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Reinsurance (Tables)
 12 Months Ended
Dec. 31, 2022
Insurance [Abstract]  
Effects of Reinsurance
The effects of the reinsurance agreements on the accompanying consolidated financial statements for the years ended December 31, 2022, 2021, and 2020, respectively, are as follows:

Years ended December 31,202220212020
(in thousands)
Premiums earned, gross
$1,085,339 $799,903 $666,297 
Premiums earned, ceded
(470)(489)(599)
Net premiums earned
$1,084,869 $799,414 $665,698 
Years ended December 31,202220212020
(in thousands)
Claims incurred, gross$985,197 $839,136 $585,915 
Claims incurred, ceded(1,166)(1,002)(483)
Net claims incurred$984,031 $838,134 $585,432 
Reinsurance recoverable for the MA plan at December 31, 2022 and 2021, respectively, were comprised of the following:
Years ended December 31,20222021
(in thousands)
Reinsurance recoverable on paid claims, gross and net
$500 $96 
The effects of the DCE reinsurance arrangements on the accompanying consolidated financial statements for the years ended December 31, 2022 and 2021, respectively, were as follows:
Years ended December 31,20222021
(in thousands)
Non-Insurance revenue, gross and net
$2,380,135 $667,639 
Claims incurred, gross and net2,460,879 705,407 
Reinsurance recoverable, gross and net52,955 12,170