Schedule of premiums earned | Three Months Ended Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 (in thousands) Direct policy premiums $ 1,660,832 $ 838,075 $ 3,317,253 $ 1,658,889 Assumed premiums 34,095 3,185 58,885 5,596 Direct and Assumed Policy Premiums 1,694,927 841,260 3,376,138 1,664,485 Risk adjustment (326,450) (117,333) (692,597) (330,459) Premiums before ceded reinsurance 1,368,477 723,927 2,683,541 1,334,026 Reinsurance premiums ceded (373,882) (195,768) (733,545) (437,330) Total premiums earned $ 994,595 $ 528,159 $ 1,949,996 $ 896,696 The following table summarizes the amounts of direct policy premiums received directly from CMS as part of APTC and Medicare Advantage for the three and six months ended June 30, 2022 and 2021: Three Months Ended Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 (in thousands) APTC $ 1,397,753 $ 591,345 $ 2,792,256 $ 1,143,688 Medicare Advantage 15,254 10,379 28,306 19,503 Total paid by CMS $ 1,413,007 $ 601,724 $ 2,820,562 $ 1,163,191 The tables below present information for the Company's reinsurance arrangements accounted for under reinsurance accounting. The composition of total reinsurance premiums ceded and reinsurance premiums assumed, which are included as components of total premiums earned in the consolidated statement of operations, is as follows: Three Months Ended Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 (in thousands) Reinsurance premiums ceded, gross $ (393,857) $ (239,253) $ (760,968) $ (504,040) Experience refunds 19,975 43,485 27,423 66,710 Reinsurance premiums ceded (373,882) (195,768) (733,545) (437,330) Reinsurance premiums assumed 34,095 3,185 58,885 5,596 Total reinsurance premiums (ceded) and assumed $ (339,787) $ (192,583) $ (674,660) $ (431,734) The Company records claims expense net of reinsurance recoveries. The following table reconciles the total claims expense to the net claims expense as presented in the consolidated statement of operations: Three Months Ended Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 (in thousands) Direct claims incurred $ 1,092,416 $ 598,904 $ 2,102,451 $ 1,056,123 Ceded reinsurance claims (316,332) (181,333) (616,043) (372,281) Assumed reinsurance claims 32,555 2,308 56,797 4,085 Total claims incurred, net $ 808,639 $ 419,879 $ 1,543,205 $ 687,927 The Company records selling, general and administrative expenses net of reinsurance ceding commissions. The following table reconciles total other insurance costs to the amount presented in the consolidated statement of operations: Three Months Ended Six Months Ended June 30, 2022 June 30, 2021 June 30, 2022 June 30, 2021 (in thousands) Other insurance costs, gross $ 211,216 $ 115,256 $ 414,929 $ 214,399 Reinsurance ceding commissions (41,016) (20,466) (79,327) (39,772) Other insurance costs, net $ 170,200 $ 94,790 $ 335,602 $ 174,627 The Company classifies reinsurance recoverable within current assets on its consolidated balance sheets. The composition of the reinsurance recoverable balance is as follows: June 30, 2022 December 31, 2021 (in thousands) Ceded reinsurance claim recoverables $ 647,299 $ 406,017 Reinsurance ceding commissions 46,742 23,517 Experience refunds on reinsurance agreements 46,163 2,456 Reinsurance recoverable $ 740,204 $ 431,990 |