Operating Segments - Schedule of Revenue by Operating Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	$ 341,722	$ 317,086
Other income	5,200	4,906
Intersegment revenues	346,922	321,992
Net medical claims incurred	265,162	274,789
Gross profit (loss)	81,760	47,203
Total assets	671,770	737,485	$ 570,671
Ceded premiums	101	122
Operating Segments | Insurance
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	341,722	317,086
Other income	3,727	1,839
Net medical claims incurred	266,076	274,504
Gross profit (loss)	79,373	44,421
Total assets	498,360	467,392
Corporate/Other
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	0	0
Other income	15,681	17,738
Net medical claims incurred	4,938	3,448
Gross profit (loss)	59,208	37,521
Total assets	838,045	936,903
Intersegment revenues
Revenue, Major Customer [Line Items]
Intersegment revenues	(48,465)	(23,231)
Intersegment revenues | Insurance
Revenue, Major Customer [Line Items]
Intersegment revenues	0	0
Eliminations
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	0	0
Other income	(14,208)	(14,671)
Net medical claims incurred	(5,852)	(3,163)
Gross profit (loss)	(56,821)	(34,739)
Total assets	$ (664,635)	$ (666,810)