BENEFITS PAYABLE

12 Months Ended

Dec. 31, 2023

On a consolidated basis, which represents our Insurance segment net of eliminations, activity in benefits payable was as follows for the years ended December 31, 2023, 2022 and 2021:


	2023		2022		2021
	(in millions)
Balances at January 1	$	9,264	$	8,289	$	8,143



Acquisitions	62		—		42
Incurred related to:
Current year	89,266		76,105		70,024
Prior years	(872)		(415)		(825)
Total incurred	88,394		75,690		69,199
Paid related to:
Current year	(79,545)		(67,287)		(62,149)
Prior years	(7,934)		(7,428)		(6,946)
Total paid	(87,479)		(74,715)		(69,095)


Balances at December 31	$	10,241	$	9,264	$	8,289

The total estimate of benefits payable for claims incurred but not reported, or IBNR, is included within the net

incurred claims amounts. At December 31, 2023 and 2022, benefits payable included IBNR of approximately $6.6 billion and $5.7 billion, primarily associated with claims incurred in each respective year. The cumulative number of reported claims as of December 31, 2023 was approximately 200.0 million for claims incurred in 2023, 182.4 million for claims incurred in 2022, and 173.7 million for claims incurred in 2021.

Amounts incurred related to prior years 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).

As previously discussed, 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. We experienced favorable medical claims reserve development related to prior fiscal years of $872 million in 2023, $415 million in 2022, and $825 million in 2021.

The medical claims reserve development for 2023, 2022, and 2021 primarily reflects the consistent application of trend and completion factors estimated using an assumption of moderately adverse conditions. The favorable development recognized in 2023 and 2021 primarily resulted from trend factors developing more favorably than originally expected as well as for 2021 completion factors developing faster than expected. The favorable development recognized in 2022 resulted primarily from completion factors remaining largely unchanged, resulting in lower overall development as compared to 2023 and 2021.

Incurred and Paid Claims Development

The following discussion provides information about incurred and paid claims development as of December 31, 2023, net of reinsurance, as well as cumulative claim frequency and the total of IBNR included within the net incurred claims amounts. The information about incurred and paid claims development for the years ended December 31, 2022 and 2021 is presented as supplementary information.

Claims frequency is measured as medical fee-for-service claims for each service encounter with a unique provider identification number. Our claims frequency measure includes claims covered by deductibles as well as claims under capitated arrangements. Claim counts may vary based on product mix and the percentage of delegated capitation arrangements.

The following tables provide information about incurred and paid claims development as of December 31, 2023, net of reinsurance.


	Incurred Claims, Net of Reinsurance
	For the Years Ended December 31,
Claims Incurred Year	2021 Unaudited		2022 Unaudited		2023
	(in millions)
2021 & Prior	$	70,066	$	69,698	$	69,484
2022			76,105		75,447
2023					89,328
Total					$	234,259


	Cumulative Paid Claims, Net of Reinsurance
	For the Years Ended December 31,
Claims Incurred Year	2021 Unaudited		2022 Unaudited		2023
	(in millions)
2021 & Prior	$	62,149	$	69,252	$	69,484
2022			67,287		74,989
2023					79,545
Total					224,018
All outstanding benefit liabilities before 2021, net of reinsurance					N/A
Benefits payable, net of reinsurance					$	10,241

For additional information regarding our benefits payable and benefits expense recognition, refer to Note 2 to the audited Consolidated Financial Statements included in Part II, Item 8, "Financial Statements and Supplementary Data" in this Form 10-K.