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
3 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Cash flows from operating activities:    
Net earnings $ 697 $ 46
Adjustments to reconcile net earnings to net cash provided by (used in) operating activities    
Depreciation and amortization 361 288
Stock compensation expense 51 117
Impairment 0 72
Loss on debt extinguishment 46 44
Deferred income taxes 156 112
Gain on divestiture 0 (93)
Other adjustments, net 2 24
Changes in assets and liabilities    
Premium and trade receivables (1,891) (2,182)
Other assets (287) 97
Medical claims liabilities 405 252
Unearned revenue 48 (88)
Accounts payable and accrued expenses 32 704
Other long-term liabilities 423 361
Other operating activities, net 0 6
Net cash provided by (used in) operating activities 43 (240)
Cash flows from investing activities:    
Capital expenditures (187) (177)
Purchases of investments (1,653) (1,400)
Sales and maturities of investments 1,391 902
Acquisitions, net of cash acquired (158) (3,048)
Divestiture proceeds, net of divested cash 0 456
Other investing activities, net 0 (5)
Net cash used in investing activities (607) (3,272)
Cash flows from financing activities:    
Proceeds from long-term debt 2,317 2,542
Payments of long-term debt (2,295) (1,039)
Common stock repurchases (29) (558)
Payments for debt extinguishment (54) (21)
Debt issuance costs (27) (92)
Other financing activities, net 15 7
Net cash provided by (used in) financing activities (73) 839
Effect of exchange rate changes on cash, cash equivalents, and restricted cash (16) (1)
Net decrease in cash, cash equivalents and restricted cash and cash equivalents (653) (2,674)
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 10,957 12,131
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 10,304 9,457
Supplemental disclosures of cash flow information:    
Interest paid 130 104
Income taxes paid 20 3
Equity issued in connection with acquisitions 0 11,526
The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:    
Cash and cash equivalents 9,627 9,308
Restricted cash and cash equivalents, included in restricted deposits 677 149
Total cash, cash equivalents, and restricted cash and cash equivalents $ 10,304 $ 9,457