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Investments in Debt and Equity Securities - Additional Information (Detail) (USD $)
In Thousands, except Share data, unless otherwise specified
1 Months Ended 12 Months Ended 1 Months Ended
Oct. 31, 2011
Dec. 31, 2011
Dec. 31, 2010
Dec. 31, 2009
Dec. 31, 2011
Common Stock
Feb. 24, 2012
Sale of Investments
Schedule of Trading Securities and Other Trading Assets [Line Items]            
Available for sale investments gross pre-tax unrealized gain (loss)   $ (255) $ 824      
Unrealized gain (loss) on investments, pre tax   (986) 1,007 1,614    
Proceeds from sale of investments available for sale   1,149 900 16,693   5,200
Pre tax reclassification of net investment realized losses (gains) into net income   (93) 22 (261)    
Reclassification of net investment realized losses (gains) into net income, net of tax   (57) 13 (159)    
Fair value of NxStage Medical Inc., warrants         4,445  
Maximum shares warrants to be earned   5,500,000        
Exercise price of the warrants   $ 14.22        
Warrants to purchase common stock   250,000        
Payments to acquire available-for-sale securities, equity upon the exercise of warrant 3,555          
Held to maturity investment to maintain certain capital requirements of the special need plans   7,224 18,537      
Held-to-maturity securities, released from regulatory agencies   $ 11,313