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Medical Claims Liability | 9 Months Ended
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Sep. 30, 2021
Insurance [Abstract] |
Medical Claims Liability | Medical Claims Liability The following table summarizes the change in medical claims liability ($ in millions):
|  | Nine Months Ended September 30,
|  | 2021 |  | 2020
Balance, January 1 |  | $ | 12,438 |  |  | $ | 7,473 |
Less: Reinsurance recoverable |  | 23 |  |  | 20 |
Balance, January 1, net |  | 12,415 |  |  | 7,453 |
Acquisitions and divestitures |  | — |  |  | 3,872 |
Incurred related to: |  |  |  |
Current year |  | 74,736 |  |  | 64,105 |
Prior years |  | (1,526) |  |  | (446) |
Total incurred |  | 73,210 |  |  | 63,659 |
Paid related to: |  |  |  |
Current year |  | 62,205 |  |  | 56,074 |
Prior years |  | 9,344 |  |  | 6,032 |
Total paid |  | 71,549 |  |  | 62,106 |
Balance at September 30, net |  | 14,076 |  |  | 12,878 |
Plus: Reinsurance recoverable |  | 23 |  |  | 21 |
Balance, September 30 |  | $ | 14,099 |  |  | $ | 12,899 |
Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of minimum health benefits ratio (HBR) and other return of premium programs, the Company recorded $438 million and $97 million as a reduction to premium revenue in the nine months ended September 30, 2021 and 2020, respectively. Incurred but not reported (IBNR) plus expected development on reported claims as of September 30, 2021 was $9,346 million. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims, and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors.

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- Definition The entire disclosure for the types of coverages and products sold, and the assets, obligations, recorded liabilities, revenues and expenses arising therefrom, and the amounts of and methodologies and assumptions used in determining the amounts of such items. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 944 -URI http://asc.fasb.org/topic&trid=2303980 + Details
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