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Significant Accounting Policies (Details)
3 Months Ended 12 Months Ended
Dec. 31, 2017
USD ($)
Dec. 31, 2017
USD ($)
Payment
Dec. 31, 2016
USD ($)
Dec. 31, 2015
USD ($)
Home office and equipment [Abstract]        
Accumulated depreciation of home office and equipment $ 33,900,000 $ 33,900,000 $ 30,600,000 $ 26,100,000
Depreciation expense of home office and equipment   $ 5,400,000 4,600,000 3,200,000
Minimum number of payments past due to be in default | Payment   2    
Decrease in premium deficiency reserve   $ 0 0 23,751,000
Maximum age for qualified employees for both medical and dental benefits   65 years    
Related party transaction amount   $ 0 $ 0 $ 0
Discrete tax benefits realized upon adoption of ASU   1,600,000    
Accumulated other comprehensive loss        
Home office and equipment [Abstract]        
Cumulative effect to reclassify certain tax effects from accumulated other comprehensive loss (10,400,000) (10,422,000)    
Retained earnings (deficit)        
Home office and equipment [Abstract]        
Cumulative effect to reclassify certain tax effects from accumulated other comprehensive loss $ 10,400,000 $ 10,422,000    
Minimum        
Home office and equipment [Abstract]        
Estimated useful life   3 years    
Award vesting period   1 year    
Maximum        
Home office and equipment [Abstract]        
Estimated useful life   45 years    
Award vesting period   3 years