CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands	9 Months Ended
Sep. 30, 2011	Sep. 30, 2010
Cash flows from operating activities:
Net income	$ 99,884	$ 105,731
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	43,288	41,607
Non-cash interest expense	320	463
Non-cash stock compensation expense	13,408	11,830
Non-cash income tax expense	(248)	32,260
Non-cash amortization (accretion) on investments	9,660	6,851
Cash flows from changes in assets and liabilities, net of effects from acquisitions of businesses:
Restricted cash	(38,825)	62,413
Accounts receivable, net	(8,439)	10,279
Other assets	(751)	(4,085)
Accounts payable and accrued liabilities	(10,216)	889
Medical claims payable and other medical liabilities	(15,463)	(14,085)
Other	3,501	126
Net cash provided by operating activities	96,119	254,279
Cash flows from investing activities:
Capital expenditures	(38,468)	(32,201)
Acquisitions and investments in businesses, net of cash acquired	(376)
Purchase of investments	(210,890)	(235,420)
Maturity of investments	231,093	154,979
Net cash used in investing activities	(18,641)	(112,642)
Cash flows from financing activities:
Payments on long-term debt and capital lease obligations		(588)
Payments to acquire treasury stock	(327,886)	(74,427)
Proceeds from issuance of equity	20,000
Proceeds from exercise of stock options and warrants	34,755	23,121
Other	839	(1,611)
Net cash used in financing activities	(272,292)	(53,505)
Net increase (decrease) in cash and cash equivalents	(194,814)	88,132
Cash and cash equivalents at beginning of period	337,179	196,507
Cash and cash equivalents at end of period	$ 142,365	$ 284,639

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Includes currency on hand as well as demand deposits with banks or financial institutions. It also includes other kinds of accounts that have the general characteristics of demand deposits in that the Entity may deposit additional funds at any time and also effectively may withdraw funds at any time without prior notice or penalty. Cash equivalents, excluding items classified as marketable securities, include short-term, highly liquid investments that are both readily convertible to known amounts of cash, and so near their maturity that they present minimal risk of changes in value because of changes in interest rates. Generally, only investments with original maturities of three months or less qualify under that definition. Original maturity means original maturity to the entity holding the investment. For example, both a three-month US Treasury bill and a three-year Treasury note purchased three months from maturity qualify as cash equivalents. However, a Treasury note purchased three years ago does not become a cash equivalent when its remaining maturity is three months. Compensating balance arrangements that do not legally restrict the withdrawal or usage of cash amounts may be reported as Cash and Cash Equivalents, while legally restricted deposits held as compensating balances against borrowing arrangements, contracts entered into with others, or company statements of intention with regard to particular deposits are not generally reported as cash and cash equivalents. Includes cash and cash equivalents associated with the entity's continuing operations. Excludes cash and cash equivalents associated with the disposal group (and discontinued operation).

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