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  "presentationDate": "2022-03-01 00:00:00",
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  "notes": "The table shows the derivation of net claims and net premiums before quota share reinsurance, resulting in an 88.9% MLR.",
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      "text": "Direct claims incurred before ceded reinsurance (000s) $ 2,403,108; Assumed reinsurance claims 21,656; Excess of loss ceded claims (12,500); State reinsurance (14,655); Net claims before ceded quota share reinsurance $ 2,397,609; Premiums before ceded reinsurance $ 2,712,988; Excess of loss reinsurance premiums (16,266); Other non-recurring items -; Net premiums before ceded quota share reinsurance $ 2,696,722; Medical Loss Ratio 88.9%",
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