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Income Taxes - Reconciliation of the U.S. Federal Statutory Income Tax Rate (Details)
12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Income Tax Disclosure [Abstract]      
Statutory federal tax (benefit) rate 21.00% 21.00% 21.00%
State income provision (benefit), net of federal 1.60% 1.40% 1.20%
Nondeductible health insurer fee (“HIF”) 6.10% 0.00% 7.30%
Nondeductible compensation 1.10% 1.20% 0.70%
Worthless stock deduction 0.00% 0.00% (1.00%)
Other 0.20% 0.60% 0.00%
Effective tax expense rate 30.00% 24.20% 29.20%