MEDICAL COSTS PAYABLE

12 Months Ended

Dec. 31, 2021

Insurance [Abstract]

MEDICAL COSTS PAYABLE

MEDICAL COSTS PAYABLE

The following table shows the components of the change in medical costs payable for the years ended December 31 (in thousands):

	2021		2020		2019
Medical costs payable – January 1	$	249,777	$	44,804	$	22,978
Incurred related to:
Current year	3,955,146		1,057,064		233,447
Prior year	9,549		(8,622)		(7,427)
Total incurred	3,964,695		1,048,442		226,020
Paid related to:
Current year	3,242,674		941,401		188,919
Prior year	246,560		33,479		15,275
Total paid	3,489,234		974,880		204,194
Acquired claims liabilities	92,737		131,411		—
Medical costs payable – December 31	$	817,975	$	249,777	$	44,804

Medical costs payable attributable to prior years increased by $9.5 million and decreased by $8.6 million and $7.4 million for the years ended December 31, 2021, 2020 and 2019, respectively, as a result of claim settlements being less than original estimates. Medical costs payable estimates are adjusted as additional information becomes known regarding claims. There were no significant changes to estimation methodologies in 2021 or 2020.

The table below details the components making up the medical costs payable as of December 31 (in thousands):

	2021		2020
Claims unpaid	$	36,874	$	23,269
Provider incentive payable	85,544		16,963
Claims adjustment expense liability	14,131		2,487
Incurred but not reported (IBNR)	681,426		207,058
Total medical costs payable	$	817,975	$	249,777

Medical costs payable are primarily related to the current year. There are no reinsurance recovery amounts assumed in medical costs payable at December 31, 2021 and 2020. The Company has recorded claims adjustment expense as a component of operating costs in the Consolidated Statements of Income (Loss).

The following is information about incurred and cumulative paid claims development as of December 31, 2021, net of reinsurance, and the total claims payable plus expected development on reported claims included within the net incurred claims amounts. The information about incurred and paid claims development for the years ended December 31, 2019 through 2021 is presented as supplementary information as follows and is inclusive of claims incurred and paid related to Brand New Day, PMA, THNM, CHP and Centrum prior and subsequent to the acquisition dates (in thousands):

	Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance (in thousands)				Total Incurred but Not Reported Liabilities Plus Expected Development on Reported Claims
	For the Years Ended December 31,
	(Unaudited)	(Unaudited)
Accident Year	2019	2020	2021
2019	1,322,197	1,305,816	1,312,836		32
2020	—	1,888,151	1,881,026		5,393
2021	—	—	4,120,436		675,931
Total			$	7,314,298

	Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance (in thousands)
	For the Years Ended December 31,
	(Unaudited)	(Unaudited)
Accident Year	2019	2020	2021
2019	1,145,194	1,299,119	1,304,658
2020	—	1,564,863	1,876,061
2021	—	—	3,370,286
Total			$	6,551,005
All outstanding liabilities before 2019, net of reinsurance			3
Liabilities for claim and claim adjustment expenses, net of reinsurance			$	763,296

	December 31, 2021
Net outstanding liabilities	$	763,296
Reinsurance recoverable on unpaid claims	54,679
Total gross liability for unpaid claims and claims	$	817,975