XML 51 R33.htm IDEA: XBRL DOCUMENT
v3.20.4

Health Care Costs Payable (Tables) | 12 Months Ended
--- | ---
Dec. 31, 2020
Insurance [Abstract] |
Information about incurred and paid health care claims development | The information about incurred and paid health care claims development for the year ended December 31, 2019 is presented as required unaudited supplemental information.
In millions | Incurred Health Care Claims, Net of Reinsurance For the Years Ended December 31,
Date of Service | 2019 |  | 2020
| (Unaudited) |  |
2019 | $ | 51,426 |  |  | $ | 51,056 |
2020 |  |  | 54,529 |
| Total |  | $ | 105,585 |
In millions | Cumulative Paid Health Care Claims, Net of Reinsurance For the Years Ended December 31,
Date of Service | 2019 |  | 2020
| (Unaudited) |  |
2019 | $ | 44,987 |  |  | $ | 50,394 |
2020 |  |  | 47,567 |
| Total |  | $ | 97,961 |
All outstanding liabilities for health care costs payable prior to 2019, net of reinsurance |  | 144 |
Total outstanding liabilities for health care costs payable, net of reinsurance |  | $ | 7,768 |
Schedule of liability for unpaid claims and claims adjustment expense | The reconciliation of the December 31, 2020 health care net incurred and paid claims development tables to the health care costs payable liability on the consolidated balance sheet is as follows:
In millions | December 31, 2020
Short-duration health care costs payable, net of reinsurance | $ | 7,768 |
Reinsurance recoverables | 10 |
Premium deficiency reserve | 11 |
Insurance lines other than short duration | 147 |
Total health care costs payable | $ | 7,936 |
Components of change in health care costs payable | The following table shows the components of the change in health care costs payable during the years ended December 31, 2020, 2019 and 2018:
In millions | 2020 |  | 2019 |  | 2018
Health care costs payable, beginning of period | $ | 6,879 |  |  | $ | 6,147 |  |  | $ | 5 |
Less: Reinsurance recoverables | 5 |  |  | 4 |  |  | — |
Health care costs payable, beginning of period, net | 6,874 |  |  | 6,143 |  |  | 5 |
Acquisitions, net | 414 |  |  | — |  |  | 5,357 |
Reclassification from pharmacy claims and discounts payable (1) | — |  |  | — |  |  | 776 |
Add: Components of incurred health care costs |  |  |  |  |
Current year | 55,835 |  |  | 52,723 |  |  | 6,594 |
Prior years | (429) |  |  | (524) |  |  | (42) |
Total incurred health care costs (2) | 55,406 |  |  | 52,199 |  |  | 6,552 |
Less: Claims paid |  |  |  |  |
Current year | 48,770 |  |  | 46,158 |  |  | 6,303 |
Prior years | 6,009 |  |  | 5,314 |  |  | 260 |
Total claims paid | 54,779 |  |  | 51,472 |  |  | 6,563 |
Add: Premium deficiency reserve | 11 |  |  | 4 |  |  | 16 |
Health care costs payable, end of period, net | 7,926 |  |  | 6,874 |  |  | 6,143 |
Add: Reinsurance recoverables | 10 |  |  | 5 |  |  | 4 |
Health care costs payable, end of period | $ | 7,936 |  |  | $ | 6,879 |  |  | $ | 6,147 |
_____________________________________________ (1)As of the Aetna Acquisition Date, the Company reclassified $776 million of the Pharmacy Services segment’s unpaid retail pharmacy claims to third parties from pharmacy claims and discounts payable to health care costs payable as the third party liability was incurred to support the Health Care Benefits segment’s insured members. (2)Total incurred health care costs for the years ended December 31, 2020, 2019 and 2018 in the table above exclude (i) $11 million, $4 million and $16 million, respectively, for a premium deficiency reserve related to the Company’s Medicaid products, (ii) $41 million, $41 million and $4 million, respectively, of benefit costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the consolidated balance sheets and (iii) $221 million, $285 million and $22 million, respectively, of benefit costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the consolidated balance sheets.

X
- References No definition available. + Details
Name: | us-gaap_InsuranceAbstract
Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of the activity in the reserve for settling insured claims and expenses incurred in the claims settlement process for the period. The estimated liability includes the amount of money that will be required for future payments of (a) claims that have been reported to the insurer, (b) claims related to insured events that have occurred but that have not been reported to the insurer as of the date the liability is estimated, and (c) claim adjustment expenses. Claim adjustment expenses include costs incurred in the claim settlement process such as legal fees; outside adjuster fees; and costs to record, process, and adjust claims. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -SubTopic 40 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=116884095&loc=d3e14764-158437 + Details
Name: | us-gaap_ScheduleOfLiabilityForUnpaidClaimsAndClaimsAdjustmentExpense
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure of undiscounted information about claims development by accident year for short-duration insurance contracts. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -SubTopic 40 -Section 50 -Paragraph 4B -URI http://asc.fasb.org/extlink&oid=116884468&loc=SL65671311-158438 + Details
Name: | us-gaap_ShortdurationInsuranceContractsClaimsDevelopmentTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration

X
- Definition Tabular disclosure for the reconciliation of claims development to the liability for unpaid claims and claim adjustment expense for short-duration insurance contracts. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -SubTopic 40 -Section 50 -Paragraph 4C -URI http://asc.fasb.org/extlink&oid=116884468&loc=SL65671315-158438 + Details
Name: | us-gaap_ShortdurationInsuranceContractsReconciliationOfClaimsDevelopmentToLiabilityTableTextBlock
Namespace Prefix: | us-gaap_
Data Type: | nonnum:textBlockItemType
Balance Type: | na
Period Type: | duration