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Medical Claims Liability | 12 Months Ended
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Dec. 31, 2014
Medical Claims Liability [Abstract] |
Medical Claims Liability | Medical Claims Liability The change in medical claims liability is summarized as follows ($ in millions):
| Year Ended December 31,
| 2014 |  | 2013 |  | 2012
Balance, January 1, | $ | 1,112 |  |  | $ | 815 |  |  | $ | 519 |
Incurred related to: |  |  |  |  |
Current year | 12,820 |  |  | 9,073 |  |  | 6,836 |
Prior years | (142 | ) |  | (78 | ) |  | (55 | )
Total incurred | 12,678 |  |  | 8,995 |  |  | 6,781 |
Paid related to: |  |  |  |  |
Current year | 11,122 |  |  | 7,975 |  |  | 6,025 |
Prior years | 945 |  |  | 723 |  |  | 460 |
Total paid | 12,067 |  |  | 8,698 |  |  | 6,485 |
Balance, December 31, | $ | 1,723 |  |  | $ | 1,112 |  |  | $ | 815 |
Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. In addition, claims processing initiatives yielded increased claim payment recoveries and coordination of benefits related to prior year dates of service. Changes in medical utilization and cost trends and the effect of medical management initiatives may also contribute to changes in medical claim liability estimates. While the Company has evidence that medical management initiatives are effective on a case by case basis, medical management initiatives primarily focus on events and behaviors prior to the incurrence of the medical event and generation of a claim. Accordingly, any change in behavior, leveling of care, or coordination of treatment occurs prior to claim generation and as a result, the costs prior to the medical management initiative are not known by the Company. Additionally, certain medical management initiatives are focused on member and provider education with the intent of influencing behavior to appropriately align the medical services provided with the member's acuity. In these cases, determining whether the medical management initiative changed the behavior cannot be determined. Because of the complexity of its business, the number of states in which it operates, and the volume of claims that it processes, the Company is unable to practically quantify the impact of these initiatives on its changes in estimates of IBNR. The Company had reinsurance recoverables related to medical claims liability of $22 million and $10 million at December 31, 2014 and 2013, respectively, included in premium and related receivables. The Company periodically reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs.

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- Definition Disclosure of medical costs and medical costs payables including estimates of obligations for medical care services that have been rendered on behalf of insured consumers but for which claims have not yet been received or processed. + References No definition available. + Details
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