Medical Claims Payable (Tables)

9 Months Ended

Sep. 30, 2018

Liability for Claims and Claims Adjustment Expense [Abstract]

Reconciliation Of The Beginning And Ending Balances For Medical Claims Payable

A reconciliation of the beginning and ending balances for medical claims payable, by segment (see Note 15, “Segment Information”), for the nine months ended September 30, 2018 is as follows:

	Commercial & Specialty Business			Government Business			Total
Gross medical claims payable, beginning of period	$	3,407		$	4,585		$	7,992
Ceded medical claims payable, beginning of period	(78		)	(27		)	(105		)
Net medical claims payable, beginning of period	3,329			4,558			7,887
Business combinations and purchase adjustments	—			199			199
Net incurred medical claims:
Current period	18,039			34,537			52,576
Prior periods redundancies	(425		)	(441		)	(866		)
Total net incurred medical claims	17,614			34,096			51,710
Net payments attributable to:
Current period medical claims	15,521			29,993			45,514
Prior periods medical claims	2,693			3,969			6,662
Total net payments	18,214			33,962			52,176
Net medical claims payable, end of period	2,729			4,891			7,620
Ceded medical claims payable, end of period	11			27			38
Gross medical claims payable, end of period	$	2,740		$	4,918		$	7,658

At September 30, 2018, the total of net incurred but not reported liabilities plus expected development on reported claims for the Commercial & Specialty Business was $18, $192 and $2,519 for the claim years 2016 and prior, 2017 and 2018, respectively.

At September 30, 2018, the total of net incurred but not reported liabilities plus expected development on reported claims for the Government Business was $33, $116 and $4,742 for the claim years 2016 and prior, 2017 and 2018, respectively.

A reconciliation of the beginning and ending balances for medical claims payable, by segment (see Note 15, “Segment Information”), for the nine months ended September 30, 2017 is as follows:

	Commercial & Specialty Business			Government Business			Total
Gross medical claims payable, beginning of period	$	3,267		$	4,626		$	7,893
Ceded medical claims payable, beginning of period	(521		)	(18		)	(539		)
Net medical claims payable, beginning of period	2,746			4,608			7,354
Net incurred medical claims:
Current period	21,871			31,634			53,505
Prior periods redundancies	(416		)	(650		)	(1,066		)
Total net incurred medical claims	21,455			30,984			52,439
Net payments attributable to:
Current period medical claims	18,724			27,274			45,998
Prior periods medical claims	2,132			3,800			5,932
Total net payments	20,856			31,074			51,930
Net medical claims payable, end of period	3,345			4,518			7,863
Ceded medical claims payable, end of period	80			21			101
Gross medical claims payable, end of period	$	3,425		$	4,539		$	7,964

Reconciliation of Net Incurred Medical Claims to Benefit Expense

The reconciliation of net incurred medical claims to benefit expense included in our consolidated statements of income is as follows:

	Three Months Ended   September 30				Nine Months Ended   September 30
	2018		2017		2018		2017
Net incurred medical claims:
Commercial & Specialty Business	$	6,168	$	7,441	$	17,614	$	21,455
Government Business	11,613		10,263		34,096		30,984
Total net incurred medical claims	17,781		17,704		51,710		52,439
Quality improvement and other claims expense	404		400		1,249		1,125
Benefit expense	$	18,185	$	18,104	$	52,959	$	53,564