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Medical Claims and Benefits Payable (Tables) | 12 Months Ended
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Dec. 31, 2021
Insurance [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.
| December 31,
| 2021 |  | 2020 |  | 2019
| (In millions)
Fee-for-service claims incurred but not paid (“IBNP”) | $ | 2,486 |  |  | $ | 1,647 |  |  | $ | 1,406 |
Pharmacy payable | 219 |  |  | 157 |  |  | 126 |
Capitation payable | 82 |  |  | 70 |  |  | 55 |
Other | 576 |  |  | 528 |  |  | 267 |
Magellan Complete Care acquisition opening balance | — |  |  | 294 |  |  | — |
Total | $ | 3,363 |  |  | $ | 2,696 |  |  | $ | 1,854 |
Components of the change in medical claims and benefits payable | The following tables present the components of the change in our medical claims and benefits payable for the periods indicated, with the prior periods recast to conform to current year presentation.
| Year Ended December 31, 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 | 18,321 |  |  | 2,970 |  |  | 2,652 |  |  | 23,943 |
Prior years | (182) |  |  | (39) |  |  | (18) |  |  | (239) |
Total medical care costs | 18,139 |  |  | 2,931 |  |  | 2,634 |  |  | 23,704 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 16,284 |  |  | 2,573 |  |  | 2,291 |  |  | 21,148 |
Prior years | 1,601 |  |  | 340 |  |  | 139 |  |  | 2,080 |
Total paid | 17,885 |  |  | 2,913 |  |  | 2,430 |  |  | 23,228 |
Acquired balances, net of post-acquisition adjustments | 205 |  |  | (8) |  |  | — |  |  | 197 |
Change in non-risk and other provider payables | (8) |  |  | 2 |  |  | — |  |  | (6) |
Medical claims and benefits payable, ending balance | $ | 2,580 |  |  | $ | 404 |  |  | $ | 379 |  |  | $ | 3,363 |
| Year Ended December 31, 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 | 12,545 |  |  | 2,189 |  |  | 1,205 |  |  | 15,939 |
Prior years | (84) |  |  | (28) |  |  | (7) |  |  | (119) |
Total medical care costs | 12,461 |  |  | 2,161 |  |  | 1,198 |  |  | 15,820 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 10,940 |  |  | 1,884 |  |  | 1,047 |  |  | 13,871 |
Prior years | 1,176 |  |  | 233 |  |  | 98 |  |  | 1,507 |
Total paid | 12,116 |  |  | 2,117 |  |  | 1,145 |  |  | 15,378 |
Acquired balances, net of post-acquisition adjustments | 215 |  |  | 79 |  |  | — |  |  | 294 |
Change in non-risk and other provider payables | 104 |  |  | 2 |  |  | — |  |  | 106 |
Medical claims and benefits payable, ending balance | $ | 2,129 |  |  | $ | 392 |  |  | $ | 175 |  |  | $ | 2,696 |
| Year Ended December 31, 2019
| Medicaid |  | Medicare |  | Marketplace |  | Consolidated
| (In millions)
Medical claims and benefits payable, beginning balance | $ | 1,554 |  |  | $ | 253 |  |  | $ | 154 |  |  | $ | 1,961 |
Components of medical care costs related to: |  |  |  |  |  |  |
Current year | 11,191 |  |  | 1,934 |  |  | 1,051 |  |  | 14,176 |
Prior years | (222) |  |  | (21) |  |  | (28) |  |  | (271) |
Total medical care costs | 10,969 |  |  | 1,913 |  |  | 1,023 |  |  | 13,905 |
Payments for medical care costs related to: |  |  |  |  |  |  |
Current year | 9,936 |  |  | 1,676 |  |  | 942 |  |  | 12,554 |
Prior years | 1,145 |  |  | 224 |  |  | 113 |  |  | 1,482 |
Total paid | 11,081 |  |  | 1,900 |  |  | 1,055 |  |  | 14,036 |
Acquired balances, net of post-acquisition adjustments | — |  |  | — |  |  | — |  |  | — |
Change in non-risk and other provider payables | 23 |  |  | 1 |  |  | — |  |  | 24 |
Medical claims and benefits payable, ending balance | $ | 1,465 |  |  | $ | 267 |  |  | $ | 122 |  |  | $ | 1,854 |
Incurred and paid claims development |
Incurred Claims and Allocated Claims Adjustment Expenses |  | Total IBNP |  | Cumulative number of reported claims
Benefit Year |  | 2019 |  | 2020 |  | 2021 |
|  | (Unaudited) |  | (Unaudited) |  |  |  |  |  |
|  | (In millions)
2019 |  | $ | 14,176 |  |  | $ | 14,083 |  |  | $ | 14,040 |  |  | $ | 12 |  |  | 105 |
2020 |  |  |  | 16,233 |  |  | 16,056 |  |  | 52 |  |  | 140 |
2021 |  |  |  |  |  | 23,943 |  |  | 2,416 |  |  | 181 |
|  |  |  |  |  | $ | 54,039 |  |  | $ | 2,480 |  |  |
Cumulative Paid Claims and Allocated Claims Adjustment Expenses |
Benefit Year |  | 2019 |  | 2020 |  | 2021 |
|  | (Unaudited) |  | (Unaudited) |  |  |
|  | (In millions) |
2019 |  | $ | 12,554 |  |  | $ | 14,056 |  |  | $ | 14,028 |  |
2020 |  |  |  | 13,871 |  |  | 16,004 |  |
2021 |  |  |  |  |  | 21,148 |  |
|  |  |  |  |  | $ | 51,180 |  |
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.
|  |  |  |  |  | 2021 |
|  |  |  |  |  | (In millions) |
Incurred claims and allocated claims adjustment expenses |  | $ | 54,039 |  |
Less: cumulative paid claims and allocated claims adjustment expenses |  | (51,180) |  |
All outstanding liabilities before 2019 |  | 6 |  |
Acquired balances |  | 224 |  |
Non-risk and other provider payables |  | 274 |  |
Medical claims and benefits payable |  | $ | 3,363 |  |

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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 + Details
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