Unpaid Claims (Tables)

12 Months Ended

Dec. 31, 2024

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, 2024 and 2023, respectively, is summarized as follows:

	Year ended December 31,
	2024		2023
	(in thousands)
Gross and net balance, beginning of period	$	137,100	$	137,395
Incurred related to:
Current year	1,016,131		996,158
Prior years	(30,539)		(9,000)
Total incurred	985,592		987,158
Paid related to:
Current year	869,574		865,930
Prior years	96,722		121,523
Total paid	966,296		987,453
Gross and net balance, end of period	$	156,396	$	137,100

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, 2024, respectively:

	Cumulative incurred claims for the year ended December 31,
Incurred year	2022*		2023*		2024		Total IBNR		Number of reported claims
	(in thousands)								(in ones)
2022 and prior	$	2,822,738	$	2,548,952	$	2,540,609	$	4,140	9,725,856
2023	—		996,158		973,962		5,699		3,225,433
2024	—		—		1,016,131		146,557		2,866,942
Total	$	2,822,738	$	3,545,110	$	4,530,702	$	156,396	15,818,231

	Cumulative net paid claims through December 31,
Incurred year	2022*		2023*		2024
	(in thousands)
2022 and prior	$	2,680,476	$	2,542,080	$	2,536,469
2023	—		865,930		968,263
2024	—		—		869,574
Total	$	2,680,476	$	3,408,010	$	4,374,306

*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, 2024
	(in thousands)
Cumulative incurred claims, net	$	4,530,702
Less: cumulative paid claims, net	4,374,306
Net unpaid claims, including claims adjustment expenses	$	156,396