Liability for Unpaid Claims - Schedule of Liability for Unpaid Health Claims (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Activity in the Liability for Unpaid Health Claims
Beginning balance less reinsurance recoverable	$ 514,875
Paid related to:
Beginning balance plus reinsurance recoverable	532,832	$ 514,875
Health claims
Activity in the Liability for Unpaid Health Claims
Beginning balance	192,652	182,202	$ 171,109
Less reinsurance recoverables, beginning balance	(2,157)	(2,084)	(2,628)
Beginning balance less reinsurance recoverable	194,809	184,286	173,737
Incurred related to:
Current year	767,076	697,521	676,189
Prior years	(10,460)	(4,853)	(15,631)
Total incurred	756,616	692,668	660,558
Paid related to:
Current year	587,473	535,971	517,855
Prior years	152,322	146,247	131,610
Total paid	739,795	682,218	649,465
Ending balance	209,473	192,652	182,202
Plus reinsurance recoverables, ending balance	1,521	2,157	2,084
Beginning balance plus reinsurance recoverable	$ 210,994	$ 194,809	$ 184,286