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Medical Claims and Benefits Payable (Tables)

12 Months Ended

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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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.

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