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Medical Claims and Benefits Payable (Tables)

9 Months Ended

Sep. 30, 2021

Other Liabilities Disclosure [Abstract]

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:

			September 30, 2021						December 31, 2020
			(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)			$	2,246					$	1,647
Pharmacy payable			209						157
Capitation payable			86						70
Other			650						528
Magellan Complete Care acquisition opening balance			—						294
Total			$	3,191					$	2,696

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, with the prior period recast to conform to the current year presentation. The amounts presented for “Components of medical care costs related to: Prior years” represent decreases in medical care costs resulting from actual medical care costs being less than we previously estimated in the prior year.

			Nine Months Ended September 30, 2021
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	2,129					$	392					$	175					$	2,696
Components of medical care costs related to:
Current year			13,491						2,195						1,872						17,558
Prior years			(158)						(36)						(22)						(216)
Total medical care costs			13,333						2,159						1,850						17,342
Payments for medical care costs related to:
Current year			11,530						1,816						1,534						14,880
Prior years			1,538						340						130						2,008
Total paid			13,068						2,156						1,664						16,888
Change in acquired balances			(19)						(8)						—						(27)
Change in non-risk and other provider payables			68						—						—						68
Medical claims and benefits payable, ending balance			$	2,443					$	387					$	361					$	3,191

			Nine Months Ended September 30, 2020
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	1,465					$	267					$	122					$	1,854
Components of medical care costs related to:
Current year			9,029						1,588						861						11,478
Prior years			(41)						(25)						—						(66)
Total medical care costs			8,988						1,563						861						11,412
Payments for medical care costs related to:
Current year			7,470						1,316						714						9,500
Prior years			1,193						233						101						1,527
Total paid			8,663						1,549						815						11,027
Change in non-risk and other provider payables			50						—						—						50
Medical claims and benefits payable, ending balance			$	1,840					$	281					$	168					$	2,289

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Components Of Change In Medical Claims And Benefits Payable [Table Text Block]

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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://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=116884095&loc=d3e14764-158437

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