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Medical Claims Payable (Tables)
 12 Months Ended
Dec. 31, 2015
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
 
2015
 
2014
 
2013
Gross medical claims payable, beginning of year
$
6,861.2

 
$
6,127.2

 
$
6,174.5

Ceded medical claims payable, beginning of year
(767.4
)
 
(23.4
)
 
(27.2
)
Net medical claims payable, beginning of year
6,093.8

 
6,103.8

 
6,147.3

Business combinations and purchase adjustments
121.8

 
—

 
—

Net incurred medical claims:
 
 
 
 
 
Current year
60,708.4

 
56,305.8

 
55,894.3

Prior years redundancies
(800.2
)
 
(541.9
)
 
(599.1
)
Total net incurred medical claims
59,908.2

 
55,763.9

 
55,295.2

Net payments attributable to:
 
 
 
 
 
Current year medical claims
54,067.7

 
50,353.9

 
49,887.2

Prior years medical claims
5,131.9

 
5,420.0

 
5,451.5

Total net payments
59,199.6

 
55,773.9

 
55,338.7

Net medical claims payable, end of year
6,924.2

 
6,093.8

 
6,103.8

Ceded medical claims payable, end of year
645.6

 
767.4

 
23.4

Gross medical claims payable, end of year
$
7,569.8

 
$
6,861.2

 
$
6,127.2
(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, 2015, 2014 and 2013, 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 Developments
by Changes in Key Assumptions
 
2015
 
2014
 
2013
Assumed trend factors
$
(467.9
)
 
$
(399.5
)
 
$
(428.4
)
Assumed completion factors
(332.3
)
 
(142.4
)
 
(170.7
)
Total
$
(800.2
)
 
$
(541.9
)
 
$
(599.1
)