Operating Segments - Schedule of Revenue by Operating Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	$ 1,235,769	$ 1,084,869	$ 799,414
Non-Insurance revenue	773,177	2,380,135	667,639
Other income	24,774	11,683	4,943
Intersegment revenues	2,033,720	3,476,687	1,471,996
Net medical claims incurred	1,776,388	3,453,952	1,551,178
Gross profit (loss)	257,332	22,735
Total assets	570,671	808,620
Ceded premiums	444	470	$ 489
Operating Segments | Insurance
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	1,235,769	1,084,869
Non-Insurance revenue	0	0
Other income	10,336	2,577
Net medical claims incurred	1,003,683	996,410
Gross profit (loss)	242,422	91,036
Total assets	401,812	354,748
Operating Segments | Non-Insurance
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	0	0
Non-Insurance revenue	773,177	2,380,135
Other income	5,267	1,311
Net medical claims incurred	771,798	2,460,879
Gross profit (loss)	6,646	(79,433)
Total assets	71,878	156,754
Corporate/Other
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	0	0
Non-Insurance revenue	0	0
Other income	59,569	74,610
Net medical claims incurred	17,432	9,042
Gross profit (loss)	197,226	173,817
Total assets	873,971	957,483
Intersegment revenues
Revenue, Major Customer [Line Items]
Intersegment revenues	(155,089)	(108,249)
Intersegment revenues | Insurance
Revenue, Major Customer [Line Items]
Intersegment revenues	0	0
Intersegment revenues | Non-Insurance
Revenue, Major Customer [Line Items]
Intersegment revenues	0	0
Eliminations
Revenue, Major Customer [Line Items]
Premiums earned, net (Net of ceded premiums)	0	0
Non-Insurance revenue	0	0
Other income	(50,398)	(66,815)
Net medical claims incurred	(16,525)	(12,379)
Gross profit (loss)	(188,962)	(162,685)
Total assets	$ (776,990)	$ (660,365)