BENEFITS PAYABLE | BENEFITS PAYABLE Reserves for medical claims expenses are estimated using actuarial assumptions and recorded as a Benefits payable liability on the Consolidated Balance Sheets. The assumptions for the estimates and for establishing the resulting liability are reviewed, and any adjustments to reserves are reflected in the Consolidated Statement of Operations in the period in which the estimates are updated. The following table provides a rollforward of the Company’s beginning and ending Benefits payable and CAE payable balances for the years ended December 31, 2024, 2023, and 2022: Year Ended December 31, 2024 (in thousands) Benefits Payable Unallocated Claims Total Benefits payable, beginning of the period $ 965,986 $ 13,192 $ 979,178 Less: Reinsurance recoverable 57,111 — 57,111 Benefits payable, beginning of the period, net $ 908,875 $ 13,192 $ 922,067 Claims incurred and CAE Current year $ 7,497,259 $ 108,492 $ 7,605,751 Prior years (164,670) — (164,670) Total claims incurred and CAE, net $ 7,332,589 $ 108,492 $ 7,441,081 Claims paid and CAE Current year $ 6,349,624 $ 92,758 $ 6,442,382 Prior years 593,745 10,685 604,430 Total claims and CAE paid, net $ 6,943,369 $ 103,443 $ 7,046,812 Benefits and CAE payable, end of period, net $ 1,298,095 $ 18,241 $ 1,316,336 Add: Reinsurance recoverable 58,635 — 58,635 Benefits and CAE payable, end of period $ 1,356,730 $ 18,241 $ 1,374,971 Year Ended December 31, 2023 (in thousands) Benefits Payable Unallocated Claims Total Benefits payable, beginning of the period $ 937,727 $ 12,712 $ 950,439 Less: Reinsurance recoverable 277,944 — 277,944 Benefits payable, beginning of the period, net $ 659,783 $ 12,712 $ 672,495 Claims incurred and CAE Current year $ 4,622,263 $ 105,565 $ 4,727,828 Prior years 19,761 — 19,761 Total claims incurred and CAE, net $ 4,642,024 $ 105,565 $ 4,747,589 Claims paid and CAE Current year $ 3,840,009 $ 94,807 $ 3,934,816 Prior years 552,923 10,278 563,201 Total claims and CAE paid, net $ 4,392,932 $ 105,085 $ 4,498,017 Benefits and CAE payable, end of period, net $ 908,875 $ 13,192 $ 922,067 Add: Reinsurance recoverable 57,111 — 57,111 Benefits and CAE payable, end of period $ 965,986 $ 13,192 $ 979,178 Year Ended December 31, 2022 (in thousands) Benefits Payable Unallocated Claims Total Benefits payable, beginning of the period $ 513,582 $ 9,101 $ 522,683 Less: Reinsurance recoverable 159,180 — 159,180 Benefits payable, beginning of the period, net $ 354,402 $ 9,101 $ 363,503 Claims incurred and CAE Current year $ 3,279,460 $ 117,541 $ 3,397,001 Prior years 1,338 — 1,338 Total claims incurred and CAE, net $ 3,280,798 $ 117,541 $ 3,398,339 Claims paid and CAE Current year $ 2,726,912 $ 106,871 $ 2,833,783 Prior years 248,505 7,059 255,564 Total claims and CAE paid, net $ 2,975,417 $ 113,930 $ 3,089,347 Benefits and CAE payable, end of period, net $ 659,783 $ 12,712 $ 672,495 Add: Reinsurance recoverable 277,944 — 277,944 Benefits and CAE payable, end of period $ 937,727 $ 12,712 $ 950,439 Amounts incurred related to prior periods vary from previously estimated liabilities as more claim information becomes available and claims are ultimately settled. The favorable development recognized in the year ended December 31, 2024 resulted primarily from lower than expected paid claims. The following tables provide information about incurred, paid healthcare claims development, unpaid claims liability, and cumulative claims frequency. The claims development information for all periods preceding the most recent reporting period is considered required unaudited supplementary information. For claims frequency information summarized below, a claim is defined as the financial settlement of a single medical event in which remuneration was paid to the servicing provider. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported and development on reported claims. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services, and other relevant factors. Incurred Healthcare Claims Net of Reinsurance Year Ended December 31, IBNR Cumulative number of reported claims (Unaudited) (Unaudited) (in thousands) 2022 2023 2024 Date of Service 2022 $ 3,279,461 $ 3,314,332 $ 3,310,967 $ 31,889 12,725 2023 4,622,263 4,469,672 95,688 11,526 2024 7,497,259 1,147,635 17,917 Total claims incurred $ 15,277,898 Cumulative Paid Healthcare Claims Net of Reinsurance Year Ended December 31, (Unaudited) (Unaudited) (in thousands) 2022 2023 2024 Date of Service 2022 $ 2,726,912 $ 3,223,917 $ 3,279,078 2023 3,840,009 4,373,984 2024 6,349,624 Total payment of incurred claims 14,002,686 All outstanding liabilities prior to 2022, net of reinsurance 22,883 Total benefits payable, net of reinsurance $ 1,298,095 The following table reconciles total outstanding liabilities, net of reinsurance to Benefits payable in the Consolidated Balance Sheet: As of December 31, (in thousands) 2024 2023 Short-duration healthcare costs payable, net of reinsurance $ 1,298,095 $ 908,875 Reinsurance recoverables 58,635 57,111 Total benefits payable $ 1,356,730 $ 965,986 |