Unpaid Service Provider Costs

6 Months Ended

Jun. 30, 2022

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

UNPAID SERVICE PROVIDER COSTS

Activity in unpaid service provider costs for the six months ended June 30, 2022 and 2021 is summarized below:


(in thousands)	2022		2021
Balance as of January 1,	$	129,110	$	54,524

Incurred related to:
Current year	843,427		305,665
Prior years	2,576		(519)
	846,003		305,146
Paid related to:
Current year	543,984		224,825
Prior years	120,997		54,005
	664,981		278,830
Balance as of June 30,	$	310,132	$	80,840

The foregoing reconciliation reflects an increase in our estimate during the six months ended June 30, 2022 of $2.6 million due to higher utilization rates and a decrease in our estimate during the six months ended June 30, 2021 of $0.5 million due to lower than expected utilization rates. $32.7 million and $14.3 million of the liabilities for medical services incurred but not reported ("IBNR") were included in other current liabilities in the consolidated balance sheet as they were in a net deficit position as of June 30, 2022 and June 30, 2021, respectively.

The Company maintains a provider excess loss insurance policy to protect against claim expenses exceeding certain levels that are incurred by the Company on behalf of members and uses a third-party cost recovery firm which specialize in care coordination charges. As of both June 30, 2022 and June 30, 2021, the Company’s excess loss insurance deductible was $0.1 million and maximum coverage was $2.0 million per member per calendar year. The Company recorded excess loss insurance premiums of $2.5 million and $4.9 million for the three and six months ended June 30, 2022, respectively, and cost recovery reimbursement of $1.6 million and $3.6 million for the three and six months ended June 30, 2022, respectively. The Company recorded excess loss insurance premiums of $1.8 million and $3.5 million for the three and six months ended June 30, 2021,respectively, and reimbursements of $0.8 million and $1.8 million for the three and six months ended June 30, 2021, respectively. The Company recorded these amounts on a net basis in the caption third-party medical costs in the accompanying unaudited condensed consolidated statements of operations. The Company records excess loss insurance recoveries in accounts receivable and third-party cost recoveries in long term other assets on the accompanying unaudited condensed consolidated balance sheets. As of June 30, 2022 and December 31, 2021, the Company recorded insurance recoverables and amounts due from a third party for other cost recoveries of $30.1 million and $15.2 million, respectively.