Medical Claims and Benefits Payable (Tables)

12 Months Ended

Dec. 31, 2018

Schedule of liability for unpaid claims and claims adjustment expense

The following table provides the details of our medical claims and benefits payable as of the dates indicated.



	December 31,
	2018		2017		2016
	(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)	$	1,562	$	1,717	$	1,352
Pharmacy payable	115		112		112
Capitation payable	52		67		37
Other	232		296		428
	$	1,961	$	2,192	$	1,929

Components of the change in medical claims and benefits payable

The following table presents the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior periods” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the period were (more) less than the actual amount of the liability based on information (principally the payment of claims) developed since that liability was first reported.



	Year Ended December 31,
	2018			2017			2016
	(In millions)
Medical claims and benefits payable, beginning balance	$	2,192		$	1,929		$	1,685
Components of medical care costs related to:
Current period	15,478			17,037			14,966
Prior periods ⁽¹⁾	(341		)	36			(192		)
Total medical care costs	15,137			17,073			14,774

Change in non-risk provider payables	13			(106		)	58

Payments for medical care costs related to:
Current period	13,671			15,130			13,304
Prior periods	1,710			1,574			1,284
Total paid	15,381			16,704			14,588
Medical claims and benefits payable, ending balance	$	1,961		$	2,192		$	1,929

Incurred and paid claims development

The following tables provide information about incurred and paid claims development as of December 31, 2018, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. The cumulative claim frequency is measured by claim event, and includes claims covered under capitated arrangements.



Incurred Claims and Allocated Claims Adjustment Expenses							Total IBNP		Cumulative number of reported claims
Benefit Year	2016		2017		2018		Total IBNP		Cumulative number of reported claims

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	15,064	$	15,093	$	15,057	$	18	105
2017			17,037		16,728		57		119
2018					15,478		1,477		105
					$	47,263	$	1,552



Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year	2016		2017		2018

	(Unaudited)		(Unaudited)
	(In millions)
2016	$	13,403	$	14,952	$	15,039
2017			15,130		16,752
2018					13,671
					$	45,462

Reconciliation of claims development to liability

The following table represents a reconciliation of claims development to the aggregate carrying amount of the liability for medical claims and benefits payable.



	2018
	(In millions)
Incurred claims and allocated claims adjustment expenses	$	47,263
Less: cumulative paid clams and allocated claims adjustment expenses	(45,462		)
All outstanding liabilities before 2016	10
Non-risk provider payables and other	150
Medical claims and benefits payable	$	1,961