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Medical Claims and Benefits Payable (Tables)

12 Months Ended

Dec. 31, 2023

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,
			2023						2022						2021
			(In millions)
Fee-for-service claims incurred but not paid (“IBNP”)			$	2,901					$	2,597					$	2,486
Pharmacy payable			202						206						219
Capitation payable			100						94						82
Other			1,001						631						576
Total			$	4,204					$	3,528					$	3,363

Schedule of 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.

			Year Ended December 31, 2023
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	2,815					$	452					$	261					$	3,528
Components of medical care costs related to:
Current year			23,749						3,802						1,545						29,096
Prior years			(395)						(11)						(21)						(427)
Total medical care costs			23,354						3,791						1,524						28,669
Payments for medical care costs related to:
Current year			20,999						3,293						1,323						25,615
Prior years			2,069						431						234						2,734
Total paid			23,068						3,724						1,557						28,349
Acquired balances, net of post-acquisition adjustments			82						14						—						96
Change in non-risk and other provider payables			261						(1)						—						260
Medical claims and benefits payable, ending balance			$	3,444					$	532					$	228					$	4,204

			Year Ended December 31, 2022
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	2,580					$	404					$	379					$	3,363
Components of medical care costs related to:
Current year			22,097						3,390						1,972						27,459
Prior years			(251)						(32)						(1)						(284)
Total medical care costs			21,846						3,358						1,971						27,175
Payments for medical care costs related to:
Current year			19,655						2,944						1,746						24,345
Prior years			1,966						361						343						2,670
Total paid			21,621						3,305						2,089						27,015
Acquired balances, net of post-acquisition adjustments			12						—						—						12
Change in non-risk and other provider payables			(2)						(5)						—						(7)
Medical claims and benefits payable, ending balance			$	2,815					$	452					$	261					$	3,528

			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

Schedule of Incurred and Paid Claims Development

The following tables provide information about our consolidated incurred and paid claims development as of December 31, 2023, as well as cumulative claims frequency and the total of incurred but not paid claims liabilities. The pattern of incurred and paid claims development is consistent across each of our segments. 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						2021						2022						2023
						(Unaudited)						(Unaudited)
						(In millions)
2021						$	24,167					$	23,979					$	23,912					$	18					133
2022												27,459						27,128						77						163
2023																		29,096						2,803						153
																		$	80,136					$	2,898

Cumulative Paid Claims and Allocated Claims Adjustment Expenses
Benefit Year						2021						2022						2023
						(Unaudited)						(Unaudited)
						(In millions)
2021						$	21,148					$	23,871					$	23,894
2022												24,345						27,051
2023																		25,615
																		$	76,560

Schedule of 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.

																		2023
																		(In millions)
Incurred claims and allocated claims adjustment expenses																		$	80,136
Less: cumulative paid claims and allocated claims adjustment expenses																		(76,560)
All outstanding liabilities before 2021																		3
Acquired balances																		96
Non-risk and other provider payables																		529
Medical claims and benefits payable																		$	4,204

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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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