
	Medicaid		Medicare		Commercial		Other		Consolidated Total
Balance, January 1, 2025	$	10,299	$	3,358	$	4,463	$	188	$	18,308
Less: Reinsurance recoverable	18		—		47		—		65
Balance, January 1, 2025, net	10,281		3,358		4,416		188		18,243

Incurred related to:
Current year	21,419		7,553		7,972		514		37,458
Prior years	(576)		(176)		(365)		(16)		(1,133)
Total incurred	20,843		7,377		7,607		498		36,325
Paid related to:
Current year	12,996		5,243		4,731		359		23,329
Prior years	6,849		1,923		2,648		150		11,570
Total paid	19,845		7,166		7,379		509		34,899
Plus: Premium deficiency reserve	—		178		—		—		178
Balance, March 31, 2025, net	11,279		3,747		4,644		177		19,847
Plus: Reinsurance recoverable	18		—		46		—		64
Balance, March 31, 2025	$	11,297	$	3,747	$	4,690	$	177	$	19,911


	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	20,179		5,495		5,884		373		31,931
Prior years	(684)		(156)		(204)		(5)		(1,049)
Total incurred	19,495		5,339		5,680		368		30,882
Paid related to:
Current year	12,823		3,266		3,339		258		19,686
Prior years	6,993		2,050		1,973		108		11,124
Total paid	19,816		5,316		5,312		366		30,810
Plus: Premium deficiency reserve	—		50		—		—		50
Balance, March 31, 2024, net	10,488		3,685		3,784		116		18,073
Plus: Reinsurance recoverable	4		—		32		—		36
Balance, March 31, 2024	$	10,492	$	3,685	$	3,816	$	116	$	18,109

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 $34 million and $54 million as a reduction to premium revenue in the three months ended March 31, 2025 and 2024, respectively, for minimum medical loss ratio (MLR) and other return of premium programs.

Incurred but not reported (IBNR) plus expected development on reported claims as of March 31, 2025 was $13,389 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 2024, the Company recorded a premium deficiency reserve of $92 million related to the 2025 Medicare Advantage contract year. In the first quarter of 2025, the premium deficiency reserve was increased to $270 million due to the intra-year flow of seasonality, including anticipated impacts of the Inflation Reduction Act to the Part D benefit within the Company's Medicare Advantage business. 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 due to the intra-year flow of seasonality.