Quarterly report pursuant to Section 13 or 15(d)

Segment Information (Details)

v2.3.0.15
Segment Information (Details) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 9 Months Ended
Sep. 30, 2011
Sep. 30, 2010
Sep. 30, 2011
Sep. 30, 2010
Number of reportable segments 2 2 2 2
Premium and service revenues from external customers $ 1,265,281 $ 1,081,513 $ 3,722,458 $ 3,154,345
Premium and service revenues from internal customers        
Premium and service revenues 1,265,281 1,081,513 3,722,458 3,154,345
Earnings from operations 48,547 40,248 142,947 111,568
Medicaid Managed Care [Member]
       
Premium and service revenues from external customers 1,080,038 934,664 3,179,601 2,715,106
Premium and service revenues from internal customers 16,976 15,512 50,020 45,739
Premium and service revenues 1,097,014 950,176 3,229,621 2,760,845
Earnings from operations 38,387 35,702 109,004 82,445
Specialty Services [Member]
       
Premium and service revenues from external customers 185,243 146,849 542,857 439,239
Premium and service revenues from internal customers 171,358 124,732 495,829 372,681
Premium and service revenues 356,601 271,581 1,038,686 811,920
Earnings from operations 10,160 4,546 33,943 29,123
Eliminations [Member]
       
Premium and service revenues from external customers        
Premium and service revenues from internal customers (188,334) (140,244) (545,849) (418,420)
Premium and service revenues (188,334) (140,244) (545,849) (418,420)
Earnings from operations