Liability for Unpaid Health Claims (Tables)

12 Months Ended

Dec. 31, 2015

Insurance [Abstract]

Summary of Liability for Unpaid Health Claims

Activity in the liability for unpaid health claims is summarized as follows:

	Year Ended December 31,
	2015			2014		2013
Balance at beginning of year	$	128,265		$	116,559	$	124,999
Incurred related to:
Current year	502,009			453,014		453,538
Prior years	(7,845		)	804		5,279
Total incurred	494,164			453,818		458,817
Paid related to:
Current year	379,037			343,648		354,358
Prior years	106,272			98,464		112,899
Total paid	485,309			442,112		467,257
Balance at end of year	$	137,120		$	128,265	$	116,559