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Liability for Unpaid Claims - Schedule of Liability for Unpaid Health Claims (Details) - USD ($)
$ in Thousands
9 Months Ended 12 Months Ended
Sep. 30, 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 530,399 $ 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 560,548 697,521
Prior years (7,914) (4,853)
Total incurred 552,634 692,668
Paid related to:    
Current year 399,412 535,971
Prior years 142,020 146,247
Total paid 541,432 682,218
Ending balance 203,854 192,652
Plus reinsurance recoverables, ending balance 1,623 2,157
Beginning balance plus reinsurance recoverable $ 205,477 $ 194,809