Liability for Claims Payable - Summary of Activity in Liability for Claims Payable for Members (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Other Liabilities Disclosure [Abstract]
Beginning Balance	$ 2,136,010	$ 2,801,468	$ 2,776,328
Net incurred related to:
Net incurred Current year	45,865,228	42,909,476	41,977,663
Net incurred Prior years	(146,287)	(147,671)	28,160
Net incurred claims	45,718,941	42,761,805	42,005,823
Net paid related to:
Net paid current year	43,648,282	40,775,534	39,177,488
Net paid prior years	1,986,944	2,651,729	2,803,195
Net paid claims	45,635,226	43,427,263	41,980,683
Ending Balance	$ 2,219,725	$ 2,136,010	$ 2,801,468