Unpaid Claims (Tables)

12 Months Ended

Dec. 31, 2023

Liability for Unpaid Claims and Claims Adjustment Expense, Activity in Liability [Abstract]

Schedule of Activity in the Liability for Unpaid Claims and Claims Adjustment Expense

Activity within the liability for Unpaid claims, including claims adjustment expenses, for the years ended December 31, 2023 and 2022, respectively, is summarized as follows:

	Years ended December 31,
	2023		2022
	(in thousands)
Gross and net balance, beginning of period (1)	$	137,395	$	136,317
Incurred related to:
Current year	996,158		1,023,355
Prior years	(9,000)		(39,324)
Total incurred	987,158		984,031
Paid related to:
Current year	865,930		892,495
Prior years	121,523		90,458
Total paid	987,453		982,953
Gross and net balance, end of period (1)(2)	$	137,100	$	137,395

(1)    Includes amounts due to related parties.

(2)    Differs from the total Unpaid claims amount reported on the Consolidated Balance Sheets due to the fact the figure here excludes unpaid claims for the Company's Non-Insurance operations of $2.9 million and $6.1 million at December 31, 2023 and 2022, respectively.

Schedule of Claims Development and Claim Frequency

The following tables provide information regarding incurred and paid claims development for medical claims, as well as cumulative claim frequency and the total of incurred but not reported liabilities at December 31, 2023, respectively:

	Cumulative incurred claims for the years ended December 31,
Incurred year	2021*		2022*		2023		Total IBNR(1)		Number of reported claims
	(in thousands)								(in ones)
2021 and prior	$	2,138,604	$	2,099,334	$	1,938,863	$	1,902	7,491,528
2022	—		1,023,355		910,776		4,652		3,358,454
2023	—		—		996,158		130,546		3,141,069
Total	$	2,138,604	$	3,122,689	$	3,845,797	$	137,100	13,991,051

(1)    Differs from the total unpaid claims amount reported on the Consolidated Balance Sheets due to the fact the figure here excludes unpaid claims for the Company's ACO of $2.9 million as of December 31, 2023.

	Cumulative net paid claims through December 31,
Paid year	2021*		2022*		2023
	(in thousands)
Incurred year
2021 and prior	$	2,002,287	$	2,092,800	$	1,936,643
2022	—		892,495		906,124
2023	—		—		865,930
Total	$	2,002,287	$	2,985,295	$	3,708,697

*Unaudited supplemental information

Schedule of Reconciliation of Net Incurred and Paid Claims Development

The reconciliation of net incurred and paid claims development tables to unpaid claims and claims adjustment expenses for medical claims on the Consolidated Balance Sheets is as follows:

	December 31, 2023
	(in thousands)
Cumulative incurred claims, net	$	3,845,797
Less: cumulative paid claims, net	3,708,697
Net unpaid claims, including claims adjustment expenses(1)	$	137,100

(1) The following balance reflects the unpaid claims for Medicare Advantage only. The ACO and other medical unpaid claims should be included in order to reconcile to the total unpaid claims on the Consolidated Balance Sheets.