
	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2024	$	10,814	$	3,612	$	3,460	$	114	$	18,000
Less: Reinsurance recoverable	5		—		44		—		49
Balance, January 1, 2024, net	10,809		3,612		3,416		114		17,951

Incurred related to:
Current year	59,327		16,134		19,211		1,216		95,888
Prior years	(1,247)		(439)		(306)		7		(1,985)
Total incurred	58,080		15,695		18,905		1,223		93,903
Paid related to:
Current year	50,198		13,006		15,773		1,040		80,017
Prior years	8,543		2,713		2,523		120		13,899
Total paid	58,741		15,719		18,296		1,160		93,916
Plus: Premium deficiency reserve	—		(5)		—		—		(5)
Balance, September 30, 2024, net	10,148		3,583		4,025		177		17,933
Plus: Reinsurance recoverable	20		—		42		—		62
Balance, September 30, 2024	$	10,168	$	3,583	$	4,067	$	177	$	17,995


	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2023	$	11,253	$	3,431	$	1,921	$	140	$	16,745
Less: Reinsurance recoverable	7		—		19		—		26
Balance, January 1, 2023, net	11,246		3,431		1,902		140		16,719

Incurred related to:
Current year	60,379		14,680		13,994		1,095		90,148
Prior years	(1,303)		(326)		(256)		(3)		(1,888)
Total incurred	59,076		14,354		13,738		1,092		88,260
Paid related to:
Current year	50,774		12,069		11,575		984		75,402
Prior years	8,517		2,452		1,376		136		12,481
Total paid	59,291		14,521		12,951		1,120		87,883
Balance, September 30, 2023, net	11,031		3,264		2,689		112		17,096
Plus: Reinsurance recoverable	4		—		41		—		45
Balance, September 30, 2023	$	11,035	$	3,264	$	2,730	$	112	$	17,141

Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of development within "Incurred related to: Prior years," the Company recorded $236 million and $341 million as a reduction to premium revenue in the nine months ended September 30, 2024 and 2023, respectively, for minimum health benefits ratio (HBR) and other return of premium programs.

Incurred but not reported (IBNR) plus expected development on reported claims as of September 30, 2024 was $12,654 million. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors.

The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year, which was increased to $300 million in the first quarter of 2024, to $335 million in the second quarter of 2024 and decreased by $90 million to $245 million in the third quarter of 2024 consistent with the intra-year flow of seasonality.