Medical Claims Payable

9 Months Ended

Sep. 30, 2020

Liability for Claims and Claims Adjustment Expense [Abstract]

Medical Claims payable

Medical Claims Payable

A reconciliation of the beginning and ending balances for medical claims payable, by segment (see Note 16, “Segment Information”), for the nine months ended September 30, 2020 is as follows:

	Commercial & Specialty Business		Government Business		Other		Total
Gross medical claims payable, beginning of period	$	3,039	$	5,608	$	—	$	8,647
Ceded medical claims payable, beginning of period	(14)		(19)		—		(33)
Net medical claims payable, beginning of period	3,025		5,589		—		8,614
Business combinations and purchase adjustments	—		141		198		339
Net incurred medical claims:
Current period	17,964		43,135		878		61,977
Prior periods redundancies	(379)		(321)		—		(700)
Total net incurred medical claims	17,585		42,814		878		61,277
Net payments attributable to:
Current period medical claims	15,319		36,680		880		52,879
Prior periods medical claims	2,426		5,063		—		7,489
Total net payments	17,745		41,743		880		60,368
Net medical claims payable, end of period	2,865		6,801		196		9,862
Ceded medical claims payable, end of period	102		27		—		129
Gross medical claims payable, end of period	$	2,967	$	6,828	$	196	$	9,991

Activity in the Other segment resulted from our acquisition of Beacon.

At September 30, 2020, the total of net incurred but not reported liabilities plus expected development on reported claims for the Commercial & Specialty Business was $30, $189 and $2,646 for the claim years 2018 and prior, 2019 and 2020, respectively.

At September 30, 2020, the total of net incurred but not reported liabilities plus expected development on reported claims for the Government Business was $42, $163 and $6,596 for the claim years 2018 and prior, 2019 and 2020, respectively.

At September 30, 2020, the total of net incurred but not reported liabilities plus expected development on reported claims for Other was $0, $0 and $196 for the claim years 2018 and prior, 2019 and 2020, respectively.

A reconciliation of the beginning and ending balances for medical claims payable, by segment (see Note 16, “Segment Information”), for the nine months ended September 30, 2019 is as follows:

	Commercial & Specialty Business		Government Business		Other		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	18,986		39,171		—		58,157
Prior periods redundancies	(162)		(275)		—		(437)
Total net incurred medical claims	18,824		38,896		—		57,720
Net payments attributable to:
Current period medical claims	16,277		33,474		—		49,751
Prior periods medical claims	2,213		4,253		—		6,466
Total net payments	18,490		37,727		—		56,217
Net medical claims payable, end of period	2,910		5,825		—		8,735
Ceded medical claims payable, end of period	8		27		—		35
Gross medical claims payable, end of period	$	2,918	$	5,852	$	—	$	8,770

The reconciliation of net incurred medical claims to benefit expense included in our consolidated statements of income for periods in 2020 are as follows:

	Three Months Ended						Nine Months Ended  September 30, 2020
	March 31, 2020		June 30, 2020		September 30, 2020
Net incurred medical claims:
Commercial & Specialty Business	$	5,797	$	5,147	$	6,641	$	17,585
Government Business	14,603		13,233		14,978		42,814
Other	130		368		$	380	878
Total net incurred medical claims	20,530		18,748		21,999		61,277
Quality improvement and other claims expense	959		799		922		2,680
Benefit expense	$	21,489	$	19,547	$	22,921	$	63,957

The reconciliation of net incurred medical claims to benefit expense included in our consolidated statements of income for periods in 2019 are as follows:

	Three Months Ended						Nine Months Ended  September 30, 2019
	March 31, 2019		June 30, 2019		September 30, 2019
Net incurred medical claims:
Commercial & Specialty Business	$	5,856	$	6,422	$	6,546	$	18,824
Government Business	12,483		13,062		13,351		38,896
Total net incurred medical claims	18,339		19,484		19,897		57,720
Quality improvement and other claims expense	943		884		856		2,683
Benefit expense	$	19,282	$	20,368	$	20,753	$	60,403

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 September 30, 2020, is as follows:

	Commercial & Specialty Business		Government Business		Other		Total
Net medical claims payable, end of period	$	2,865	$	6,801	$	196	$	9,862
Ceded medical claims payable, end of period	102		27		—		129
Insurance lines other than short duration	—		261		—		261
Gross medical claims payable, end of period	$	2,967	$	7,089	$	196	$	10,252