Reinsurance - Medicare Advantage (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Premiums Earned, Net [Abstract]
Premiums earned, ceded	$ (470)	$ (489)	$ (599)
Net premiums earned	1,084,869	799,414	665,698
Policyholder Benefits and Claims Incurred, Net [Abstract]
Net claims incurred	3,453,952	1,551,178	590,082
Insurance Operations
Premiums Earned, Net [Abstract]
Premiums earned, gross	1,085,339	799,903	666,297
Premiums earned, ceded	(470)	(489)	(599)
Net premiums earned	1,084,869	799,414	665,698
Policyholder Benefits and Claims Incurred, Net [Abstract]
Claims incurred, gross	985,197	839,136	585,915
Claims incurred, ceded	(1,166)	(1,002)	(483)
Net claims incurred	984,031	838,134	$ 585,432
Reinsurance Recoverables, Including Reinsurance Premium Paid [Abstract]
Reinsurance recoverable on paid claims, gross	500	96
Reinsurance recoverable on paid claims, net	$ 500	$ 96