financial Instruments

The following table summarizes the fair values and the presentation of our derivative financial instruments (defined and discussed individually below) in the consolidated balance sheets:



		December 31,
	Balance Sheet Location	2018		2017
		(In millions)
Derivative asset:
1.125% Call Option	Current assets: Derivative asset	$	476	$	522

Derivative liability:
1.125% Conversion Option	Current liabilities: Derivative liability	$	476	$	522

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Provision for income taxes

ncome tax expense (benefit) consisted of the following:



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Current:
Federal	$	272		$	(9	)	$	134
State	18			3			3
Foreign	8			—			(6		)
Total current	298			(6		)	131
Deferred:
Federal	(3		)	(85		)	19
State	(3		)	(9		)	2
Foreign	—			—			1
Total deferred	(6		)	(94		)	22
Income tax expense (benefit)	$	292		$	(100	)	$	153

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 is as follows:



	Year Ended December 31,
	2018		2017		2016
Statutory federal tax (benefit) rate	21.0	%	(35.0	)%	35.0	%
State income provision (benefit), net of federal	1.2		(0.7	)	1.6
Nondeductible health insurer fee (“HIF”)	7.3		—		37.0
Nondeductible compensation	0.7		2.8		3.1
Nondeductible goodwill impairment	—		6.6		—
Worthless stock deduction	(1.0	)	—		—
Revaluation of net deferred tax assets	(0.4	)	8.8		—
Change in purchase agreement that increased tax basis in assets	—		—		(2.2	)
Other	0.4		1.1		0.3
Effective tax (benefit) rate	29.2	%	(16.4	)%	74.8	%

Significant components of deferred tax assets and liabilities

Significant components of our deferred tax assets and liabilities as of December 31, 2018 and 2017 were as follows:



	December 31,
	2018			2017
	(In millions)
Accrued expenses	$	32		$	15
Reserve liabilities	7			11
Other accrued medical costs	12			16
Net operating losses	16			27
Fixed assets and intangibles	30			23
Unearned premiums	9			19
Lease financing obligation	30			30
Tax credit carryover	12			15
Other	3			3
Valuation allowance	(28		)	(41		)
Total deferred income tax assets, net of valuation allowance	123			118
Prepaid expenses	(6		)	(6		)
Basis in debt	—			(9		)
Total deferred income tax liabilities	(6		)	(15		)
Net deferred income tax asset	$	117		$	103

Unrecognized tax benefits roll forward

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



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Gross unrecognized tax benefits at beginning of period	$	(13	)	$	(11	)	$	(9	)
Increases in tax positions for current year	(9		)	(1		)	(1		)
Increases in tax positions for prior years	—			(4		)	(1		)
Decreases in tax positions for prior years	—			3			—
Lapse in statute of limitations	2			—			—
Gross unrecognized tax benefits at end of period	$	(20	)	$	(13	)	$	(11	)

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Stock based compensation expense

Total share-based compensation expense was as follows:



	Year Ended December 31,
	2018				2017				2016
	(In millions)
	Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount		Pretax Charges		Net-of-Tax Amount
RSAs, PSAs and PSUs	$	17	$	17	$	39	$	35	$	20	$	17
Employee stock purchase plan and stock options	10		9		7		5		6		5
	$	27	$	26	$	46	$	40	$	26	$	22

Restricted and performance stock activity

ctivity for such awards in the year ended December 31, 2018 is summarized below:



	RSAs		PSAs		PSUs		Total Shares		Weighted Average Grant Date Fair Value
Unvested balance as of December 31, 2017	401,804		84,762		91,828		578,394		$	58.35
Granted	363,740		—		214,952		578,692		75.38
Vested	(192,609	)	(32,929	)	—		(225,538	)	59.08
Forfeited	(173,140	)	(48,701	)	(105,397	)	(327,238	)	63.69
Unvested balance as of December 31, 2018	399,795		3,132		201,383		604,310		$	71.50

Stock Options, Activity

The total grant date fair value of awards granted and vested is presented in the following table:



	Year Ended December 31,
	2018		2017		2016
	(In millions)
Granted:
RSAs	$	28	$	20	$	19
PSAs	—		—		15
PSUs	16		16		—
	$	44	$	36	$	34
Vested:
RSAs	$	15	$	23	$	22
PSAs	3		15		—
PSUs	—		9		—
	$	18	$	47	$	22



	Shares	Weighted Average Exercise Price		Aggregate Intrinsic Value		Weighted Average Remaining Contractual term
				(In millions)		(Years)
Stock options outstanding as of December 31, 2017	405,000	$	64.79
Granted	—	—
Exercised	—	—
Stock options outstanding as of December 31, 2018	405,000	64.79		$	21	8.5
Stock options exercisable and expected to vest as of December 31, 2018	405,000	64.79		$	21	8.5
Exercisable as of December 31, 2018	155,000	60.69		$	9	8.0

Stock Option Plans, by Exercise Price Range

The following is a summary of information about stock options outstanding and exercisable at December 31, 2018:



	Options Outstanding				Options Exercisable
	Number Outstanding	Weighted Average Remaining Contractual Life (Years)	Weighted-Average Exercise Price		Number Exercisable	Weighted-Average Exercise Price
Range of Exercise Prices
$33.02	30,000	4.2	$	33.02	30,000	$	33.02
$67.33	375,000	8.9	67.33		125,000	67.33
	405,000				155,000

Restructuring and Separation Costs (Tables)

12 Months Ended

Dec. 31, 2018

Restructuring and Related Activities [Abstract]

Restructuring Costs



	Year Ended December 31, 2018
	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs							Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Current and Long-lived Assets			Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	—	$	(1	)	$	—	$	12	$	11
Other	—		5		20			1		—		26
	$	—	$	5	$	19		$	1	$	12	$	37



	Year Ended December 31, 2017
	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs						Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Long-lived Assets		Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	33	$	16	$	—	$	24	$	73
Other	36		34		45		44		2		161
	$	36	$	67	$	61	$	44	$	26	$	234

As of December 31, 2018, we had incurred cumulative restructuring costs under the 2017 Restructuring Plan as follows:



	Separation Costs - Former Executives		One-Time Termination Benefits		Other Restructuring Costs						Total
	Separation Costs - Former Executives		One-Time Termination Benefits		Write-offs of Current and Long-lived Assets		Consulting Fees		Contract Termination Costs		Total
	(In millions)
Health Plans	$	—	$	33	$	15	$	—	$	36	$	84
Other	36		39		65		45		2		187
	$	36	$	72	$	80	$	45	$	38	$	271

We have incurred expenses under the IT Restructuring Plan as follows:



	Year Ended December 31, 2018
	One-Time Termination Benefits		Other Restructuring Costs		Total
	One-Time Termination Benefits		Consulting Fees		Total
	(In millions)
Other	$	7	$	2	$	9

Reconciliation of Liability



	One-Time Termination Benefits			Other Restructuring Costs			Total
	(In millions)
Accrued as of December 31, 2017	$	—		$	—		$	—
Charges	7			2			9
Cash payments	(2		)	(1		)	(3		)
Accrued as of December 31, 2018	$	5		$	1		$	6

Restructuring Reserve



	Separation Costs - Former Executives			One-Time Termination Benefits			Other Restructuring Costs			Total
	(In millions)
Accrued as of December 31, 2017	$	2		$	11		$	35		$	48
Adjustments	—			(1		)	11			10
Charges	—			6			2			8
Cash payments	(2		)	(15		)	(31		)	(48		)
Accrued as of December 31, 2018	$	—		$	1		$	17		$	18

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2018

Commitments and Contingencies Disclosure [Abstract]

Summary of future minimum lease payments

Future minimum lease payments by year and in the aggregate under operating leases and lease financing obligations consist of the following amounts:



	Lease Financing Obligations		Operating Leases		Total
	(In millions)
2019	$	19	$	46	$	65
2020	19		34		53
2021	20		24		44
2022	21		16		37
2023	21		12		33
Thereafter	311		15		326
	$	411	$	147	$	558

Segment Information (Tables)

12 Months Ended

Dec. 31, 2018

Segment Reporting [Abstract]

Operating segment information



	Health Plans		Other		Consolidated
	(In millions)
2018
Total revenue	$	18,471	$	419	18,890
Margin	2,475		43		2,518
Goodwill, and intangible assets, net	190		—		190
Total assets	6,165		989		7,154
2017
Total revenue	$	19,352	$	531	$	19,883
Margin	1,781		29		1,810
Goodwill, and intangible assets, net	212		43		255
Total assets	6,347		2,124		8,471
2016
Total revenue	$	17,234	$	548	$	17,782
Margin	1,671		54		1,725
Goodwill, and intangible assets, net	513		247		760
Total assets	5,897		1,552		7,449

The following table reconciles margin by segment to consolidated income (loss) before income tax expense (benefit):



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Margin:
Health Plans	$	2,475		$	1,781		$	1,671
Other	43			29			54
Total margin	2,518			1,810			1,725
Add: other operating revenues ⁽¹⁾	871			508			798
Less: other operating expenses ⁽²⁾	(2,243		)	(2,873		)	(2,217		)
Less: loss on sales of subsidiaries, net of gain	(15		)	—			—
Operating income (loss)	1,131			(555		)	306
Less: other expenses, net	132			57			101
Income (loss) before income tax expense (benefit)	$	999		$	(612	)	$	205

______________________


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


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

Quarterly Results of Operations (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Summary of quarterly results of operations

The following table summarizes quarterly unaudited results of operations for the years ended December 31, 2018 and 2017.



	For The Quarter Ended
	March 31, 2018		June 30, 2018		Sept. 30, 2018		December 31, 2018
	(In millions, except per-share data)
Total revenue	$	4,646	$	4,883	$	4,697	$	4,664
Margin	615		673		566		664
Gain (loss) on sales of subsidiaries	—		—		37		(52		)
Restructuring and separation costs	25		8		5		8
Net income	107		202		197		201

Net income per share ⁽¹⁾:
Basic	$	1.79	$	3.29	$	3.22	$	3.24
Diluted	$	1.64	$	3.02	$	2.90	$	3.01



	For The Quarter Ended
	March 31, 2017		June 30, 2017			Sept. 30, 2017			December 31, 2017
	(In millions, except per-share data)
Total revenue	$	4,904	$	4,999		$	5,031		$	4,949
Margin	546		254			564			446
Impairment losses	—		72			129			269
Restructuring and separation costs	—		43			118			73
Net income (loss)	77		(230		)	(97		)	(262		)

Net income (loss) per share ⁽¹⁾:
Basic	$	1.38	$	(4.10	)	$	(1.70	)	$	(4.59	)
Diluted	$	1.37	$	(4.10	)	$	(1.70	)	$	(4.59	)

_______________________________

(1)

Condensed Financial Information of Registrant (Tables)

12 Months Ended

Dec. 31, 2018

Condensed Financial Information Disclosure [Abstract]

Condensed Balance Sheets



	December 31,
	2018			2017
	(In millions, except share data)
ASSETS
Current assets:
Cash and cash equivalents	$	70		$	504
Investments	100			192
Restricted investments	—			169
Receivables	2			2
Due from affiliates	90			148
Prepaid expenses and other current assets	47			103
Derivative asset	476			522
Total current assets	785			1,640
Property, equipment, and capitalized software, net	176			223
Goodwill and intangible assets, net	13			15
Investments in subsidiaries	2,768			2,306
Deferred income taxes	39			17
Advances to related parties and other assets	40			32
	$	3,821		$	4,233
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4		$	3
Accounts payable and accrued liabilities	223			178
Current portion of long-term debt	241			653
Derivative liability	476			522
Total current liabilities	944			1,356
Long-term debt	1,020			1,318
Lease financing obligations	197			198
Other long-term liabilities	13			24
Total liabilities	2,174			2,896
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding:
62 million shares at December 31, 2018 and 60 million shares at December 31, 2017	—			—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	—			—
Additional paid-in capital	643			1,044
Accumulated other comprehensive loss	(8		)	(5		)
Retained earnings	1,012			298
Total stockholders’ equity	1,647			1,337
	$	3,821		$	4,233

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2018
	Parent Issuer		Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	70	$	2		$	2,754		$	—		$	2,826
Investments	100		—			1,581			—			1,681
Receivables	2		—			1,328			—			1,330
Due from (to) affiliates	90		7			(97		)	—			—
Prepaid expenses and other current assets	47		29			73			—			149
Derivative asset	476		—			—			—			476
Total current assets	785		38			5,639			—			6,462
Property, equipment, and capitalized software, net	176		—			65			—			241
Goodwill and intangible assets, net	13		—			177			—			190
Restricted investments	—		—			120			—			120
Investment in subsidiaries, net	2,768		(5		)	—			(2,763		)	—
Deferred income taxes	39		—			78			—			117
Other assets	40		—			5			(21		)	24
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4	$	—		$	1,957		$	—		$	1,961
Amounts due government agencies	—		—			967			—			967
Accounts payable and accrued liabilities	223		—			167			—			390
Deferred revenue	—		—			211			—			211
Current portion of long-term debt	241		—			—			—			241
Derivative liability	476		—			—			—			476
Total current liabilities	944		—			3,302			—			4,246
Long-term debt and lease financing obligations	1,217		—			20			(20		)	1,217
Other long-term liabilities	13		—			32			(1		)	44
Total liabilities	2,174		—			3,354			(21		)	5,507
Total stockholders’ equity	1,647		33			2,730			(2,763		)	1,647
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2017
	Parent Issuer		Other Guarantor		Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	504	$	—	$	2,682		$	—		$	3,186
Investments	192		—		2,332			—			2,524
Restricted investments	169		—		—			—			169
Receivables	2		—		869			—			871
Due from (to) affiliates	148		2		(150		)	—			—
Prepaid expenses and other current assets	103		2		150			(16		)	239
Derivative asset	522		—		—			—			522
Total current assets	1,640		4		5,883			(16		)	7,511
Property, equipment, and capitalized software, net	223		—		119			—			342
Goodwill and intangible assets, net	15		—		240			—			255
Restricted investments	—		—		119			—			119
Investment in subsidiaries, net	2,306		75		—			(2,381		)	—
Deferred income taxes	17		—		101			(15		)	103
Other assets	32		—		110			(1		)	141
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	3	$	—	$	2,189		$	—		$	2,192
Amounts due government agencies	—		—		1,542			—			1,542
Accounts payable and accrued liabilities	178		1		188			(1		)	366
Deferred revenue	—		—		282			—			282
Current portion of long-term debt	653		—		16			(16		)	653
Derivative liability	522		—		—			—			522
Total current liabilities	1,356		1		4,217			(17		)	5,557
Long-term debt and lease financing obligations	1,516		—		—			—			1,516
Deferred income taxes	—		—		15			(15		)	—
Other long-term liabilities	24		—		37			—			61
Total liabilities	2,896		1		4,269			(32		)	7,134
Total stockholders’ equity	1,337		78		2,303			(2,381		)	1,337
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471

Condensed Statements of Income

Condensed Statements of Operations



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Revenue:
Management fees	$	1,138		$	1,317		$	1,062
Investment income and other revenue	17			16			16
Total revenue	1,155			1,333			1,078
Expenses:
Medical care costs	8			16			73
General and administrative expenses	1,007			1,082			899
Depreciation and amortization	69			93			95
Restructuring and separation costs	35			153			—
Impairment losses	—			39			—
Total operating expenses	1,119			1,383			1,067
Gain on sale of subsidiary	37			—			—
Operating income (loss)	73			(50		)	11
Interest expense	114			117			101
Other expense (income)	17			(61		)	—
Loss before income tax (benefit) expense and equity in net earnings (losses) of subsidiaries	(58		)	(106		)	(90		)
Income tax (benefit) expense	(14		)	8			(24		)
Net loss before equity in net earnings (losses) of subsidiaries	(44		)	(114		)	(66		)
Equity in net earnings (losses) of subsidiaries	751			(398		)	118
Net income (loss)	$	707		$	(512	)	$	52

CONDENSED CONSOLIDATING STATEMENTS OF OPERATIONS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,155		$	3		$	18,884	$	(1,152	)	$	18,890
Expenses:
Medical care costs	8			—			15,129		—			15,137
Cost of service revenue	—			—			364		—			364
General and administrative expenses	1,007			4			1,474		(1,152		)	1,333
Premium tax expenses	—			—			417		—			417
Health insurer fees	—			—			348		—			348
Depreciation and amortization	69			—			30		—			99
Restructuring and separation costs	35			—			11		—			46
Total operating expenses	1,119			4			17,773		(1,152		)	17,744
Gain (loss) on sales of subsidiaries	37			(52		)	—		—			(15		)
Operating income (loss)	73			(53		)	1,111		—			1,131
Interest expense	114			—			1		—			115
Other expense	17			—			—		—			17
(Loss) income before income tax (benefit) expense	(58		)	(53		)	1,110		—			999
Income tax (benefit) expense	(14		)	(11		)	317		—			292
Net (loss) income before equity in net earnings (losses) of subsidiaries	(44		)	(42		)	793		—			707
Equity in net earnings (losses) of subsidiaries	751			(5		)	—		(746		)	—
Net income (loss)	$	707		$	(47	)	$	793	$	(746	)	$	707



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,333		$	2		$	19,904		$	(1,356	)	$	19,883
Expenses:
Medical care costs	16			—			17,058			(1		)	17,073
Cost of service revenue	—			—			492			—			492
General and administrative expenses	1,082			2			1,865			(1,355		)	1,594
Premium tax expenses	—			—			438			—			438
Depreciation and amortization	93			—			44			—			137
Restructuring and separation costs	153			—			81			—			234
Impairment losses	39			—			431			—			470
Total operating expenses	1,383			2			20,409			(1,356		)	20,438
Operating loss	(50		)	—			(505		)	—			(555		)
Total other expenses, net	56			—			1			—			57
Loss before income taxes	(106		)	—			(506		)	—			(612		)
Income tax expense (benefit)	8			—			(108		)	—			(100		)
Net loss before equity in net (losses) earnings of subsidiaries	(114		)	—			(398		)	—			(512		)
Equity in net (losses) earnings of subsidiaries	(398		)	(164		)	8			554			—
Net loss	$	(512	)	$	(164	)	$	(390	)	$	554		$	(512	)



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,078		$	—		$	17,786	$	(1,082	)	$	17,782
Expenses:
Medical care costs	73			—			14,702		(1		)	14,774
Cost of service revenue	—			—			485		—			485
General and administrative expenses	899			2			1,573		(1,081		)	1,393
Premium tax expenses	—			—			468		—			468
Health insurer fees	—			—			217		—			217
Depreciation and amortization	95			—			44		—			139
Total operating expenses	1,067			2			17,489		(1,082		)	17,476
Operating income (loss)	11			(2		)	297		—			306
Total other expenses, net	101			—			—		—			101
(Loss) income before income taxes	(90		)	(2		)	297		—			205
Income tax (benefit) expense	(24		)	(1		)	178		—			153
Net (loss) income before equity in earnings of subsidiaries	(66		)	(1		)	119		—			52
Equity in net earnings of subsidiaries	118			2			—		(120		)	—
Net income	$	52		$	1		$	119	$	(120	)	$	52

Condensed Statements of Comprehensive (Loss) Income

Condensed Statements of Comprehensive Income (Loss)



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Net income (loss)	$	707		$	(512	)	$	52
Other comprehensive (loss) income:
Unrealized investment (loss) gain	(3		)	(5		)	3
Less: effect of income taxes	(1		)	(2		)	1
Other comprehensive (loss) income, net of tax	(2		)	(3		)	2
Comprehensive income (loss)	$	705		$	(515	)	$	54

Condensed Statements of Cash Flows



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Operating activities:
Net cash provided by operating activities	$	118		$	166		$	55
Investing activities:
Capital contributions to subsidiaries	(145		)	(370		)	(386		)
Dividends received from subsidiaries	298			286			101
Purchases of investments	(136		)	(331		)	(115		)
Proceeds from sales and maturities of investments	388			156			188
Purchases of property, equipment and capitalized software	(22		)	(67		)	(125		)
Net cash received from sale of subsidiaries	242			—			—
Change in amounts due to/from affiliates	6			(49		)	(18		)
Other, net	—			—			6
Net cash provided by (used in) investing activities	631			(375		)	(349		)
Financing activities:
Repayment of credit facility	(300		)	—			—
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—
Cash received for partial settlement of 1.125% Call Option	623			—			—
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—
Proceeds from senior notes offerings, net of issuance costs	—			325			—
Proceeds from borrowings under credit facility	—			300			—
Other, net	19			11			20
Net cash (used in) provided by financing activities	(1,192		)	636			20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	427			(274		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			86			360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	513		$	86

See accompanying notes.

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	118		(2		)	(430		)	—		$	(314	)
Investing activities:
Purchases of investments	(136		)	—			(1,308		)	—		(1,444		)
Proceeds from sales and maturities of investments	388			—			2,057			—		2,445
Purchases of property, equipment and capitalized software	(22		)	—			(8		)	—		(30		)
Net cash received from sales of subsidiaries	242			—			(52		)	—		190
Capital contributions to subsidiaries	(145		)	—			145			—		—
Dividends received from subsidiaries	298			—			(298		)	—		—
Change in amounts due to/from affiliates	6			4			(10		)	—		—
Other, net	—			—			(18		)	—		(18		)
Net cash provided by investing activities	631			4			508			—		1,143
Financing activities:
Repayment of credit facility	(300		)	—			—			—		(300		)
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—			—		(298		)
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—			—		(623		)
Cash received for partial settlement of 1.125% Call Option	623			—			—			—		623
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—			—		(549		)
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—			—		(64		)
Other, net	19			—			(1		)	—		18
Net cash used in financing activities	(1,192		)	—			(1		)	—		(1,193		)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	2			77			—		(364		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			—			2,777			—		3,290
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	2		$	2,854		$	—	$	2,926



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by operating activities	$	166		—			638			—		$	804
Investing activities:
Purchases of investments	(331		)	—			(2,366		)	—		(2,697		)
Proceeds from sales and maturities of investments	156			—			1,603			—		1,759
Purchases of property, equipment and capitalized software	(67		)	—			(19		)	—		(86		)
Capital contributions to subsidiaries	(370		)	2			368			—		—
Dividends received from subsidiaries	286			—			(286		)	—		—
Change in amounts due to/from affiliates	(49		)	(2		)	51			—		—
Other, net	—			—			(38		)	—		(38		)
Net cash used in investing activities	(375		)	—			(687		)	—		(1,062		)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs	325			—			—			—		325
Proceeds from borrowings under credit facility	300			—			—			—		300
Other, net	11			—			—			—		11
Net cash provided by financing activities	636			—			—			—		636
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	427			—			(49		)	—		378
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	86			—			2,826			—		2,912
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	513		$	—		$	2,777		$	—	$	3,290



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	55		(1		)	619			—		$	673
Investing activities:
Purchases of investments	(115		)	—			(1,814		)	—		(1,929		)
Proceeds from sales and maturities of investments	188			—			1,778			—		1,966
Purchases of property, equipment and capitalized software	(125		)	—			(51		)	—		(176		)
Net cash paid in business combinations	—			—			(48		)	—		(48		)
Capital contributions to subsidiaries	(386		)	7			379			—		—
Dividends received from subsidiaries	101			—			(101		)	—		—
Change in amounts due to/from affiliates	(18		)	(6		)	24			—		—
Other, net	6			—			(25		)	—		(19		)
Net cash (used in) provided by investing activities	(349		)	1			142			—		(206		)
Financing activities:
Other, net	20			—			(1		)	—		19
Net cash provided by (used in) financing activities	20			—			(1		)	—		19
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	(274		)	—			760			—		486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	360			—			2,066			—		2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	86		$	—		$	2,826		$	—	$	2,912

Supplemental Condensed Consolidating Financial Information (Tables)

12 Months Ended

Dec. 31, 2018

Condensed Financial Information [Abstract]

Condensed Consolidating Statements of Income

Condensed Statements of Operations



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Revenue:
Management fees	$	1,138		$	1,317		$	1,062
Investment income and other revenue	17			16			16
Total revenue	1,155			1,333			1,078
Expenses:
Medical care costs	8			16			73
General and administrative expenses	1,007			1,082			899
Depreciation and amortization	69			93			95
Restructuring and separation costs	35			153			—
Impairment losses	—			39			—
Total operating expenses	1,119			1,383			1,067
Gain on sale of subsidiary	37			—			—
Operating income (loss)	73			(50		)	11
Interest expense	114			117			101
Other expense (income)	17			(61		)	—
Loss before income tax (benefit) expense and equity in net earnings (losses) of subsidiaries	(58		)	(106		)	(90		)
Income tax (benefit) expense	(14		)	8			(24		)
Net loss before equity in net earnings (losses) of subsidiaries	(44		)	(114		)	(66		)
Equity in net earnings (losses) of subsidiaries	751			(398		)	118
Net income (loss)	$	707		$	(512	)	$	52

CONDENSED CONSOLIDATING STATEMENTS OF OPERATIONS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,155		$	3		$	18,884	$	(1,152	)	$	18,890
Expenses:
Medical care costs	8			—			15,129		—			15,137
Cost of service revenue	—			—			364		—			364
General and administrative expenses	1,007			4			1,474		(1,152		)	1,333
Premium tax expenses	—			—			417		—			417
Health insurer fees	—			—			348		—			348
Depreciation and amortization	69			—			30		—			99
Restructuring and separation costs	35			—			11		—			46
Total operating expenses	1,119			4			17,773		(1,152		)	17,744
Gain (loss) on sales of subsidiaries	37			(52		)	—		—			(15		)
Operating income (loss)	73			(53		)	1,111		—			1,131
Interest expense	114			—			1		—			115
Other expense	17			—			—		—			17
(Loss) income before income tax (benefit) expense	(58		)	(53		)	1,110		—			999
Income tax (benefit) expense	(14		)	(11		)	317		—			292
Net (loss) income before equity in net earnings (losses) of subsidiaries	(44		)	(42		)	793		—			707
Equity in net earnings (losses) of subsidiaries	751			(5		)	—		(746		)	—
Net income (loss)	$	707		$	(47	)	$	793	$	(746	)	$	707



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,333		$	2		$	19,904		$	(1,356	)	$	19,883
Expenses:
Medical care costs	16			—			17,058			(1		)	17,073
Cost of service revenue	—			—			492			—			492
General and administrative expenses	1,082			2			1,865			(1,355		)	1,594
Premium tax expenses	—			—			438			—			438
Depreciation and amortization	93			—			44			—			137
Restructuring and separation costs	153			—			81			—			234
Impairment losses	39			—			431			—			470
Total operating expenses	1,383			2			20,409			(1,356		)	20,438
Operating loss	(50		)	—			(505		)	—			(555		)
Total other expenses, net	56			—			1			—			57
Loss before income taxes	(106		)	—			(506		)	—			(612		)
Income tax expense (benefit)	8			—			(108		)	—			(100		)
Net loss before equity in net (losses) earnings of subsidiaries	(114		)	—			(398		)	—			(512		)
Equity in net (losses) earnings of subsidiaries	(398		)	(164		)	8			554			—
Net loss	$	(512	)	$	(164	)	$	(390	)	$	554		$	(512	)



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors		Eliminations			Consolidated
	(In millions)
Revenue:
Total revenue	$	1,078		$	—		$	17,786	$	(1,082	)	$	17,782
Expenses:
Medical care costs	73			—			14,702		(1		)	14,774
Cost of service revenue	—			—			485		—			485
General and administrative expenses	899			2			1,573		(1,081		)	1,393
Premium tax expenses	—			—			468		—			468
Health insurer fees	—			—			217		—			217
Depreciation and amortization	95			—			44		—			139
Total operating expenses	1,067			2			17,489		(1,082		)	17,476
Operating income (loss)	11			(2		)	297		—			306
Total other expenses, net	101			—			—		—			101
(Loss) income before income taxes	(90		)	(2		)	297		—			205
Income tax (benefit) expense	(24		)	(1		)	178		—			153
Net (loss) income before equity in earnings of subsidiaries	(66		)	(1		)	119		—			52
Equity in net earnings of subsidiaries	118			2			—		(120		)	—
Net income	$	52		$	1		$	119	$	(120	)	$	52

Condensed Consolidating Statements of Comprehensive Income (Loss)

CONDENSED CONSOLIDATING STATEMENTS OF COMPREHENSIVE INCOME (LOSS)



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations			Consolidated

	(In millions)
Net income (loss)	$	707		$	(47	)	$	793		$	(746	)	$	707
Other comprehensive loss, net of tax	(2		)	—			(2		)	2			(2		)
Comprehensive income (loss)	$	705		$	(47	)	$	791		$	(744	)	$	705



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated

	(In millions)
Net loss	$	(512	)	$	(164	)	$	(390	)	$	554	$	(512	)
Other comprehensive loss, net of tax	(3		)	—			(2		)	2		(3		)
Comprehensive loss	$	(515	)	$	(164	)	$	(392	)	$	556	$	(515	)



	Year Ended December 31, 2016
	Parent Issuer		Other Guarantor		Non-Guarantors		Eliminations			Consolidated

	(In millions)
Net income	$	52	$	1	$	119	$	(120	)	$	52
Other comprehensive income, net of tax	2		—		1		(1		)	2
Comprehensive income	$	54	$	1	$	120	$	(121	)	$	54

Condensed Consolidating Balance Sheets

Condensed Balance Sheets



	December 31,
	2018			2017
	(In millions, except share data)
ASSETS
Current assets:
Cash and cash equivalents	$	70		$	504
Investments	100			192
Restricted investments	—			169
Receivables	2			2
Due from affiliates	90			148
Prepaid expenses and other current assets	47			103
Derivative asset	476			522
Total current assets	785			1,640
Property, equipment, and capitalized software, net	176			223
Goodwill and intangible assets, net	13			15
Investments in subsidiaries	2,768			2,306
Deferred income taxes	39			17
Advances to related parties and other assets	40			32
	$	3,821		$	4,233
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4		$	3
Accounts payable and accrued liabilities	223			178
Current portion of long-term debt	241			653
Derivative liability	476			522
Total current liabilities	944			1,356
Long-term debt	1,020			1,318
Lease financing obligations	197			198
Other long-term liabilities	13			24
Total liabilities	2,174			2,896
Stockholders’ equity:
Common stock, $0.001 par value; 150 million shares authorized; outstanding:
62 million shares at December 31, 2018 and 60 million shares at December 31, 2017	—			—
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	—			—
Additional paid-in capital	643			1,044
Accumulated other comprehensive loss	(8		)	(5		)
Retained earnings	1,012			298
Total stockholders’ equity	1,647			1,337
	$	3,821		$	4,233

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2018
	Parent Issuer		Other Guarantor			Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	70	$	2		$	2,754		$	—		$	2,826
Investments	100		—			1,581			—			1,681
Receivables	2		—			1,328			—			1,330
Due from (to) affiliates	90		7			(97		)	—			—
Prepaid expenses and other current assets	47		29			73			—			149
Derivative asset	476		—			—			—			476
Total current assets	785		38			5,639			—			6,462
Property, equipment, and capitalized software, net	176		—			65			—			241
Goodwill and intangible assets, net	13		—			177			—			190
Restricted investments	—		—			120			—			120
Investment in subsidiaries, net	2,768		(5		)	—			(2,763		)	—
Deferred income taxes	39		—			78			—			117
Other assets	40		—			5			(21		)	24
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	4	$	—		$	1,957		$	—		$	1,961
Amounts due government agencies	—		—			967			—			967
Accounts payable and accrued liabilities	223		—			167			—			390
Deferred revenue	—		—			211			—			211
Current portion of long-term debt	241		—			—			—			241
Derivative liability	476		—			—			—			476
Total current liabilities	944		—			3,302			—			4,246
Long-term debt and lease financing obligations	1,217		—			20			(20		)	1,217
Other long-term liabilities	13		—			32			(1		)	44
Total liabilities	2,174		—			3,354			(21		)	5,507
Total stockholders’ equity	1,647		33			2,730			(2,763		)	1,647
	$	3,821	$	33		$	6,084		$	(2,784	)	$	7,154

CONDENSED CONSOLIDATING BALANCE SHEETS



	December 31, 2017
	Parent Issuer		Other Guarantor		Non-Guarantors			Eliminations			Consolidated
	(In millions)
ASSETS
Current assets:
Cash and cash equivalents	$	504	$	—	$	2,682		$	—		$	3,186
Investments	192		—		2,332			—			2,524
Restricted investments	169		—		—			—			169
Receivables	2		—		869			—			871
Due from (to) affiliates	148		2		(150		)	—			—
Prepaid expenses and other current assets	103		2		150			(16		)	239
Derivative asset	522		—		—			—			522
Total current assets	1,640		4		5,883			(16		)	7,511
Property, equipment, and capitalized software, net	223		—		119			—			342
Goodwill and intangible assets, net	15		—		240			—			255
Restricted investments	—		—		119			—			119
Investment in subsidiaries, net	2,306		75		—			(2,381		)	—
Deferred income taxes	17		—		101			(15		)	103
Other assets	32		—		110			(1		)	141
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Medical claims and benefits payable	$	3	$	—	$	2,189		$	—		$	2,192
Amounts due government agencies	—		—		1,542			—			1,542
Accounts payable and accrued liabilities	178		1		188			(1		)	366
Deferred revenue	—		—		282			—			282
Current portion of long-term debt	653		—		16			(16		)	653
Derivative liability	522		—		—			—			522
Total current liabilities	1,356		1		4,217			(17		)	5,557
Long-term debt and lease financing obligations	1,516		—		—			—			1,516
Deferred income taxes	—		—		15			(15		)	—
Other long-term liabilities	24		—		37			—			61
Total liabilities	2,896		1		4,269			(32		)	7,134
Total stockholders’ equity	1,337		78		2,303			(2,381		)	1,337
	$	4,233	$	79	$	6,572		$	(2,413	)	$	8,471

Condensed Consolidating Statements of Cash Flows

Condensed Statements of Cash Flows



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Operating activities:
Net cash provided by operating activities	$	118		$	166		$	55
Investing activities:
Capital contributions to subsidiaries	(145		)	(370		)	(386		)
Dividends received from subsidiaries	298			286			101
Purchases of investments	(136		)	(331		)	(115		)
Proceeds from sales and maturities of investments	388			156			188
Purchases of property, equipment and capitalized software	(22		)	(67		)	(125		)
Net cash received from sale of subsidiaries	242			—			—
Change in amounts due to/from affiliates	6			(49		)	(18		)
Other, net	—			—			6
Net cash provided by (used in) investing activities	631			(375		)	(349		)
Financing activities:
Repayment of credit facility	(300		)	—			—
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—
Cash received for partial settlement of 1.125% Call Option	623			—			—
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—
Proceeds from senior notes offerings, net of issuance costs	—			325			—
Proceeds from borrowings under credit facility	—			300			—
Other, net	19			11			20
Net cash (used in) provided by financing activities	(1,192		)	636			20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	427			(274		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			86			360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	513		$	86

See accompanying notes.

CONDENSED CONSOLIDATING STATEMENTS OF CASH FLOWS



	Year Ended December 31, 2018
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	118		(2		)	(430		)	—		$	(314	)
Investing activities:
Purchases of investments	(136		)	—			(1,308		)	—		(1,444		)
Proceeds from sales and maturities of investments	388			—			2,057			—		2,445
Purchases of property, equipment and capitalized software	(22		)	—			(8		)	—		(30		)
Net cash received from sales of subsidiaries	242			—			(52		)	—		190
Capital contributions to subsidiaries	(145		)	—			145			—		—
Dividends received from subsidiaries	298			—			(298		)	—		—
Change in amounts due to/from affiliates	6			4			(10		)	—		—
Other, net	—			—			(18		)	—		(18		)
Net cash provided by investing activities	631			4			508			—		1,143
Financing activities:
Repayment of credit facility	(300		)	—			—			—		(300		)
Repayment of principal amount of 1.125% Convertible Notes	(298		)	—			—			—		(298		)
Cash paid for partial settlement of 1.125% Conversion Option	(623		)	—			—			—		(623		)
Cash received for partial settlement of 1.125% Call Option	623			—			—			—		623
Cash paid for partial termination of 1.125% Warrants	(549		)	—			—			—		(549		)
Repayment of principal amount of 1.625% Convertible Notes	(64		)	—			—			—		(64		)
Other, net	19			—			(1		)	—		18
Net cash used in financing activities	(1,192		)	—			(1		)	—		(1,193		)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443		)	2			77			—		(364		)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513			—			2,777			—		3,290
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	70		$	2		$	2,854		$	—	$	2,926



	Year Ended December 31, 2017
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by operating activities	$	166		—			638			—		$	804
Investing activities:
Purchases of investments	(331		)	—			(2,366		)	—		(2,697		)
Proceeds from sales and maturities of investments	156			—			1,603			—		1,759
Purchases of property, equipment and capitalized software	(67		)	—			(19		)	—		(86		)
Capital contributions to subsidiaries	(370		)	2			368			—		—
Dividends received from subsidiaries	286			—			(286		)	—		—
Change in amounts due to/from affiliates	(49		)	(2		)	51			—		—
Other, net	—			—			(38		)	—		(38		)
Net cash used in investing activities	(375		)	—			(687		)	—		(1,062		)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs	325			—			—			—		325
Proceeds from borrowings under credit facility	300			—			—			—		300
Other, net	11			—			—			—		11
Net cash provided by financing activities	636			—			—			—		636
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	427			—			(49		)	—		378
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	86			—			2,826			—		2,912
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	513		$	—		$	2,777		$	—	$	3,290



	Year Ended December 31, 2016
	Parent Issuer			Other Guarantor			Non-Guarantors			Eliminations		Consolidated
	(In millions)
Operating activities:
Net cash provided by (used in) operating activities	$	55		(1		)	619			—		$	673
Investing activities:
Purchases of investments	(115		)	—			(1,814		)	—		(1,929		)
Proceeds from sales and maturities of investments	188			—			1,778			—		1,966
Purchases of property, equipment and capitalized software	(125		)	—			(51		)	—		(176		)
Net cash paid in business combinations	—			—			(48		)	—		(48		)
Capital contributions to subsidiaries	(386		)	7			379			—		—
Dividends received from subsidiaries	101			—			(101		)	—		—
Change in amounts due to/from affiliates	(18		)	(6		)	24			—		—
Other, net	6			—			(25		)	—		(19		)
Net cash (used in) provided by investing activities	(349		)	1			142			—		(206		)
Financing activities:
Other, net	20			—			(1		)	—		19
Net cash provided by (used in) financing activities	20			—			(1		)	—		19
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents	(274		)	—			760			—		486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	360			—			2,066			—		2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$	86		$	—		$	2,826		$	—	$	2,912

Organization and Basis of Presentation (Details) $ in Millions		3 Months Ended				12 Months Ended
	Oct. 19, 2018 USD ($)	Dec. 31, 2018 USD ($) member State medical_member	Sep. 30, 2018 USD ($) member	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Dec. 31, 2018 USD ($) member State medical_member	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Basis Of Presentation [Line Items]
Loss on sales of subsidiaries, net of gain		$ (52)	$ 37	$ 0	$ 0	$ (15)	$ 0	$ 0
Health Plans
Basis Of Presentation [Line Items]
Number of States in which company operates (in state) \| State		14				14
Number of members eligible for the health care programs \| member		3,800,000				3,800,000
Minimum contract terms						3 years
Maximum contract terms						5 years
Mississippi
Basis Of Presentation [Line Items]
Expected number of members \| member		26,000				26,000
New Mexico
Basis Of Presentation [Line Items]
Number of members served, approximately (in member) \| member		196,000				196,000
Puerto Rico
Basis Of Presentation [Line Items]
Number of members served, approximately (in member) \| member		252,000	320,000			252,000
Medical care costs \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						$ 17,612	18,854	16,445
Medical care costs \| New Mexico \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						1,356	1,368	1,305
Medical care costs \| Puerto Rico \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						696	732	726
Medical care costs \| Florida \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						$ 1,790	2,568	1,938
Medical care costs \| Miami Dade and Monroe Counties \| Health Plans
Basis Of Presentation [Line Items]
Number of members served, approximately (in member) \| medical_member		98,000				98,000
Premium revenue						$ 462
Medical care costs \| Washington \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						2,361	$ 2,608	$ 2,222
Molina Medicaid Solutions
Basis Of Presentation [Line Items]
Net cash selling price of equity interests		$ 233				233
Loss on sales of subsidiaries, net of gain						37
Gain (loss) on disposition of business, net of tax						$ 28
Pathways Health and Community Support LLC
Basis Of Presentation [Line Items]
Loss on sales of subsidiaries, net of gain	$ 52
Gain (loss) on disposition of business, net of tax	$ (32)
Medicaid \| Washington
Basis Of Presentation [Line Items]
Number of members served, approximately (in member) \| member		751,000				751,000
Medicaid \| Medical care costs \| New Mexico \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						$ 1,181
Medicaid \| Medical care costs \| Florida \| Health Plans
Basis Of Presentation [Line Items]
Number of members served, approximately (in member) \| member		272,000				272,000
Premium revenue						$ 1,479
Medicaid \| Medical care costs \| Washington \| Health Plans
Basis Of Presentation [Line Items]
Premium revenue						$ 2,035

Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accounting Policies [Abstract]
Cash and cash equivalents	$ 2,826	$ 3,186	$ 2,819
Restricted cash and cash equivalents, non-current	100	95	93
Restricted cash and cash equivalents, current	0	9	0
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 2,926	$ 3,290	$ 2,912	$ 2,426

Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2019	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Final maturities of investments			10 years
Average maturity of investments			3 years
Amounts due government agencies	$ 967		$ 967	$ 1,542
Premium revenue			17,612	18,854	$ 16,445
Prepaid reinsurance premiums	16		16	20	30
Reinsurance recoveries			33	24	65
Reinsurance recoverable for unpaid claims adjustments	31		31	16	61
Marketplace risk adjustment payable	(466)		(466)	(917)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	2,926		2,926	3,290	2,912		$ 2,426
Net cash provided by (used in) investing activities			1,143	(1,062)	(206)
Medicaid Expansion
Property, Plant and Equipment [Line Items]
Amounts due government agencies	87		87	96
Medical Premium Liability Due to Agency
Property, Plant and Equipment [Line Items]
Medical premium liability based on medical costs threshold	103		$ 103	135
Minimum
Property, Plant and Equipment [Line Items]
Useful life			5 years
Minimum \| California, Illinois, New Mexico, Ohio, South Carolina, Texas, Washington, and Wisconsin
Property, Plant and Equipment [Line Items]
Percentage of additional incremental revenue earned			1.00%
Maximum
Property, Plant and Equipment [Line Items]
Useful life			15 years
Maximum \| California, Illinois, New Mexico, Ohio, South Carolina, Texas, Washington, and Wisconsin
Property, Plant and Equipment [Line Items]
Percentage of additional incremental revenue earned			3.00%
CMS Subsidies
Property, Plant and Equipment [Line Items]
Disposal group, operating expense			$ 81
California Department of Health Care Services
Property, Plant and Equipment [Line Items]
Premium revenue	$ (24)	$ 57
Forecast
Property, Plant and Equipment [Line Items]
Finance lease, liability						$ 230
Forecast \| Minimum
Property, Plant and Equipment [Line Items]
Operating lease, right-of-use asset						80
Operating lease, liability						90
Finance lease, right-of-use asset						230
Forecast \| Minimum \| Property, Plant and Equipment
Property, Plant and Equipment [Line Items]
Adoption of ASU						75
Forecast \| Minimum \| Lease Financing Obligations
Property, Plant and Equipment [Line Items]
Adoption of ASU						195
Forecast \| Minimum \| Retained Earnings
Property, Plant and Equipment [Line Items]
Adoption of ASU						80
Forecast \| Maximum
Property, Plant and Equipment [Line Items]
Operating lease, right-of-use asset						90
Operating lease, liability						100
Finance lease, right-of-use asset						240
Finance lease, liability						240
Forecast \| Maximum \| Property, Plant and Equipment
Property, Plant and Equipment [Line Items]
Adoption of ASU						95
Forecast \| Maximum \| Lease Financing Obligations
Property, Plant and Equipment [Line Items]
Adoption of ASU						205
Forecast \| Maximum \| Retained Earnings
Property, Plant and Equipment [Line Items]
Adoption of ASU						$ 100
Accounting Standards Update 2016-18
Property, Plant and Equipment [Line Items]
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents				104	93
Net cash provided by (used in) investing activities				$ (104)	$ (93)

Significant Accounting Policies - Schedule of Premium Revenue (Details) - Health Plans - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	100.00%	100.00%	100.00%
Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 17,612	$ 18,854	$ 16,445
California
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	12.20%	14.30%	14.40%
California \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 2,150	$ 2,701	$ 2,378
Florida
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	10.20%	13.60%	11.80%
Florida \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 1,790	$ 2,568	$ 1,938
Illinois
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	4.50%	3.10%	3.70%
Illinois \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 793	$ 593	$ 603
Michigan
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	9.10%	8.50%	9.30%
Michigan \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 1,601	$ 1,596	$ 1,527
New Mexico
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	7.70%	7.30%	7.90%
New Mexico \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 1,356	$ 1,368	$ 1,305
Ohio
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	13.60%	11.80%	12.00%
Ohio \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 2,388	$ 2,216	$ 1,967
Puerto Rico
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	3.90%	3.90%	4.40%
Puerto Rico \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 696	$ 732	$ 726
South Carolina
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	2.80%	2.40%	2.30%
South Carolina \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 495	$ 445	$ 378
Texas
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	18.40%	14.90%	15.00%
Texas \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 3,244	$ 2,813	$ 2,461
Washington
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	13.40%	13.80%	13.50%
Washington \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 2,361	$ 2,608	$ 2,222
Other
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue percentage	4.20%	6.40%	5.70%
Other \| Medical care costs
Schedule of Premium Revenue by Health Plan Type [Line Items]
Premium revenue	$ 738	$ 1,214	$ 940

Significant Accounting Policies - Quality Incentive Premium Revenue (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Maximum available quality incentive premium - current period	$ 182	$ 150	$ 147
Amount of quality incentive premium revenue recognized in current period - Earned current period	133	97	104
Amount of quality incentive premium revenue recognized in current period - Earned prior periods	31	10	47
Total quality incentive premium revenue recognized	$ 164	$ 107	$ 151
Quality incentive premium revenue recognized as a percentage of total premium revenue	0.90%	0.60%	0.90%

Significant Accounting Policies - Due to Government Agencies (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Medicaid program:
Medical cost floors and corridors	$ 103	$ 135
Other amounts due to states	81	71
Marketplace program:
Risk adjustment	466	917
Cost sharing reduction	183	275
Other	134	144
Amounts due government agencies	$ 967	$ 1,542

Significant Accounting Policies - Consolidated Medical Care Costs (Details) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Medical Care Costs
Fee-for-service	$ 11,278,000,000	$ 12,682,000,000	$ 10,993,000,000
Pharmacy	2,138,000,000	2,563,000,000	2,213,000,000
Capitation	1,184,000,000	1,360,000,000	1,218,000,000
Other	537,000,000	468,000,000	350,000,000
Total	15,137,000,000	17,073,000,000	14,774,000,000
Medical Care Costs, PMPM
Fee-for-service (per member per month)	232.15	229.63	217.84
Pharmacy (per member per month)	44.01	46.40	43.84
Capitation (per member per month)	24.38	24.63	24.13
Other (per member per month)	11.05	8.48	6.94
Total (per member per month)	$ 311.59	$ 309.14	$ 292.75
Medical Care Costs, Percentage
Percentage of total in Fee for service	74.50%	74.30%	74.40%
Percentage of total in pharmacy	14.10%	15.00%	15.00%
Percentage of total in capitation	7.80%	8.00%	8.20%
Percentage of total in other	3.60%	2.70%	2.40%
Percentage of total	100.00%	100.00%	100.00%

Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Numerator:
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	$ 707	$ (512)	$ 52
Denominator:
Shares outstanding at the beginning of the period (in shares)					59.3					59.3	55.8	55.1
Weighted-average number of shares issued:
Exchange of 1.625% Convertible Notes (in shares)									1.4	0.1	0.0
Conversion of 1.625% Convertible Notes (in shares)									0.2	0.0	0.0
Stock-based compensation (in shares)									0.2	0.5	0.3
Denominator for basic net income (loss) per share (in shares)									61.1	56.4	55.4
Effect of dilutive securities:
1.125% Warrants (in shares)									4.8	0.0	0.5
1.625% Convertible Notes (in shares)									0.4	0.0	0.0
Share-based compensation (in shares)									0.3	0.0	0.3
Denominator for diluted net (loss) income per share (in shares)									66.6	56.4	56.2
Net income (loss) per share:
Basic (in dollars per share)	$ 3.24	$ 3.22	$ 3.29	$ 1.79	$ (4.59)	$ (1.70)	$ (4.10)	$ 1.38	$ 11.57	$ (9.07)	$ 0.93
Diluted (in dollars per share)	$ 3.01	$ 2.90	$ 3.02	$ 1.64	$ (4.59)	$ (1.70)	$ (4.10)	$ 1.37	$ 10.61	$ (9.07)	$ 0.92
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Stock-based compensation (in shares)									0.0	0.3	0.0
1.125% Warrants
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potentially dilutive common shares excluded from calculations (in shares)									0.0	1.9	0.0
1.625% Notes
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Potentially dilutive common shares excluded from calculations (in shares)									0.0	0.4	0.0
Stated interest rate	1.625%								1.625%
1.125% Warrants
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Stated interest rate	1.125%								1.125%

Fair Value Measurements - Additional Information (Details)	Dec. 31, 2018
1.125% Call Option
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fixed interest rate on derivative	1.125%

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Fair value of assets measured on recurring basis
Total assets	$ 2,157	$ 3,215
Total liabilities	476	522
Corporate debt securities
Fair value of assets measured on recurring basis
Total assets		101
U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets		68
Subtotal - current restricted investments
Fair value of assets measured on recurring basis
Total assets		169
Corporate debt securities
Fair value of assets measured on recurring basis
Total assets	1,123	1,588
U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets	181	388
Government-sponsored enterprise securities (GSEs)
Fair value of assets measured on recurring basis
Total assets	163	253
Municipal securities
Fair value of assets measured on recurring basis
Total assets	114	141
Asset-backed securities
Fair value of assets measured on recurring basis
Total assets	82	117
Certificates of deposit
Fair value of assets measured on recurring basis
Total assets	14	37
Other
Fair value of assets measured on recurring basis
Total assets	4
Subtotal - current investments
Fair value of assets measured on recurring basis
Total assets	1,681	2,524
1.125% Call Option derivative asset
Fair value of assets measured on recurring basis
Total assets	476	522
Level 1
Fair value of assets measured on recurring basis
Total assets	0	0
Total liabilities	0	0
Level 1 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets		0
Level 1 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets		0
Level 1 \| Subtotal - current restricted investments
Fair value of assets measured on recurring basis
Total assets		0
Level 1 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| Government-sponsored enterprise securities (GSEs)
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| Municipal securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| Asset-backed securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| Certificates of deposit
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| Other
Fair value of assets measured on recurring basis
Total assets	0
Level 1 \| Subtotal - current investments
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| 1.125% Call Option derivative asset
Fair value of assets measured on recurring basis
Total assets	0	0
Level 1 \| 1.125% Conversion Option
Fair value of assets measured on recurring basis
1.125% Conversion Option derivative liability	0	0
Level 2
Fair value of assets measured on recurring basis
Total assets	1,681	2,693
Total liabilities	0	0
Level 2 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets		101
Level 2 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets		68
Level 2 \| Subtotal - current restricted investments
Fair value of assets measured on recurring basis
Total assets		169
Level 2 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets	1,123	1,588
Level 2 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets	181	388
Level 2 \| Government-sponsored enterprise securities (GSEs)
Fair value of assets measured on recurring basis
Total assets	163	253
Level 2 \| Municipal securities
Fair value of assets measured on recurring basis
Total assets	114	141
Level 2 \| Asset-backed securities
Fair value of assets measured on recurring basis
Total assets	82	117
Level 2 \| Certificates of deposit
Fair value of assets measured on recurring basis
Total assets	14	37
Level 2 \| Other
Fair value of assets measured on recurring basis
Total assets	4
Level 2 \| Subtotal - current investments
Fair value of assets measured on recurring basis
Total assets	1,681	2,524
Level 2 \| 1.125% Call Option derivative asset
Fair value of assets measured on recurring basis
Total assets	0	0
Level 2 \| 1.125% Conversion Option
Fair value of assets measured on recurring basis
1.125% Conversion Option derivative liability	0	0
Level 3
Fair value of assets measured on recurring basis
Total assets	476	522
Total liabilities	476	522
Level 3 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets		0
Level 3 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets		0
Level 3 \| Subtotal - current restricted investments
Fair value of assets measured on recurring basis
Total assets		0
Level 3 \| Corporate debt securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| U.S. Treasury notes
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| Government-sponsored enterprise securities (GSEs)
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| Municipal securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| Asset-backed securities
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| Certificates of deposit
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| Other
Fair value of assets measured on recurring basis
Total assets	0
Level 3 \| Subtotal - current investments
Fair value of assets measured on recurring basis
Total assets	0	0
Level 3 \| 1.125% Call Option derivative asset
Fair value of assets measured on recurring basis
Total assets	476	522
Level 3 \| 1.125% Conversion Option
Fair value of assets measured on recurring basis
1.125% Conversion Option derivative liability	$ 476	$ 522

Fair Value Measurements - Long-term Debt (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Jun. 06, 2017
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 1,260	$ 1,970
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 1,707	2,631
5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	5.375%
4.875% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	4.875%
1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	1.125%
1.625% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	1.625%
Senior Notes \| 5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	5.375%
Senior Notes \| 5.375% Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 694	692
Senior Notes \| 5.375% Notes \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 674	730
Senior Notes \| 4.875% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	4.875%		4.875%
Senior Notes \| 4.875% Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 326	325
Senior Notes \| 4.875% Notes \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 301	329
Convertible Debt \| 1.125% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	1.125%
Convertible Debt \| 1.125% Convertible Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 240	496
Convertible Debt \| 1.125% Convertible Notes \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 732	1,052
Convertible Debt \| 1.625% Convertible Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Percentage of contractual interest rate	1.625%
Convertible Debt \| 1.625% Convertible Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	$ 0	157
Convertible Debt \| 1.625% Convertible Notes \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	0	220
Credit Facility \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	0	300
Credit Facility \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Estimated fair values of long-term debt	0	300
Current liabilities \| 1.125% Conversion Option
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative liability	$ 476	$ 522

Investments - Schedule of Investments (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Investments
Amortized Cost	$ 1,692	$ 2,700
Gross Unrealized Gains	0	1
Gross Unrealized Losses	11	8
Estimated Fair Value	1,681	2,693
U.S. Treasury notes
Investments
Amortized Cost		68
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Estimated Fair Value		68
Corporate debt securities
Investments
Amortized Cost		101
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Estimated Fair Value		101
Subtotal - current restricted investments
Investments
Amortized Cost		169
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Estimated Fair Value		169
Corporate debt securities
Investments
Amortized Cost	1,131	1,591
Gross Unrealized Gains	0	1
Gross Unrealized Losses	8	4
Estimated Fair Value	1,123	1,588
U.S. Treasury notes
Investments
Amortized Cost	181	389
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	1
Estimated Fair Value	181	388
GSEs
Investments
Amortized Cost	164	255
Gross Unrealized Gains	0	0
Gross Unrealized Losses	1	2
Estimated Fair Value	163	253
Municipal securities
Investments
Amortized Cost	115	142
Gross Unrealized Gains	0	0
Gross Unrealized Losses	1	1
Estimated Fair Value	114	141
Asset-backed securities
Investments
Amortized Cost	83	117
Gross Unrealized Gains	0	0
Gross Unrealized Losses	1	0
Estimated Fair Value	82	117
Certificates of deposit
Investments
Amortized Cost	14	37
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Estimated Fair Value	14	37
Other
Investments
Amortized Cost	4
Gross Unrealized Gains	0
Gross Unrealized Losses	0
Estimated Fair Value	$ 4
Subtotal - current investments
Investments
Amortized Cost		2,531
Gross Unrealized Gains		1
Gross Unrealized Losses		8
Estimated Fair Value		$ 2,524

Investments - Contractual Maturities (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Amortized Cost
Due in one year or less	$ 1,000
Due after one year through five years	692
Amortized Cost	1,692	$ 2,700
Estimated Fair Value
Due in one year or less	997
Due after one year through five years	684
Estimated Fair Value	$ 1,681

Investments - Available-for-Sale (Details) $ in Millions	Dec. 31, 2018 USD ($) Security	Dec. 31, 2017 USD ($) Security
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 509	$ 1,940
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses	$ 3	$ 5
Number of Positions, 12 Months or Less (in security) \| Security	285	719
In a Continuous Loss Position for 12 Months or More, Estimated Fair value	$ 694	$ 227
In a Continuous Loss Position for 12 Months or More, Unrealized Losses	$ 8	$ 3
Number of Positions, 12 Months or More (in security) \| Security	516	164
Corporate debt securities
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 509	$ 1,297
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses	$ 3	$ 3
Number of Positions, 12 Months or Less (in security) \| Security	285	561
In a Continuous Loss Position for 12 Months or More, Estimated Fair value	$ 412	$ 94
In a Continuous Loss Position for 12 Months or More, Unrealized Losses	$ 5	$ 1
Number of Positions, 12 Months or More (in security) \| Security	298	69
GSEs
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0	$ 173
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses	$ 0	$ 1
Number of Positions, 12 Months or Less (in security) \| Security	0	69
In a Continuous Loss Position for 12 Months or More, Estimated Fair value	$ 127	$ 95
In a Continuous Loss Position for 12 Months or More, Unrealized Losses	$ 1	$ 1
Number of Positions, 12 Months or More (in security) \| Security	76	47
U.S. Treasury notes
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value		$ 470
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses		$ 1
Number of Positions, 12 Months or Less (in security) \| Security		89
In a Continuous Loss Position for 12 Months or More, Estimated Fair value		$ 0
In a Continuous Loss Position for 12 Months or More, Unrealized Losses		$ 0
Number of Positions, 12 Months or More (in security) \| Security		0
Municipal securities
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0	$ 0
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses	$ 0	$ 0
Number of Positions, 12 Months or Less (in security) \| Security	0	0
In a Continuous Loss Position for 12 Months or More, Estimated Fair value	$ 87	$ 38
In a Continuous Loss Position for 12 Months or More, Unrealized Losses	$ 1	$ 1
Number of Positions, 12 Months or More (in security) \| Security	90	48
Asset-backed securities
Available-for-sale investments
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 0
In a Continuous Loss Position for Less than 12 Months, Unrealized Losses	$ 0
Number of Positions, 12 Months or Less (in security) \| Security	0
In a Continuous Loss Position for 12 Months or More, Estimated Fair value	$ 68
In a Continuous Loss Position for 12 Months or More, Unrealized Losses	$ 1
Number of Positions, 12 Months or More (in security) \| Security	52

Receivables (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Summary of accounts receivable
Total receivables	$ 1,330	$ 871
Premiums and other receivables
Summary of accounts receivable
Total receivables	855	695
Pharmacy administrative services receivables
Summary of accounts receivable
Total receivables	179	0
Pharmacy rebate receivables
Summary of accounts receivable
Total receivables	155	154
Health insurer fee reimbursement receivables
Summary of accounts receivable
Total receivables	$ 141	$ 22

Property, Equipment, and Capitalized Software, Net - Additional Information (Details)	12 Months Ended
	Dec. 31, 2018
Furniture and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Useful life of property plant and equipment	3 years
Furniture 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

Property, Equipment, and Capitalized Software, Net - Summary of Property, Equipment, and Capitalized Software (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Summary of property and equipment
Property and equipment, gross	$ 774	$ 883
Less: accumulated amortization - capitalized software	(320)	(308)
Less: accumulated depreciation and amortization - building and improvements, furniture and equipment	(213)	(233)
Total accumulated depreciation and amortization	(533)	(541)
Property, equipment, and capitalized software, net	241	342
Capitalized software
Summary of property and equipment
Property and equipment, gross	373	417
Furniture and equipment
Summary of property and equipment
Property and equipment, gross	231	289
Building and improvements
Summary of property and equipment
Property and equipment, gross	154	161
Land
Summary of property and equipment
Property and equipment, gross	$ 16	$ 16

Property, Equipment, and Capitalized Software, Net - Depreciation and Amortization (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Amortization of capitalized software	$ 42	$ 64	$ 62
Depreciation of property and equipment	36	42	45
Amortization of intangible assets	21	31	32
Subtotal	99	137	139
Recorded in cost of service revenue:	28	41	43
Total depreciation and amortization recognized	127	178	182
Capitalized software
Property, Plant and Equipment [Line Items]
Recorded in cost of service revenue:	19	28	22
Deferred contract costs
Property, Plant and Equipment [Line Items]
Recorded in cost of service revenue:	$ 9	$ 13	$ 21

Goodwill and Intangible Assets, Net - Additional Information (Details) - USD ($)	3 Months Ended	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Goodwill impairment charges		$ 0		$ 0
Impairment of intangible assets		0		$ 0
Future Amortization Expenses
Future amortization expense, 2019		18,000,000
Future amortization expense, 2020		14,000,000
Future amortization expense, 2021		5,000,000
Future amortization expense, 2022		3,000,000
Future amortization expense, 2023		$ 3,000,000
Health Plans
Finite-Lived Intangible Assets [Line Items]
Goodwill impairment charges			$ 244,000,000
Impairment of intangible assets	$ (25,000,000)
Other
Finite-Lived Intangible Assets [Line Items]
Goodwill impairment charges			$ 190,000,000
Impairment of intangible assets	$ 11,000,000

Goodwill and Intangible Assets, Net - Balances of Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Historical goodwill		$ 678
Accumulated impairment losses	$ (492)	(492)
Changes in the carrying amount of goodwill
Beginning balance	186
Sale of subsidiary	(43)
Ending balance	143
Health Plans
Goodwill [Line Items]
Historical goodwill		445
Accumulated impairment losses	(302)	(302)
Changes in the carrying amount of goodwill
Beginning balance	143
Sale of subsidiary	0
Ending balance	143
Other
Goodwill [Line Items]
Historical goodwill		233
Accumulated impairment losses	(190)	$ (190)
Changes in the carrying amount of goodwill
Beginning balance	43
Sale of subsidiary	(43)
Ending balance	$ 0

Goodwill and Intangible Assets, Net - Intangible Assets Balances (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Cost	$ 221	$ 221
Accumulated Amortization	174	152
Carrying Amount	47	69
Contract rights and licenses
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Cost	201	201
Accumulated Amortization	162	141
Carrying Amount	39	60
Provider network
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Cost	20	20
Accumulated Amortization	12	11
Carrying Amount	$ 8	$ 9

Restricted Investments - Balances of Restricted Investments (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Summary of restricted investments by health plan
Restricted investments by health plan	$ 120	$ 119
Health Plans
Summary of restricted investments by health plan
Restricted investments by health plan	120	119
Health Plans \| Florida
Summary of restricted investments by health plan
Restricted investments by health plan	32	31
Health Plans \| New Mexico
Summary of restricted investments by health plan
Restricted investments by health plan	43	43
Health Plans \| Ohio
Summary of restricted investments by health plan
Restricted investments by health plan	12	12
Health Plans \| Puerto Rico
Summary of restricted investments by health plan
Restricted investments by health plan	10	10
Health Plans \| Other
Summary of restricted investments by health plan
Restricted investments by health plan	$ 23	$ 23

Restricted Investments - Maturities of Held-to-Maturity (Details) $ in Millions	Dec. 31, 2018 USD ($)
Contractual maturities of our held-to-maturity restricted investments
Amortized Cost, Due in one year or less	$ 105
Amortized Cost, Due one year through five years	15
Amortized Cost, Total	120
Estimated Fair Value, Due in one year or less	105
Estimated Fair Value, Due one year through five years	15
Estimated Fair Value, Total	$ 120

Medical Claims and Benefits Payable - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Insurance Claims [Line Items]
Medical claims and benefits payable	$ 107	$ 122	$ 225
Prior period claims expense (benefit) recognized	341	$ (36)	$ 192
CMS Subsidies
Insurance Claims [Line Items]
Disposal group, operating expense	$ 81

Medical Claims and Benefits Payable - Medical Claims and Future Benefits (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Insurance [Abstract]
Fee-for-service claims incurred but not paid (“IBNP”)	$ 1,562	$ 1,717	$ 1,352
Pharmacy payable	115	112	112
Capitation payable	52	67	37
Other	232	296	428
Medical claims and benefits payable	$ 1,961	$ 2,192	$ 1,929	$ 1,685

Medical Claims and Benefits Payable - Components of the Change (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and benefits payable, beginning balance	$ 2,192	$ 1,929	$ 1,685
Components of medical care costs related to:
Current period	15,478	17,037	14,966
Prior periods	(341)	36	(192)
Total medical care costs	15,137	17,073	14,774
Change in non-risk provider payables	13	(106)	58
Payments for medical care costs related to:
Current period	13,671	15,130	13,304
Prior periods	1,710	1,574	1,284
Total paid	15,381	16,704	14,588
Medical claims and benefits payable, ending balance	1,961	$ 2,192	$ 1,929
CMS Subsidies
Liability for Claims and Claims Adjustment Expense [Line Items]
Disposal group, operating expense	$ 81

Medical Claims and Benefits Payable - Incurred Claims and Allocated Adjustment Expense (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) claim	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 15,137	$ 17,073	$ 14,774
Incurred Claims and Allocated Claims Adjustment Expenses	47,263
Total IBNP	1,552
Benefit Year 2016
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	15,057	15,093	$ 15,064
Total IBNP	$ 18
Cumulative number of reported claims (in claim) \| claim	105,000,000
Benefit Year 2017
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 16,728	$ 17,037
Total IBNP	$ 57
Cumulative number of reported claims (in claim) \| claim	119,000,000
Benefit Year 2018
Product Information [Line Items]
Incurred Claims and Allocated Claims Adjustment Expenses	$ 15,478
Total IBNP	$ 1,477
Cumulative number of reported claims (in claim) \| claim	105,000,000

Medical Claims and Benefits Payable - Cumulative Paid Claims and Allocated Claims Adjustment Expenses (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2015
Product Information [Line Items]
Claims paid	$ 45,462
Benefit Year 2016
Product Information [Line Items]
Claims paid	15,039	$ 14,952	$ 13,403
Benefit Year 2017
Product Information [Line Items]
Claims paid	16,752	$ 15,130
Benefit Year 2018
Product Information [Line Items]
Claims paid	$ 13,671

Medical Claims and Benefits Payable - Reconciliation of Claims Development (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Insurance [Abstract]
Incurred claims and allocated claims adjustment expenses	$ 47,263
Less: cumulative paid clams and allocated claims adjustment expenses	(45,462)
All outstanding liabilities before 2016	10
Non-risk provider payables and other	150
Medical claims and benefits payable	$ 1,961	$ 2,192	$ 1,929	$ 1,685

Debt - Maturities (Details) - USD ($)	Dec. 31, 2018	Jun. 06, 2017
Maturities of Long-term Debt [Abstract]
Net carrying amount	$ 1,282,000,000
2019	0
2020	252,000,000
2021	0
2022	700,000,000
2023	0
Thereafter	$ 330,000,000
5.375% Notes
Maturities of Long-term Debt [Abstract]
Percentage of contractual interest rate	5.375%
4.875% Notes
Maturities of Long-term Debt [Abstract]
Percentage of contractual interest rate	4.875%
1.125% Convertible Notes
Maturities of Long-term Debt [Abstract]
Percentage of contractual interest rate	1.125%
Senior Notes \| 5.375% Notes
Maturities of Long-term Debt [Abstract]
Net carrying amount	$ 700,000,000
2019	0
2020	0
2021	0
2022	700,000,000
2023	0
Thereafter	$ 0
Percentage of contractual interest rate	5.375%
Senior Notes \| 4.875% Notes
Maturities of Long-term Debt [Abstract]
Net carrying amount	$ 330,000,000
2019	0
2020	0
2021	0
2022	0
2023	0
Thereafter	$ 330,000,000
Percentage of contractual interest rate	4.875%	4.875%
Convertible Debt \| 1.125% Convertible Notes
Maturities of Long-term Debt [Abstract]
Net carrying amount	$ 252,000,000
2019	0
2020	252,000,000
2021	0
2022	0
2023	0
Thereafter	$ 0
Percentage of contractual interest rate	1.125%

Debt - Details of the Liability Component (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Jun. 06, 2017
Debt Instrument [Line Items]
Lease financing obligations	$ 1	$ 1
Debt issuance costs	(1)	(4)
Current portion of long-term debt	241	653
Debt issuance costs	(10)	(12)
Long-term debt	1,020	1,318
Lease financing obligations	197	198
Long-term debt and capital lease obligations	$ 1,458	2,169
1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.125%
1.625% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	1.625%
5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	5.375%
4.875% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.875%
Convertible Debt \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Current portion of long-term debt	$ 241	499
Percentage of contractual interest rate	1.125%
Convertible Debt \| 1.625% Convertible Notes
Debt Instrument [Line Items]
Current portion of long-term debt	$ 0	157
Percentage of contractual interest rate	1.625%
Senior Notes \| 5.375% Notes
Debt Instrument [Line Items]
Non-current portion of long-term debt	$ 700	700
Percentage of contractual interest rate	5.375%
Senior Notes \| 4.875% Notes
Debt Instrument [Line Items]
Non-current portion of long-term debt	$ 330	330
Percentage of contractual interest rate	4.875%		4.875%
Credit Facility
Debt Instrument [Line Items]
Non-current portion of long-term debt	$ 0	$ 300

Debt - Interest Cost Recognized (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Interest cost recognized for the period relating to the:
Contractual interest coupon rate	$ 6	$ 11	$ 11
Amortization of the discount	21	32	30
Total interest cost recognized	$ 27	$ 43	$ 41

Debt - Credit Facility (Details) - Credit Facility - USD ($)		12 Months Ended
	Jan. 31, 2019	Dec. 31, 2018	May 31, 2018	Jan. 31, 2017
Revolving Credit Facility
Line of Credit Facility [Line Items]
Maximum borrowing capacity			$ 300,000,000	$ 500,000,000
Term of debt instrument		5 years
Current borrowing capacity		$ 493,000,000
Letter of Credit
Line of Credit Facility [Line Items]
Amount outstanding under Letter of Credit		$ 7,000,000
Subsequent Event \| Revolving Credit Facility
Line of Credit Facility [Line Items]
Maximum borrowing capacity	$ 600,000,000
Minimum threshold for advancements	$ 50,000,000
Delayed draw ticking fee	0.375%
Subsequent Event \| Minimum \| Revolving Credit Facility
Line of Credit Facility [Line Items]
Amortization payment percentage	1.25%
Subsequent Event \| Maximum \| Revolving Credit Facility
Line of Credit Facility [Line Items]
Amortization payment percentage	2.50%

Debt - Senior Notes (Details) - USD ($)	Dec. 31, 2018	Jun. 06, 2017
4.875% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate	4.875%
5.375% Senior Notes due 2022
Debt Instrument [Line Items]
Percentage of contractual interest rate	5.375%
Senior Notes \| 4.875% Notes
Debt Instrument [Line Items]
Principal amount		$ 330,000,000
Percentage of contractual interest rate	4.875%	4.875%
Senior Notes \| 5.375% Senior Notes due 2022
Debt Instrument [Line Items]
Principal amount	$ 700,000,000
Percentage of contractual interest rate	5.375%

Debt - Convertible Notes (Details) $ / shares in Units, shares in Millions	1 Months Ended			3 Months Ended			12 Months Ended
	Sep. 30, 2018 USD ($)	Mar. 31, 2018 USD ($) shares	Dec. 31, 2017 USD ($) shares	Dec. 31, 2018 USD ($) $ / shares	Sep. 30, 2018 USD ($) shares	Jun. 30, 2018 USD ($)	Dec. 31, 2018 USD ($) d $ / shares	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Debt Instrument [Line Items]
Loss on debt extinguishment							$ 22,000,000	$ 14,000,000	$ 0
Net carrying amount of debt				$ 1,282,000,000			$ 1,282,000,000
Convertible debt, converted amount of instrument				$ 16,000,000	$ 37,000,000	$ 21,000,000
1.125% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate				1.125%			1.125%
1.625% Convertible Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate				1.625%			1.625%
Convertible Debt \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Debt instrument repayment of principal				$ 62,000,000	140,000,000	96,000,000
Repayments of debt				202,000,000	$ 483,000,000	$ 228,000,000
Loss on debt extinguishment							$ 12,000,000
Net carrying amount of debt				$ 252,000,000			$ 252,000,000
Percentage of contractual interest rate				1.125%			1.125%
Debt instrument conversion price per share (usd per share) \| $ / shares				$ 40.77			$ 40.77
Senior note effective interest rate				6.00%			6.00%
Senior notes amortization period							1 year
If-converted value in excess of principal on convertible debt							$ 581,000,000	406,000,000
Debt instrument, conversion ratio							0.0245277
Convertible Debt \| 1.625% Convertible Notes
Debt Instrument [Line Items]
Loss on debt extinguishment		$ 10,000,000	$ 14,000,000
Net carrying amount of debt				$ 64,000,000			$ 64,000,000
Percentage of contractual interest rate				1.625%			1.625%
Debt instrument conversion price per share (usd per share) \| $ / shares				$ 58.09			$ 58.09
Equity component			12,000,000					$ 12,000,000
Debt instrument, conversion ratio							0.0172157
Convertible debt, converted amount of instrument	$ 64,000,000	$ 97,000,000	$ 141,000,000
Convertible debt, shares converted in transaction (in shares) \| shares		1.8	2.6		0.6
Convertible Debt \| Redemption period, option one \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Debt convertible threshold trading days \| d							20
Debt convertible threshold consecutive trading days \| d							30
Debt convertible threshold percentage of stock price trigger							130.00%
Convertible Debt \| Redemption period, option two \| 1.125% Convertible Notes
Debt Instrument [Line Items]
Debt convertible threshold trading days \| d							5
Debt convertible threshold consecutive trading days \| d							5
Debt convertible maximum threshold percentage of stock price							98.00%

Debt - Lease Financing Obligations and Debt Committment Letter (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) Lease_Renewal_Option extension property	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Debt Instrument [Line Items]
Interest expense under leases \| $	$ 17	$ 17	$ 17
Molina Center And Ohio Exchange
Debt Instrument [Line Items]
Annual increase in rental payment	3.00%
Number of extensions available (in extension) \| extension	6
Lease renewal terms	5 years
Property Subject to Operating Lease \| 6th & Pine Development, LLC
Debt Instrument [Line Items]
Lease renewal terms	5 years
Number of properties \| property	2
Annual increase in rental payment	3.40%
Operating lease renewal options \| Lease_Renewal_Option	2

Derivatives (Details) - USD ($) $ in Millions	3 Months Ended			12 Months Ended
Derivatives (Details) - USD ($) $ in Millions	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Derivative [Line Items]
Cash received for partial settlement of 1.125% Call Option				$ 623	$ 0	$ 0
Cash paid for partial termination of 1.125% Warrants				$ 549	0	$ 0
Convertible debt, converted amount of instrument	$ 16	$ 37	$ 21
1.125% Convertible Notes
Derivative [Line Items]
Percentage of contractual interest rate	1.125%			1.125%
1.125% Call Option
Derivative [Line Items]
Fixed interest rate on derivative	1.125%			1.125%
1.125% Call Option \| Current assets
Derivative [Line Items]
Derivative asset	$ 476			$ 476	522
1.125% Conversion Option
Derivative [Line Items]
Cash received for partial settlement of 1.125% Call Option	$ 146	343	134
Fixed interest rate on derivative	1.125%			1.125%
1.125% Conversion Option \| Current liabilities
Derivative [Line Items]
Derivative liability	$ 476			$ 476	$ 522
1.125% Warrants
Derivative [Line Items]
Cash paid for partial termination of 1.125% Warrants	$ 130	$ 306	$ 113

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	$ 332
Change in tax rate, deferred tax asset, income tax expense (benefit)		$ 54
Income tax (benefit) expense	292	(100)	$ 153
Measurement period adjustment, income tax expense (benefit)	4
Deferred tax assets	28
Increase in deferred tax asset valuation allowance	13
Valuation allowance	28	41
Impact on effective tax rate if tax benefits are recognized	18	$ 12	$ 9
Liability for unrecognized tax benefits, potential decrease	3
State
Operating Loss Carryforwards [Line Items]
Tax credit carryovers	$ 14

Income Taxes - Provision for income taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current:
Federal	$ 272	$ (9)	$ 134
State	18	3	3
Foreign	8	0	(6)
Total current	298	(6)	131
Deferred:
Federal	(3)	(85)	19
State	(3)	(9)	2
Foreign	0	0	1
Total deferred	(6)	(94)	22
Income tax expense (benefit)	$ 292	$ (100)	$ 153

Income Taxes - Reconciliation of the U.S. Federal Statutory Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Effective income tax rate reconciliation to the statutory federal income tax rate
Statutory federal tax (benefit) rate	21.00%	35.00%	35.00%
State income provision (benefit), net of federal	(1.20%)	(0.70%)	(1.60%)
Nondeductible health insurer fee (“HIF”)	7.30%	0.00%	37.00%
Nondeductible compensation	0.70%	(2.80%)	3.10%
Nondeductible goodwill impairment	0.00%	(6.60%)	0.00%
Worthless stock deduction	(1.00%)	0.00%	0.00%
Revaluation of net deferred tax assets	(0.40%)	(8.80%)	0.00%
Change in purchase agreement that increased tax basis in assets	(0.00%)	(0.00%)	(2.20%)
Other	(0.40%)	1.10%	(0.30%)
Effective tax (benefit) rate	29.20%	16.40%	74.80%

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Significant components of deferred tax assets and liabilities
Accrued expenses	$ 32	$ 15
Reserve liabilities	7	11
Other accrued medical costs	12	16
Net operating losses	16	27
Fixed assets and intangibles	30	23
Unearned premiums	9	19
Lease financing obligation	30	30
Tax credit carryover	12	15
Other	3	3
Valuation allowance	(28)	(41)
Total deferred income tax assets, net of valuation allowance	123	118
Prepaid expenses	(6)	(6)
Basis in debt	0	(9)
Total deferred income tax liabilities	(6)	(15)
Net deferred income tax asset	$ 117	$ 103

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Unrecognized tax benefits roll forward
Gross unrecognized tax benefits at beginning of period	$ (13)	$ (11)	$ (9)
Increases in tax positions for current year	(9)	(1)	(1)
Increases in tax positions for prior years	0	(4)	(1)
Decreases in tax positions for prior years	0	3	0
Lapse in statute of limitations	2	0	0
Gross unrecognized tax benefits at end of period	$ (20)	$ (13)	$ (11)

Stockholders' Equity - Additional Information (Details) - USD ($)	1 Months Ended		3 Months Ended			12 Months Ended
	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of warrants issued (in shares)									13,490,236
Striking price of Warrants (USD per share)									$ 53.8475
Cash paid for partial termination of 1.125% Warrants						$ 549,000,000	$ 0	$ 0
Unrecognized compensation expense			$ 35,000,000			$ 35,000,000
Unrecognized compensation forfeited rate						16.10%
Weighted average grant date fair value of stock options granted (usd per share)						$ 41.43
Granted (in shares)						0		0
Common stock issued during period (in shares)						216,000	351,000	410,000
Separation Costs - Former Executives
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Restructuring settled without cash							$ 23,000,000
RSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average period of unrecognized compensation expense						2 years 7 months
Accelerating vesting awards (in shares)							133,957
PSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average period of unrecognized compensation expense						2 months
Accelerating vesting awards (in shares)							153,574
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average period of unrecognized compensation expense						2 years
Accelerating vesting awards (in shares)							139,272
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense			$ 9,000,000			$ 9,000,000
Weighted average period of unrecognized compensation expense						1 year 9 months
Risk free interest rate						2.30%
Expected volatility rate						38.40%
Dividend yield						0.00%
Expected term of awards						8 years 5 months
Options exercised, intrinsic value							$ 2,000,000	$ 1,000,000
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares)			3,000,000			3,000,000
Dividend yield						0.00%
Expected term of awards						6 months 4 days
Employee purchase price as a percentage of stock price						85.00%
Maximum annual contribution per employee						$ 25,000
Risk-free interest rate, minimum						0.40%
Risk-free interest rate, maximum						1.90%
Minimum expected volatility rate inputs for fair value measurement						31.00%
Maximum expected volatility rate inputs for fair value measurement						44.00%
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation (in shares)						365,000	857,000
2011 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized (in shares)			4,500,000.0			4,500,000.0
2011 Plan \| RSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum award vesting period						4 years
2011 Plan \| 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
1.625% Convertible Notes \| Convertible Debt
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Convertible debt, shares converted in transaction (in shares)	1,800,000	2,600,000		600,000
1.125% Warrants
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stated interest rate			1.125%			1.125%
Class of warrant			6,200,000			6,200,000
Cash paid for partial termination of 1.125% Warrants			$ 130,000,000	$ 306,000,000	$ 113,000,000
Options terminated (in shares)			1,500,000	3,400,000	2,400,000

Stockholders' Equity - Components of Share-based Compensation Expenses (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Stock based compensation expense
Pretax Charges	$ 27	$ 46	$ 26
Net-of-Tax Amount	26	40	22
RSAs, PSAs and PSUs
Stock based compensation expense
Pretax Charges	17	39	20
Net-of-Tax Amount	17	35	17
Employee stock purchase plan and stock options
Stock based compensation expense
Pretax Charges	10	7	6
Net-of-Tax Amount	$ 9	$ 5	$ 5

Stockholders' Equity - Restricted and Performance Stock Activity (Details)	12 Months Ended
	Dec. 31, 2018 $ / shares shares
Shares
Unvested, shares beginning of period (in shares)	578,394
Granted (in shares)	578,692
Vested (in shares)	(225,538)
Forfeited (in shares)	(327,238)
Unvested, shares end of period (in shares)	604,310
Weighted Average Grant Date Fair Value
Unvested, weighted average grant date fair value beginning balance (USD per share) \| $ / shares	$ 58.35
Granted (USD per share) \| $ / shares	75.38
Vested (USD per share) \| $ / shares	59.08
Forfeited (USD per share) \| $ / shares	63.69
Unvested, weighted average grant date fair value ending balance (USD per share) \| $ / shares	$ 71.50
RSAs
Shares
Unvested, shares beginning of period (in shares)	401,804
Granted (in shares)	363,740
Vested (in shares)	(192,609)
Forfeited (in shares)	(173,140)
Unvested, shares end of period (in shares)	399,795
PSAs
Shares
Unvested, shares beginning of period (in shares)	84,762
Granted (in shares)	0
Vested (in shares)	(32,929)
Forfeited (in shares)	(48,701)
Unvested, shares end of period (in shares)	3,132
PSUs
Shares
Unvested, shares beginning of period (in shares)	91,828
Granted (in shares)	214,952
Vested (in shares)	0
Forfeited (in shares)	(105,397)
Unvested, shares end of period (in shares)	201,383

Stockholders' Equity - Fair Value of Awards Granted and Vested (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares granted	$ 44	$ 36	$ 34
Fair value of restricted shares vested	18	47	22
RSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares granted	28	20	19
Fair value of restricted shares vested	15	23	22
PSAs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares granted	0	0	15
Fair value of restricted shares vested	3	15	0
PSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Fair value of restricted shares granted	16	16	0
Fair value of restricted shares vested	$ 0	$ 9	$ 0

Stockholders' Equity - Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2016
Shares
Beginning balance, outstanding (in shares)	405,000
Granted (in shares)	0	0
Exercised (in shares)	0
Ending balance, outstanding (in shares)	405,000
Weighted Average Exercise Price
Beginning balance, outstanding (usd per share)	$ 64.79
Granted (usd per share)	0.00
Exercised (usd per share)	0.00
Ending balance, outstanding (usd per share)	$ 64.79
Outstanding, Aggregate Intrinsic Value	$ 21
Outstanding, Weighted Average Remaining Contractual term	8 years 6 months
Stock options exercisable and expected to vest (in shares)	405,000
Stock options exercisable and expected to vest (usd per share)	$ 64.79
Exercisable (in shares)	155,000
Exercisable (usd per share)	$ 60.69
Exercisable, Aggregate Intrinsic Value	$ 9
Exercisable, Weighted Average Remaining Contractual term	8 years

Stockholders' Equity - Stock Options by Exercise Price (Details)	12 Months Ended
	Dec. 31, 2018 $ / shares shares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Outstanding Options	405,000
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Exercisable Options	155,000
$33.02
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Outstanding Options	30,000
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Outstanding Options, Weighted Average Remaining Contractual Term	4 years 2 months
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Outstanding Options, Weighted Average Exercise Price \| $ / shares	$ 33.02
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Exercisable Options	30,000
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Exercisable Options, Weighted Average Exercise Price \| $ / shares	$ 33.02
$67.33
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Outstanding Options	375,000
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Outstanding Options, Weighted Average Remaining Contractual Term	8 years 11 months
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Outstanding Options, Weighted Average Exercise Price \| $ / shares	$ 67.33
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Number of Exercisable Options	125,000
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range, Exercisable Options, Weighted Average Exercise Price \| $ / shares	$ 67.33

Restructuring and Separation Costs - Narrative (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended			24 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2018
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs	$ 8	$ 5	$ 8	$ 25	$ 73	$ 118	$ 43	$ 0	$ 46	$ 234	$ 0
2017 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									37	234		$ 271
Other \| IT Restructuring
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									9
Restructuring costs expected	$ 11								11			11
Other \| 2017 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									$ 26	$ 161		$ 187

Restructuring and Separation Costs - Restructuring Costs by Segment (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended			24 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2018
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs	$ 8	$ 5	$ 8	$ 25	$ 73	$ 118	$ 43	$ 0	$ 46	$ 234	$ 0
IT Restructuring \| Other
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									9
IT Restructuring \| Other \| One-Time Termination Benefits
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									7
IT Restructuring \| Other \| Consulting Fees
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									2
2017 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									37	234		$ 271
2017 Restructuring Plan \| Separation Costs - Former Executives
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									0	36		36
2017 Restructuring Plan \| One-Time Termination Benefits
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									5	67		72
2017 Restructuring Plan \| Write-offs of Current and Long-lived Assets
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									19	61		80
2017 Restructuring Plan \| Consulting Fees
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									1	44		45
2017 Restructuring Plan \| Contract Termination Costs
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									12	26		38
2017 Restructuring Plan \| Health Plans
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									11	73		84
2017 Restructuring Plan \| Health Plans \| Separation Costs - Former Executives
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									0	0		0
2017 Restructuring Plan \| Health Plans \| One-Time Termination Benefits
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									0	33		33
2017 Restructuring Plan \| Health Plans \| Write-offs of Current and Long-lived Assets
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									(1)	16		15
2017 Restructuring Plan \| Health Plans \| Consulting Fees
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									0	0		0
2017 Restructuring Plan \| Health Plans \| Contract Termination Costs
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									12	24		36
2017 Restructuring Plan \| Other
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									26	161		187
2017 Restructuring Plan \| Other \| Separation Costs - Former Executives
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									0	36		36
2017 Restructuring Plan \| Other \| One-Time Termination Benefits
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									5	34		39
2017 Restructuring Plan \| Other \| Write-offs of Current and Long-lived Assets
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									20	45		65
2017 Restructuring Plan \| Other \| Consulting Fees
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									1	44		45
2017 Restructuring Plan \| Other \| Contract Termination Costs
Restructuring Cost and Reserve [Line Items]
Restructuring and separation costs									$ 0	$ 2		$ 2

Restructuring and Separation Costs - Other Restructuring Costs (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($)
Restructuring Reserve
Accrued, beginning of period	$ 48
Adjustments	10
Charges	8
Cash payments	(48)
Accrued, end of period	18
Separation Costs - Former Executives
Restructuring Reserve
Accrued, beginning of period	2
Adjustments	0
Charges	0
Cash payments	(2)
Accrued, end of period	0
One-Time Termination Benefits
Restructuring Reserve
Accrued, beginning of period	11
Adjustments	(1)
Charges	6
Cash payments	(15)
Accrued, end of period	1
Other Restructuring Costs
Restructuring Reserve
Accrued, beginning of period	35
Adjustments	11
Charges	2
Cash payments	(31)
Accrued, end of period	17
IT Restructuring
Restructuring Reserve
Accrued, beginning of period	0
Charges	9
Cash payments	(3)
Accrued, end of period	6
IT Restructuring \| One-Time Termination Benefits
Restructuring Reserve
Accrued, beginning of period	0
Charges	7
Cash payments	(2)
Accrued, end of period	5
IT Restructuring \| Other Restructuring Costs
Restructuring Reserve
Accrued, beginning of period	0
Charges	2
Cash payments	(1)
Accrued, end of period	$ 1

Employee Benefits (Details) - USD ($) $ in Millions	12 Months Ended
Employee Benefits (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Postemployment Benefits [Abstract]
Maximum matching contribution by employer under defined contribution plan	4.00%
Expense recognized in connection with contributions	$ 36	$ 43	$ 36
Deferred compensation plan deferral percentage of basic salary	100.00%
Deferred compensation plan deferral percentage of bonus	100.00%

Commitments and Contingencies - Additional Information (Details) $ in Millions	12 Months Ended
	Dec. 31, 2018 USD ($) Lease_Renewal_Option	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Sale Leaseback Transaction [Line Items]
Net assets of subsidiaries subject to restrictions	$ 2,262	$ 1,691
Aggregate statutory capital and surplus	2,388
Required minimum statutory capital surplus	1,040
Rental expense related to leases	$ 62	75	$ 64
Minimum
Sale Leaseback Transaction [Line Items]
Operating lease terms	5 years
Operating lease renewal options \| Lease_Renewal_Option	1
Maximum
Sale Leaseback Transaction [Line Items]
Operating lease terms	10 years
Operating lease renewal options \| Lease_Renewal_Option	2
Parent Company
Sale Leaseback Transaction [Line Items]
Cash, cash equivalents, and investments	$ 170	$ 696

Commitments and Contingencies - Future Minimum Lease Payments (Details) $ in Millions	Dec. 31, 2018 USD ($)
Summary of future minimum lease payments
2019	$ 65
2020	53
2021	44
2022	37
2023	33
Thereafter	326
Total minimum lease payments	558
Lease Financing Obligations
Summary of future minimum lease payments
2019	19
2020	19
2021	20
2022	21
2023	21
Thereafter	311
Total minimum lease payments	411
Operating Leases
Summary of future minimum lease payments
2019	46
2020	34
2021	24
2022	16
2023	12
Thereafter	15
Total minimum lease payments	$ 147

Segment Information - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Total revenue	$ 4,664	$ 4,697	$ 4,883	$ 4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	$ 18,890	$ 19,883	$ 17,782
Margin	664	$ 566	$ 673	$ 615	446	$ 564	$ 254	$ 546	2,518	1,810	1,725
Goodwill and intangible assets, net	190				255				190	255	760
Total assets	7,154				8,471				7,154	8,471	7,449
Health Plans
Segment Reporting Information [Line Items]
Total revenue									18,471	19,352	17,234
Goodwill and intangible assets, net	190				212				190	212	513
Total assets	6,165				6,347				6,165	6,347	5,897
Other
Segment Reporting Information [Line Items]
Total revenue									419	531	548
Margin									43	29	54
Goodwill and intangible assets, net	0				43				0	43	247
Total assets	$ 989				$ 2,124				$ 989	$ 2,124	$ 1,552

Segment Information - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment Reporting Information [Line Items]
Total margin	$ 664	$ 566	$ 673	$ 615	$ 446	$ 564	$ 254	$ 546	$ 2,518	$ 1,810	$ 1,725
Add: Other operating revenues	4,664	4,697	4,883	4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	18,890	19,883	17,782
Less: Other operating expenses									(17,744)	(20,438)	(17,476)
Less: loss on sales of subsidiaries, net of gain	$ (52)	$ 37	$ 0	$ 0					(15)	0	0
Operating income (loss)									1,131	(555)	306
Less: other expenses, net									132	57	101
Income (loss) before income tax expense (benefit)									999	(612)	205
Health Plans
Segment Reporting Information [Line Items]
Add: Other operating revenues									18,471	19,352	17,234
Other
Segment Reporting Information [Line Items]
Total margin									43	29	54
Add: Other operating revenues									419	531	548
Operating Segments
Segment Reporting Information [Line Items]
Total margin									2,518	1,810	1,725
Operating Segments \| Health Plans
Segment Reporting Information [Line Items]
Total margin									2,475	1,781	1,671
Operating Segments \| Other
Segment Reporting Information [Line Items]
Total margin									43	29	54
Other Operating
Segment Reporting Information [Line Items]
Add: Other operating revenues									871	508	798
Less: Other operating expenses									(2,243)	(2,873)	(2,217)
Less: loss on sales of subsidiaries, net of gain									$ (15)	$ 0	$ 0

Quarterly Results of Operations (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Summary of quarterly results of operations
Total revenue	$ 4,664	$ 4,697	$ 4,883	$ 4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	$ 18,890	$ 19,883	$ 17,782
Margin	664	566	673	615	446	564	254	546	2,518	1,810	1,725
Gain (loss) on sales of subsidiaries	(52)	37	0	0					(15)	0	0
Impairment losses					269	129	72	0	0	470	0
Restructuring and separation costs	8	5	8	25	73	118	43	0	46	234	0
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	$ 707	$ (512)	$ 52
Net income (loss) per share:
Basic (in dollars per share)	$ 3.24	$ 3.22	$ 3.29	$ 1.79	$ (4.59)	$ (1.70)	$ (4.10)	$ 1.38	$ 11.57	$ (9.07)	$ 0.93
Diluted (in dollars per share)	$ 3.01	$ 2.90	$ 3.02	$ 1.64	$ (4.59)	$ (1.70)	$ (4.10)	$ 1.37	$ 10.61	$ (9.07)	$ 0.92

Condensed Financial Information of Registrant - Condensed Balance Sheets (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 2,826	$ 3,186	$ 2,819
Investments	1,681	2,524
Restricted investments	0	169
Receivables	1,330	871
Due from affiliates	0	0
Prepaid expenses and other current assets	149	239
Derivative asset	476	522
Total current assets	6,462	7,511
Property, equipment, and capitalized software, net	241	342
Goodwill and intangible assets, net	190	255	760
Investments in subsidiaries	0	0
Deferred income taxes	117	103
Total assets	7,154	8,471	7,449
Current liabilities:
Medical claims and benefits payable	1,961	2,192	$ 1,929	$ 1,685
Accounts payable and accrued liabilities	390	366
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	4,246	5,557
Other long-term liabilities	44	61
Total liabilities	5,507	7,134
Stockholders’ equity:
Common stock, $0.001 par value; 150 shares authorized; outstanding: 62 shares at December 31, 2018 and 60 shares at December 31, 2017	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	643	1,044
Accumulated other comprehensive loss	(8)	(5)
Retained earnings	1,012	298
Total stockholders’ equity	1,647	1,337
Total liabilities and stockholders' equity	7,154	8,471
Parent Company
Current assets:
Cash and cash equivalents	70	504
Investments	100	192
Restricted investments	0	169
Receivables	2	2
Due from affiliates	90	148
Prepaid expenses and other current assets	47	103
Derivative asset	476	522
Total current assets	785	1,640
Property, equipment, and capitalized software, net	176	223
Goodwill and intangible assets, net	13	15
Investments in subsidiaries	2,768	2,306
Deferred income taxes	39	17
Advances to related parties and other assets	40	32
Total assets	3,821	4,233
Current liabilities:
Medical claims and benefits payable	4	3
Accounts payable and accrued liabilities	223	178
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	944	1,356
Long-term debt	1,020	1,318
Lease financing obligations	197	198
Other long-term liabilities	13	24
Total liabilities	2,174	2,896
Stockholders’ equity:
Common stock, $0.001 par value; 150 shares authorized; outstanding: 62 shares at December 31, 2018 and 60 shares at December 31, 2017	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	643	1,044
Accumulated other comprehensive loss	(8)	(5)
Retained earnings	1,012	298
Total stockholders’ equity	1,647	1,337
Total liabilities and stockholders' equity	$ 3,821	$ 4,233

Condensed Financial Information of Registrant - Condensed Balance Sheets - Additional Information (Details) - $ / shares	Dec. 31, 2018	Dec. 31, 2017
Common stock, par value (dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares outstanding	62,000,000	60,000,000
Preferred stock, par value (dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	20,000,000	20,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Parent Company
Common stock, par value (dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares outstanding	62,000,000	60,000,000
Preferred stock, par value (dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	20,000,000	20,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

Condensed Financial Information of Registrant - Condensed Statements of Income (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Total revenue	$ 4,664	$ 4,697	$ 4,883	$ 4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	$ 18,890	$ 19,883	$ 17,782
Expenses:
General and administrative expenses									1,333	1,594	1,393
Depreciation and amortization									99	137	139
Impairment losses					269	129	72	0	0	470	0
Restructuring and separation costs	8	5	8	25	73	118	43	0	46	234	0
Total operating expenses									17,744	20,438	17,476
Gain (loss) on sales of subsidiaries	(52)	37	0	0					(15)	0	0
Operating income (loss)									1,131	(555)	306
Interest expense									115	118	101
Other expense (income)									17	(61)	0
Income tax (benefit) expense									292	(100)	153
Net loss before equity in net earnings (losses) of subsidiaries									707	(512)	52
Equity in net earnings (losses) of subsidiaries									0	0	0
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	707	(512)	52
Parent Company
Revenue:
Investment income and other revenue									17	16	16
Total revenue									1,155	1,333	1,078
Expenses:
Medical care costs									8	16	73
General and administrative expenses									1,007	1,082	899
Depreciation and amortization									69	93	95
Impairment losses									0	39	0
Restructuring and separation costs									35	153	0
Total operating expenses									1,119	1,383	1,067
Gain (loss) on sales of subsidiaries									37	0	0
Operating income (loss)									73	(50)	11
Interest expense									114	117	101
Other expense (income)									17	(61)	0
Loss before income tax (benefit) expense and equity in net earnings (losses) of subsidiaries									(58)	(106)	(90)
Income tax (benefit) expense									(14)	8	(24)
Net loss before equity in net earnings (losses) of subsidiaries									(44)	(114)	(66)
Equity in net earnings (losses) of subsidiaries									751	(398)	118
Net income (loss)									707	(512)	52
Management Fees \| Parent Company
Revenue:
Management fees									$ 1,138	$ 1,317	$ 1,062

Condensed Financial Information of Registrant - Condensed Statements of Comprehensive Income (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Condensed Financial Statements, Captions [Line Items]
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	$ 707	$ (512)	$ 52
Unrealized investment (loss) gain									(3)	(5)	3
Less: effect of income taxes									(1)	(2)	1
Other comprehensive (loss) income, net of tax									(2)	(3)	2
Comprehensive income (loss)									705	(515)	54
Parent Company
Condensed Financial Statements, Captions [Line Items]
Net income (loss)									707	(512)	52
Unrealized investment (loss) gain									(3)	(5)	3
Less: effect of income taxes									(1)	(2)	1
Other comprehensive (loss) income, net of tax									(2)	(3)	2
Comprehensive income (loss)									$ 705	$ (515)	$ 54

- Definition

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

+ References + Details

Condensed Financial Information of Registrant - Condensed Statements of Cash Flows (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating activities:
Net cash provided by operating activities	$ (314)	$ 804	$ 673
Investing activities:
Capital contributions to subsidiaries			0
Dividends received from subsidiaries	0	0	0
Purchases of investments	(1,444)	(2,697)	(1,929)
Proceeds from sales and maturities of investments	2,445	1,759	1,966
Purchases of property, equipment and capitalized software	(30)	(86)	(176)
Net cash received from sale of subsidiaries	190	0	0
Change in amounts due to/from affiliates	0	0	0
Other, net	(18)	(38)	(19)
Net cash provided by (used in) investing activities	1,143	(1,062)	(206)
Financing activities:
Repayment of credit facility	(300)	0	0
Cash paid for partial settlement of 1.125% Conversion Option	(623)	0	0
Cash received for partial settlement of 1.125% Call Option	623	0	0
Cash paid for partial termination of 1.125% Warrants	(549)	0	0
Proceeds from senior notes offerings, net of issuance costs	0	325	0
Proceeds from borrowings under credit facility	0	300	0
Other, net	18	11	19
Net cash (used in) provided by financing activities	(1,193)	636	19
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(364)	378	486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	3,290	2,912	2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	2,926	3,290	2,912
Parent Company
Operating activities:
Net cash provided by operating activities	118	166	55
Investing activities:
Capital contributions to subsidiaries	(145)	(370)	(386)
Dividends received from subsidiaries	298	286	101
Purchases of investments	(136)	(331)	(115)
Proceeds from sales and maturities of investments	388	156	188
Purchases of property, equipment and capitalized software	(22)	(67)	(125)
Net cash received from sale of subsidiaries	242	0	0
Change in amounts due to/from affiliates	6	(49)	(18)
Other, net	0	0	6
Net cash provided by (used in) investing activities	631	(375)	(349)
Financing activities:
Repayment of credit facility	(300)	0	0
Cash paid for partial settlement of 1.125% Conversion Option	(623)	0	0
Cash received for partial settlement of 1.125% Call Option	623	0	0
Cash paid for partial termination of 1.125% Warrants	(549)	0	0
Proceeds from senior notes offerings, net of issuance costs	0	325	0
Proceeds from borrowings under credit facility	0	300	0
Other, net	19	11	20
Net cash (used in) provided by financing activities	(1,192)	636	20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443)	427	(274)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513	86	360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	70	513	86
1.125% Notes
Financing activities:
Repayment of principal amount of Notes	(298)	0	0
1.125% Notes \| Parent Company
Financing activities:
Repayment of principal amount of Notes	(298)	0	0
1.625% Notes
Financing activities:
Repayment of principal amount of Notes	(64)	0	0
1.625% Notes \| Parent Company
Financing activities:
Repayment of principal amount of Notes	$ (64)	$ 0	$ 0

Condensed Financial Information of Registrant - Notes to Condensed Financial Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Parent Company
Related Party Transaction [Line Items]
Services revenue from subsidiaries	$ 1,137	$ 1,317	$ 1,062

Supplemental Condensed Consolidating Financial Information - Additional Information (Details) - 5.375% Notes $ in Millions	Dec. 31, 2018 USD ($)
Condensed Financial Statements, Captions [Line Items]
Percentage of contractual interest rate on Notes	5.375%
Senior Notes
Condensed Financial Statements, Captions [Line Items]
Face amount of debt	$ 700
Percentage of contractual interest rate on Notes	5.375%

Supplemental Condensed Consolidating Financial Information - Condensed Consolidating Statements of Operations (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Total revenue	$ 4,664	$ 4,697	$ 4,883	$ 4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	$ 18,890	$ 19,883	$ 17,782
Expenses:
General and administrative expenses									1,333	1,594	1,393
Premium tax expenses									417	438	468
Health insurer fees									348	0	217
Depreciation and amortization									99	137	139
Restructuring and separation costs	8	5	8	25	73	118	43	0	46	234	0
Impairment losses					269	129	72	0	0	470	0
Total operating expenses									17,744	20,438	17,476
Gain (loss) on sales of subsidiaries	(52)	37	0	0					(15)	0	0
Operating income (loss)									1,131	(555)	306
Interest expense									115	118	101
Other expense									(17)	61	0
Total other expenses, net									(132)	(57)	(101)
Income (loss) before income tax expense (benefit)									999	(612)	205
Income tax (benefit) expense									292	(100)	153
Net loss before equity in net earnings (losses) of subsidiaries									707	(512)	52
Equity in net earnings (losses) of subsidiaries									0	0	0
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	707	(512)	52
Parent Issuer
Revenue:
Total revenue									1,155	1,333	1,078
Expenses:
General and administrative expenses									1,007	1,082	899
Depreciation and amortization									69	93	95
Restructuring and separation costs									35	153	0
Impairment losses									0	39	0
Total operating expenses									1,119	1,383	1,067
Gain (loss) on sales of subsidiaries									37	0	0
Operating income (loss)									73	(50)	11
Interest expense									114	117	101
Other expense									(17)	61	0
Income tax (benefit) expense									(14)	8	(24)
Net loss before equity in net earnings (losses) of subsidiaries									(44)	(114)	(66)
Equity in net earnings (losses) of subsidiaries									751	(398)	118
Net income (loss)									707	(512)	52
Reportable Legal Entities \| Parent Issuer
Revenue:
Total revenue									1,155	1,333	1,078
Expenses:
General and administrative expenses									1,007	1,082	899
Premium tax expenses									0	0	0
Health insurer fees									0		0
Depreciation and amortization									69	93	95
Restructuring and separation costs									35	153
Impairment losses										39
Total operating expenses									1,119	1,383	1,067
Gain (loss) on sales of subsidiaries									37
Operating income (loss)									73	(50)	11
Interest expense									114
Other expense									(17)
Total other expenses, net										(56)	(101)
Income (loss) before income tax expense (benefit)									(58)	(106)	(90)
Income tax (benefit) expense									(14)	8	(24)
Net loss before equity in net earnings (losses) of subsidiaries									(44)	(114)	(66)
Equity in net earnings (losses) of subsidiaries									751	(398)	118
Net income (loss)									707	(512)	52
Reportable Legal Entities \| Other Guarantor
Revenue:
Total revenue									3	2	0
Expenses:
General and administrative expenses									4	2	2
Premium tax expenses									0	0	0
Health insurer fees									0		0
Depreciation and amortization									0	0	0
Restructuring and separation costs									0	0
Impairment losses										0
Total operating expenses									4	2	2
Gain (loss) on sales of subsidiaries									(52)
Operating income (loss)									(53)	0	(2)
Interest expense									0
Other expense									0
Total other expenses, net										0	0
Income (loss) before income tax expense (benefit)									(53)	0	(2)
Income tax (benefit) expense									(11)	0	(1)
Net loss before equity in net earnings (losses) of subsidiaries									(42)	0	(1)
Equity in net earnings (losses) of subsidiaries									(5)	(164)	2
Net income (loss)									(47)	(164)	1
Reportable Legal Entities \| Non-Guarantors
Revenue:
Total revenue									18,884	19,904	17,786
Expenses:
General and administrative expenses									1,474	1,865	1,573
Premium tax expenses									417	438	468
Health insurer fees									348		217
Depreciation and amortization									30	44	44
Restructuring and separation costs									11	81
Impairment losses										431
Total operating expenses									17,773	20,409	17,489
Gain (loss) on sales of subsidiaries									0
Operating income (loss)									1,111	(505)	297
Interest expense									1
Other expense									0
Total other expenses, net										(1)	0
Income (loss) before income tax expense (benefit)									1,110	(506)	297
Income tax (benefit) expense									317	(108)	178
Net loss before equity in net earnings (losses) of subsidiaries									793	(398)	119
Equity in net earnings (losses) of subsidiaries									0	8	0
Net income (loss)									793	(390)	119
Eliminations
Revenue:
Total revenue									(1,152)	(1,356)	(1,082)
Expenses:
General and administrative expenses									(1,152)	(1,355)	(1,081)
Premium tax expenses									0	0	0
Health insurer fees									0		0
Depreciation and amortization									0	0	0
Restructuring and separation costs									0	0
Impairment losses										0
Total operating expenses									(1,152)	(1,356)	(1,082)
Gain (loss) on sales of subsidiaries									0
Operating income (loss)									0	0	0
Interest expense									0
Other expense									0
Total other expenses, net										0	0
Income (loss) before income tax expense (benefit)									0	0	0
Income tax (benefit) expense									0	0	0
Net loss before equity in net earnings (losses) of subsidiaries									0	0	0
Equity in net earnings (losses) of subsidiaries									(746)	554	(120)
Net income (loss)									(746)	554	(120)
Medical care costs
Expenses:
Cost of revenue									15,137	17,073	14,774
Medical care costs \| Reportable Legal Entities \| Parent Issuer
Expenses:
Cost of revenue									8	16	73
Medical care costs \| Reportable Legal Entities \| Other Guarantor
Expenses:
Cost of revenue									0	0	0
Medical care costs \| Reportable Legal Entities \| Non-Guarantors
Expenses:
Cost of revenue									15,129	17,058	14,702
Medical care costs \| Eliminations
Expenses:
Cost of revenue									0	(1)	(1)
Cost of service revenue
Expenses:
Cost of revenue									364	492	485
Cost of service revenue \| Reportable Legal Entities \| Parent Issuer
Expenses:
Cost of revenue									0	0	0
Cost of service revenue \| Reportable Legal Entities \| Other Guarantor
Expenses:
Cost of revenue									0	0	0
Cost of service revenue \| Reportable Legal Entities \| Non-Guarantors
Expenses:
Cost of revenue									364	492	485
Cost of service revenue \| Eliminations
Expenses:
Cost of revenue									$ 0	$ 0	$ 0

Supplemental Condensed Consolidating Financial Information - Condensed Consolidating Statements of Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Condensed Statement of Income Captions [Line Items]
Net income (loss)	$ 201	$ 197	$ 202	$ 107	$ (262)	$ (97)	$ (230)	$ 77	$ 707	$ (512)	$ 52
Other comprehensive income (loss), net of tax									(2)	(3)	2
Comprehensive income (loss)									705	(515)	54
Parent Issuer
Condensed Statement of Income Captions [Line Items]
Net income (loss)									707	(512)	52
Other comprehensive income (loss), net of tax									(2)	(3)	2
Comprehensive income (loss)									705	(515)	54
Reportable Legal Entities \| Parent Issuer
Condensed Statement of Income Captions [Line Items]
Net income (loss)									707	(512)	52
Other comprehensive income (loss), net of tax									(2)	(3)	2
Comprehensive income (loss)									705	(515)	54
Reportable Legal Entities \| Other Guarantor
Condensed Statement of Income Captions [Line Items]
Net income (loss)									(47)	(164)	1
Other comprehensive income (loss), net of tax									0	0	0
Comprehensive income (loss)									(47)	(164)	1
Reportable Legal Entities \| Non-Guarantors
Condensed Statement of Income Captions [Line Items]
Net income (loss)									793	(390)	119
Other comprehensive income (loss), net of tax									(2)	(2)	1
Comprehensive income (loss)									791	(392)	120
Eliminations
Condensed Statement of Income Captions [Line Items]
Net income (loss)									(746)	554	(120)
Other comprehensive income (loss), net of tax									2	2	(1)
Comprehensive income (loss)									$ (744)	$ 556	$ (121)

- Definition

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

+ References + Details

Supplemental Condensed Consolidating Financial Information - Condensed Consolidating Balance Sheet (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 2,826	$ 3,186	$ 2,819
Investments	1,681	2,524
Restricted investments	0	169
Receivables	1,330	871
Due from (to) affiliates	0	0
Prepaid expenses and other current assets	149	239
Derivative asset	476	522
Total current assets	6,462	7,511
Property, equipment, and capitalized software, net	241	342
Goodwill and intangible assets, net	190	255	760
Restricted investments	120	119
Investments in subsidiaries	0	0
Deferred income taxes	117	103
Other assets	24	141
Total assets	7,154	8,471	7,449
Current liabilities:
Medical claims and benefits payable	1,961	2,192	$ 1,929	$ 1,685
Amounts due government agencies	967	1,542
Accounts payable and accrued liabilities	390	366
Deferred revenue	211	282
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	4,246	5,557
Long-term debt and lease financing obligations	1,217	1,516
Deferred income taxes		0
Other long-term liabilities	44	61
Total liabilities	5,507	7,134
Total stockholders' equity	1,647	1,337
Total liabilities and stockholders' equity	7,154	8,471
Parent Issuer
Current assets:
Cash and cash equivalents	70	504
Investments	100	192
Restricted investments	0	169
Receivables	2	2
Due from (to) affiliates	90	148
Prepaid expenses and other current assets	47	103
Derivative asset	476	522
Total current assets	785	1,640
Property, equipment, and capitalized software, net	176	223
Goodwill and intangible assets, net	13	15
Investments in subsidiaries	2,768	2,306
Deferred income taxes	39	17
Total assets	3,821	4,233
Current liabilities:
Medical claims and benefits payable	4	3
Accounts payable and accrued liabilities	223	178
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	944	1,356
Other long-term liabilities	13	24
Total liabilities	2,174	2,896
Total stockholders' equity	1,647	1,337
Total liabilities and stockholders' equity	3,821	4,233
Reportable Legal Entities \| Parent Issuer
Current assets:
Cash and cash equivalents	70	504
Investments	100	192
Restricted investments		169
Receivables	2	2
Due from (to) affiliates	90	148
Prepaid expenses and other current assets	47	103
Derivative asset	476	522
Total current assets	785	1,640
Property, equipment, and capitalized software, net	176	223
Goodwill and intangible assets, net	13	15
Restricted investments	0	0
Investments in subsidiaries	2,768	2,306
Deferred income taxes	39	17
Other assets	40	32
Total assets	3,821	4,233
Current liabilities:
Medical claims and benefits payable	4	3
Amounts due government agencies	0	0
Accounts payable and accrued liabilities	223	178
Deferred revenue	0	0
Current portion of long-term debt	241	653
Derivative liability	476	522
Total current liabilities	944	1,356
Long-term debt and lease financing obligations	1,217	1,516
Deferred income taxes		0
Other long-term liabilities	13	24
Total liabilities	2,174	2,896
Total stockholders' equity	1,647	1,337
Total liabilities and stockholders' equity	3,821	4,233
Reportable Legal Entities \| Other Guarantor
Current assets:
Cash and cash equivalents	2	0
Investments	0	0
Restricted investments		0
Receivables	0	0
Due from (to) affiliates	7	2
Prepaid expenses and other current assets	29	2
Derivative asset	0	0
Total current assets	38	4
Property, equipment, and capitalized software, net	0	0
Goodwill and intangible assets, net	0	0
Restricted investments	0	0
Investments in subsidiaries	(5)	75
Deferred income taxes	0	0
Other assets	0	0
Total assets	33	79
Current liabilities:
Medical claims and benefits payable	0	0
Amounts due government agencies	0	0
Accounts payable and accrued liabilities	0	1
Deferred revenue	0	0
Current portion of long-term debt	0	0
Derivative liability	0	0
Total current liabilities	0	1
Long-term debt and lease financing obligations	0	0
Deferred income taxes		0
Other long-term liabilities	0	0
Total liabilities	0	1
Total stockholders' equity	33	78
Total liabilities and stockholders' equity	33	79
Reportable Legal Entities \| Non-Guarantors
Current assets:
Cash and cash equivalents	2,754	2,682
Investments	1,581	2,332
Restricted investments		0
Receivables	1,328	869
Due from (to) affiliates	(97)	(150)
Prepaid expenses and other current assets	73	150
Derivative asset	0	0
Total current assets	5,639	5,883
Property, equipment, and capitalized software, net	65	119
Goodwill and intangible assets, net	177	240
Restricted investments	120	119
Investments in subsidiaries	0	0
Deferred income taxes	78	101
Other assets	5	110
Total assets	6,084	6,572
Current liabilities:
Medical claims and benefits payable	1,957	2,189
Amounts due government agencies	967	1,542
Accounts payable and accrued liabilities	167	188
Deferred revenue	211	282
Current portion of long-term debt	0	16
Derivative liability	0	0
Total current liabilities	3,302	4,217
Long-term debt and lease financing obligations	20	0
Deferred income taxes		15
Other long-term liabilities	32	37
Total liabilities	3,354	4,269
Total stockholders' equity	2,730	2,303
Total liabilities and stockholders' equity	6,084	6,572
Eliminations
Current assets:
Cash and cash equivalents	0	0
Investments	0	0
Restricted investments		0
Receivables	0	0
Due from (to) affiliates	0	0
Prepaid expenses and other current assets	0	(16)
Derivative asset	0	0
Total current assets	0	(16)
Property, equipment, and capitalized software, net	0	0
Goodwill and intangible assets, net	0	0
Restricted investments	0	0
Investments in subsidiaries	(2,763)	(2,381)
Deferred income taxes	0	(15)
Other assets	(21)	(1)
Total assets	(2,784)	(2,413)
Current liabilities:
Medical claims and benefits payable	0	0
Amounts due government agencies	0	0
Accounts payable and accrued liabilities	0	(1)
Deferred revenue	0	0
Current portion of long-term debt	0	(16)
Derivative liability	0	0
Total current liabilities	0	(17)
Long-term debt and lease financing obligations	(20)	0
Deferred income taxes		(15)
Other long-term liabilities	(1)	0
Total liabilities	(21)	(32)
Total stockholders' equity	(2,763)	(2,381)
Total liabilities and stockholders' equity	$ (2,784)	$ (2,413)

Supplemental Condensed Consolidating Financial Information - Condensed Consolidating Statements of Cash Flow (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating activities:
Net cash provided by operating activities	$ (314)	$ 804	$ 673
Investing activities:
Purchases of investments	(1,444)	(2,697)	(1,929)
Proceeds from sales and maturities of investments	2,445	1,759	1,966
Purchases of property, equipment and capitalized software	(30)	(86)	(176)
Capital contributions to subsidiaries	0	0
Net cash received from sales of subsidiaries	190
Net cash paid in business combinations	0	0	(48)
Capital contributions to subsidiaries			0
Dividends received from subsidiaries	0	0	0
Change in amounts due to/from affiliates	0	0	0
Other, net	(18)	(38)	(19)
Net cash provided by (used in) investing activities	1,143	(1,062)	(206)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs	0	325	0
Proceeds from borrowings under credit facility	0	300	0
Repayment of credit facility	(300)	0	0
Cash paid for partial settlement of 1.125% Conversion Option	(623)	0	0
Cash received for partial settlement of 1.125% Call Option	623	0	0
Cash paid for partial termination of 1.125% Warrants	549	0	0
Other, net	18	11	19
Net cash (used in) provided by financing activities	(1,193)	636	19
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(364)	378	486
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	3,290	2,912	2,426
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	2,926	3,290	2,912
Eliminations
Operating activities:
Net cash provided by operating activities	0	0	0
Investing activities:
Purchases of investments	0	0	0
Proceeds from sales and maturities of investments	0	0	0
Purchases of property, equipment and capitalized software	0	0	0
Capital contributions to subsidiaries	0	0
Net cash received from sales of subsidiaries	0
Net cash paid in business combinations			0
Capital contributions to subsidiaries			0
Dividends received from subsidiaries	0	0	0
Change in amounts due to/from affiliates	0	0	0
Other, net	0	0	0
Net cash provided by (used in) investing activities	0	0	0
Financing activities:
Proceeds from senior notes offerings, net of issuance costs		0
Proceeds from borrowings under credit facility		0
Repayment of credit facility	0
Cash paid for partial settlement of 1.125% Conversion Option	0
Cash received for partial settlement of 1.125% Call Option	0
Cash paid for partial termination of 1.125% Warrants	0
Other, net	0	0	0
Net cash (used in) provided by financing activities	0	0	0
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	0	0	0
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	0	0	0
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	0	0	0
Parent Issuer
Operating activities:
Net cash provided by operating activities	118	166	55
Investing activities:
Purchases of investments	(136)	(331)	(115)
Proceeds from sales and maturities of investments	388	156	188
Purchases of property, equipment and capitalized software	(22)	(67)	(125)
Capital contributions to subsidiaries	(145)	(370)	(386)
Dividends received from subsidiaries	298	286	101
Change in amounts due to/from affiliates	6	(49)	(18)
Other, net	0	0	6
Net cash provided by (used in) investing activities	631	(375)	(349)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs	0	325	0
Proceeds from borrowings under credit facility	0	300	0
Repayment of credit facility	(300)	0	0
Cash paid for partial settlement of 1.125% Conversion Option	(623)	0	0
Cash received for partial settlement of 1.125% Call Option	623	0	0
Cash paid for partial termination of 1.125% Warrants	549	0	0
Other, net	19	11	20
Net cash (used in) provided by financing activities	(1,192)	636	20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443)	427	(274)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513	86	360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	70	513	86
Parent Issuer \| Reportable Legal Entities
Operating activities:
Net cash provided by operating activities	118	166	55
Investing activities:
Purchases of investments	(136)	(331)	(115)
Proceeds from sales and maturities of investments	388	156	188
Purchases of property, equipment and capitalized software	(22)	(67)	(125)
Capital contributions to subsidiaries	145	370
Net cash received from sales of subsidiaries	242
Net cash paid in business combinations			0
Capital contributions to subsidiaries			(386)
Dividends received from subsidiaries	298	286	101
Change in amounts due to/from affiliates	6	(49)	(18)
Other, net	0	0	6
Net cash provided by (used in) investing activities	631	(375)	(349)
Financing activities:
Proceeds from senior notes offerings, net of issuance costs		325
Proceeds from borrowings under credit facility		300
Repayment of credit facility	(300)
Cash paid for partial settlement of 1.125% Conversion Option	(623)
Cash received for partial settlement of 1.125% Call Option	623
Cash paid for partial termination of 1.125% Warrants	549
Other, net	19	11	20
Net cash (used in) provided by financing activities	(1,192)	636	20
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(443)	427	(274)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	513	86	360
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	70	513	86
Other Guarantor \| Reportable Legal Entities
Operating activities:
Net cash provided by operating activities	(2)	0	(1)
Investing activities:
Purchases of investments	0	0	0
Proceeds from sales and maturities of investments	0	0	0
Purchases of property, equipment and capitalized software	0	0	0
Capital contributions to subsidiaries	0	(2)
Net cash received from sales of subsidiaries	0
Net cash paid in business combinations			0
Capital contributions to subsidiaries			7
Dividends received from subsidiaries	0	0	0
Change in amounts due to/from affiliates	4	(2)	(6)
Other, net	0	0	0
Net cash provided by (used in) investing activities	4	0	1
Financing activities:
Proceeds from senior notes offerings, net of issuance costs		0
Proceeds from borrowings under credit facility		0
Repayment of credit facility	0
Cash paid for partial settlement of 1.125% Conversion Option	0
Cash received for partial settlement of 1.125% Call Option	0
Cash paid for partial termination of 1.125% Warrants	0
Other, net	0	0	0
Net cash (used in) provided by financing activities	0	0	0
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	2	0	0
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	0	0	0
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	2	0	0
Non-Guarantors \| Reportable Legal Entities
Operating activities:
Net cash provided by operating activities	(430)	638	619
Investing activities:
Purchases of investments	(1,308)	(2,366)	(1,814)
Proceeds from sales and maturities of investments	2,057	1,603	1,778
Purchases of property, equipment and capitalized software	(8)	(19)	(51)
Capital contributions to subsidiaries	(145)	(368)
Net cash received from sales of subsidiaries	(52)
Net cash paid in business combinations			(48)
Capital contributions to subsidiaries			379
Dividends received from subsidiaries	(298)	(286)	(101)
Change in amounts due to/from affiliates	(10)	51	24
Other, net	(18)	(38)	(25)
Net cash provided by (used in) investing activities	508	(687)	142
Financing activities:
Proceeds from senior notes offerings, net of issuance costs		0
Proceeds from borrowings under credit facility		0
Repayment of credit facility	0
Cash paid for partial settlement of 1.125% Conversion Option	0
Cash received for partial settlement of 1.125% Call Option	0
Cash paid for partial termination of 1.125% Warrants	0
Other, net	(1)	0	(1)
Net cash (used in) provided by financing activities	(1)	0	(1)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	77	(49)	760
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	2,777	2,826	2,066
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	2,854	2,777	2,826
1.125% Notes
Financing activities:
Repayment of principal amount of Notes	(298)	0	0
1.125% Notes \| Eliminations
Financing activities:
Repayment of principal amount of Notes	0
1.125% Notes \| Parent Issuer
Financing activities:
Repayment of principal amount of Notes	(298)	0	0
1.125% Notes \| Parent Issuer \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	(298)
1.125% Notes \| Other Guarantor \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	0
1.125% Notes \| Non-Guarantors \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	0
1.625% Notes
Financing activities:
Repayment of principal amount of Notes	(64)	0	0
1.625% Notes \| Eliminations
Financing activities:
Repayment of principal amount of Notes	0
1.625% Notes \| Parent Issuer
Financing activities:
Repayment of principal amount of Notes	(64)	$ 0	$ 0
1.625% Notes \| Parent Issuer \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	(64)
1.625% Notes \| Other Guarantor \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	0
1.625% Notes \| Non-Guarantors \| Reportable Legal Entities
Financing activities:
Repayment of principal amount of Notes	$ 0