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, 2020
Mar. 31, 2019
Cash flows from operating activities:    
Net earnings $ 46 $ 519
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 288 155
Stock compensation expense 117 38
Impairment 72 0
Loss on debt extinguishment 44 0
Deferred income taxes 112 23
Gain on divestiture (93) 0
Other adjustments, net 24 (11)
Changes in assets and liabilities    
Premium and trade receivables (2,182) (662)
Other assets 97 20
Medical claims liabilities 252 548
Unearned revenue (88) (22)
Accounts payable and accrued expenses 704 357
Other long-term liabilities 361 347
Other operating activities, net 6 4
Net cash (used in) provided by operating activities (240) 1,316
Cash flows from investing activities:    
Capital expenditures (177) (176)
Purchases of investments (1,400) (580)
Sales and maturities of investments 902 383
Acquisitions, net of cash acquired (3,048) 0
Divestiture proceeds, net of divested cash 456 0
Other investing activities, net (5) 0
Net cash used in investing activities (3,272) (373)
Cash flows from financing activities:    
Proceeds from long-term debt 2,542 1,018
Payments of long-term debt (1,039) (927)
Common stock repurchases (558) (35)
Payments for debt extinguishment (21) 0
Debt issuance costs (92) 0
Other financing activities, net 7 2
Net cash provided by financing activities 839 58
Effect of exchange rate changes on cash, cash equivalents, and restricted cash (1) 0
Net increase (decrease) (2,674) 1,001
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 12,131 5,350
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 9,457 6,351
Supplemental disclosures of cash flow information:    
Interest paid 104 87
Income taxes paid 3 6
Equity issued in connection with acquisitions 11,526 0
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 9,308 6,345
Restricted cash and cash equivalents, included in restricted deposits 149 6
Total cash, cash equivalents, and restricted cash and cash equivalents $ 9,457 $ 6,351