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Medical Claims Liability | 3 Months Ended
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Mar. 31, 2026
Insurance [Abstract] |
Medical Claims Liability | Medical Claims Liability The following table summarizes the change in medical claims liability for the three months ended March 31, 2026 ($ in millions):
| Medicaid |  | Medicare |  | Commercial |  | Other |  | Consolidated Total
Balance, January 1, 2026 | $ | 10,375 |  |  | $ | 4,401 |  |  | $ | 5,683 |  |  | $ | 85 |  |  | $ | 20,544 |
Less: Reinsurance recoverable | 16 |  |  | — |  |  | 60 |  |  | — |  |  | 76 |
Balance, January 1, 2026, net | 10,359 |  |  | 4,401 |  |  | 5,623 |  |  | 85 |  |  | 20,468 |
Incurred related to: |  |  |  |  |  |  |  |  |
Current year | 22,608 |  |  | 9,013 |  |  | 7,490 |  |  | 386 |  |  | 39,497 |
Prior years | (653) |  |  | (241) |  |  | (292) |  |  | (8) |  |  | (1,194) |
Total incurred | 21,955 |  |  | 8,772 |  |  | 7,198 |  |  | 378 |  |  | 38,303 |
Paid related to: |  |  |  |  |  |  |  |  |
Current year | 14,092 |  |  | 6,397 |  |  | 4,521 |  |  | 358 |  |  | 25,368 |
Prior years | 6,820 |  |  | 2,710 |  |  | 3,252 |  |  | 76 |  |  | 12,858 |
Total paid | 20,912 |  |  | 9,107 |  |  | 7,773 |  |  | 434 |  |  | 38,226 |
Balance, March 31, 2026, net | 11,402 |  |  | 4,066 |  |  | 5,048 |  |  | 29 |  |  | 20,545 |
Plus: Reinsurance recoverable | 14 |  |  |  |  | 68 |  |  |  |  | 82 |
Balance, March 31, 2026 | $ | 11,416 |  |  | $ | 4,066 |  |  | $ | 5,116 |  |  | $ | 29 |  |  | $ | 20,627 |
The following table summarizes the change in medical claims liability for the three months ended March 31, 2025 ($ in millions):
| Medicaid |  | Medicare |  | Commercial |  | Other |  | Consolidated Total
Balance, January 1, 2025 | $ | 10,299 |  |  | $ | 3,358 |  |  | $ | 4,463 |  |  | $ | 188 |  |  | $ | 18,308 |
Less: Reinsurance recoverable | 18 |  |  | — |  |  | 47 |  |  | — |  |  | 65 |
Balance, January 1, 2025, net | 10,281 |  |  | 3,358 |  |  | 4,416 |  |  | 188 |  |  | 18,243 |
Incurred related to: |  |  |  |  |  |  |  |  |
Current year | 21,419 |  |  | 7,553 |  |  | 7,972 |  |  | 514 |  |  | 37,458 |
Prior years | (576) |  |  | (176) |  |  | (365) |  |  | (16) |  |  | (1,133) |
Total incurred | 20,843 |  |  | 7,377 |  |  | 7,607 |  |  | 498 |  |  | 36,325 |
Paid related to: |  |  |  |  |  |  |  |  |
Current year | 12,996 |  |  | 5,243 |  |  | 4,731 |  |  | 359 |  |  | 23,329 |
Prior years | 6,849 |  |  | 1,923 |  |  | 2,648 |  |  | 150 |  |  | 11,570 |
Total paid | 19,845 |  |  | 7,166 |  |  | 7,379 |  |  | 509 |  |  | 34,899 |
Plus: Premium deficiency reserve | — |  |  | 178 |  |  | — |  |  | — |  |  | 178 |
Balance, March 31, 2025, net | 11,279 |  |  | 3,747 |  |  | 4,644 |  |  | 177 |  |  | 19,847 |
Plus: Reinsurance recoverable | 18 |  |  | — |  |  | 46 |  |  | — |  |  | 64 |
Balance, March 31, 2025 | $ | 11,297 |  |  | $ | 3,747 |  |  | $ | 4,690 |  |  | $ | 177 |  |  | $ | 19,911 |
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 development within "Incurred related to: Prior years," the Company recorded $21 million and $34 million as a reduction to premium revenue in the three months ended March 31, 2026 and 2025, respectively, for minimum medical loss ratio (MLR) and other return of premium programs. Incurred but not reported (IBNR) plus expected development on reported claims as of March 31, 2026 was $13,510 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. The Company 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. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2024, the Company recorded a premium deficiency reserve of $92 million related to the 2025 Medicare Advantage contract year, which was increased to $270 million in the first quarter of 2025 based on the progression of earnings during the year (with higher earnings at the beginning of the year and lower at the end of the year, given cost sharing progression), including anticipated impacts of the Inflation Reduction Act to the Part D benefit within the Company's Medicare Advantage business. As of March 2026, the Company did not record a premium deficiency reserve related to the 2026 Medicare Advantage contract year.

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