Quarterly report pursuant to Section 13 or 15(d)

CONSOLIDATED STATEMENTS OF CASH FLOWS

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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2018
Sep. 30, 2017
Cash flows from operating activities:    
Net earnings $ 653 $ 585
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 354 264
Stock compensation expense 105 99
Deferred income taxes (103) (32)
Changes in assets and liabilities    
Premium and trade receivables (696) (749)
Other assets 65 (39)
Medical claims liabilities 1,380 406
Unearned revenue (150) 255
Accounts payable and accrued expenses 35 205
Other long-term liabilities 199 45
Other operating activities, net 26 0
Net cash provided by operating activities 1,868 1,039
Cash flows from investing activities:    
Capital expenditures (489) (301)
Purchases of investments (2,691) (1,693)
Sales and maturities of investments 1,575 1,308
Acquisitions, net of cash acquired (1,958) 0
Net cash used in investing activities (3,563) (686)
Cash flows from financing activities:    
Proceeds from the issuance of common stock 2,779 0
Proceeds from long-term debt 5,480 1,170
Payments of long-term debt (3,692) (1,124)
Common stock repurchases (17) (18)
Purchase of noncontrolling interest (63) (33)
Debt issuance costs (25) 0
Other financing activities, net (2) 2
Net cash provided by (used in) financing activities 4,460 (3)
Effect of exchange rate changes on cash, cash equivalents and restricted cash 0 1
Net increase in cash, cash equivalents and restricted cash 2,765 351
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 4,089 3,936
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 6,854 4,287
Supplemental disclosures of cash flow information:    
Interest paid 213 210
Income taxes paid 340 358
Equity issued in connection with acquisitions $ 507 $ 0