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Components of Changes in Health Care Costs Payable (Detail)
$ in Thousands
 9 Months Ended
Sep. 30, 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 313,869
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 1,261,046
Prior years 2,142
Total incurred health care costs 1,263,188
Less: Claims paid  
Current year 1,061,880
Prior years 199,015
Total claims paid 1,260,895
Health care costs payable, end of the period $ 214,934