BENEFITS PAYABLE

9 Months Ended

Sep. 30, 2021

On a consolidated basis, activity in benefits payable was as follows for the nine months ended September 30, 2021 and 2020:


	For the nine months ended September 30,
		2021		2020
	(in millions)
Balances, beginning of period		$	8,143	$	6,004

Less: Reinsurance recoverables		—		(68)
Balances, beginning of period, net		8,143		5,936
Acquisitions		42		—
Incurred related to:
Current year		52,529		45,693
Prior years		(768)		(278)
Total incurred		51,761		45,415
Paid related to:
Current year		(44,370)		(37,810)
Prior years		(6,818)		(5,334)
Total paid		(51,188)		(43,144)

Reinsurance recoverable		—		1
Balances, end of period		$	8,758	$	8,208

Amounts incurred related to prior periods vary from previously estimated liabilities as the claims ultimately are settled. Negative amounts reported for incurred related to prior years result from claims being ultimately settled for amounts less than originally estimated (favorable development).

Our reserving practice is to consistently recognize the actuarial best estimate of our ultimate liability for claims. Actuarial standards require the use of assumptions based on moderately adverse experience, which generally results in favorable reserve development, or reserves that are considered redundant.

The higher prior year favorable development for the nine months ended September 30, 2021 was primarily attributable to the reversal of actions taken in 2020, including the suspension of certain financial recovery programs for a period of time. The suspension during 2020 was intended to provide financial and administrative relief for providers facing unprecedented strain as a result of the COVID-19 pandemic.

Incurred and Paid Claims Development

The following discussion provides information about incurred and paid claims development for our Retail and Group and Specialty segments as of September 30, 2021 and 2020, net of reinsurance, and the total estimate of benefits payable for claims incurred but not reported, or IBNR, included within the net incurred claims amounts.

Retail Segment

Activity in benefits payable for our Retail segment was as follows for the nine months ended September 30, 2021 and 2020:


	For the nine months ended September 30,
		2021		2020
	(in millions)
Balances, beginning of period		$	7,428	$	5,363

Less: Reinsurance recoverables		—		(68)
Balances, beginning of period, net		7,428		5,295
Acquisitions		42		—
Incurred related to:
Current year		49,247		42,186
Prior years		(673)		(235)
Total incurred		48,574		41,951
Paid related to:
Current year		(41,721)		(34,946)
Prior years		(6,216)		(4,759)
Total paid		(47,937)		(39,705)

Reinsurance recoverable		—		1
Balances, end of period		$	8,107	$	7,542

At September 30, 2021, benefits payable for our Retail segment included IBNR of approximately $5.4 billion, primarily associated with claims incurred in 2021.

Group and Specialty Segment

Activity in benefits payable for our Group and Specialty segment was as follows for the nine months ended September 30, 2021 and 2020:


	For the nine months ended September 30,
		2021		2020
	(in millions)
Balances, beginning of period		$	715	$	641




Incurred related to:
Current year		3,769		3,929
Prior years		(95)		(43)
Total incurred		3,674		3,886
Paid related to:
Current year		(3,136)		(3,286)
Prior years		(602)		(575)
Total paid		(3,738)		(3,861)


Balances, end of period		$	651	$	666

At September 30, 2021, benefits payable for our Group and Specialty segment included IBNR of approximately $564 million, primarily associated with claims incurred in 2021.