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Medical Expenses Payable

9 Months Ended

Sep. 30, 2025

Insurance [Abstract]

Medical Expenses Payable

Medical Expenses Payable

The following table is a detail of medical expenses payable as of September 30, 2025 and December 31, 2024:

			September 30, 2025						December 31, 2024
Claims incurred but not paid			$	298,176					$	168,357
Capitation and risk-sharing payable			74,541						52,016
Other			156,079						69,415
Medical expenses payable			$	528,796					$	289,788

Each period, we re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. As more complete claim information becomes available, we adjust the amount of the estimates and include the changes in estimates in claim costs in the period in which the change is identified. Substantially, all of the total claims paid by us are known and settled within the first year from the date of service, and substantially, all remaining claim amounts are paid within a three-year period.

The following table presents components of the change in medical expenses payable as of September 30, 2025 and 2024:

			September 30, 2025						September 30, 2024
Claims incurred but not paid - beginning balance			$	168,357					$	95,664
Incurred related to:
Current year			848,585						619,772
Prior years			(26,163)						(7,031)
Total incurred, net of reinsurance			822,422						612,741
Payments related to:
Current year			563,755						470,460
Prior years			128,848						79,771
Total payments, net of reinsurance			692,603						550,231
Claims incurred but not paid - ending balance			298,176						158,174
Capitation payable, risk-sharing payable, and other			230,620						138,951
Total medical expenses payable			$	528,796					$	297,125

We re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. We recognized a favorable prior year development, excluding provision for adverse deviation, of $5,091 and $17,586 for the three and nine months ended September 30, 2025. The favorable prior year development was primarily due to better-than-expected claims recoveries and actual claims expense being less than expected.

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- References

No definition available.

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- Definition

The entire disclosure for insurance products considered to be short-duration contracts because the contract provides insurance protection for a fixed period of short duration and enables the insurer to cancel the contract or to adjust the provisions of the contract at the end of any contract period, such as adjusting the amount of premiums charged or coverage provided, and on contracts on which amounts are paid but insurance risk is not transferred.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/944/tableOfContent

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 4D
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480081/944-40-50-4D

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