XML 64 R43.htm IDEA: XBRL DOCUMENT v3.25.4
Medical Claims Payable (Tables)
 12 Months Ended
Dec. 31, 2025
Insurance [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, 2025, 2024 and 2023 is as follows:
202520242023
Gross medical claims payable, beginning of year$15,580 $15,865 $15,348 
Ceded medical claims payable, beginning of year(13)(7)(6)
Net medical claims payable, beginning of year15,567 15,858 15,342 
Business combinations and purchase adjustments344 143 — 
Net incurred medical claims:
Current year145,566 125,370 121,798 
Prior years redundancies(1,290)(1,731)(1,571)
Total net incurred medical claims144,276 123,639 120,227 
Net payments attributable to:
Current year medical claims130,265 110,930 107,146 
Prior years medical claims13,141 13,143 12,565 
Total net payments143,406 124,073 119,711 
Net medical claims payable, end of year16,781 15,567 15,858 
Ceded medical claims payable, end of year48 13 7 
Gross medical claims payable, end of year$16,829 $15,580 $15,865 
Schedule of Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense
The following table provides a summary of the two key assumptions having the most significant impact on our incurred but not paid liability estimates for the years ended December 31, 2025, 2024 and 2023, which are the completion and trend factors. These vital assumptions can be affected by variables such as utilization levels, unit costs, mix of business, benefit plan designs, provider reimbursement levels, processing system conversions and changes, claim inventory levels, claim processing and submission patterns, and operational changes resulting from business combinations.
 Favorable Developments
by Changes in Key Assumptions
 202520242023
Assumed trend factors$(1,000)$(688)$(895)
Assumed completion factors(290)(1,043)(676)
Total$(1,290)$(1,731)$(1,571)
Reconciliation of Net Incurred Medical Claims to Benefit Expense
The reconciliation of net incurred medical claims to benefit expense included in the consolidated statements of income is as follows:
Years Ended December 31
202520242023
Net incurred medical claims with medical claims payable
$140,560 $123,639 $120,227 
Performance-based risk arrangements without medical claims payable
3,716 — — 
Total net incurred medical claims144,276 123,639 120,227 
Quality improvement and other claims expense3,947 3,928 4,103 
Benefit expense$148,223 $127,567 $124,330 
Short-Duration Insurance Contracts, Claims Development
Incurred claims development, net of reinsurance, for the years ended December 31, 2025, 2024 and 2023 is as follows:
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202320242025
Claim Years(Unaudited)(Unaudited)
2023 & Prior$135,569 $133,837 $133,879 
2024125,513 124,181 
2025145,910 
Total$403,970 
Paid claims development, net of reinsurance, for the years ended December 31, 2025, 2024 and 2023 is as follows:
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
202320242025
Claim Years(Unaudited)(Unaudited)
2023 & Prior$119,711 $132,853 $133,572 
2024110,930 123,352 
2025130,265 
Total$387,189 
Reconciliation of Short Duration Medical Claims Payable to the Consolidated Medical Claims Payable
The reconciliation of incurred and paid claims development information for the three years ended December 31, 2025, reflected in the tables above, to the consolidated ending balance for medical claims payable included in the consolidated balance sheets, as of December 31, 2025, is as follows:
Total
Cumulative incurred claims and allocated claim adjustment expenses, net of reinsurance$403,970 
Less: Cumulative paid claims and allocated claim adjustment expenses, net of reinsurance387,189 
Net medical claims payable, end of year16,781 
Ceded medical claims payable, end of year48 
Insurance lines other than short duration255 
Gross medical claims payable, end of year$17,084