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Liability for Unpaid Claims - Schedule of Liability for Unpaid Health Claims (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Mar. 31, 2024
Dec. 31, 2023
Activity in the Liability for Unpaid Health Claims    
Beginning balance less reinsurance recoverable $ 514,875  
Paid related to:    
Beginning balance plus reinsurance recoverable 520,094 $ 514,875
Health claims    
Activity in the Liability for Unpaid Health Claims    
Beginning balance 192,652 182,202
Less reinsurance recoverables, beginning balance 2,157 2,084
Beginning balance less reinsurance recoverable 194,809 184,286
Incurred related to:    
Current year 184,167 697,521
Prior years 188 (4,853)
Total incurred 184,355 692,668
Paid related to:    
Current year 74,254 535,971
Prior years 103,375 146,247
Total paid 177,629 682,218
Ending balance 199,378 192,652
Plus reinsurance recoverables, ending balance 1,667 2,157
Beginning balance plus reinsurance recoverable $ 201,045 $ 194,809