Health Care Costs Payable

3 Months Ended

Mar. 31, 2023

Health Care and Other Insurance Liabilities [Abstract]

The following table shows the components of the change in health care costs payable during the three months ended March 31, 2023 and 2022:


	Three Months Ended March 31,
In millions	2023		2022
Health care costs payable, beginning of the period	$	10,142	$	8,678
Less: Reinsurance recoverables	5		8
Less: Impact of discount rate on long-duration insurance reserves (1)	8		—
Health care costs payable, beginning of the period, net	10,129		8,670

Add: Components of incurred health care costs
Current year	21,068		18,504
Prior years	(693)		(676)
Total incurred health care costs (2)	20,375		17,828
Less: Claims paid
Current year	11,957		10,225
Prior years	7,645		6,183
Total claims paid	19,602		16,408
Add: Premium deficiency reserve	—		13
Other (3)	—		(13)
Health care costs payable, end of the period, net	10,902		10,090
Add: Reinsurance recoverables	5		8
Add: Impact of discount rate on long-duration insurance reserves (1)	(12)		7
Health care costs payable, end of the period	$	10,895	$	10,105

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(1)Reflects the difference between the current discount rate and the locked-in discount rate on long-duration insurance reserves which is recorded within accumulated other comprehensive loss on the unaudited condensed consolidated balance sheets. Refer to Note 1 ‘‘Significant Accounting Policies’’ for further information related to the adoption of the long-duration insurance contracts accounting standard.

(2)Total incurred health care costs for the three months ended March 31, 2023 and 2022 in the table above exclude $22 million and $21 million, respectively, of benefit costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the unaudited condensed consolidated balance sheets and $51 million and $61 million, respectively, of benefit costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the unaudited condensed consolidated balance sheets. The incurred health care costs for the three months ended March 31, 2022 also exclude $13 million for a premium deficiency reserve related to the Company’s Medicaid products.

(3)As a result of the divestiture of the international health care business domiciled in Thailand (“Thailand business”), the net assets associated with this business were accounted for as assets held for sale and the associated health care costs payable balance was included in accrued expenses on the unaudited condensed consolidated balance sheet at March 31, 2022.

The Company’s estimates of prior years’ health care costs payable decreased by $693 million and $676 million, respectively, in the three months ended March 31, 2023 and 2022, because claims were settled for amounts less than originally estimated (i.e., the amount of claims incurred was lower than originally estimated), primarily due to lower health care cost trends as well as the actual claim submission time being faster than originally assumed (i.e., the Company’s completion factors were higher than originally assumed) in estimating health care costs payable at the end of the prior year.

At March 31, 2023, the Company’s liabilities for the ultimate cost of (i) services rendered to the Company’s Insured members but not yet reported to the Company and (ii) claims which have been reported to the Company but not yet paid (collectively, “IBNR”) plus expected development on reported claims totaled approximately $8.0 billion. The majority of the Company’s liabilities for IBNR plus expected development on reported claims at March 31, 2023 related to the current year.