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REINSURANCE (Tables)
 3 Months Ended
Mar. 31, 2024
Insurance [Abstract]  
Effects of Reinsurance
Three Months Ended March 31,
(in thousands)20242023
Direct policy premiums$2,310,100 $1,663,474 
Assumed premiums57,612 55,935 
Risk adjustment(269,398)(293,147)
Premiums before ceded reinsurance2,098,314 1,426,262 
Reinsurance premiums ceded(4,632)2,364 
Premium$2,093,682 $1,428,626 
The following table reconciles total Medical expenses to the amount presented in the condensed consolidated statement of operations:
Three Months Ended March 31,
(in thousands)20242023
Direct claims incurred
$1,523,646 $1,048,058 
Ceded reinsurance claims
(19,698)(3,624)
Assumed reinsurance claims
50,826 47,158 
Medical expenses
$1,554,774 $1,091,592 
The Company records Selling, general and administrative ("SG&A") expenses net of reinsurance ceding commissions and assumed SG&A expenses. The following table reconciles total Selling, general and administrative expenses to the amount presented in the condensed consolidated statement of operations:
Three Months Ended March 31,
(in thousands)20242023
Selling, general and administrative expenses, gross
$394,696 $396,984 
Reinsurance ceding commissions
(534)1,535 
Selling, general and administrative expenses
$394,162 $398,519 

The Company classifies Reinsurance recoverable within current assets on its condensed consolidated balance sheets. The composition of the Reinsurance recoverable balance is as follows:

(in thousands)March 31, 2024December 31, 2023
Reinsurance premium and claim recoverables$235,216 $224,837 
Reinsurance ceding commissions7,613 7,054 
Experience refunds on reinsurance agreements106 9,303 
Reinsurance recoverable$242,935 $241,194