Goodwill and Intangible Assets Disclosure [Text Block] (Details) - USD ($) $ in Thousands	12 Months Ended
Dec. 31, 2019	Dec. 31, 2018
Goodwill	$ 60,165	$ 50,697
Intangible Assets, Net (Excluding Goodwill)	13,379	13,163
Amortization of Intangible Assets	1,284	$ 1,506
Series of Individually Immaterial Business Acquisitions
Goodwill, Acquired During Period	$ 9,468
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life	17 years
Specialty Health Segment Member
Goodwill, Acquired During Period	$ 9,468
Finite-lived Intangible Assets Acquired	$ 1,500

Weighted average amortization period of finite-lived intangible assets acquired either individually or as part of a group of assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method.

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Amount of increase in assets, excluding financial assets, lacking physical substance with a definite life, from an acquisition.

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Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

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Sum of the carrying amounts of all intangible assets, excluding goodwill, as of the balance sheet date, net of accumulated amortization and impairment charges.

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