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Medical Claims Liability (Tables)

12 Months Ended

Dec. 31, 2024

Insurance [Abstract]

Schedule of Change in Medical Claims Liability by Operating Segment

The following table summarizes the change in medical claims liability for the year ended December 31, 2024 ($ in millions):

			Medicaid						Medicare						Commercial						Other						Consolidated Total
Balance, January 1, 2024			$	10,814					$	3,612					$	3,460					$	114					$	18,000
Less: Reinsurance recoverables			5						—						44						—						49
Balance, January 1, 2024, net			10,809						3,612						3,416						114						17,951
Incurred related to:
Current year			78,886						21,170						26,548						1,708						128,312
Prior years			(1,370)						(575)						(509)						7						(2,447)
Total incurred			77,516						20,595						26,039						1,715						125,865
Paid related to:
Current year			69,351						18,036						22,547						1,522						111,456
Prior years			8,693						2,655						2,492						119						13,959
Total paid			78,044						20,691						25,039						1,641						125,415
Plus: Premium deficiency reserve			—						(158)						—						—						(158)
Balance, December 31, 2024, net			10,281						3,358						4,416						188						18,243
Plus: Reinsurance recoverables			18						—						47						—						65
Balance, December 31, 2024			$	10,299					$	3,358					$	4,463					$	188					$	18,308

The following table summarizes the change in medical claims liability for the year ended December 31, 2023 ($ in millions):

			Medicaid						Medicare						Commercial						Other						Consolidated Total
Balance, January 1, 2023			$	11,253					$	3,431					$	1,921					$	140					$	16,745
Less: Reinsurance recoverables			7						—						19						—						26
Balance, January 1, 2023, net			11,246						3,431						1,902						140						16,719
Incurred related to:
Current year			79,747						19,487						19,966						1,480						120,680
Prior years			(1,537)						(343)						(150)						(6)						(2,036)
Total incurred			78,210						19,144						19,816						1,474						118,644
Paid related to:
Current year			69,904						16,631						16,823						1,367						104,725
Prior years			8,743						2,582						1,479						133						12,937
Total paid			78,647						19,213						18,302						1,500						117,662
Plus: Premium deficiency reserve			—						250						—						—						250
Balance, December 31, 2023, net			10,809						3,612						3,416						114						17,951
Plus: Reinsurance recoverables			5						—						44						—						49
Balance, December 31, 2023			$	10,814					$	3,612					$	3,460					$	114					$	18,000

The following table summarizes the change in medical claims liability for the year ended December 31, 2022 ($ in millions):

			Medicaid						Medicare						Commercial						Other						Consolidated Total
Balance, January 1, 2022			$	9,845					$	2,286					$	2,014					$	98					$	14,243
Less: Reinsurance recoverables			23						—						—						—						23
Balance, January 1, 2022, net			9,822						2,286						2,014						98						14,220
Acquisitions and divestitures			—						—						—						105						105
Incurred related to:
Current year			76,344						19,474						14,296						2,782						112,896
Prior years			(1,046)						(102)						(204)						(15)						(1,367)
Total incurred			75,298						19,372						14,092						2,767						111,529
Paid related to:
Current year			66,221						16,275						12,556						2,747						97,799
Prior years			7,653						1,952						1,648						83						11,336
Total paid			73,874						18,227						14,204						2,830						109,135
Balance, December 31, 2022, net			11,246						3,431						1,902						140						16,719
Plus: Reinsurance recoverables			7						—						19						—						26
Balance, December 31, 2022			$	11,253					$	3,431					$	1,921					$	140					$	16,745

Schedule of Short-duration Insurance Contracts, Claims Development

Consolidated incurred and paid claims development as of December 31, 2024 is as follows ($ in millions):

Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	112,896					$	110,870					$	110,394
2023												120,680						118,709
2024																		128,312
						Total incurred claims												$	357,415
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	97,799					$	109,680					$	110,097
2023												104,725						117,635
2024																		111,456
						Total payment of incurred claims												339,188
						All outstanding liabilities prior to 2022, net of reinsurance												174
						Medical claims liability, net of reinsurance												$	18,401

Incurred and paid claims development for the Medicaid segment as of December 31, 2024 is as follows ($ in millions):

Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	76,344					$	74,861					$	74,722
2023												79,747						78,517
2024																		78,885
						Total incurred claims												$	232,124
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	66,220					$	74,125					$	74,608
2023												69,904						77,952
2024																		69,351
						Total payment of incurred claims												221,911
						All outstanding liabilities prior to 2022, net of reinsurance												68
						Medical claims liability, net of reinsurance												$	10,281

Incurred and paid claims development for the Medicare segment as of December 31, 2024 is as follows ($ in millions):

Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	19,475					$	19,124					$	19,027
2023												19,487						19,008
2024																		21,171
						Total incurred claims												$	59,206
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	16,276					$	18,818					$	18,942
2023												16,631						18,778
2024																		18,036
						Total payment of incurred claims												55,756
						All outstanding liabilities prior to 2022, net of reinsurance												66
						Medical claims liability, net of reinsurance												$	3,516

Incurred and paid claims development for the Commercial segment as of December 31, 2024 is as follows ($ in millions):

Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	14,296					$	14,110					$	13,870
2023												19,966						19,698
2024																		26,548
						Total incurred claims												$	60,116
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	12,556					$	13,963					$	13,773
2023												16,823						19,420
2024																		22,547
						Total payment of incurred claims												55,740
						All outstanding liabilities prior to 2022, net of reinsurance												40
						Medical claims liability, net of reinsurance												$	4,416

Incurred and paid claims development for the Other segment as of December 31, 2024 is as follows ($ in millions):

Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	2,781					$	2,775					$	2,775
2023												1,480						1,486
2024																		1,708
						Total incurred claims												$	5,969
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance
For the Year Ended December 31,
Claim Year						2022 (unaudited)						2023 (unaudited)						2024
2022						$	2,747					$	2,774					$	2,774
2023												1,367						1,485
2024																		1,522
						Total payment of incurred claims												5,781
						All outstanding liabilities prior to 2022, net of reinsurance												—
						Medical claims liability, net of reinsurance												$	188

Consolidated information is summarized as follows (in millions):

			December 31, 2024
			Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance						Total IBNR Plus Expected Development on Reported Claims						Cumulative Paid Claims
2022			$	110,394					$	3					638.0
2023			118,709						383						623.6
2024			128,312						12,079						641.3

Information for the Medicaid segment is summarized as follows (in millions):

			December 31, 2024
			Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance						Total IBNR Plus Expected Development on Reported Claims						Cumulative Paid Claims
2022			$	74,722					$	3					370.9
2023			78,517						218						345.6
2024			78,885						6,968						300.1

Information for the Medicare segment is summarized as follows (in millions):

			December 31, 2024
			Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance						Total IBNR Plus Expected Development on Reported Claims						Cumulative Paid Claims
2022			$	19,027					$	—					204.8
2023			19,008						102						200.6
2024			21,171						1,724						253.0

Information for the Commercial segment is summarized as follows (in millions):

			December 31, 2024
			Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance						Total IBNR Plus Expected Development on Reported Claims						Cumulative Paid Claims
2022			$	13,870					$	—					57.5
2023			19,698						62						72.9
2024			26,548						3,211						83.0

Information for the Other segment is summarized as follows (in millions):

			December 31, 2024
			Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance						Total IBNR Plus Expected Development on Reported Claims						Cumulative Paid Claims
2022			$	2,775					$	—					4.8
2023			1,486						1						4.5
2024			1,708						176						5.2

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- 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://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480081/944-40-50-3

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- Definition

Tabular disclosure of undiscounted information about claims development by accident year for short-duration insurance contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 55
-Paragraph 9E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480046/944-40-55-9E

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 4D
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-Publisher FASB
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 4E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480081/944-40-50-4E

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 4B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480081/944-40-50-4B

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