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Medical Claims Payable (Tables)
 12 Months Ended
Dec. 31, 2013
Medical Claims Payable [Abstract]  
Reconciliation Of The Beginning And Ending Balances For Medical Claims Payable
A reconciliation of the beginning and ending balances for medical claims payable for the years ended December 31 is as follows:
 
Years Ended December 31
 
2013
 
2012
 
2011
Gross medical claims payable, beginning of year
$
6,174.5

 
$
5,489.0

 
$
4,852.4

Ceded medical claims payable, beginning of year
(27.2
)
 
(16.4
)
 
(32.9
)
Net medical claims payable, beginning of year
6,147.3

 
5,472.6

 
4,819.5

Business combinations and purchase adjustments
—

 
804.4

 
100.9

Net incurred medical claims:
 
 
 
 
 
Current year
55,894.3

 
48,080.1

 
47,281.6

Prior years redundancies
(599.1
)
 
(513.6
)
 
(209.7
)
Total net incurred medical claims
55,295.2

 
47,566.5

 
47,071.9

Net payments attributable to:
 
 
 
 
 
Current year medical claims
49,887.2

 
42,832.4

 
41,999.0

Prior years medical claims
5,451.5

 
4,863.8

 
4,520.7

Total net payments
55,338.7

 
47,696.2

 
46,519.7

Net medical claims payable, end of year
6,103.8

 
6,147.3

 
5,472.6

Ceded medical claims payable, end of year
23.4

 
27.2

 
16.4

Gross medical claims payable, end of year
$
6,127.2

 
$
6,174.5

 
$
5,489.0
(Favorable) Unfavorable Developments By Changes In Key Assumptions
The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the years ended December 31, 2013, 2012 and 2011, which are the completion and trend factors. These two key assumptions can be influenced by utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing patterns, claim submission patterns and operational changes resulting from business combinations.
 
(Favorable) Unfavorable Developments
by Changes in Key Assumptions
 
2013
 
2012
 
2011
Assumed trend factors
$
(428.4
)
 
$
(394.4
)
 
$
(264.8
)
Assumed completion factors
(170.7
)
 
(119.2
)
 
55.1

Total
$
(599.1
)
 
$
(513.6
)
 
$
(209.7
)