Medical Claims Payable (Tables)

6 Months Ended

Jun. 30, 2019

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 six months ended June 30, 2019 is as follows:

	Commercial & Specialty Business			Government Business			Total
Gross medical claims payable, beginning of period	$	2,586		$	4,680		$	7,266
Ceded medical claims payable, beginning of period	(10		)	(24		)	(34		)
Net medical claims payable, beginning of period	2,576			4,656			7,232
Net incurred medical claims:
Current period	12,460			25,777			38,237
Prior periods redundancies	(182		)	(232		)	(414		)
Total net incurred medical claims	12,278			25,545			37,823
Net payments attributable to:
Current period medical claims	9,928			20,439			30,367
Prior periods medical claims	2,081			4,101			6,182
Total net payments	12,009			24,540			36,549
Net medical claims payable, end of period	2,845			5,661			8,506
Ceded medical claims payable, end of period	14			29			43
Gross medical claims payable, end of period	$	2,859		$	5,690		$	8,549

At June 30, 2019, the total of net incurred but not reported liabilities plus expected development on reported claims for the Commercial & Specialty Business was $45, $267 and $2,533 for the claim years 2017 and prior, 2018 and 2019, respectively.

At June 30, 2019, the total of net incurred but not reported liabilities plus expected development on reported claims for the Government Business was $35, $289 and $5,337 for the claim years 2017 and prior, 2018 and 2019, respectively.

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

	Commercial & Specialty Business			Government Business			Total
Gross medical claims payable, beginning of period	$	3,383		$	4,431		$	7,814
Ceded medical claims payable, beginning of period	(78		)	(27		)	(105		)
Net medical claims payable, beginning of period	3,305			4,404			7,709
Business combinations and purchase adjustments	—			199			199
Net incurred medical claims:
Current period	11,699			22,223			33,922
Prior periods redundancies	(405		)	(390		)	(795		)
Total net incurred medical claims	11,294			21,833			33,127
Net payments attributable to:
Current period medical claims	9,367			18,135			27,502
Prior periods medical claims	2,520			3,688			6,208
Total net payments	11,887			21,823			33,710
Net medical claims payable, end of period	2,712			4,613			7,325
Ceded medical claims payable, end of period	4			31			35
Gross medical claims payable, end of period	$	2,716		$	4,644		$	7,360

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   June 30				Six Months Ended   June 30
	2019		2018		2019		2018
Net incurred medical claims:
Commercial & Specialty Business	$	6,780	$	5,884	$	12,278	$	11,294
Government Business	12,704		11,039		25,545		21,833
Total net incurred medical claims	19,484		16,923		37,823		33,127
Quality improvement and other claims expense	884		805		1,827		1,647
Benefit expense	$	20,368	$	17,728	$	39,650	$	34,774

Reconciliation of Short Duration Medical Claims Payable to the Consolidated Medical Claims Payable

The reconciliation of the medical claims payable reflected in the tables above to the consolidated ending balance for medical claims payable included in the consolidated balance sheet, as of June 30, 2019, is as follows:

	Commercial & Specialty Business		Government Business		Total
Net medical claims payable, end of period	$	2,845	$	5,661	$	8,506
Ceded medical claims payable, end of period	14		29		43
Insurance lines other than short duration	—		209		209
Gross medical claims payable, end of period	$	2,859	$	5,899	$	8,758