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Components of Changes in Healthcare Costs Payable (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2015
Dec. 31, 2014
Medical Expense And Medical Claims Payable [Line Items]    
Healthcare costs payable, beginning of the period $ 314,346  
Less: Claims paid    
Healthcare costs payable, end of the period 332,102 $ 314,346
Healthcare Cost    
Medical Expense And Medical Claims Payable [Line Items]    
Healthcare costs payable, beginning of the period 214,405 172,310
Add: Components of incurred healthcare costs    
Current year 1,587,036 1,572,723
Prior years 1,523 3,429
Total incurred healthcare costs 1,588,559 1,576,152
Less: Claims paid    
Current year 1,397,378 1,378,137
Prior years 192,945 155,920
Total claims paid 1,590,323 1,534,057
Healthcare costs payable, end of the period $ 212,641 $ 214,405