Quarterly report pursuant to Section 13 or 15(d)

Segment Information (Details)

v2.4.0.8
Segment Information (Details) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 9 Months Ended
Sep. 30, 2013
Sep. 30, 2012
Sep. 30, 2013
segments
Sep. 30, 2012
segments
Number of reportable segments     2 2
Premium and service revenues from external customers $ 2,734,148 $ 2,212,464 $ 7,910,708 $ 5,937,531
Premium and service revenues from internal customers 0 0 0 0
Premium and service revenues 2,734,148 2,212,464 7,910,708 5,937,531
Earnings (loss) from operations 82,231 (27,641) 189,361 (40,189)
Medicaid Managed Care [Member]
       
Premium and service revenues from external customers 2,510,221 2,072,079 7,367,236 5,507,972
Premium and service revenues from internal customers 9,885 25,138 31,050 62,751
Premium and service revenues 2,520,106 2,097,217 7,398,286 5,570,723
Earnings (loss) from operations 68,083 (55,239) 116,609 (72,740)
Specialty Services [Member]
       
Premium and service revenues from external customers 223,927 140,385 543,472 429,559
Premium and service revenues from internal customers 542,238 442,388 1,660,639 1,206,293
Premium and service revenues 766,165 582,773 2,204,111 1,635,852
Earnings (loss) from operations 14,148 27,598 72,752 32,551
Eliminations [Member]
       
Premium and service revenues from external customers 0 0 0 0
Premium and service revenues from internal customers (552,123) (467,526) (1,691,689) (1,269,044)
Premium and service revenues (552,123) (467,526) (1,691,689) (1,269,044)
Earnings (loss) from operations $ 0 $ 0 $ 0 $ 0