Liability for Unpaid Claims - Schedule of Liability for Unpaid Health Claims (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2025	Dec. 31, 2024
Activity in the Liability for Unpaid Health Claims
Beginning balance less reinsurance recoverable	$ 532,832
Paid related to:
Beginning balance plus reinsurance recoverable	529,911	$ 532,832
Health insurance
Activity in the Liability for Unpaid Health Claims
Beginning balance less reinsurance recoverable	210,994	194,809
Less reinsurance recoverables	(1,521)	(2,157)
Beginning balance	209,473	192,652
Incurred related to:
Current year	635,042	767,076
Prior years	896	(10,460)
Total incurred	635,938	756,616
Paid related to:
Current year	456,164	587,473
Prior years	166,937	152,322
Total paid	623,101	739,795
Ending balance	222,310	209,473
Plus reinsurance recoverables	1,332	1,521
Beginning balance plus reinsurance recoverable	$ 223,642	$ 210,994