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Acquisitions - Schedule of Pro Forma Information (Details) - Discovery Benefits and Noventis - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Business Acquisition, Pro Forma Information, Nonrecurring Adjustment [Line Items]
Total revenues	$ 441,807	$ 397,408	$ 842,789	$ 779,234
Net income attributable to shareholders	$ 15,225	$ 33,790	$ 34,035	$ 76,277
Net income attributable to shareholders per share:
Basic (in dollars per share)	$ 0.35	$ 0.78	$ 0.79	$ 1.77
Diluted (in dollars per share)	$ 0.35	$ 0.77	$ 0.78	$ 1.75

X

- Definition

The pro forma basic net income per share for a period as if the business combination or combinations had been completed at the beginning of a period.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 2
-Subparagraph (h)(3)
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The pro forma diluted net income per share for a period as if the business combination or combinations had been completed at the beginning of a period.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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+ References

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+ References

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