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Compensation and Employee Benefit Plans [Text Block] (Details) - Independence Holding Company Share Based Plans Total Member - USD ($)
$ / shares in Units, $ in Thousands
9 Months Ended
Sep. 30, 2018
Sep. 30, 2017
Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant 846,300    
Employee Stock Option      
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period 3 years    
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value $ 9.77 $ 7.01  
Proceeds from Stock Options Exercised $ 357    
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercises in Period, Intrinsic Value 886 $ 621  
Employee Service Share-based Compensation, Tax Benefit from Exercise of Stock Options 165 180  
Payments Related to Tax Withholding for Share-based Compensation   303  
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Stock Options $ 1,473    
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition 1 year 8 months 12 days    
Employee Stock Option | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period 10 years    
Stock Appreciation Rights (SARs)      
Share-based Compensation Arrangement by Share-based Payment Award, Non-Option Equity Instruments, Outstanding, Number 64,900   64,900
Stock Appreciation Rights (SARs) | Accounts Payable and Accrued Liabilities      
Deferred Compensation Share-based Arrangements, Liability, Current and Noncurrent $ 240   $ 22
Stock Appreciation Rights (SARs) | Maximum      
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period 10 years    
Restricted Stock Units (RSUs)      
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period 3 years    
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition 1 year 8 months 12 days    
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value $ 92 $ 94  
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options $ 269