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Income Taxes - Reconciliation of the U.S. Federal Statutory Income Tax Rate (Details) | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Effective income tax rate reconciliation to the statutory federal income tax rate |  |  |
Statutory federal tax (benefit) rate | 21.00% | 35.00% | 35.00%
State income provision (benefit), net of federal | (1.20%) | (0.70%) | (1.60%)
Nondeductible health insurer fee (“HIF”) | 7.30% | 0.00% | 37.00%
Nondeductible compensation | 0.70% | (2.80%) | 3.10%
Nondeductible goodwill impairment | 0.00% | (6.60%) | 0.00%
Worthless stock deduction | (1.00%) | 0.00% | 0.00%
Revaluation of net deferred tax assets | (0.40%) | (8.80%) | 0.00%
Change in purchase agreement that increased tax basis in assets | (0.00%) | (0.00%) | (2.20%)
Other | (0.40%) | 1.10% | (0.30%)
Effective tax (benefit) rate | 29.20% | 16.40% | 74.80%

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- Definition Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(h)(2)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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- Definition Percentage of domestic federal statutory tax rate applicable to pretax income (loss). + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 6.I) -URI http://asc.fasb.org/extlink&oid=34349781&loc=d3e330036-122817 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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- Definition Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to changes in the valuation allowance for deferred tax assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 6.I) -URI http://asc.fasb.org/extlink&oid=34349781&loc=d3e330036-122817 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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