Quarterly report pursuant to Section 13 or 15(d)

Segment Information (Details)

v2.4.0.6
Segment Information (Details) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 9 Months Ended
Sep. 30, 2012
Sep. 30, 2011
Sep. 30, 2012
segments
Sep. 30, 2011
segments
Number of reportable segments     2 2
Premium and service revenues from external customers $ 2,212,464 $ 1,265,281 $ 5,937,531 $ 3,722,458
Premium and service revenues from internal customers 0 0 0 0
Premium and service revenues 2,212,464 1,265,281 5,937,531 3,722,458
Earnings (loss) from operations (27,641) 48,547 (40,189) 142,947
Medicaid Managed Care [Member]
       
Premium and service revenues from external customers 1,994,867 1,080,038 5,293,736 3,179,601
Premium and service revenues from internal customers 25,138 16,976 62,751 50,020
Premium and service revenues 2,020,005 1,097,014 5,356,487 3,229,621
Earnings (loss) from operations (55,363) 38,387 (69,846) 109,004
Specialty Services [Member]
       
Premium and service revenues from external customers 217,597 185,243 643,795 542,857
Premium and service revenues from internal customers 442,387 171,358 1,206,293 495,829
Premium and service revenues 659,984 356,601 1,850,088 1,038,686
Earnings (loss) from operations 27,722 10,160 29,657 33,943
Eliminations [Member]
       
Premium and service revenues from external customers 0 0 0 0
Premium and service revenues from internal customers (467,525) (188,334) (1,269,044) (545,849)
Premium and service revenues (467,525) (188,334) (1,269,044) (545,849)
Earnings (loss) from operations $ 0 $ 0 $ 0 $ 0