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RISK ADJUSTMENT
 6 Months Ended
Jun. 30, 2026
Risks and Uncertainties [Abstract]  
RISK ADJUSTMENT RISK ADJUSTMENT
The risk adjustment programs in the markets the Company serves are administered federally by CMS and are designed to mitigate the potential impact of adverse selection and provide stability for health insurers. Under these programs, each plan is assigned a risk score based upon demographic information and current year claims information related to its members. Plans with lower than average risk scores generally pay into the pool (included within Payables to CMS on the Condensed Consolidated Balance Sheets), while plans with higher than average risk scores generally receive distributions (included within Receivables from CMS on the Condensed Consolidated Balance Sheets). The Company estimates its risk adjustment transfer receivable or payable for each state by comparing its estimated risk score to the state average risk score. Changes in the Company's membership throughout the year, including the impact of member disenrollments, may affect the Company's estimate of its risk adjustment transfer receivable or payable. The Company records a receivable or payable as an adjustment to its premium revenues to reflect the year-to-date impact of the risk adjustment based on its best estimate. The Company reevaluates its risk adjustment transfer estimates as new information and market data becomes available until final reporting is received from CMS in later periods, which may be up to twelve months in arrears.

The following table provides a rollforward of the Company’s beginning and ending risk adjustment receivable and payable balances for the six months ended June 30, 2026 and 2025:

Six Months Ended June 30, 2026Six Months Ended June 30, 2025
(in thousands)Risk Adjustment ReceivableRisk Adjustment PayableNet Risk Adjustment PayableRisk Adjustment ReceivableRisk Adjustment PayableNet Risk Adjustment Payable
Beginning balance (1)
$56,066 $2,587,700 $2,531,634 $64,779 $1,558,341 $1,493,562 
Change in accrual:
Current year$27,970 $2,401,634 $2,373,664 $33,303 $1,021,779 $988,476 
Prior years (2)
11,719 (47,432)(59,151)(10,465)67,067 77,532 
Change in accrual, net$39,689 $2,354,202 $2,314,513 $22,838 $1,088,846 $1,066,008 
Ending balance:
Current year$27,970 $2,401,634 $2,373,664 $33,303 $1,021,779 $988,476 
Prior years 67,785 2,540,268 2,472,483 54,314 1,625,408 1,571,094 
Ending balance$95,755 $4,941,902 $4,846,147 $87,617 $2,647,187 $2,559,570 
(1)The table includes risk adjustment data validation (“RADV”) receivables and payables. The balance at the beginning of each year presented pertains to prior policy years.
(2)Includes immaterial payments for prior policy years.

The six months ended June 30, 2026, reflected higher net risk adjustment payables compared to the six months ended June 30, 2025, primarily due to higher membership, as well as higher net risk adjustment payables per member.