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Components of Changes in Health Care Costs Payable (Detail)
$ in Thousands
 3 Months Ended
Mar. 31, 2016
USD ($)
Medical Expense And Medical Claims Payable [Line Items]  
Health care costs payable, beginning of the period $ 332,102
Less: Claims paid  
Health care costs payable, end of the period 317,747
Healthcare Cost  
Medical Expense And Medical Claims Payable [Line Items]  
Health care costs payable, beginning of the period 212,641
Add: Components of incurred health care costs  
Current year 409,170
Prior years 5,354
Total incurred health care costs 414,524
Less: Claims paid  
Current year 232,310
Prior years 180,185
Total claims paid 412,495
Health care costs payable, end of the period $ 214,670