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Components of Changes in Healthcare Costs Payable (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Medical Expense And Medical Claims Payable [Line Items]    
Healthcare costs payable, beginning of the year $ 332,102  
Less: Claims paid    
Healthcare costs payable, end of the year 336,381 $ 332,102
Healthcare Cost    
Medical Expense And Medical Claims Payable [Line Items]    
Healthcare costs payable, beginning of the year 212,641 214,405
Add: Components of incurred healthcare costs    
Current year 1,673,742 1,587,036
Prior years (141) 1,523
Total incurred healthcare costs 1,673,601 1,588,559
Less: Claims paid    
Current year 1,473,723 1,397,378
Prior years 198,244 192,945
Total claims paid 1,671,967 1,590,323
Healthcare costs payable, end of the year $ 214,275 $ 212,641