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, 2019
Mar. 31, 2018
Cash flows from operating activities:    
Net earnings $ 519 $ 338
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 155 104
Stock compensation expense 38 33
Deferred income taxes 23 30
Changes in assets and liabilities    
Premium and trade receivables (662) (176)
Other assets 20 51
Medical claims liabilities 548 485
Unearned revenue (22) 317
Accounts payable and accrued expenses 357 157
Other long-term liabilities 347 477
Other operating activities, net (7) 30
Net cash provided by operating activities 1,316 1,846
Cash flows from investing activities:    
Capital expenditures (176) (218)
Purchases of investments (580) (765)
Sales and maturities of investments 383 445
Acquisitions, net of cash acquired 0 (226)
Net cash used in investing activities (373) (764)
Cash flows from financing activities:    
Proceeds from long-term debt 1,018 2,015
Payments of long-term debt (927) (1,491)
Common stock repurchases (35) (9)
Other financing activities, net 2 (2)
Net cash provided by financing activities 58 513
Net increase in cash, cash equivalents and restricted cash and cash equivalents 1,001 1,595
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 5,350 4,089
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 6,351 5,684
Supplemental disclosures of cash flow information:    
Interest paid 87 73
Income taxes paid 6 1
Equity issued in connection with acquisitions 0 324
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 6,345 5,668
Restricted cash and cash equivalents, included in restricted deposits 6 16
Cash, cash equivalents, and restricted cash and cash equivalents, end of period $ 6,351 $ 5,684