10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Form 10-Q

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2022

or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                      to                     

Commission File Number: 001-37477

TELADOC HEALTH, INC.

(Exact name of registrant as specified in its charter)

Delaware	04-3705970
(State of incorporation)	(I.R.S. Employer Identification No.)
2 Manhattanville Road, Suite 203
Purchase, New York	10577
(Address of principal executive office)	(Zip code)

(203) 635-2002

(Registrant’s telephone number including area

code)

Securities registered pursuant to Section 12(b) of the Act:

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock, par value $0.001 per share	TDOC	The New York Stock Exchange

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ⌧  No ◻

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes  ⌧  No  ◻

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.:

Large accelerated filer	⌧	Accelerated filer	◻	Non-accelerated filer	◻	Smaller reporting company	☐
Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ◻

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act.) Yes  ☐  No  ⌧

As of April 27, 2022, the Registrant had 161,182,633 shares of Common Stock outstanding.

TELADOC HEALTH, INC.

QUARTERLY REPORT ON FORM 10-Q

For the period ended March 31, 2022

TABLE OF CONTENTS

		Page Number
PART I	Financial Information	2
Item 1.	Financial Statements	2
	Condensed Consolidated Balance Sheets as of March 31, 2022 (unaudited) and December 31, 2021	2
	Condensed Consolidated Statements of Operations and Comprehensive Loss (unaudited) for the quarters ended March 31, 2022 and 2021	3
	Condensed Consolidated Statements of Stockholders’ Equity (unaudited) for the quarters ended March 31, 2022 and 2021	4
	Condensed Consolidated Statements of Cash Flows (unaudited) for the three months ended March 31, 2022 and 2021	5
	Notes to Unaudited Condensed Consolidated Financial Statements	6
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	22
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	31
Item 4.	Controls and Procedures	32
PART II	Other Information	33
Item 1.	Legal Proceedings	33
Item 1A.	Risk Factors	33
Item 6.	Exhibits	34
Exhibit Index		34
Signatures		36

1

PART I

FINANCIAL INFORMATION

ITEM 1. Financial Statements

TELADOC HEALTH, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(In thousands, except share and per share data, unaudited)

	March 31,		December 31,
	2022		2021
Assets
Current assets:
Cash and cash equivalents	$	836,444	$	893,480
Short-term investments		2,544		2,537
Accounts receivable, net of provision of $13,056 and $12,384, respectively		191,528		168,956
Inventories		70,654		73,079
Prepaid expenses and other current assets		106,875		87,387
Total current assets		1,208,045		1,225,439
Property and equipment, net		28,419		27,234
Goodwill		7,899,795		14,504,174
Intangible assets, net		1,883,897		1,910,278
Operating lease - right-of-use assets		45,552		46,780
Other assets		26,629		20,703
Total assets	$	11,092,337	$	17,734,608
Liabilities and stockholders’ equity
Current liabilities:
Accounts payable	$	47,412	$	47,257
Accrued expenses and other current liabilities		116,689		102,933
Accrued compensation		46,075		91,941
Deferred revenue-current		83,847		75,569
Advances from financing companies		12,664		13,313
Total current liabilities		306,687		331,013
Other liabilities		1,445		1,492
Operating lease liabilities, net of current portion		40,163		41,773
Deferred revenue, net of current portion		2,884		3,834
Advances from financing companies, net of current portion		8,252		9,291
Deferred taxes, net		57,516		75,777
Convertible senior notes, net		1,532,780		1,225,671
Commitments and contingencies (Note 10)
Stockholders’ equity:
Common stock, $0.001 par value; 300,000,000 shares authorized as of March 31, 2022 and December 31, 2021; 161,434,513 shares and 160,469,325 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively		161		160
Additional paid-in capital		17,177,152		17,473,336
Accumulated deficit		(8,023,279)		(1,421,454)
Accumulated other comprehensive loss		(11,424)		(6,285)
Total stockholders’ equity		9,142,610		16,045,757
Total liabilities and stockholders’ equity	$	11,092,337	$	17,734,608

See accompanying notes to unaudited condensed consolidated financial statements.

2

TELADOC HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

(In thousands, except share and per share data, unaudited)

	Quarter Ended March 31,
	2022		2021
Revenue	$	565,350	$	453,675
Expenses:
Cost of revenue (exclusive of depreciation and amortization, which is shown separately below)		187,025		145,959
Operating expenses:
Advertising and marketing		133,600		89,439
Sales		58,329		64,793
Technology and development		87,412		78,008
General and administrative		104,923		105,172
Acquisition, integration, and transformation costs		4,507		6,323
Depreciation and amortization		58,933		48,659
Goodwill impairment		6,600,000		0
Total expenses		7,234,729		538,353
Loss from operations		(6,669,379)		(84,678)
Loss on extinguishment of debt		0		11,459
Other income, net		(724)		(5,652)
Interest expense, net		5,480		22,125
Net loss before taxes		(6,674,135)		(112,610)
Income tax expense		388		87,039
Net loss		(6,674,523)		(199,649)
Other comprehensive loss, net of tax:
Currency translation adjustment and other		(5,139)		(13,492)
Comprehensive loss	$	(6,679,662)	$	(213,141)
Net loss per share, basic and diluted	$	(41.58)	$	(1.31)
Weighted-average shares used to compute basic and diluted net loss per share		160,532,301		152,167,606

See accompanying notes to unaudited condensed consolidated financial statements.

3

TELADOC HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

(In thousands, except share data, unaudited)

								Accumulated
				Additional				Other		Total
	Common Stock			Paid-In		Accumulated		Comprehensive		Stockholders’
	Shares	Amount		Capital		Deficit		Gain (Loss)		Equity
Balance as of December 31, 2021	160,469,325	$	160	$	17,473,336	$	(1,421,454)	$	(6,285)	$	16,045,757
Cumulative effect adjustment due to adoption of ASU 2020-06 (see Note 2)	0		0		(363,731)		72,698		0		(291,033)
Exercise of stock options	267,586		0		3,585		0		0		3,585
Issuance of common stock upon vesting of restricted stock units	697,602		1		(1)		0		0		0
Stock-based compensation	0		0		63,963		0		0		63,963
Other comprehensive loss, net of tax	0		0		0		0		(5,139)		(5,139)
Net loss	0		0		0		(6,674,523)		0		(6,674,523)
Balance as of March 31, 2022	161,434,513	$	161	$	17,177,152	$	(8,023,279)	$	(11,424)	$	9,142,610
Balance as of December 31, 2020	150,281,099	$	150	$	16,857,797	$	(992,661)	$	18,518	$	15,883,804
Exercise of stock options	1,238,112		1		11,907		0		0		11,908
Issuance of common stock upon vesting of restricted stock units	976,999		1		(1)		0		0		(0)
Issuance of common stock for 2022 Notes	1,058,373		1		270,111		0		0		270,112
Equity portion of extinguishment of 2022 Notes	0		0		(224,081)		0		0		(224,081)
Issuance of common stock for 2025 Notes	1,056,861		1		288,485		0		0		288,486
Equity portion of extinguishment of 2025 Notes	0		0		(237,261)		0		0		(237,261)
Recovery of excess common stock issued for acquisition	(205,280)		(0)		(40,329)		0		0		(40,329)
Stock-based compensation	0		0		90,000		0		0		90,000
Other comprehensive loss, net of tax	0		0		0		0		(13,492)		(13,492)
Net loss	0		0		0		(199,649)		0		(199,649)
Balance as of March 31, 2021	154,406,164	$	154	$	17,016,628	$	(1,192,310)	$	5,026	$	15,829,498

See accompanying notes to unaudited condensed consolidated financial statements.

4

TELADOC HEALTH, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(In thousands, unaudited)

	Quarter Ended March 31,
	2022		2021
Operating activities:
Net loss	$	(6,674,523)	$	(199,649)
Adjustments to reconcile net loss to net cash used in operating activities:
Goodwill impairment		6,600,000		0
Depreciation and amortization		58,933		48,659
Depreciation of rental equipment		770		824
Amortization of right-of-use assets		3,173		2,948
Provision for doubtful accounts		4,591		3,074
Stock-based compensation		60,436		86,300
Deferred income taxes		(2,319)		87,004
Accretion of interest		826		16,829
Loss on extinguishment of debt		0		11,459
Gain on sale of investment		0		(5,852)
Other, net		0		38
Changes in operating assets and liabilities:
Accounts receivable		(27,842)		(11,717)
Prepaid expenses and other current assets		(18,993)		(12,799)
Inventory		2,023		(2,877)
Other assets		(6,047)		1,244
Accounts payable		492		(11,989)
Accrued expenses and other current liabilities		11,706		(1,889)
Accrued compensation		(48,819)		(43,624)
Deferred revenue		7,479		17,086
Operating lease liabilities		(3,626)		(3,076)
Other liabilities		(7)		(19)
Net cash used in operating activities		(31,747)		(18,026)
Investing activities:
Capital expenditures		(3,913)		(2,115)
Capitalized software		(26,918)		(11,144)
Proceeds from marketable securities		0		50,000
Acquisitions of business, net of cash acquired		0		(55,921)
Other, net		3,264		3,150
Net cash used in investing activities		(27,567)		(16,030)
Financing activities:
Net proceeds from the exercise of stock options		3,585		11,908
Repurchase of 2022 Notes		0		(130)
Proceeds from advances from financing companies		2,232		4,816
Payment against advances from financing companies		(3,921)		(4,098)
Proceeds from employee stock purchase plan		3,680		8,648
Cash received for withholding taxes on stock-based compensation, net		103		1,218
Other, net		(2,863)		(187)
Net cash provided by financing activities		2,816		22,175
Net decrease in cash and cash equivalents		(56,498)		(11,881)
Foreign exchange difference		(538)		(1,339)
Cash and cash equivalents at beginning of the period		893,480		733,324
Cash and cash equivalents at end of the period	$	836,444	$	720,104
Income taxes paid	$	261	$	52
Interest paid	$	7	$	3

See accompanying notes to unaudited condensed consolidated financial statements.

5

Note 1. Organization and Description of Business

Teladoc Health, Inc., together with its subsidiaries, is referred to herein as “Teladoc Health,” or the “Company,” and is the global leader in whole person virtual care, forging a new healthcare experience with better convenience, outcomes, and value. The Company’s mission is to empower all people everywhere to live their healthiest lives by transforming the healthcare experience.

The Company was incorporated in the State of Texas in June 2002 and changed its state of incorporation to the State of Delaware in October 2008. Effective August 10, 2018, Teladoc, Inc. changed its corporate name to Teladoc Health, Inc. The Company’s principal executive office is located in Purchase, New York.

On October 30, 2020, the Company completed the merger with Livongo Health, Inc. (“Livongo”), a transformational opportunity to improve the delivery, access and experience of chronic healthcare for individuals around the world.

On July 1, 2020, the Company completed the acquisition of InTouch Technologies, Inc. (“InTouch”), a leading provider of enterprise telehealth solutions for hospitals and health systems.

Note 2. Basis of Presentation and Principles of Consolidation

The accompanying unaudited condensed consolidated financial statements for the three months ended March 31, 2022 and 2021, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals) necessary for a fair presentation of the condensed consolidated results of operations, financial position and cash flows of Teladoc Health for the periods presented. However, the financial results for interim periods are not necessarily indicative of the results that may be expected for a full fiscal year or for any other future period.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles (“GAAP”) in the United States (“U.S.”) have been omitted or condensed pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). The information in this report should be read in conjunction with the Company’s Annual Report on Form 10-K filed with the SEC for the fiscal year ended December 31, 2021 (the “2021 Form 10-K”), which includes a complete set of footnote disclosures, including the Company’s significant accounting policies.

These financial statements include the results of Teladoc Health, as well as three professional associations and twelve professional corporations (collectively, the “THMG Association”). All intercompany transactions and balances have been eliminated. Certain prior year amounts have been reclassified to conform to the current year presentation.

Teladoc Health Medical Group, P.A., formerly Teladoc Physicians, P.A. (“THMG”) is party to several Services Agreements by and among it and the professional associations and professional corporations pursuant to which each professional association and professional corporation provides services to THMG. Each professional association and professional corporation is established pursuant to the requirements of its respective domestic jurisdiction governing the corporate practice of medicine.

The Company holds a variable interest in the THMG Association which contracts with physicians and other health professionals in order to provide services to the Company. The THMG Association is considered a variable interest entity (“VIE”) since it does not have sufficient equity to finance its activities without additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if it has both power and benefits—that is, it has (1) the power to direct the activities of a VIE that most significantly impact the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has the power and rights to control all activities of the THMG Association and funds and absorbs all losses of the VIE and appropriately consolidates the THMG Association.

Total revenue and net income (loss) for the VIE were $60.1 million and $2.3 million, and $54.2 million and $1.2 million, for the quarters ended March 31, 2022 and 2021, respectively. The VIE’s total assets, all of which were current, were $33.1 million and $58.5 million at March 31, 2022 and December 31, 2021, respectively. The VIE’s total liabilities, all of which were current, were $71.5 million and $94.7 million at March 31, 2022 and December 31, 2021,

6

respectively. The VIE’s total stockholders’ deficit was $38.4 million and $36.1 million at March 31, 2022 and December 31, 2021, respectively.

Business Combinations

The Company accounts for its business combinations using the acquisition method of accounting. The purchase price is attributed to the fair value of the assets acquired and liabilities assumed. Transaction costs directly attributable to the acquisition are expensed as incurred. Identifiable assets and liabilities acquired or assumed are measured separately at their fair values as of the acquisition date. The excess of the purchase price of acquisition over the fair value of the identifiable net assets of the acquiree is recorded as goodwill. The results of businesses acquired in a business combination are included in the Company’s condensed consolidated financial statements from the date of acquisition.

When the Company issues stock-based or cash awards to an acquired company’s stockholders, the Company evaluates whether the awards are consideration or compensation for post-acquisition services. The evaluation includes, among other things, whether the vesting of the awards is contingent on the continued employment of the acquired company’s stockholders beyond the acquisition date. If continued employment is required for vesting, the awards are treated as compensation for post-acquisition services and recognized as expense over the requisite service period.

Determining the fair value of assets acquired and liabilities assumed requires management to use significant judgment and estimates, including the selection of valuation methodologies, estimates of future revenue and cash flows, discount rates and selection of comparable companies. The estimates and assumptions used to determine the fair values and useful lives of identified intangible assets could change due to numerous factors, including market conditions, technological developments, economic conditions, and competition. In connection with determination of fair values, the Company may engage a third-party valuation specialist to assist with the valuation of intangible and certain tangible assets acquired and certain assumed obligations. Acquisition-related transaction costs incurred by the Company are not included as a component of consideration transferred but are accounted for as an operating expense in the period in which the costs are incurred.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business and economic factors, and various other assumptions that the Company believes are necessary to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained and as the Company’s operating environment evolves. The Company believes that estimates used in the preparation of these condensed consolidated financial statements are reasonable; however, actual results could differ materially from these estimates.

Changes in estimates are made when circumstances warrant. Such changes in estimates and refinements in estimation methodologies are reflected in reported results of operations; if material, the effects of changes in estimates are disclosed in the notes to the condensed consolidated financial statements.

Significant estimates and assumptions by management affect areas including the carrying value and useful life of long-lived assets (including intangible assets), the carrying value of goodwill, the capitalization and amortization of software development costs, deferred costs, the allowance for doubtful accounts, and the accounting for business combinations. Other significant areas include revenue recognition (including performance guarantees, the accounting for income taxes, contingences, litigation and related legal accruals, and the accounting for stock-based compensation awards, and other items as described in the Summary of Significant Accounting policies in this Quarterly Report and in the 2021 Form 10-K.

7

Recently Adopted Accounting Standards

In August 2020, the financial accounting standards board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06—"Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity.” ASU 2020-06 simplifies the accounting for convertible instruments by eliminating the conversion option separation model for convertible debt that can be settled in cash and by eliminating the measurement model for beneficial conversion features. Convertible instruments that continue to be subject to separation models are (1) those with conversion options that are required to be accounted for as bifurcated derivatives and (2) convertible debt instruments issued with substantial premiums for which the premiums are recorded as paid-in capital. This ASU also requires entities to use the if-converted method for all convertible instruments in the diluted earnings per share calculation and include the effect of share settlement for instruments that may be settled in cash or shares, except for certain liability-classified share-based payment awards.

The Company adopted ASU 2020-06 as of January 1, 2022, under the modified retrospective transition method, and accordingly, its prior period financial statements were not restated. Upon adoption of ASU 2020-06, the conversion feature of the Company’s convertible senior notes is no longer reported as a component of equity. Instead, the previously-separated equity component is now combined with the liability component, thereby eliminating the amortization of the debt discount arising from the conversion option separation model. As such, the Company currently anticipates a reduction of approximately $58 million in non-cash interest to be recorded on its convertible senior notes for the year ended December 31, 2022, as compared to the year ended December 31, 2021. To reflect the adoption of ASU 2020-06, the Company recorded an increase to convertible senior notes of $306.3 million and decreases to additional paid-in capital, accumulated deficit and net deferred tax liabilities of $363.7 million, $72.7 million and $15.3 million, respectively, as of January 1, 2022.

Note 3. Revenue, Deferred Revenue, and Deferred Device and Contract Costs

The Company generates access fees from customers, consisting of employers, health plans, hospitals and health systems, insurance, and financial services companies (collectively “Clients”), as well as individual members, accessing its professional provider network, hosted virtual healthcare platform and chronic care management platforms. Visit fee revenue is generated for general medical, expert medical service and other specialty visits. In addition, other revenue is primarily associated with virtual healthcare device equipment included with its hosted virtual healthcare platform. Access revenue accounted for 87% and 84% of the Company’s revenue for the quarters ended March 31, 2022 and 2021, respectively.

8

The following table presents the Company’s revenues disaggregated by revenue source (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Access Fees Revenue
U.S.	$	421,146	$	327,553
International		70,191		54,553
Total		491,337		382,106
Visit Fee Revenue
U.S.		64,473		57,128
International		3,455		3,383
Total		67,928		60,511
Other
U.S.		5,581		10,671
International		504		387
Total		6,085		11,058
Total Revenues	$	565,350	$	453,675

During the fourth quarter of 2021, the Company refined its definition of international revenues to reflect all international revenues based on location of the customer. Previously, Direct-to-Consumer (“D2C”) activities were primarily reflected based on the location of operations. In addition, certain activities related to the Company’s international operations are now reflected in visit revenues versus access fee revenues. Prior period amounts have been recast to conform with current presentation.

Deferred Revenue

Deferred revenue represents billed, but unrecognized revenue, and is comprised of fees received in advance of the delivery or completion of the services and amounts received in instances when revenue recognition criteria have not been met. Deferred revenue associated with upfront payments for a device is amortized ratably over the expected member enrollment period. Deferred revenue that will be recognized during the succeeding twelve-month period is recorded as current deferred revenue and the remaining portion is recorded as noncurrent deferred revenue.

For certain services, payment is required for future months before the service is delivered to the member. The Company records deferred revenue when cash payments are received in advance of the Company’s performance obligation to provide services. Deferred revenue, current plus long-term, was $87.1 million at March 31, 2022 and $73.2 million at March 31, 2021. The net increase of $7.6 million and $18.4 million in the deferred revenue balance for the three months ended March 31, 2022 and 2021, respectively, was primarily driven by InTouch and Livongo as well as BetterHelp, the Company’s D2C mental health product, and cash payments received or due in advance of satisfying the Company’s performance obligations, offset by revenue recognized that were included in the deferred revenue balance at the beginning of the period. The Company anticipates that it will satisfy most of its performance obligation associated with the deferred revenue within the prospective fiscal year. Revenue recognized during the quarters ended March 31, 2022 and 2021 that was included in deferred revenue at the beginning of the periods was $51.6 million and $32.7 million, respectively.

The Company expects to recognize $73.0 million and $5.0 million of revenue in 2022 and 2023, respectively, related to future performance obligations that are unsatisfied or partially unsatisfied as of March 31, 2022.

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Deferred Device and Contract Costs

Deferred device and contract costs are classified as a component of Prepaid expenses and other current assets or Other assets depending on term, and consisted of the following as of March 31, 2022 (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Deferred device and contract costs, current	$	27,335	$	22,304
Deferred device and contract costs, noncurrent		7,636		6,249
Total deferred device and contract costs	$	34,971	$	28,553

Deferred costs and other activity were as follows (in thousands):

	Deferred Device and Contract Costs
Beginning balance as of December 31, 2021	$	28,553
Additions		13,986
Cost of revenue recognized		(7,568)
Ending balance as of March 31, 2022	$	34,971

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Note 4. Inventories

Inventories consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Raw materials and purchased parts	$	25,006	$	26,164
Work in process		379		313
Finished goods		45,269		46,602
Total inventories	$	70,654	$	73,079

Note 5. Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Prepaid expenses	$	51,397	$	38,179
Deferred device and contract costs, current		27,335		22,304
Other receivables		22,817		21,170
Other current asset		5,326		5,734
Total prepaid expenses and other current assets	$	106,875	$	87,387

Note 6. Intangible Assets, Net

Intangible assets, net consist of the following (in thousands):

								Weighted
								Average
								Remaining
	Useful			Accumulated		Net Carrying		Useful Life
	Life	Gross Value		Amortization		Value		(Years)
March 31, 2022
Client relationships	2 to 20 years	$	1,463,335	$	(222,285)	$	1,241,050	14.3
Trademarks	2 to 15 years		325,958		(58,823)		267,135	7.4
Software	3 to 5 years		155,456		(45,101)		110,355	2.8
Technology	5 to 7 years		343,310		(77,953)		265,357	5.3
Intangible assets, net		$	2,288,059	$	(404,162)	$	1,883,897	11.4
December 31, 2021
Client relationships	2 to 20 years	$	1,465,926	$	(199,866)	$	1,266,060	14.5
Trademarks	3 to 15 years		326,392		(45,555)		280,837	9.5
Software	3 to 5 years		126,188		(40,767)		85,421	2.7
Technology	5 to 7 years		343,262		(65,302)		277,960	5.6
Intangible assets, net		$	2,261,768	$	(351,490)	$	1,910,278	12.0

Amortization expense for intangible assets net of foreign currency remeasurement for intangible assets was $56.6 million and $46.6 million for the quarters ended March 31, 2022 and 2021, respectively.

In January 2022, the Company embarked upon a two-year migration strategy that integrates and moves selected consumer brands under Teladoc Health – which will serve as the primary business-to-business-to-consumer brand that meets all consumer healthcare needs. The evolution of brand names results in the weighted average life of our trademarks decreasing from 9.5 years to 7.4 years as of March 31, 2022, and an acceleration of amortization expense being expensed over 2022 and 2023. This change resulted in additional amortization expense of $5.8 million (or $0.04 per basic and diluted share) in the first quarter of 2022.

Refer to Note 7 to the condensed consolidated financial statements for the results of impairment testing of the Company’s intangible assets including goodwill.

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Note 7. Goodwill

Goodwill consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Beginning balance as of December 31, 2021 and 2020, respectively	$	14,504,174	$	14,581,255
Impairment		(6,600,000)		0
Additions associated with acquisitions		0		64,269
Purchase consideration adjustments net of deferred tax impacts		0		(122,306)
Currency translation adjustment		(4,379)		(19,044)
Ending balance as of March 31, 2022 and December 31, 2021	$	7,899,795	$	14,504,174

As a result of sustained decreases in the Company’s publicly quoted share price and market capitalization continuing into 2022, the Company conducted additional testing of its goodwill, definite-lived intangibles, and other long-lived assets as of March 31, 2022. As a result of this review, the Company did not identify an impairment to its definite-lived intangible assets or other long-lived assets, but the Company recorded a $6.6 billion non-deductible, non-cash goodwill impairment charge (or $41.11 per basic and diluted share) for the quarter ended March 31, 2022. 

Consistent with prior goodwill impairment testing, the Company’s March 31, 2022, testing reflected a 75%/25% allocation between the income and market approaches. The Company believes the 75% weighting to the income approach continues to be appropriate as it more directly reflects its future growth and profitability expectations. For the Company’s March 31, 2022 impairment testing, as compared to its December 1, 2021 testing, the Company reduced its estimated future cash flows used in the impairment assessment, including revenues, margin, and capital expenditures to reflect its best estimates at this time. The Company also updated certain significant inputs into the valuation models including the discount rate which increased reflecting, in part, higher interest rates and market volatility, and the Company reduced its revenue market multiples, reflecting declining valuations across the Company’s selected peer group. The Company’s updates to its discount rate, market multiples, and estimated future cash flows each had a significant impact to the estimated fair value of the reporting unit.

The following table reflects changes in the most significant inputs to the Company’s impairment analysis on each testing date since its last annual test.

Testing dates	Discount Rate	Peer Group Revenue Multiples (current year/subsequent year)	% Excess of Reporting Unit Fair Value over Carrying Value
December 1, 2021	10.5%	7.0x/5.5x	15.0%
March 31, 2022	12.0%	3.0x/2.5x	0% post impairment

Note 8. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Professional fees	$	5,485	$	5,373
Consulting fees/provider fees		18,029		19,292
Client performance guarantees		10,034		7,653
Interest payable		5,809		1,480
Income tax payable		5,131		3,098
Insurance		5,779		3,884
Marketing		6,104		3,471
Operating lease liabilities - current		13,052		12,687
Franchise and sales taxes		11,429		9,965
Device replacement cost		5,913		6,263
Other		29,924		29,767
Total	$	116,689	$	102,933

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Note 9. Fair Value Measurements

The carrying value of the Company’s cash equivalents, short-term investments, accounts receivable, accounts payable, and accrued liabilities approximates fair value due to their short-term nature.

The Company measures its financial assets and liabilities at fair value at each reporting period using a fair value hierarchy that requires it to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. A financial instrument’s classification within the fair value hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Three levels of inputs may be used to measure fair value:

Level 1—Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active

markets.

Level 2—Include other inputs that are directly or indirectly observable in the marketplace.

Level 3—Unobservable inputs that are supported by little or no market activity.

The Company measures its cash equivalents at fair value on a recurring basis. The Company classifies its cash equivalents within Level 1 because they are valued using observable inputs that reflect quoted prices for identical assets in active markets and quoted prices directly in active markets.

The Company’s short-term investments held as of March 31, 2022 and 2021 consisted primarily of certificates of deposit held at financial institutions. The amortized cost of these investments, which are classified as Level 2, approximated their fair value.

The following tables present information about the Company’s assets and liabilities that are measured at fair value on a recurring basis using the above input categories (in thousands):

	March 31, 2022
	Level 1		Level 2		Total
Cash and cash equivalents	$	836,444	$	0	$	836,444
Short-term investments	$	0	$	2,544	$	2,544

	December 31, 2021
	Level 1		Level 2		Total
Cash and cash equivalents	$	893,480	$	0	$	893,480
Short-term investments	$	0	$	2,537	$	2,537

There were no transfers between fair value measurement levels during the quarters ended March 31, 2022 and December 31, 2021.

Note 10. Leases

The Company has operating leases for facilities, hosting co-location facilities and certain equipment under non-cancelable leases in the U.S. and various international locations. The leases have remaining lease terms of 1 to 11 years, with options to extend the lease term from 1 to 6 years. At the inception of an arrangement, the Company determines whether the arrangement is or contains a lease based on the arrangement covering the right to use property, plant or equipment for a stated period of time. For new and amended leases beginning in 2020 and after, the Company separately allocates the lease (e.g., fixed lease payments for right-to-use land, building, etc.) and non-lease components (e.g., common area maintenance) for its leases.

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Operating Leases

The Company leases office space under non-cancelable operating leases in the U.S. and various international locations. As of March 31, 2022, the future minimum lease payments under non-cancelable operating leases were as follows (in thousands):

	As of March 31,
Operating Leases:	2022
2022	$	15,023
2023		14,261
2024		9,634
2025		7,197
2026		5,822
2027 and thereafter		12,638
Total future minimum payments	$	64,575

The Company rents certain information systems to selected qualified customers under arrangements that qualify as either sales-type lease or operating lease arrangements. Leases have terms that generally range from 2 to 5 years.

Note 11. Convertible Senior Notes

Outstanding Convertible Senior Notes

As of March 31, 2022, the Company had three series of convertible senior notes outstanding. The issuances of such notes originally consisted of (i) $1.0 billion aggregate principal amount of 1.25% convertible senior notes due 2027 (the “2027 Notes”), issued on May 19, 2020 for net proceeds to the Company of $975.9 million after deducting offering costs of approximately $24.1 million, (ii) $287.5 million aggregate principal amount of 1.375% convertible senior notes due 2025 (the “2025 Notes”), issued on May 8, 2018 for net proceeds to the Company of $279.1 million after deducting offering costs of approximately $8.4 million, and (iii) $550.0 million aggregate principal amount of 0.875% convertible senior notes due 2025 that were issued by Livongo on June 4, 2020 for which the Company has agreed to guarantee Livongo’s obligations (the “Livongo Notes;” and together with the 2027 Notes, the 2025 Notes and the 2022 Notes (as defined below), the “Notes”). On June 27, 2017, the Company issued, at par value, $275.0 million aggregate principal amount of 3% convertible senior notes due 2022 (the “2022 Notes”), which were redeemed during the quarter ended March 31, 2021 as described below.

The following table presents certain terms of the Notes that were outstanding as of March 31, 2022:

	2027 Notes			2025 Notes			Livongo Notes
Interest Rate Per Year		1.25	%		1.375	%		0.875	%
Fair Value as of March 31, 2022 (in millions) (1)	$	843.5		$	1.0		$	553.3
Fair Value as of December 31, 2021 (in millions) (1)	$	940.0		$	1.3		$	605.0
Maturity Date		June 1, 2027			May 15, 2025			June 1, 2025
Optional Redemption Date		June 5, 2024			May 22, 2022			June 5, 2023
Conversion Date		December 1, 2026			November 15, 2024			March 1, 2025
Share Conversion Rate Per $1,000 Principal Amount as of March 31, 2022		4.1258			18.6621			13.94
Remaining Contractual Life as of March 31, 2022		5.2 years			3.1 years			3.2 years

(1) The Notes are classified as Level 1 within the fair value hierarchy, as defined in Note 9.

All of the Notes are unsecured obligations of the Company and rank senior in right of payment to the Company’s indebtedness that is expressly subordinated in right of payment to such Notes; equal in right of payment to the Company’s liabilities that are not so subordinated; effectively junior in right of payment to any of the Company’s secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities incurred by the Company’s subsidiaries.

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Holders may convert all or any portion of their Notes in integral multiples of $1,000 principal amount, at their option, at any time prior to the close of business on the business day immediately preceding the applicable conversion date only under the following circumstances:

● during any quarter (and only during such quarter), if the last reported sale price of the shares of Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding quarter is greater than or equal to 130% of the conversion price for the applicable Notes on each applicable trading day;

● during the five business day period after any ten consecutive trading day period (or five consecutive trading day period in the case of the Livongo Notes) in which the trading price was less than 98% of the product of the last reported sale price of Company’s common stock and the conversion rate for the applicable Notes on each such trading day;

● upon the occurrence of specified corporate events described under the applicable indenture; or

● if the Company calls the applicable Notes for redemption, at any time until the close of business on the second business day immediately preceding the redemption date.

On or after the applicable conversion date, until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of such Notes, regardless of the foregoing circumstances.

The 2027 Notes and the 2025 Notes are convertible into shares of the Company’s common stock at the applicable conversion rate shown in the table above. Upon conversion, the Company will pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and shares of the Company’s common stock or units of reference property, the amount of cash and shares of the Company’s common stock due upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 25 consecutive trading day observation period.

The Livongo Notes are convertible at the applicable conversion rate shown in the table above into “units of reference property,” each of which is comprised of 0.5920 of a share of the Company’s common stock and $4.24 in cash, without interest. Upon conversion, the Company will pay or deliver, as the case may be, cash, units of reference property, or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and units of reference property, the amount of cash and units of reference property, if any, due upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 40 consecutive trading day observation period.

For each Note series, the Company may redeem for cash all or part of the Notes, at its option, on or after the applicable optional redemption date shown in the table above (and prior to the 41st scheduled trading day immediately preceding the maturity date in the case of the Livongo Notes) if the last reported sale price of its common stock exceeds 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading days ending on, and including, the trading day immediately preceding the date on which the Company provides notice of the redemption. The redemption price will be the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any. In addition, calling any 2027 Note or 2025 Note for redemption on or after the applicable optional redemption date will constitute a make-whole fundamental change with respect to that Note, in which case the conversion rate applicable to the conversion of that Note, if it is converted in connection with the redemption, will be increased in certain circumstances as described in the applicable indenture. If Livongo undergoes a fundamental change (as defined in the applicable indenture) at any time prior to the maturity date, holders will have the right, at their option, to require Livongo to repurchase for cash all or any portion of their Livongo Notes at a fundamental change repurchase price equal to 100% of the principal amount of the Livongo Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date.

Following the adoption of ASU 2020-06 on January 1, 2022 as described in Note 2, the Company accounts for each Note series at amortized cost within the liability section of its condensed consolidated balance sheets. The Company has reserved an aggregate of 8.7 million shares of common stock for the Notes.

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The net carrying values of the Notes consisted of the following (in thousands):

	As of March 31,		As of December 31,
2027 Notes	2022		2021
Principal	$	1,000,000	$	1,000,000
Less: Debt discount, net (1)		(17,940)		(250,846)
Net carrying amount	$	982,060	$	749,154
2025 Notes
Principal	$	730	$	730
Less: Debt discount, net (1)		(10)		(166)
Net carrying amount	$	720	$	564
Livongo Notes
Principal	$	550,000	$	550,000
Less: Debt discount, net (1)		0		(74,047)
Net carrying amount	$	550,000	$	475,953

(1) Included in the accompanying condensed consolidated balance sheet within convertible senior notes and amortized to interest expense over the expected life of the Notes using the effective interest rate method.

The following table sets forth total interest expense recognized related to the Notes (in thousands):

		Quarter Ended
		March 31,
2027 Notes:		2022		2021
Contractual interest expense	$	3,125		$	3,125
Amortization of debt discount		831			9,059
Total	$	3,956		$	12,184
Effective interest rate		0.8	%		3.4	%
	Quarter Ended
	March 31,
2025 Notes:		2022		2021
Contractual interest expense	$	3		$	814
Amortization of debt discount		1			2,719
Total	$	4		$	3,533
Effective interest rate		0.9	%		3.9	%
	Quarter Ended
	March 31,
Livongo Notes:		2022		2021
Contractual interest expense	$	1,203		$	1,203
Amortization of debt discount		0			4,734
Total	$	1,203		$	5,937
Effective interest rate		0	%		5.2	%
	Quarter Ended
	March 31,
2022 Notes:		2022		2021
Contractual interest expense	$	0		$	104
Amortization of debt discount		0			316
Total	$	0		$	420
Effective interest rate		0	%		9.6	%

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Conversions of Convertible Senior Notes Due 2025

Certain holders of the 2025 Notes converted their 2025 Notes in exchange for 1.1 million shares of the Company’s common stock during the quarter ended March 31, 2021. As a result, the Company recorded a charge associated with the loss on extinguishment of debt of $8.1 million during the quarter ended March 31, 2021.

Redemption of Convertible Senior Notes Due 2022

In March 2021, the Company completed a redemption of all of the then outstanding 2022 Notes in exchange for approximately $0.1 million in cash (including accrued and unpaid interest). Prior to that redemption, certain holders of the 2022 Notes converted their 2022 Notes in exchange for 1.1 million shares of the Company’s common stock during the quarter ended March 31, 2021. As a result of the redemption and conversions, the Company recorded a charge associated with the loss on extinguishment of debt of $3.4 million during the quarter ended March 31, 2021.

Note 12. Advances from Financing Companies

The Company utilizes a third-party financing company to provide certain Clients with a rental option. The principal portion of these up-front payments are reported as advances from financing companies in the accompanying condensed consolidated balance sheet. Interest rates applicable to the outstanding advances as of March 31, 2022 ranged from 3.35% to 8.25%.

Client lease payments to third party financing companies will reduce the advances from financing companies as of March 31, 2022 by year as follows (in thousands):

	As of March 31,
	2022
2022	$	10,105
2023		8,024
2024		2,678
2025		109
Total	$	20,916

Note 13. Legal Matters

From time to time, Teladoc Health is involved in various litigation matters arising in the normal course of business, including the matters described below. The Company consults with legal counsel on those issues related to litigation and seeks input from other experts and advisors with respect to such matters. Estimating the probable losses or a range of probable losses resulting from litigation, government actions and other legal proceedings is inherently difficult and requires an extensive degree of judgment, particularly where the matters involve indeterminate claims for monetary damages, may involve discretionary amounts, present novel legal theories, are in the early stages of the proceedings, or are subject to appeal. Whether any losses, damages or remedies ultimately resulting from such matters could reasonably have a material effect on the Company’s business, financial condition, results of operations, or cash flows will depend on a number of variables, including, for example, the timing and amount of such losses or damages (if any) and the structure and type of any such remedies. As of the date of these financial statements, Teladoc Health’s management does not expect any litigation matter to have a material adverse impact on its business, financial condition, results of operations or cash flows.

On May 14, 2018, a purported class action complaint (Thomas v. Best Doctors, Inc.) was filed in the United States District Court for the District of Massachusetts against the Company’s wholly owned subsidiary, Best Doctors, Inc. The complaint alleges that on or about May 16, 2017, Best Doctors violated the U.S. Telephone Consumer Protection Act (the “TCPA”) by sending unsolicited facsimiles to plaintiff and certain other recipients without the recipients’ prior express invitation or permission. The lawsuit seeks statutory damages for each violation, subject to trebling under the TCPA, and injunctive relief. The Company will vigorously defend the lawsuit and any potential loss is currently deemed to be immaterial.

On August 27, 2021, a purported securities class action complaint (City of Hialeah Employees’ Retirement System v. Teladoc Health, Inc., et.al.) was filed in the Circuit Court of Cook County, Illinois against the Company and

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certain of the Company’s current and former officers and directors. The complaint was brought on behalf of a purported class consisting of all persons who acquired shares of Teladoc Health common stock issued in the Livongo merger. The complaint asserted violations of Sections 11, 12(a)(2) and 15 of the Securities Act of 1933 based on allegedly false or misleading statements and omissions with respect to the registration statement and prospectus filed in connection with the Livongo merger. The complaint sought certification as a class action, unspecified compensatory damages plus interest and attorneys’ fees, rescission or a rescissory measure of damages and equitable or other relief. On January 18, 2022, the case was voluntarily dismissed without prejudice in the Circuit Court of Cook County, Illinois and on January 26, 2022, was refiled in the Supreme Court of the State of New York. The refiled case includes substantially the same allegations. The Company believes that these claims are without merit, and the Company and its named current and former officers and directors intend to defend the Company vigorously.

Note 14. Common Stock and Stockholders’ Equity

Capitalization

Effective October 30, 2020, the authorized number of shares of the Company’s common stock was increased from 150,000,000 to 300,000,000 shares.

Warrants

The Company had no warrants outstanding as of March 31, 2022 or December 31, 2021.

Stock Plans

The Company’s 2015 Incentive Award Plan, 2017 Employment Inducement Incentive Award Plan and Livongo Acquisition Incentive Award Plan (collectively, the “Plans”) provide for the issuance of incentive and non-statutory options and other equity-based awards to its employees and non-employee service providers.

All stock-based awards to employees are measured based on the grant-date fair value or replacement grant date fair value in relation to the Livongo transaction, and are generally recognized on a straight line basis in the Company’s condensed consolidated statement of operations over the period during which the employee is required to perform services in exchange for the award (generally requiring a four-year vesting period for each stock option and a three-year vesting period for each restricted stock unit (“RSU”)).

Stock Options

Options issued under the Plans are exercisable for periods not to exceed ten years, and vest and contain such other terms and conditions as specified in the applicable award document. Options to buy common stock are issued under the Plans, with exercise prices equal to the closing price of shares of the Company’s common stock on the New York Stock Exchange on the date of award. The Company had 10,218,931 shares available for grant at March 31, 2022.

Activity under the Plans was as follows (in thousands, except share and per share amounts and years):

				Weighted-
		Weighted-		Average
	Number of	Average		Remaining	Aggregate
	Shares	Exercise		Contractual	Intrinsic
	Outstanding	Price		Life in Years	Value
Balance at December 31, 2021	3,426,978	$	22.88	5.32	$	242,569
Stock option grants	45,434	$	79.40	N/A
Stock options exercised	(267,586)	$	13.40	N/A	$	(15,090)
Stock options forfeited	(15,767)	$	19.63	N/A
Balance at March 31, 2022	3,189,059	$	24.50	5.16	$	160,501
Vested or expected to vest at March 31, 2022	3,189,059	$	24.50	8.35	$	2,352
Exercisable at March 31, 2022	3,011,138	$	20.36	4.97	$	158,148

The total grant-date fair value of stock options granted during the quarters ended March 31, 2022 and 2021 were $1.6 million and $0.4 million, respectively.

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The Company estimates the fair value of stock options granted using the Black Scholes option pricing model.

The assumptions used in the Black-Scholes option-pricing model are determined as follows:

Volatility. The expected volatility was derived from the historical stock volatilities of the Company’s stock volatility over a period equivalent to the expected term of the stock option grants.

Expected Term. The expected term represents the period that the stock-based awards are expected to be outstanding. When establishing the expected term assumption, the Company utilizes historical data.

Risk-Free Interest Rate. The risk-free interest rate is based on U.S. Treasury zero-coupon issues with terms similar to the expected term on the options.

Dividend Yield. The Company has never declared or paid any cash dividends and does not plan to pay cash dividends in the foreseeable future, and therefore, it used an expected dividend yield of zero.

Forfeiture rate. The Company recognizes forfeitures as they occur.

The fair value of each option grant was estimated on the date of grant using the Black-Scholes option-pricing model with the following assumptions and fair value per share:

	Quarter Ended March 31,
	2022		2021
Volatility		56.69% - 57.86%		57.02% - 57.49%
Expected term (in years)		4.1		4.1
Risk-free interest rate		1.13% - 1.52%		0.31% - 0.51%
Dividend yield		0		0
Weighted-average fair value of underlying stock options	$	$35.94	$	$107.06

For the quarters ended March 31, 2022 and 2021, the Company recorded compensation expense related to stock options of $10.7 million and $28.2 million, respectively.

As of March 31, 2022, the Company had $10.9 million in unrecognized compensation cost related to non-vested stock options, which is expected to be recognized over a weighted-average period of approximately 1.9 years.

Restricted Stock Units

The fair value of RSUs is determined on the date of grant. The Company records compensation expense in the condensed consolidated statement of operations on a straight-line basis over the vesting period for RSUs. The vesting period for employees and members of the Board of Directors ranges from one to four years.

Activity under RSUs was as follows:

		Weighted-Average
		Grant Date
	RSUs	Fair Value Per RSU
Balance at December 31, 2021	2,133,501	$	168.43
Granted	2,433,620	$	74.74
Vested and issued	(499,486)	$	146.13
Forfeited	(153,581)	$	153.09
Balance at March 31, 2022	3,914,054	$	113.99
Vested and unissued at March 31, 2022	16,507	$	71.96
Non-vested at March 31, 2022	3,897,547	$	113.99

The total grant-date fair value of RSUs granted during the quarters ended March 31, 2022 and 2021 was $181.9 million and $88.0 million, respectively.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to RSUs of $44.5 million and $50.9 million, respectively.

As of March 31, 2022, the Company had $407.8 million in unrecognized compensation cost related to non-vested RSUs, which is expected to be recognized over a weighted-average period of approximately 2.3 years.

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Performance Stock Units

Stock-based compensation costs associated with the Company’s performance stock units (“PSUs”) are initially determined using the fair market value of the Company's common stock on the date the awards are approved by the Compensation Committee of the Board of Directors (service inception date). The vesting of these PSUs is subject to certain performance conditions and a service requirement ranging from 1 to 3 years. Until the performance conditions are met, stock compensation costs associated with these PSUs are re-assessed each reporting period based upon the estimated performance attainment on the reporting date. The ultimate number of PSUs that are issued to an employee is the result of the actual performance of the Company at the end of the performance period compared to the performance targets and generally range from 25% to 200% of the initial grant. Stock compensation expense for PSUs is recognized on an accelerated tranche by tranche basis for performance-based awards. Forfeitures are accounted for at the time they occur consistent with Company policy.

Activity under PSUs was as follows:

		Weighted-Average
		Grant Date
	Shares	Fair Value Per PSU
Balance at December 31, 2021	356,249	$	140.01
Granted	420,274	$	74.21
Vested and issued	(197,849)	$	109.03
Balance at March 31, 2022	578,674	$	106.35
Vested and unissued at March 31, 2022	0	$	0
Non-vested at March 31, 2022	578,674	$	106.35

The total grant-date fair value of PSUs granted during the quarter ended March 31, 2022 and 2021 was $30.1 million and $67.9 million, respectively.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to PSUs of $7.3 million and $7.2 million, respectively.

As of March 31, 2022, the Company had $26.9 million in unrecognized compensation cost related to non-vested PSUs, which is expected to be recognized over a weighted-average period of approximately 2.3 years.

Employee Stock Purchase Plan

In July 2015, the Company adopted the 2015 Employee Stock Purchase Plan (“ESPP”) in connection with its initial public offering. A total of 1,019,726 shares of common stock were reserved for issuance under this plan as of March 31, 2022. The Company’s ESPP permits eligible employees to purchase common stock at a discount through payroll deductions during defined offering periods. Under the ESPP, the Company may specify offerings with durations of not more than 27 months and may specify shorter purchase periods within each offering. Each offering will have one or more purchase dates on which shares of its common stock will be purchased for employees participating in the offering. An offering may be terminated under certain circumstances. The price at which the stock is purchased is equal to the lower of 85% of the fair market value of the common stock at the beginning of an offering period or on the date of purchase.

During the quarters ended March 31, 2022 and 2021, the Company did not issue any shares under the ESPP. As of March 31, 2022, 570,661 shares remained available for issuance.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to the ESPP of $1.5 million and $2.2 million, respectively.

As of March 31, 2022, the Company had $0.6 million in unrecognized compensation cost related to the ESPP, which is expected to be recognized over a weighted-average period of approximately 0.1 year.

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Total compensation costs for stock-based awards were recorded as follows (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Cost of revenue (exclusive of depreciation and amortization, which is shown separately)	$	2,196	$	2,362
Advertising and marketing		3,711		5,082
Sales		12,071		21,167
Technology and development		18,087		26,726
General and administrative		24,371		30,963
Total stock-based compensation expense (1)	$	60,436	$	86,300

(1) Excluding the amount capitalized related to internal software development projects.

Note 15. Income Taxes

The Company recorded income tax expense of $0.4 million for the quarter ended March 31, 2022.

For the quarter ended March 31, 2022, the Company recognized a reversal of $15.3 million of the net deferred tax liability associated with the convertible senior notes upon the adoption of ASU 2020-06, recorded entirely through the balance sheet.

The Company’s income tax expense for the quarter ended March 31, 2021 of $87.0 million primarily was related to additional valuation allowance recorded on excess stock compensation associated with the Livongo merger.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Special Note Regarding Forward-Looking Statements

Many statements made in this Quarterly Report on Form 10-Q that are not statements of historical fact, including statements about our beliefs and expectations, are forward-looking statements and should be evaluated as such. Forward-looking statements include information concerning possible or assumed future results of operations, including descriptions of our business plan and strategies. These statements often include words such as “anticipates,” “believes,” “suggests,” “targets,” “projects,” “plans,” “expects,” “future,” “intends,” “estimates,” “predicts,” “potential,” “may,” “will,” “should,” “could,” “would,” “likely,” “foresee,” “forecast,” “continue” and other similar words or phrases, as well as statements in the future tense to identify these forward-looking statements. These forward-looking statements and projections are contained throughout this Form 10-Q, including the section entitled” “Management’s Discussion and Analysis of Financial Condition and Results of Operations” (“MD&A”). We base these forward-looking statements or projections on our current expectations, plans and assumptions that we have made in light of our experience in the industry, as well as our perceptions of historical trends, current conditions, expected future developments and other factors we believe are appropriate under the circumstances and at such time. As you read and consider this Form 10-Q, you should understand that these statements are not guarantees of performance or results. The forward-looking statements and projections are subject to and involve risks, uncertainties and assumptions and you should not place undue reliance on these forward-looking statements or projections. Although we believe that these forward-looking statements and projections are based on reasonable assumptions at the time they are made, you should be aware that many factors could affect our actual financial results or results of operations and could cause actual results to differ materially from those expressed in the forward-looking statements and projections. Factors that may materially affect such forward-looking statements and projections include, but are not limited to, the section entitled “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2021 (the “2021 Form 10-K”) and in our other reports and United States (“U.S.”) Securities and Exchange Commission (“SEC”) filings. These cautionary statements should not be construed by you to be exhaustive and are made only as of the date of this Form 10-Q. We undertake no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. You should evaluate all forward-looking statements made in this Form 10-Q in the context of these risks and uncertainties.

Overview

Teladoc, Inc. was incorporated in the State of Texas in June 2002 and changed its state of incorporation to the State of Delaware in October 2008. Effective August 10, 2018, Teladoc, Inc. changed its corporate name to Teladoc Health, Inc. Unless the context otherwise requires, Teladoc Health, Inc., together with its subsidiaries, is referred to herein as “Teladoc Health,” the “Company,” or “we.” The Company’s principal executive office is located in Purchase, New York. Teladoc Health is the global leader in whole person virtual care focused on forging a new healthcare experience with better convenience, outcomes and value around the world.

Teladoc Health was founded on a simple, yet revolutionary idea: that everyone should have access to the best healthcare, anywhere in the world on their terms. Today, we have a vision of making virtual care the first step on any healthcare journey, and we are delivering on this mission by providing whole person virtual care that includes primary care, mental health, chronic condition management, and more.

COVID-19 Update

We believe that favorable existing secular trends in the healthcare industry were accelerated by the impacts of the COVID-19 pandemic, driving greater consumer use of virtual care, and increased adoption by employers, health plans, hospitals and health systems, and healthcare providers. In combination with the expansion of our capabilities, we believe that these trends present significant opportunities for virtual healthcare to address the most pressing, universal healthcare challenges through trusted solutions, such as ours, that deliver convenient, affordable, and high-quality care; empower individuals to manage and improve their health; and enable providers to offer their best care for their patients.

We continue to closely monitor the impact of the COVID-19 pandemic on all aspects of our business. COVID-19 has increased utilization of our telehealth services, but it is uncertain whether such increase in demand will continue. While the COVID-19 pandemic has not had a material adverse impact on our financial condition and results of operations to date, the future impact on our operational and financial performance will depend on certain developments, including the duration and spread of the pandemic, impact on our customers, consisting of employers, health plans,

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hospitals and health systems, insurance, and financial services companies (collectively “Clients”), and members, impact on our sales cycles, and effect on our vendors, all of which are uncertain and cannot be predicted. Public and private sector policies and initiatives to reduce the transmission of COVID-19 and disruptions to our operations and the operations of our third-party suppliers, along with any related global slowdown in economic activity, may result in decreased revenues, decreased collections, and increased costs. Further, the economic effects of the COVID-19 pandemic have financially constrained some of our prospective and existing Clients’ healthcare spending, which may negatively impact our ability to acquire new Clients and our ability to renew subscriptions with or sell additional solutions to our existing Clients. We also may experience increased member attrition to the extent our existing Clients reduce their respective workforces in response to economic conditions. In addition, due to our subscription-based business model, the effect of the COVID-19 pandemic may not be fully reflected in our revenue until future periods. It is possible that the COVID-19 pandemic, the measures taken by the governments and businesses affected and any resulting economic impact may materially and adversely affect our business, results of operations, cash flows, and financial positions as well as our customers.

We have also taken measures in response to the COVID-19 pandemic, and we may take further actions that alter our business operations as may be required by federal, state, local, or foreign authorities or that we determine are in the best interests of our employees, Clients, members, and stockholders. The effects of these operational modifications are unknown and may not be realized until further reporting periods.

Acquisition History

We have scaled and intend to continue to scale our platform through the pursuit of selective acquisitions. We have completed multiple acquisitions since our inception, which we believe have expanded our distribution capabilities and broadened our service offerings.

On October 30, 2020, we completed the merger with Livongo. The total final consideration was $13,876.9 million, consisting of $380.2 million of net cash, $555.4 million related to the conversion feature of the Livongo Notes guaranteed by the Company and 60.2 million shares of Teladoc Health’s common stock valued at approximately $12,941.3 million on October 30, 2020. Livongo is a leading provider to empower people with chronic conditions to live better and healthier lives.

On July 1, 2020, we completed the acquisition of InTouch for aggregate consideration of $1,069.8 million, which was comprised of 4.6 million shares of our common stock valued at $903.3 million on July 1, 2020, and $166.5 million of net cash. InTouch is a leading provider of enterprise telehealth solutions for hospitals and health systems.

Net Income

For the quarter ended March 31, 2022, we recorded a loss of $6,674.5 million or $41.58 per share. The quarter included a non-cash goodwill impairment charge of $6,600.0 million. Refer to Critical Accounting Estimates and Policies: Goodwill Impairment Charge and Note 7, Goodwill, to the Company’s condensed consolidated financial statements for more information.

For the quarter ended March 31, 2021, we recorded a loss of $199.6 million.

Refer to the condensed consolidated results of operations in the MD&A for other supplemental financial measures we use to assess our operating performance.

Key Factors Affecting Our Performance

We believe that our future performance will depend on many factors, including the following:

Number of Members and Revenue per Member. Our revenue growth rate and long-term profitability are affected by our ability to increase cross selling capability among our existing members because we derive a substantial portion of our revenue from access and other fees via Client contracts that provide members access to our professional provider network in exchange for a contractual based periodic fee or access fees derived from our Direct-to-Consumer (“D2C”) members. Therefore, we believe that our ability to add new members, retain existing members, and increase the revenue generated from each member is a key indicator of our increasing market adoption, the growth of our business,

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and future revenue potential, and that increasing our membership and revenue per member is an integral objective that will provide us with the ability to continually innovate our services and support initiatives that will enhance members’ experiences. U.S. paid membership increased by 2.7 to 54.3 million at March 31, 2022, compared to the same period in 2021. Average U.S. revenue per member measures the average amount of access revenue that we generate from a U.S. paid member for a particular period. It is calculated by dividing the U.S. access revenue generated from our U.S. paid members, excluding certain non-member based access fees, by the total average number of U.S. paid members during the applicable period. For the first quarter of 2022, average U.S. revenue per member was $2.52 compared to $2.09 for the same period in 2021.

Number of Visits and Utilization. We also recognize revenue in connection with the completion of a general medical visit, expert medical service, and other specialty visits for contracts where the service is not part of access fees. Visit fee revenue is driven primarily by the number of Clients, the number of members in a Client’s population, member utilization of our provider network services and the contractually negotiated prices of our services. We believe that increasing our current member utilization rate and increasing penetration further into existing and new health plan Clients is a key objective in order for our Clients to realize tangible healthcare savings with our service. Visits increased by 35%, or 1.2 million, to approximately 4.5 million for the quarter ended March 31, 2022 compared to the same period in 2021. Utilization measures the ratio of visits to total U.S. paid members. It is calculated by dividing visits during a particular period (excluding visit fee only visits) by U.S. paid members in the applicable period and annualizing the result. Utilization increased by 593 basis points to approximately 23.4% for the quarter ended March 31, 2022, compared to 17.5% in the same period in 2021.

Number of Platform-Enabled Sessions. A platform-enabled session is a unique instance in which our licensed software platform has facilitated a virtual voice or video encounter between a care provider and our Client’s patient, or between care providers. We believe platform-enabled sessions are an indicator of the value our Clients derive from the platform they license from us in order to facilitate virtual care. Our Clients completed 1.2 million platform-enabled sessions during the quarter ended March 31, 2022, compared to 1.1 million during the same period in 2021.

Chronic Care Enrollment. Our chronic care programs are one of the key components of our whole person virtual care platform that we believe position us to drive greater engagement with our platforms and increased revenue. Chronic care enrollment measures the number of unique individuals enrolled in one or more of our chronic care programs. Chronic care enrollment increased by 12% to 0.7 million at March 31, 2022, compared to 0.7 million at March 31, 2021.

Seasonality. We have typically in the past seen the strongest increases in consecutive quarterly revenue during the fourth and first quarters of each year, which coincides with traditional annual benefit enrollment seasons. However, as our business has become more diversified across services, channels, and geographies, we see a growing diversification of Client start dates, resulting from growth in mental health offerings, health plan expansions, cross sales of new services, international growth, and mid-market employer growth, all of which are not constrained by a calendar year start. See “Risk Factors—Risks Related to Our Business—Our quarterly results may fluctuate significantly, which could adversely impact the value of our common stock” included in the 2021 Form 10-K.

Critical Accounting Estimates and Policies

Our discussion and analysis of our results of operations, liquidity and capital resources are based on our condensed consolidated financial statements which have been prepared in conformity with accounting principles generally accepted in the U.S. (“GAAP”). The preparation of these condensed consolidated financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses, and disclosure of contingent assets and liabilities.

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On an ongoing basis, we evaluate our estimates and judgments, including those related to revenue recognition, business combinations, goodwill and other intangible assets, income taxes, and other items. We base our estimates on historical and anticipated results and trends and on various other assumptions that we believe are reasonable under the circumstances, including assumptions as to future events. These estimates form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. By their nature, estimates are subject to an inherent degree of uncertainty. Actual results may differ from our estimates and could have a significant adverse effect on our results of operations and financial position. For a discussion of our critical accounting policies and estimates see Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the 2021 Form 10-K. In addition, the following updates our discussion of impairment testing therein as of March 31, 2022.

Goodwill Impairment Charge

As a result of sustained decreases in our publicly quoted share price and market capitalization continuing into 2022, we conducted additional testing of our goodwill, definite-lived intangibles and other long-lived assets as of March 31, 2022. As a result of this review, we did not identify an impairment to our definite-lived intangible assets or other long-lived assets, but we recorded a $6.6 billion non-deductible, non-cash goodwill impairment charge (or $41.11 per basic and diluted share) for the quarter ended March 31, 2022.

Consistent with prior goodwill impairment testing, our March 31, 2022, testing reflected a 75%/25% allocation between the income and market approaches. We believe the 75% weighting to the income approach continues to be appropriate as it more directly reflects our future growth and profitability expectations. For our March 31, 2022 impairment testing, as compared to our December 1, 2021 testing, we reduced our estimated future cash flows used in the impairment assessment, including revenues, margin, and capital expenditures to reflect our best estimates at this time. We also updated certain significant inputs into the valuation models including the discount rate which increased reflecting, in part, higher interest rates and market volatility, and we reduced our revenue market multiples, reflecting declining valuations across our selected peer group. Our updates to our discount rate, market multiples, and estimated future cash flows each had a significant impact to the estimated fair value of our reporting unit.

The following table indicates changes in the most significant inputs to our impairment analysis on each testing date since our last annual test.

Testing dates	Discount Rate	Peer Group Revenue Multiples (current year/subsequent year)	% Excess of Reporting Unit Fair Value over Carrying Value
December 1, 2021	10.5%	7.0x/5.5x	15.0%
March 31, 2022	12.0%	3.0x/2.5x	0% post impairment

Overall, in the event there are future adverse changes in our estimated future cash flows and/or changes in key assumptions, including but not limited to discount rate increases, lower market multiples, lower revenue growth, lower margin, and/or a lower terminal growth rate, we may be required to record additional non-cash impairment charges to our goodwill, or impairment charges to other intangibles, and/or long-lived assets. Such non-cash charges would likely have a material adverse effect on our consolidated statements of operations and balance sheets in the reporting period of the charge. Following the March 2022 impairment there is no excess of reporting unit fair value over the carrying amount, so any further decrease in estimated fair value would result in an additional goodwill impairment charge.

In the period following March 31, 2022 there has been a further decline in our market capitalization, based on our publicly quoted share price. To the extent the decline is sustained, it would require further testing of our goodwill in our next reporting period and it may result in an additional goodwill impairment. Absent further changes to our estimated future cash flows, it may prompt updates to other key valuation inputs, including the discount rate and market multiples. Further reductions in estimated future cash flows could also result in an additional decline in estimated reporting unit value. As an illustration, if the estimated fair value of the reporting unit at March 31, 2022, decreased by 50%, it would result in a goodwill impairment charge of approximately $4.6 billion.

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Condensed Consolidated Results of Operations

The following table sets forth our condensed consolidated statement of operations data for the quarters ended March 31, 2022 and 2021 and the dollar and percentage change between the respective periods (dollars in thousands except for per share data):

	Quarter Ended March 31,				Year over Year Growth
	2022		2021			Variance	%
Revenue	$	565,350	$	453,675	$	111,675	25	%
Expenses:
Cost of revenue (exclusive of depreciation and amortization, which is shown separately below)		187,025		145,959		41,066	28	%
Operating expenses:
Advertising and marketing		133,600		89,439		44,161	49	%
Sales		58,329		64,793		(6,464)	(10)	%
Technology and development		87,412		78,008		9,404	12	%
General and administrative		104,923		105,172		(249)	0	%
Acquisition, integration, and transformation costs		4,507		6,323		(1,816)	(29)	%
Depreciation and amortization		58,933		48,659		10,274	21	%
Goodwill impairment		6,600,000		0		6,600,000	N/M
Total expenses		7,234,729		538,353		6,696,376	N/M
Loss from operations		(6,669,379)		(84,678)		(6,584,701)	N/M
Loss on extinguishment of debt		0		11,459		(11,459)	(100)	%
Other income, net		(724)		(5,652)		4,928	(87)	%
Interest expense, net		5,480		22,125		(16,645)	(75)	%
Net loss before taxes		(6,674,135)		(112,610)		(6,561,525)	N/M
Income tax expense		388		87,039		(86,651)	(100)	%
Net loss	$	(6,674,523)	$	(199,649)	$	(6,474,874)	N/M
Net loss per share, basic and diluted	$	(41.58)	$	(1.31)	$	(40.27)	N/M
EBITDA (1)	$	(10,446)	$	(36,019)	$	25,573	(71)	%
Adjusted EBITDA (1)	$	54,497	$	56,604	$	(2,107)	(4)	%

(1) Non-GAAP Financial Measures

N/M – not meaningful

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The following is a reconciliation of net loss, the most directly comparable U.S. GAAP financial measure, to EBITDA and Adjusted EBITDA for the quarters ended March 31, 2022 and 2021 (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Net loss	$	(6,674,523)	$	(199,649)
Add:
Goodwill impairment		6,600,000		0
Loss on extinguishment of debt		0		11,459
Other income, net		(724)		(5,652)
Interest expense, net		5,480		22,125
Income tax expense		388		87,039
Depreciation and amortization		58,933		48,659
EBITDA		(10,446)		(36,019)
Stock-based compensation		60,436		86,300
Acquisition, integration, and transformation costs		4,507		6,323
Adjusted EBITDA	$	54,497	$	56,604

EBITDA and Adjusted EBITDA

To supplement our financial information presented in accordance with U.S. GAAP, we use earnings before interest, taxes, depreciation, and amortization (“EBITDA”) and Adjusted EBITDA, which are non-U.S. GAAP financial measures, to clarify and enhance an understanding of past performance. We believe that the presentation of these financial measures enhances an investor’s understanding of our financial performance. We further believe that these financial measures are useful financial metrics to assess our operating performance and financial and business trends from period-to-period by excluding certain items that we believe are not representative of our core business. We use certain financial measures for business planning purposes and in measuring our performance relative to that of our competitors. We utilize Adjusted EBITDA as the primary measure of our performance.

EBITDA consists of net loss before interest; other income, net, including foreign exchange gain or loss; taxes; depreciation and amortization; goodwill impairment; and loss on extinguishment of debt. Adjusted EBITDA consists of net loss before interest; other income, net, including foreign exchange gain or loss; taxes; depreciation and amortization; goodwill impairment; loss on extinguishment of debt; stock-based compensation; and acquisition, integration and transformation costs.

We believe the above financial measures are commonly used by investors to evaluate our performance and that of our competitors. However, our use of the terms EBITDA and Adjusted EBITDA may vary from that of others in our industry. Neither EBITDA nor Adjusted EBITDA should be considered as an alternative to net loss before taxes, net loss, net loss per share or any other performance measures derived in accordance with U.S. GAAP.

EBITDA and Adjusted EBITDA have important limitations as analytical tools and you should not consider them in isolation or as a substitute for analysis of our results as reported under U.S. GAAP. Some of these limitations are:

● EBITDA and Adjusted EBITDA do not reflect goodwill impairment;

● EBITDA and Adjusted EBITDA do not reflect the interest expense on our debt;

● EBITDA and Adjusted EBITDA eliminate the impact of income taxes on our results of operations;

● EBITDA and Adjusted EBITDA do not reflect the loss on extinguishment of debt;

● EBITDA and Adjusted EBITDA do not reflect other income, net;

● Adjusted EBITDA does not reflect the significant acquisition, integration and transformation costs. Acquisition, integration and transformation costs include investment banking, financing, legal, accounting, consultancy, integration, fair value changes related to contingent consideration and certain other transaction

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costs related to mergers and acquisitions. It also includes costs related to certain business transformation initiatives focused on integrating and optimizing various operations and systems, including upgrading our customer relationship management (“CRM”) and enterprise resource planning (“ERP”) systems. These transformation cost adjustments made to our results do not represent normal, recurring, operating expenses necessary to operate the business but rather, incremental costs incurred in connection with our acquisition and integration activities;

● Adjusted EBITDA does not reflect the significant non-cash stock compensation expense which should be viewed as a component of recurring operating costs; and

● other companies in our industry may calculate EBITDA and Adjusted EBITDA differently than we do, limiting the usefulness of these measures as comparative measures.

In addition, although depreciation and amortization are non-cash charges, the assets being depreciated and amortized will often have to be replaced in the future, and both EBITDA and Adjusted EBITDA do not reflect any expenditures for such replacements.

We compensate for these limitations by using EBITDA and Adjusted EBITDA along with other comparative tools, together with U.S. GAAP measurements, to assist in the evaluation of operating performance. Such U.S. GAAP measurements include net loss, net loss per share and other performance measures.

In evaluating these financial measures, you should be aware that in the future we may incur expenses similar to those eliminated in this presentation. Our presentation of EBITDA and Adjusted EBITDA should not be construed as an inference that our future results will be unaffected by unusual or nonrecurring items.

Condensed Consolidated Results of Operations

Revenue. Total revenue was $565.4 million for the quarter ended March 31, 2022, compared to $453.7 million during the quarter ended March 31, 2021, an increase of $111.7 million, or 25%. This increase in revenue was driven substantially by the generation of additional access fees by our membership base, most significantly from our D2C mental health service, BetterHelp. Revenue from access fees was $491.3 million for the quarter ended March 31, 2022 compared to $382.1 million for the quarter ended March 31, 2021, an increase of $109.2 million, or 29%. Visit fee revenue increased 12% to $67.9 million and other revenue was $6.1 million, down 45% primarily related to the completion of a long-term development services contract. U.S. revenue grew 24% to $491.2 million and International revenue grew 27% to $74.2 million. For the quarter ended March 31, 2022, 87%, 12% and 1% of our revenue was derived from access fees, visit fees and other revenue, respectively, as compared to 84%, 13% and 3%, respectively, for the quarter ended March 31, 2021.

Cost of Revenue (exclusive of depreciation and amortization, which is shown separately below). Cost of revenue (exclusive of depreciation and amortization, which is shown separately below) was $187.0 million for the quarter ended March 31, 2022 compared to $146.0 million for the quarter ended March 31, 2021, an increase of $41.1 million, or 28%. The increase was primarily due to growth in visits associated with higher revenue which resulted in increased provider fees, as well as higher device-related costs.

Advertising and Marketing Expenses. Advertising and marketing expenses were $133.6 million for the quarter ended March 31, 2022 compared to $89.4 million for the quarter ended March 31, 2021, an increase of $44.2 million, or 49%. The increase was substantially driven by higher digital and media advertising costs from BetterHelp.

Sales Expenses. Sales expenses were $58.3 million for the quarter ended March 31, 2022 compared to $64.8 million for the quarter ended March 31, 2021, a decrease of $6.5 million, or 10%. The decrease was primarily driven by lower stock-based compensation, partially offset by higher sales and partner commissions due to higher results, as well as higher expense associated with conferences and events to support business activity.

Technology and Development Expenses. Technology and development expenses were $87.4 million for the quarter ended March 31, 2022 compared to $78.0 million for the quarter ended March 31, 2021, an increase of $9.4 million, or 12%. The increase primarily reflects additional personnel and staff augmentation costs; higher professional, recruiting and consulting fees; and higher infrastructure, hosting and software license costs. These increases were associated with ongoing projects and services to continuously improve and optimize our technology portfolio. Partially

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offsetting this increase was lower stock-based compensation. For the quarters ended March 31, 2022 and 2021, research and development costs were $54.7 million and $53.4 million, respectively.

Acquisition, Integration and Transformation Costs. Acquisition, integration and transformation costs were $4.5 million for the quarter ended March 31, 2022, and primarily consisted of integration and transformation costs to integrate and upgrade our CRM and ERP ecosystem. For the quarter ended March 31, 2021, acquisition, integration and transformation costs were $6.3 million and primarily consisted of acquisition related costs.

General and Administrative Expenses. General and administrative expenses were essentially flat at $104.9 million for the quarter ended March 31, 2022 compared to $105.2 million for the quarter ended March 31, 2021. Higher therapist recruiting costs, bank charges, legal fees, dues, subscriptions and licenses, and other corporate expenses were offset by lower stock-based compensation, insurance and bad debt expenses.

Depreciation and Amortization. Depreciation and amortization was $58.9 million for the quarter ended March 31, 2022 compared to $48.7 million for the quarter ended March 31, 2021, an increase of $10.3 million. The higher expense was primarily due to additional amortization expense related to the acceleration of the amortization of certain trademarks, and to a lesser extent, higher amortization associated with higher capitalized software development costs. As it relates to the acceleration of the useful lives for certain trademarks, this change related to the Company’s strategy to integrate and move certain consumer brands under the Teladoc Health brand. This acceleration of amortization resulted in decreasing the weighted average useful life of all trademarks at the date of the change from 9.5 years to 7.5 years. This change will increase annual amortization by approximately $23.0 million in 2022 and 2023.

Goodwill Impairment. The Company took a non-cash goodwill impairment charge of $6.6 billion in the quarter ended March 31, 2022, following goodwill impairment testing performed as a result of sustained decreases in our publicly quoted share price. The non-cash charge had no impact on income taxes. Refer to Critical Accounting Estimates and Policies: Goodwill Impairment Charge and Note 7, Goodwill, to the Company’s condensed consolidated financial statements.

Loss on Extinguishment of Debt. There was no loss on extinguishment of debt for the quarter ended March 31, 2022 compared to $11.5 million for the quarter ended March 31, 2021.

Other Income, Net. Other income, net was ($0.7) million for the quarter ended March 31, 2022 compared to ($5.7) million for the quarter ended March 31, 2021 and included foreign exchange remeasurements. In addition, the quarter ended March 31, 2021 included a $5.9 million unrealized gain on a non-marketable equity security.

Interest Expense, Net. Interest expense, net consists of interest costs and amortization of debt discount associated with advances from financing companies, our convertible senior notes, interest income from cash and cash equivalents and short-term investments. Interest expense, net was $5.5 million and $22.1 million for the quarters ended March 31, 2022 and 2021, respectively. The decrease in interest expense substantially reflects the adoption of ASU 2020-06, “Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity,” which resulted in the elimination of non-cash interest expense associated with the accretion of the recorded debt value to stated value. Refer to Note 11, Convertible Senior Notes, to the condensed consolidated financial statements. The associated non-cash expense was $14.6 million, or $0.10 per share, in the quarter ended March 31, 2021.

Income Tax Expense.   Income tax expense was $0.4 million for the quarter ended March 31, 2022 compared to $87.0 million expense for the quarter ended March 31, 2021. The expense in the prior year quarter largely reflected an increase in valuation allowances needed to reflect the Company’s ability to utilize future net operating losses, primarily associated with stock compensation benefits associated with the Livongo merger.

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Liquidity and Capital Resources

The following table presents a summary of our cash flow activity for the periods set forth below (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Condensed Consolidated Statements of Cash Flows - Summary
Net cash used in operating activities	$	(31,747)	$	(18,026)
Net cash used in investing activities		(27,567)		(16,030)
Net cash provided by financing activities		2,816		22,175
Total	$	(56,498)	$	(11,881)

Our principal sources of liquidity were cash and cash equivalents, comprised substantially of deposit accounts and money market funds, totaling $836.4 million, including restricted cash of $3.8 million as of March 31, 2022. Additionally, we had short-term marketable securities of $2.5 million as of March 31, 2022.

We believe that our existing cash and cash equivalents and short-term investments will be sufficient to meet our working capital, capital expenditure, and contractual obligation needs for at least the next 12 months. Our future capital requirements will depend on many factors including our growth rate, contract renewal activity, number of visits, the timing and extent of spending to support product development efforts, our expansion of sales and marketing activities, the introduction of new and enhanced services offerings, the continuing market acceptance of telehealth, and our debt service obligations. We may in the future enter into arrangements to acquire or invest in complementary businesses, services, technologies, and intellectual property rights. We may be required to seek additional equity or debt financing to fund working capital, capital expenditures and acquisitions, and to settle debt obligations. In the event that additional financing is required from outside sources, we may not be able to raise it on terms acceptable to us or at all, which would adversely affect our business, financial condition and results of operations.

Historically, we have financed our operations primarily through sales of equity securities, debt issuance, and bank borrowings. See Note 11, “Convertible Senior Notes” of the notes to the condensed consolidated financial statements in this Quarterly Report on Form 10-Q for additional information on the Notes.

We routinely enter into contractual obligations with third parties to provide professional services, licensing, and other products and services in support of our ongoing business. The current estimated cost of these contracts is not expected to be significant to our liquidity and capital resources based on contracts in place as of March 31, 2022.

Cash Used in Operating Activities

For the three months ended March 31, 2022 cash flows used in operating activities consisted of net loss adjusted for certain non-cash items and changes in assets and liabilities. Cash used in operating activities was $31.7 million for the three months ended March 31, 2022 compared to cash used in operating activities of $18.0 million for the three months ended March 31, 2021. The year-over-year higher outflow was primarily driven by an increase in accounts receivable and prepaid expenses, substantially related to software licenses and deferred device costs, and higher bonus and payroll tax payments.

Our primary uses of cash from operating activities are for the payment of cash compensation, provider fees, engagement marketing, D2C digital and media advertising, inventory, insurance, technology costs, interest expense and acquisition, integration, and transformation costs. Historically, our cash compensation is at its highest level in the first quarter when we pay discretionary employee compensation related to the previous fiscal year.

Cash Used in Investing Activities

Cash used in investing activities was $27.6 million for the three months ended March 31, 2022. Cash used in investing activities consisted of capital expenditures totaling $3.9 million and capitalized software development costs of $26.9 million.

Cash used in investing activities was $16.0 million for the three months ended March 31, 2021. Cash used in investing activities consisted of the acquisition of businesses of $55.9 million, investment in capital expenditures totaling

30

$2.1 million and capitalized software development costs of $11.1 million, partially offset by proceeds from short-term marketable securities of $50.0 million.

Cash Provided by Financing Activities

Cash provided by financing activities for the three months ended March 31, 2022 was $2.8 million. Cash provided by financing activities primarily consisted of $3.6 million of proceeds from the exercise of employee stock options, $3.7 million of proceeds withheld from participants in the employee stock purchase plan, and $2.2 million of proceeds from advances from financing companies, partially offset by ($3.9) million from a net change in payments against advances from financing companies and other items of ($2.9) million.

Cash provided by financing activities for the three months ended March 31, 2021 was $22.2 million. Cash provided by financing activities primarily consisted of $11.9 million of proceeds from the exercise of employee stock options, $8.6 million of proceeds withheld from participants in the employee stock purchase plan, $4.8 million of proceeds from advances from financing companies, $1.2 million of timing associated with net cash proceeds for tax withholding for stock-based compensation and redemption of 2022 Notes, and $4.1 million from a net change in payments from customers against advances from financing companies.

Recently Adopted Accounting Standards

In August 2020, the financial accounting standards board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06—"Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity.” ASU 2020-06 simplifies the accounting for convertible instruments by eliminating the conversion option separation model for convertible debt that can be settled in cash and by eliminating the measurement model for beneficial conversion features. Convertible instruments that continue to be subject to separation models are (1) those with conversion options that are required to be accounted for as bifurcated derivatives and (2) convertible debt instruments issued with substantial premiums for which the premiums are recorded as paid-in capital. This ASU also requires entities to use the if-converted method for all convertible instruments in the diluted earnings per share calculation and include the effect of share settlement for instruments that may be settled in cash or shares, except for certain liability-classified share-based payment awards.

We adopted ASU 2020-06 as of January 1, 2022, under the modified retrospective transition method, and accordingly, our prior period financial statements were not restated. Upon adoption of ASU 2020-06, the conversion feature of our convertible senior notes is no longer reported as a component of equity. Instead, the previously-separated equity component is now combined with the liability component, thereby eliminating the amortization of the debt discount arising from the conversion option separation model. As such, we currently anticipate a reduction of approximately $58 million in non-cash interest to be recorded on our convertible senior notes for the year ended December 31, 2022, as compared to the year ended December 31, 2021. To reflect the adoption of ASU 2020-06, we recorded an increase to convertible senior notes of $306.3 million and decreases to additional paid-in capital, accumulated deficit and net deferred tax liabilities of $363.7 million, $72.7 million, and $15.3 million, respectively, as of January 1, 2022.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

Interest Rate Risk and Foreign Exchange Risk

Cash equivalents that are subject to interest rate volatility represent our principal market risk. We do not expect cash flows to be affected to any significant degree by a sudden change in market interest rates as our Notes and Livongo Notes bear fixed interest rates. We do not enter into investments for trading or speculative purposes.

We operate our business primarily within the U.S. which accounts for approximately 87% of our revenues. We have not utilized hedging strategies with respect to our foreign exchange exposure as we believe it is not expected to have a material impact on our condensed consolidated financial statements.

Concentrations of Risk and Significant Clients

The Company’s financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents, short-term investments and accounts receivable. The Company deposits its cash with financial

31

institutions in the U.S. and in foreign countries, however, its deposits, at times, may exceed federally insured limits. The Company’s short-term investment balance as of March 31, 2022 and December 31, 2021 consisted primarily of a domestic certificate of deposit with an original maturity of one year.

No Client represented over 10% of revenues for the quarters ended March 31, 2022 or 2021.

No Client represented over 10% of accounts receivable at March 31, 2022 or December 31, 2021.

Item 4. Controls and Procedures

Management’s Report on Internal Control over Financial Reporting

In designing and evaluating our disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives and management necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures.

Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated, as of the end of the period covered by this Quarterly Report on Form 10-Q, the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”)). Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that as of March 31, 2022, our disclosure controls and procedures were effective to provide reasonable assurance that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms and to provide reasonable assurance that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.

No changes in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) occurred during the quarter ended March 31, 2022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

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PART II - OTHER INFORMATION

Item 1. Legal Proceedings

We are subject to legal proceedings, claims and litigation arising in the ordinary course of our business. Descriptions of certain legal proceedings to which we are a party are contained in Note 13, “Legal Matters”, to our condensed consolidated financial statements included in this Quarterly Report on Form 10-Q and are incorporated by reference herein.

Item 1A. Risk Factors

For a discussion of potential risks and uncertainties related to our Company see the information in Part I, Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2021. There have been no material changes to the risk factors previously disclosed in our Annual Report on Form 10-K for the year ended December 31, 2021.

In addition to the other information set forth in this Quarterly Report on Form 10-Q, you should carefully consider the factors discussed in the “Special Note Regarding Forward-Looking Statements” section in Part I, Item 2, of this Quarterly Report on Form 10-Q.

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Item 6. Exhibits

Exhibit

Index

		Incorporated by Reference
Exhibit Number	Exhibit Description	Form	File No.	Exhibit	Filing Date	Filed Herewith
3.1	Sixth Amended and Restated Certificate of Incorporation of Teladoc Health, Inc.	8-K	001-37477	3.1	5/31/17
3.2	Certificate of Amendment of Sixth Amended and Restated Certificate of Incorporation of Teladoc, Inc.	8-K	001-37477	3.1	6/1/18
3.3	Second Certificate of Amendment of Sixth Amended and Restated Certificate of Incorporation of Teladoc Health, Inc.	8-K	001-37477	3.1	8/10/18
3.4	Certificate of Amendment of the Sixth Amended and Restated Certificate of Incorporation of Teladoc Health, Inc.	8-K	001-37477	3.1	10/30/20
3.5	Fifth Amended and Restated Bylaws of Teladoc Health, Inc.	8-K	001-37477	3.1	2/19/21
10.1	Form of Performance Restricted Stock Unit Agreements under the Teladoc Health, Inc. 2015 Incentive Award Plan.					*
10.2	Executive Severance Agreement, dated July 15, 2015, by and between Teladoc Health, Inc. and Andrew Turitz, as amended by Amendment No. 1 to Executive Severance Agreement, dated October 29, 2019, by and between Teladoc Health, Inc. and Andrew Turitz.	10-K	001-37477	10.34	2/26/20
31.1	Chief Executive Officer—Certification pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.					*
31.2	Chief Financial Officer—Certification pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.					*
32.1	Chief Executive Officer—Certification pursuant to Rule13a-14(b) or Rule 15d-14(b) of the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.					**
32.2	Chief Financial Officer—Certification pursuant to Rule 13a-14(b) or Rule 15d-14(b) of the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.					**

34

101.INS	XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.	*
101.SCH	XBRL Taxonomy Extension Schema Document.	*
101.CAL	XBRL Taxonomy Calculation Linkbase Document.	*
101.DEF	XBRL Definition Linkbase Document.	*
101.LAB	XBRL Taxonomy Label Linkbase Document.	*
101.PRE	XBRL Taxonomy Presentation Linkbase Document.	*
104	Cover Page Interactive Data File – The Cover page interactive data file does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document

*     Filed herewith.

**   Furnished herewith.

35

Signatures

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

	TELADOC HEALTH, INC.
Date: May 2, 2022	By:	/s/ JASON GOREVIC
	Name:	Jason Gorevic
	Title:	Chief Executive Officer
Date: May 2, 2022	By:	/s/ MALA MURTHY
	Name:	Mala Murthy
	Title:	Chief Financial Officer

36

EX-10.1

Exhibit 10.1

TELADOC HEALTH, INC.

2015 INCENTIVE AWARD PLAN

PERFORMANCE RESTRICTED STOCK UNIT GRANT NOTICE

Capitalized terms not specifically defined in this Performance Restricted Stock Unit Grant Notice (the “Grant Notice”) have the meanings given to them in the 2015 Incentive Award Plan (as amended from time to time, the “Plan”) of Teladoc Health, Inc. (f/k/a Teladoc, Inc.) (the “Company”).

The Company hereby grants to the participant listed below (“Participant”) the Restricted Stock Units described in this Grant Notice (the “PSUs”), subject to the terms and conditions of the Plan and the Performance Restricted Stock Unit Agreement attached hereto as Exhibit A (the “Agreement”), both of which are incorporated into this Grant Notice by reference.

Participant:
Grant Date:
Number of PSUs:
Performance Period:
Vesting Schedule:	The PSUs will vest in accordance with the vesting schedule set forth in Exhibit A.

By Participant’s signature below, Participant agrees to be bound by the terms of this Grant Notice, the Plan and the Agreement.  Participant has reviewed the Plan, this Grant Notice and the Agreement in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Grant Notice and fully understands all provisions of the Plan, this Grant Notice and the Agreement.  Participant hereby agrees to accept as binding, conclusive and final all decisions or interpretations of the Administrator upon any questions arising under the Plan, this Grant Notice or the Agreement.

TELADOC HEALTH, INC.	PARTICIPANT
By:
Print Name:	Print Name:
Title:

Exhibit A

PERFORMANCE RESTRICTED STOCK UNIT AGREEMENT

Capitalized terms not specifically defined in this Agreement have the meanings specified in the Grant Notice or, if not defined in the Grant Notice, in the Plan.

ARTICLE I.

GENERAL

1.1Award of PSUs and Dividend Equivalents.

(a)The Company has granted the PSUs to Participant effective as of the grant date set forth in the Grant Notice (the “Grant Date”).  The number of PSUs stated in the Grant Notice is the target number of PSUs that may be earned under this Award (the “Target Number of PSUs”).  The number of PSUs that may actually be earned under this Award can be zero or ranges from between [__]% and [__]% of the Target Number of PSUs.  Each earned PSU represents the right to receive one Share or, at the option of the Administrator, an amount of cash, in either case, as set forth in this Agreement.  Participant will have no right to the distribution of any Shares or payment of any cash until the time (if ever) the PSUs have vested.

(b)The Company hereby grants to Participant, with respect to each earned PSU, a Dividend Equivalent for ordinary cash dividends paid to substantially all holders of outstanding Shares with a record date after the Grant Date and prior to the date the applicable PSU is settled, forfeited or otherwise expires.  Each Dividend Equivalent entitles Participant to receive the equivalent value of any such ordinary cash dividends paid on a single Share.  The Company will establish a separate Dividend Equivalent bookkeeping account (a “Dividend Equivalent Account”) for each Dividend Equivalent and credit the Dividend Equivalent Account (without interest) on the applicable dividend payment date with the amount of any such cash paid.

1.2Incorporation of Terms of Plan.  The PSUs and Dividend Equivalents are subject to the terms and conditions set forth in this Agreement and the Plan, which is incorporated herein by reference.  In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan will control.

1.3Unsecured Promise.  The PSUs and Dividend Equivalents will at all times prior to settlement represent an unsecured Company obligation payable only from the Company’s general assets.

ARTICLE II.

VESTING; FORFEITURE AND SETTLEMENT

2.1Vesting; Forfeiture.

(a)The PSUs will be earned, if at all, based on the Company’s achievement of the [_______] performance conditions fixed by the Compensation Committee of the Board of Directors of the Company over the Performance Period set forth in the Grant Notice (the “Performance Period”).  Within ninety (90) days following completion of the Performance Period, the Administrator will determine, in its sole and absolute discretion, the extent to which the performance conditions have been satisfied (the date of such determination, the “Determination Date”).  To the extent earned, the PSUs will vest as set forth in Section 2.1(c).

(b)Change in Control.  Notwithstanding Section 2.1(a), if a Change in Control occurs on or prior to the last day of the Performance Period, the PSUs will be earned on the date of the Change in Control or an earlier date determined by the Administrator (the date of such determination, the “CICDetermination Date”) and the number of earned PSUs will equal the greater of (i) 100% of the Target Number of PSUs and (ii) the sum of the number of earned PSUs using the Company’s expected full period performance based on its then current period-to-date results, in each case, as determined

by the Administrator prior to the date of the Change in Control; provided that, if the Administrator does not make such a determination or determines that there is insufficient information to accurately estimate the Company’s full period performance, the number of earned PSUs will equal the Target Number of PSUs.  Any PSUs that have not been earned will be automatically forfeited on the CIC Determination Date unless the Administrator otherwise determines.

(c)Vesting of Earned PSUs; Forfeiture.  The earned PSUs will vest [as to [            ]] on [each of] the Determination Date or the CIC Determination Date, as applicable[, and the [[            ] anniversary/ies] thereof].  Any fraction of a PSU that would otherwise be vested will be accumulated and will vest only when a whole PSU has accumulated.  In the event of Participant’s Termination of Service for any reason, all unvested PSUs will immediately and automatically be cancelled and forfeited, except as otherwise determined by the Administrator or provided in a binding written agreement between Participant and the Company.  Dividend Equivalents (including any Dividend Equivalent Account balance) will vest or be forfeited, as applicable, upon the vesting or forfeiture of the corresponding PSU.

2.2Settlement.

(a)PSUs and Dividend Equivalents (including any Dividend Equivalent Account balance) will be paid in Shares or cash at the Administrator’s option as soon as administratively practicable after the vesting of the applicable PSU, but in no event more than sixty (60) days after the PSU’s vesting date.  Notwithstanding the foregoing, the Company may delay any payment under this Agreement that the Company reasonably determines would violate Applicable Law until the earliest date the Company reasonably determines the making of the payment will not cause such a violation (in accordance with Treasury Regulation Section 1.409A-2(b)(7)(ii)), provided the Company reasonably believes the delay will not result in the imposition of excise taxes under Section 409A.

(b)If a PSU is paid in cash, the amount of cash paid with respect to the PSU will equal the Fair Market Value of a Share on the day immediately preceding the payment date.  If a Dividend Equivalent is paid in Shares, the number of Shares paid with respect to the Dividend Equivalent will equal the quotient, rounded down to the nearest whole Share, of the Dividend Equivalent Account balance divided by the Fair Market Value of a Share on the day immediately preceding the payment date.

ARTICLE III.

TAXATION AND TAX WITHHOLDING

3.1Representation.  Participant represents to the Company that Participant has reviewed with Participant’s own tax advisors the tax consequences of this Award and the transactions contemplated by the Grant Notice and this Agreement.  Participant is relying solely on such advisors and not on any statements or representations of the Company or any of its agents.

3.2Tax Withholding.

(a)The Company has the right and option, but not the obligation, to treat Participant’s failure to provide timely payment in accordance with the Plan of any withholding tax arising in connection with the PSUs or Dividend Equivalents as Participant’s election to satisfy all or any portion of the withholding tax by requesting the Company retain Shares otherwise issuable under the Award.

(b)Participant acknowledges that Participant is ultimately liable and responsible for all taxes owed in connection with the PSUs and the Dividend Equivalents, regardless of any action the Company or any Subsidiary takes with respect to any tax withholding obligations that arise in connection with the PSUs or Dividend Equivalents.  Neither the Company nor any Subsidiary makes any representation or undertaking regarding the treatment of any tax withholding in connection with the awarding, vesting or payment of the PSUs or the Dividend Equivalents or the subsequent sale of Shares.  The Company and the Subsidiaries do not commit and are under no obligation to structure the PSUs or Dividend Equivalents to reduce or eliminate Participant’s tax liability.

A-2

ARTICLE IV.

OTHER PROVISIONS

4.1Adjustments.  Participant acknowledges that the PSUs, the Shares subject to the PSUs and the Dividend Equivalents are subject to adjustment, modification and termination in certain events as provided in this Agreement and the Plan.

4.2Notices.  Any notice to be given under the terms of this Agreement to the Company must be in writing and addressed to the Company in care of the Company’s Secretary at the Company’s principal office or the Secretary’s then-current email address or facsimile number.  Any notice to be given under the terms of this Agreement to Participant must be in writing and addressed to Participant at Participant’s last known mailing address, email address or facsimile number in the Company’s personnel files.  By a notice given pursuant to this Section, either party may designate a different address for notices to be given to that party.  Any notice will be deemed duly given when actually received, when sent by email, when sent by certified mail (return receipt requested) and deposited with postage prepaid in a post office or branch post office regularly maintained by the United States Postal Service, when delivered by a nationally recognized express shipping company or upon receipt of a facsimile transmission confirmation.

4.3Titles.  Titles are provided herein for convenience only and are not to serve as a basis for interpretation or construction of this Agreement.

4.4Conformity to Securities Laws.  Participant acknowledges that the Plan, the Grant Notice and this Agreement are intended to conform to the extent necessary with all Applicable Laws and, to the extent Applicable Laws permit, will be deemed amended as necessary to conform to Applicable Laws.

4.5Successors and Assigns.  The Company may assign any of its rights under this Agreement to single or multiple assignees, and this Agreement will inure to the benefit of the successors and assigns of the Company.  Subject to the restrictions on transfer set forth in the Plan, this Agreement will be binding upon and inure to the benefit of the heirs, legatees, legal representatives, successors and assigns of the parties hereto.

4.6Limitations Applicable to Section 16 Persons.  Notwithstanding any other provision of the Plan or this Agreement, if Participant is subject to Section 16 of the Exchange Act, the Plan, the Grant Notice, this Agreement, the PSUs and the Dividend Equivalents will be subject to any additional limitations set forth in any applicable exemptive rule under Section 16 of the Exchange Act (including any amendment to Rule 16b-3) that are requirements for the application of such exemptive rule.  To the extent Applicable Laws permit, this Agreement will be deemed amended as necessary to conform to such applicable exemptive rule.

4.7Entire Agreement.  The Plan, the Grant Notice and this Agreement (including any exhibit hereto) constitute the entire agreement of the parties and supersede in their entirety all prior undertakings and agreements of the Company and Participant with respect to the subject matter hereof.

4.8Agreement Severable.  In the event that any provision of the Grant Notice or this Agreement is held illegal or invalid, the provision will be severable from, and the illegality or invalidity of the provision will not be construed to have any effect on, the remaining provisions of the Grant Notice or this Agreement.

4.9Limitation on Participant’s Rights.  Participation in the Plan confers no rights or interests other than as herein provided.  This Agreement creates only a contractual obligation on the part of the Company as to amounts payable and may not be construed as creating a trust.  Neither the Plan nor any underlying program, in and of itself, has any assets.  Participant will have only the rights of a general unsecured creditor of the Company with respect to amounts credited and benefits payable, if any, with respect to the PSUs and Dividend Equivalents, and rights no greater than the right to receive cash or the Shares as a general unsecured creditor with respect to the PSUs and Dividend Equivalents, as and when settled pursuant to the terms of this Agreement.

A-3

4.10Not a Contract of Employment.  Nothing in the Plan, the Grant Notice or this Agreement confers upon Participant any right to continue in the employ or service of the Company or any Subsidiary or interferes with or restricts in any way the rights of the Company and its Subsidiaries, which rights are hereby expressly reserved, to discharge or terminate the services of Participant at any time for any reason whatsoever, with or without Cause, except to the extent expressly provided otherwise in a written agreement between the Company or a Subsidiary and Participant.

4.11Counterparts.  The Grant Notice may be executed in one or more counterparts, including by way of any electronic signature, subject to Applicable Law, each of which will be deemed an original and all of which together will constitute one instrument.

* * * * *

A-4

EX-31.1

Exhibit 31.1

Certification

I, Jason Gorevic, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q of Teladoc Health, Inc. (the “registrant”) for the period ended March 31, 2022;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)   Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)   Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a)   All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b)   Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: May 2, 2022

/s/ JASON GOREVIC

Jason Gorevic

Chief Executive Officer

EX-31.2

Exhibit 31.2

Certification

I, Mala Murthy, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q of Teladoc Health, Inc. (the “registrant”) for the period ended March 31, 2022;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)   Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)   Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a)   All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b)   Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: May 2, 2022

/s/ MALA MURTHY

Mala Murthy

Chief Financial Officer

EX-32.1

Exhibit 32.1

CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Teladoc Health, Inc. (the “Company”) on Form 10-Q for the period ended March 31, 2022 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Jason Gorevic, Chief Executive Officer of the Company, certify, to my knowledge, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

1. The Report fully complies with the requirements of Section 13(a) or Section 15(d) of the Securities Exchange Act of 1934, as amended; and

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date: May 2, 2022

/s/ JASON GOREVIC

Jason Gorevic

Chief Executive Officer

EX-32.2

Exhibit 32.2

CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Teladoc Health, Inc. (the “Company”) on Form 10-Q for the period ended March 31, 2022 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Mala Murthy, Chief Financial Officer of the Company, certify, to my knowledge, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

1. The Report fully complies with the requirements of Section 13(a) or Section 15(d) of the Securities Exchange Act of 1934, as amended; and

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date: May 2, 2022

/s/ MALA MURTHY

Mala Murthy

Chief Financial Officer

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Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2022	Apr. 27, 2022
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Mar. 31, 2022
Current Fiscal Year End Date	--12-31
Entity File Number	001-37477
Entity Registrant Name	TELADOC HEALTH, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-3705970
Entity Address, Address Line One	2 Manhattanville Road
Entity Address, Address Line Two	Suite 203
Entity Address, City or Town	Purchase
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	10577
City Area Code	203
Local Phone Number	635-2002
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	TDOC
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		161,182,633
Entity Central Index Key	0001477449
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Amendment Flag	false

XML

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 836,444	$ 893,480
Short-term investments	2,544	2,537
Accounts receivable, net of provision of $13,056 and $12,384, respectively	191,528	168,956
Inventories	70,654	73,079
Prepaid expenses and other current assets	106,875	87,387
Total current assets	1,208,045	1,225,439
Property and equipment, net	28,419	27,234
Goodwill	7,899,795	14,504,174
Intangible assets, net	1,883,897	1,910,278
Operating lease - right-of-use assets	45,552	46,780
Other assets	26,629	20,703
Total assets	11,092,337	17,734,608
Current liabilities:
Accounts payable	47,412	47,257
Accrued expenses and other current liabilities	116,689	102,933
Accrued compensation	46,075	91,941
Deferred revenue-current	83,847	75,569
Advances from financing companies	12,664	13,313
Total current liabilities	306,687	331,013
Other liabilities	1,445	1,492
Operating lease liabilities, net of current portion	40,163	41,773
Deferred revenue, net of current portion	2,884	3,834
Advances from financing companies, net of current portion	8,252	9,291
Deferred taxes, net	57,516	75,777
Convertible senior notes, net	1,532,780	1,225,671
Commitments and contingencies (Note 10)
Stockholders' equity:
Common stock, $0.001 par value; 300,000,000 shares authorized as of March 31, 2022 and December 31, 2021; 161,434,513 shares and 160,469,325 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively	161	160
Additional paid-in capital	17,177,152	17,473,336
Accumulated deficit	(8,023,279)	(1,421,454)
Accumulated other comprehensive loss	(11,424)	(6,285)
Total stockholders' equity	9,142,610	16,045,757
Total liabilities and stockholders' equity	$ 11,092,337	$ 17,734,608

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CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
CONDENSED CONSOLIDATED BALANCE SHEETS
Provision of Accounts receivable	$ 13,056	$ 12,384
Common stock par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	161,434,513	160,469,325
Common stock, shares outstanding	161,434,513	160,469,325

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CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
Revenue	$ 565,350	$ 453,675
Expenses:
Cost of revenue (exclusive of depreciation and amortization, which is shown separately below)	187,025	145,959
Operating expenses:
Advertising and marketing	133,600	89,439
Sales	58,329	64,793
Technology and development	87,412	78,008
General and administrative	104,923	105,172
Acquisition, integration, and transformation costs	4,507	6,323
Depreciation and amortization	58,933	48,659
Goodwill impairment	6,600,000	0
Total expenses	7,234,729	538,353
Loss from operations	(6,669,379)	(84,678)
Loss on extinguishment of debt	0	11,459
Other income, net	(724)	(5,652)
Interest expense, net	5,480	22,125
Net loss before taxes	(6,674,135)	(112,610)
Income tax expense	388	87,039
Net loss	(6,674,523)	(199,649)
Other comprehensive loss, net of tax:
Currency translation adjustment and other	(5,139)	(13,492)
Comprehensive loss	$ (6,679,662)	$ (213,141)
Net loss per share, basic (in dollars per share)	$ (41.58)	$ (1.31)
Net loss per share, diluted (in dollars per share)	$ (41.58)	$ (1.31)
Weighted-average shares used to compute basic net loss per share	160,532,301	152,167,606
Weighted-average shares used to compute diluted net loss per share	160,532,301	152,167,606

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CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($)	Common Stock 2022 Notes	Common Stock 2025 Notes	Common Stock Cumulative effect adjustment due to adoption of ASU 2020-06	Common Stock	Additional Paid-In Capital 2022 Notes	Additional Paid-In Capital 2025 Notes	Additional Paid-In Capital Cumulative effect adjustment due to adoption of ASU 2020-06	Additional Paid-In Capital	Accumulated Deficit 2022 Notes	Accumulated Deficit 2025 Notes	Accumulated Deficit Cumulative effect adjustment due to adoption of ASU 2020-06	Accumulated Deficit	Accumulated Other Comprehensive Loss 2022 Notes	Accumulated Other Comprehensive Loss 2025 Notes	Accumulated Other Comprehensive Loss Cumulative effect adjustment due to adoption of ASU 2020-06	Accumulated Other Comprehensive Loss	2022 Notes	2025 Notes	Cumulative effect adjustment due to adoption of ASU 2020-06	Total
Balance as of beginning of the period at Dec. 31, 2020				$ 150,000				$ 16,857,797,000				$ (992,661,000)				$ 18,518,000				$ 15,883,804,000
Balance as of beginning of the period (in shares) at Dec. 31, 2020				150,281,099
Stockholders' Equity (Deficit)
Exercise of stock options				$ 1,000				11,907,000				0				0				11,908,000
Exercise of stock options (in shares)				1,238,112
Issuance of common stock upon vesting of restricted stock units				$ 1,000				(1,000)				0				0				0
Issuance of common stock upon vesting of restricted stock units (in shares)				976,999
Issuance of common stock for Notes	$ 1,000	$ 1,000			$ 270,111,000	$ 288,485,000			$ 0	$ 0			$ 0	$ 0			$ 270,112,000	$ 288,486,000
Issuance of common stock for Notes (in shares)	1,058,373	1,056,861
Recovery of excess common stock issued for acquisition				$ 0				(40,329,000)				0				0				(40,329,000)
Recovery of excess common stock issued for acquisition (in shares)				(205,280)
Equity portion of extinguishment of Notes	$ 0	$ 0			$ (224,081,000)	$ (237,261,000)			$ 0	$ 0			$ 0	$ 0			$ (224,081,000)	$ (237,261,000)
Stock-based compensation				$ 0				90,000,000				0				0				90,000,000
Other comprehensive loss, net of tax				0				0				0				(13,492,000)				(13,492,000)
Net loss				0				0				(199,649,000)				0				(199,649,000)
Balance as of end of the period at Mar. 31, 2021				$ 154,000				17,016,628,000				(1,192,310,000)				5,026,000				15,829,498,000
Balance as of end of the period (in shares) at Mar. 31, 2021				154,406,164
Balance as of beginning of the period at Dec. 31, 2021			$ 0	$ 160,000			$ (363,731,000)	17,473,336,000			$ 72,698,000	(1,421,454,000)			$ 0	(6,285,000)			$ (291,033,000)	16,045,757,000
Balance as of beginning of the period (in shares) at Dec. 31, 2021			0	160,469,325
Stockholders' Equity (Deficit)
Exercise of stock options				$ 0				3,585,000				0				0				3,585,000
Exercise of stock options (in shares)				267,586
Issuance of common stock upon vesting of restricted stock units				$ 1,000				(1,000)				0				0				0
Issuance of common stock upon vesting of restricted stock units (in shares)				697,602
Stock-based compensation				$ 0				63,963,000				0				0				63,963,000
Other comprehensive loss, net of tax				0				0				0				(5,139,000)				(5,139,000)
Net loss				0				0				(6,674,523,000)				0				(6,674,523,000)
Balance as of end of the period at Mar. 31, 2022				$ 161,000				$ 17,177,152,000				$ (8,023,279,000)				$ (11,424,000)				$ 9,142,610,000
Balance as of end of the period (in shares) at Mar. 31, 2022				161,434,513

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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Operating activities:
Net loss	$ (6,674,523)	$ (199,649)
Adjustments to reconcile net loss to net cash used in operating activities:
Goodwill impairment	6,600,000	0	$ 0
Depreciation and amortization	58,933	48,659
Depreciation of rental equipment	770	824
Amortization of right-of-use assets	3,173	2,948
Provision for doubtful accounts	4,591	3,074
Stock-based compensation	60,436	86,300
Deferred income taxes	(2,319)	87,004
Accretion of interest	826	16,829
Loss on extinguishment of debt	0	11,459
Gain on sale of investment	0	(5,852)
Other, net	0	38
Changes in operating assets and liabilities:
Accounts receivable	(27,842)	(11,717)
Prepaid expenses and other current assets	(18,993)	(12,799)
Inventory	2,023	(2,877)
Other assets	(6,047)	1,244
Accounts payable	492	(11,989)
Accrued expenses and other current liabilities	11,706	(1,889)
Accrued compensation	(48,819)	(43,624)
Deferred revenue	7,479	17,086
Operating lease liabilities	(3,626)	(3,076)
Other liabilities	(7)	(19)
Net cash used in operating activities	(31,747)	(18,026)
Investing activities:
Capital expenditures	(3,913)	(2,115)
Capitalized software	(26,918)	(11,144)
Proceeds from marketable securities	0	50,000
Acquisitions of business, net of cash acquired	0	(55,921)
Other, net	3,264	3,150
Net cash used in investing activities	(27,567)	(16,030)
Financing activities:
Net proceeds from the exercise of stock options	3,585	11,908
Repurchase of 2022 Notes	0	(130)
Proceeds from advances from financing companies	2,232	4,816
Payment against advances from financing companies	(3,921)	(4,098)
Proceeds from employee stock purchase plan	3,680	8,648
Cash received for withholding taxes on stock-based compensation, net	103	1,218
Other, net	(2,863)	(187)
Net cash provided by financing activities	2,816	22,175
Net decrease in cash and cash equivalents	(56,498)	(11,881)
Foreign exchange difference	(538)	(1,339)
Cash and cash equivalents at beginning of the period	893,480	733,324	733,324
Cash and cash equivalents at end of the period	836,444	720,104	$ 893,480
Income taxes paid	261	52
Interest paid	$ 7	$ 3

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Organization and Description of Business

3 Months Ended

Mar. 31, 2022

Organization and Description of Business

Organization and Description of Business

Note 1. Organization and Description of Business

Teladoc Health, Inc., together with its subsidiaries, is referred to herein as “Teladoc Health,” or the “Company,” and is the global leader in whole person virtual care, forging a new healthcare experience with better convenience, outcomes, and value. The Company’s mission is to empower all people everywhere to live their healthiest lives by transforming the healthcare experience.

The Company was incorporated in the State of Texas in June 2002 and changed its state of incorporation to the State of Delaware in October 2008. Effective August 10, 2018, Teladoc, Inc. changed its corporate name to Teladoc Health, Inc. The Company’s principal executive office is located in Purchase, New York.

On October 30, 2020, the Company completed the merger with Livongo Health, Inc. (“Livongo”), a transformational opportunity to improve the delivery, access and experience of chronic healthcare for individuals around the world.

On July 1, 2020, the Company completed the acquisition of InTouch Technologies, Inc. (“InTouch”), a leading provider of enterprise telehealth solutions for hospitals and health systems.

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Basis of Presentation and Principles of Consolidation

3 Months Ended

Mar. 31, 2022

Basis Of Presentation And Principles Of Consolidation

Basis of Presentation and Principles of Consolidation

Note 2. Basis of Presentation and Principles of Consolidation

The accompanying unaudited condensed consolidated financial statements for the three months ended March 31, 2022 and 2021, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals) necessary for a fair presentation of the condensed consolidated results of operations, financial position and cash flows of Teladoc Health for the periods presented. However, the financial results for interim periods are not necessarily indicative of the results that may be expected for a full fiscal year or for any other future period.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles (“GAAP”) in the United States (“U.S.”) have been omitted or condensed pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). The information in this report should be read in conjunction with the Company’s Annual Report on Form 10-K filed with the SEC for the fiscal year ended December 31, 2021 (the “2021 Form 10-K”), which includes a complete set of footnote disclosures, including the Company’s significant accounting policies.

These financial statements include the results of Teladoc Health, as well as three professional associations and twelve professional corporations (collectively, the “THMG Association”). All intercompany transactions and balances have been eliminated. Certain prior year amounts have been reclassified to conform to the current year presentation.

Teladoc Health Medical Group, P.A., formerly Teladoc Physicians, P.A. (“THMG”) is party to several Services Agreements by and among it and the professional associations and professional corporations pursuant to which each professional association and professional corporation provides services to THMG. Each professional association and professional corporation is established pursuant to the requirements of its respective domestic jurisdiction governing the corporate practice of medicine.

The Company holds a variable interest in the THMG Association which contracts with physicians and other health professionals in order to provide services to the Company. The THMG Association is considered a variable interest entity (“VIE”) since it does not have sufficient equity to finance its activities without additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if it has both power and benefits—that is, it has (1) the power to direct the activities of a VIE that most significantly impact the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has the power and rights to control all activities of the THMG Association and funds and absorbs all losses of the VIE and appropriately consolidates the THMG Association.

Total revenue and net income (loss) for the VIE were $60.1 million and $2.3 million, and $54.2 million and $1.2 million, for the quarters ended March 31, 2022 and 2021, respectively. The VIE’s total assets, all of which were current, were $33.1 million and $58.5 million at March 31, 2022 and December 31, 2021, respectively. The VIE’s total liabilities, all of which were current, were $71.5 million and $94.7 million at March 31, 2022 and December 31, 2021,

respectively. The VIE’s total stockholders’ deficit was $38.4 million and $36.1 million at March 31, 2022 and December 31, 2021, respectively.

Business Combinations

The Company accounts for its business combinations using the acquisition method of accounting. The purchase price is attributed to the fair value of the assets acquired and liabilities assumed. Transaction costs directly attributable to the acquisition are expensed as incurred. Identifiable assets and liabilities acquired or assumed are measured separately at their fair values as of the acquisition date. The excess of the purchase price of acquisition over the fair value of the identifiable net assets of the acquiree is recorded as goodwill. The results of businesses acquired in a business combination are included in the Company’s condensed consolidated financial statements from the date of acquisition.

When the Company issues stock-based or cash awards to an acquired company’s stockholders, the Company evaluates whether the awards are consideration or compensation for post-acquisition services. The evaluation includes, among other things, whether the vesting of the awards is contingent on the continued employment of the acquired company’s stockholders beyond the acquisition date. If continued employment is required for vesting, the awards are treated as compensation for post-acquisition services and recognized as expense over the requisite service period.

Determining the fair value of assets acquired and liabilities assumed requires management to use significant judgment and estimates, including the selection of valuation methodologies, estimates of future revenue and cash flows, discount rates and selection of comparable companies. The estimates and assumptions used to determine the fair values and useful lives of identified intangible assets could change due to numerous factors, including market conditions, technological developments, economic conditions, and competition. In connection with determination of fair values, the Company may engage a third-party valuation specialist to assist with the valuation of intangible and certain tangible assets acquired and certain assumed obligations. Acquisition-related transaction costs incurred by the Company are not included as a component of consideration transferred but are accounted for as an operating expense in the period in which the costs are incurred.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business and economic factors, and various other assumptions that the Company believes are necessary to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained and as the Company’s operating environment evolves. The Company believes that estimates used in the preparation of these condensed consolidated financial statements are reasonable; however, actual results could differ materially from these estimates.

Changes in estimates are made when circumstances warrant. Such changes in estimates and refinements in estimation methodologies are reflected in reported results of operations; if material, the effects of changes in estimates are disclosed in the notes to the condensed consolidated financial statements.

Significant estimates and assumptions by management affect areas including the carrying value and useful life of long-lived assets (including intangible assets), the carrying value of goodwill, the capitalization and amortization of software development costs, deferred costs, the allowance for doubtful accounts, and the accounting for business combinations. Other significant areas include revenue recognition (including performance guarantees, the accounting for income taxes, contingences, litigation and related legal accruals, and the accounting for stock-based compensation awards, and other items as described in the Summary of Significant Accounting policies in this Quarterly Report and in the 2021 Form 10-K.

Recently Adopted Accounting Standards

In August 2020, the financial accounting standards board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06—"Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity.” ASU 2020-06 simplifies the accounting for convertible instruments by eliminating the conversion option separation model for convertible debt that can be settled in cash and by eliminating the measurement model for beneficial conversion features. Convertible instruments that continue to be subject to separation models are (1) those with conversion options that are required to be accounted for as bifurcated derivatives and (2) convertible debt instruments issued with substantial premiums for which the premiums are recorded as paid-in capital. This ASU also requires entities to use the if-converted method for all convertible instruments in the diluted earnings per share calculation and include the effect of share settlement for instruments that may be settled in cash or shares, except for certain liability-classified share-based payment awards.

The Company adopted ASU 2020-06 as of January 1, 2022, under the modified retrospective transition method, and accordingly, its prior period financial statements were not restated. Upon adoption of ASU 2020-06, the conversion feature of the Company’s convertible senior notes is no longer reported as a component of equity. Instead, the previously-separated equity component is now combined with the liability component, thereby eliminating the amortization of the debt discount arising from the conversion option separation model. As such, the Company currently anticipates a reduction of approximately $58 million in non-cash interest to be recorded on its convertible senior notes for the year ended December 31, 2022, as compared to the year ended December 31, 2021. To reflect the adoption of ASU 2020-06, the Company recorded an increase to convertible senior notes of $306.3 million and decreases to additional paid-in capital, accumulated deficit and net deferred tax liabilities of $363.7 million, $72.7 million and $15.3 million, respectively, as of January 1, 2022.

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs

3 Months Ended

Mar. 31, 2022

Revenue, Deferred Revenue, and Deferred Device and Contract Costs

Revenue, Deferred Revenue, and Deferred Device and Contract Costs

Note 3. Revenue, Deferred Revenue, and Deferred Device and Contract Costs

The Company generates access fees from customers, consisting of employers, health plans, hospitals and health systems, insurance, and financial services companies (collectively “Clients”), as well as individual members, accessing its professional provider network, hosted virtual healthcare platform and chronic care management platforms. Visit fee revenue is generated for general medical, expert medical service and other specialty visits. In addition, other revenue is primarily associated with virtual healthcare device equipment included with its hosted virtual healthcare platform. Access revenue accounted for 87% and 84% of the Company’s revenue for the quarters ended March 31, 2022 and 2021, respectively.

The following table presents the Company’s revenues disaggregated by revenue source (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Access Fees Revenue
U.S.	$	421,146	$	327,553
International		70,191		54,553
Total		491,337		382,106
Visit Fee Revenue
U.S.		64,473		57,128
International		3,455		3,383
Total		67,928		60,511
Other
U.S.		5,581		10,671
International		504		387
Total		6,085		11,058
Total Revenues	$	565,350	$	453,675

During the fourth quarter of 2021, the Company refined its definition of international revenues to reflect all international revenues based on location of the customer. Previously, Direct-to-Consumer (“D2C”) activities were primarily reflected based on the location of operations. In addition, certain activities related to the Company’s international operations are now reflected in visit revenues versus access fee revenues. Prior period amounts have been recast to conform with current presentation.

Deferred Revenue

Deferred revenue represents billed, but unrecognized revenue, and is comprised of fees received in advance of the delivery or completion of the services and amounts received in instances when revenue recognition criteria have not been met. Deferred revenue associated with upfront payments for a device is amortized ratably over the expected member enrollment period. Deferred revenue that will be recognized during the succeeding twelve-month period is recorded as current deferred revenue and the remaining portion is recorded as noncurrent deferred revenue.

For certain services, payment is required for future months before the service is delivered to the member. The Company records deferred revenue when cash payments are received in advance of the Company’s performance obligation to provide services. Deferred revenue, current plus long-term, was $87.1 million at March 31, 2022 and $73.2 million at March 31, 2021. The net increase of $7.6 million and $18.4 million in the deferred revenue balance for the three months ended March 31, 2022 and 2021, respectively, was primarily driven by InTouch and Livongo as well as BetterHelp, the Company’s D2C mental health product, and cash payments received or due in advance of satisfying the Company’s performance obligations, offset by revenue recognized that were included in the deferred revenue balance at the beginning of the period. The Company anticipates that it will satisfy most of its performance obligation associated with the deferred revenue within the prospective fiscal year. Revenue recognized during the quarters ended March 31, 2022 and 2021 that was included in deferred revenue at the beginning of the periods was $51.6 million and $32.7 million, respectively.

The Company expects to recognize $73.0 million and $5.0 million of revenue in 2022 and 2023, respectively, related to future performance obligations that are unsatisfied or partially unsatisfied as of March 31, 2022.

Deferred Device and Contract Costs

Deferred device and contract costs are classified as a component of Prepaid expenses and other current assets or Other assets depending on term, and consisted of the following as of March 31, 2022 (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Deferred device and contract costs, current	$	27,335	$	22,304
Deferred device and contract costs, noncurrent		7,636		6,249
Total deferred device and contract costs	$	34,971	$	28,553

Deferred costs and other activity were as follows (in thousands):

	Deferred Device and Contract Costs
Beginning balance as of December 31, 2021	$	28,553
Additions		13,986
Cost of revenue recognized		(7,568)
Ending balance as of March 31, 2022	$	34,971

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Inventories

3 Months Ended

Mar. 31, 2022

Inventories

Inventories

Note 4. Inventories

Inventories consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Raw materials and purchased parts	$	25,006	$	26,164
Work in process		379		313
Finished goods		45,269		46,602
Total inventories	$	70,654	$	73,079

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Prepaid Expenses and Other Current Assets

3 Months Ended

Mar. 31, 2022

Prepaid Expenses and Other Current Assets

Prepaid Expenses and Other Current Assets

Note 5. Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Prepaid expenses	$	51,397	$	38,179
Deferred device and contract costs, current		27,335		22,304
Other receivables		22,817		21,170
Other current asset		5,326		5,734
Total prepaid expenses and other current assets	$	106,875	$	87,387

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Intangible Assets, Net

3 Months Ended

Mar. 31, 2022

Intangible Assets, Net

Intangible Assets, Net

Note 6. Intangible Assets, Net

Intangible assets, net consist of the following (in thousands):

								Weighted
								Average
								Remaining
	Useful			Accumulated		Net Carrying		Useful Life
	Life	Gross Value		Amortization		Value		(Years)
March 31, 2022
Client relationships	2 to 20 years	$	1,463,335	$	(222,285)	$	1,241,050	14.3
Trademarks	2 to 15 years		325,958		(58,823)		267,135	7.4
Software	3 to 5 years		155,456		(45,101)		110,355	2.8
Technology	5 to 7 years		343,310		(77,953)		265,357	5.3
Intangible assets, net		$	2,288,059	$	(404,162)	$	1,883,897	11.4
December 31, 2021
Client relationships	2 to 20 years	$	1,465,926	$	(199,866)	$	1,266,060	14.5
Trademarks	3 to 15 years		326,392		(45,555)		280,837	9.5
Software	3 to 5 years		126,188		(40,767)		85,421	2.7
Technology	5 to 7 years		343,262		(65,302)		277,960	5.6
Intangible assets, net		$	2,261,768	$	(351,490)	$	1,910,278	12.0

Amortization expense for intangible assets net of foreign currency remeasurement for intangible assets was $56.6 million and $46.6 million for the quarters ended March 31, 2022 and 2021, respectively.

In January 2022, the Company embarked upon a two-year migration strategy that integrates and moves selected consumer brands under Teladoc Health – which will serve as the primary business-to-business-to-consumer brand that meets all consumer healthcare needs. The evolution of brand names results in the weighted average life of our trademarks decreasing from 9.5 years to 7.4 years as of March 31, 2022, and an acceleration of amortization expense being expensed over 2022 and 2023. This change resulted in additional amortization expense of $5.8 million (or $0.04 per basic and diluted share) in the first quarter of 2022.

Refer to Note 7 to the condensed consolidated financial statements for the results of impairment testing of the Company’s intangible assets including goodwill.

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Goodwill

3 Months Ended

Mar. 31, 2022

Goodwill

Goodwill

Note 7. Goodwill

Goodwill consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Beginning balance as of December 31, 2021 and 2020, respectively	$	14,504,174	$	14,581,255
Impairment		(6,600,000)		0
Additions associated with acquisitions		0		64,269
Purchase consideration adjustments net of deferred tax impacts		0		(122,306)
Currency translation adjustment		(4,379)		(19,044)
Ending balance as of March 31, 2022 and December 31, 2021	$	7,899,795	$	14,504,174

As a result of sustained decreases in the Company’s publicly quoted share price and market capitalization continuing into 2022, the Company conducted additional testing of its goodwill, definite-lived intangibles, and other long-lived assets as of March 31, 2022. As a result of this review, the Company did not identify an impairment to its definite-lived intangible assets or other long-lived assets, but the Company recorded a $6.6 billion non-deductible, non-cash goodwill impairment charge (or $41.11 per basic and diluted share) for the quarter ended March 31, 2022. 

Consistent with prior goodwill impairment testing, the Company’s March 31, 2022, testing reflected a 75%/25% allocation between the income and market approaches. The Company believes the 75% weighting to the income approach continues to be appropriate as it more directly reflects its future growth and profitability expectations. For the Company’s March 31, 2022 impairment testing, as compared to its December 1, 2021 testing, the Company reduced its estimated future cash flows used in the impairment assessment, including revenues, margin, and capital expenditures to reflect its best estimates at this time. The Company also updated certain significant inputs into the valuation models including the discount rate which increased reflecting, in part, higher interest rates and market volatility, and the Company reduced its revenue market multiples, reflecting declining valuations across the Company’s selected peer group. The Company’s updates to its discount rate, market multiples, and estimated future cash flows each had a significant impact to the estimated fair value of the reporting unit.

The following table reflects changes in the most significant inputs to the Company’s impairment analysis on each testing date since its last annual test.

Testing dates	Discount Rate	Peer Group Revenue Multiples (current year/subsequent year)	% Excess of Reporting Unit Fair Value over Carrying Value
December 1, 2021	10.5%	7.0x/5.5x	15.0%
March 31, 2022	12.0%	3.0x/2.5x	0% post impairment

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Accrued Expenses and Other Current Liabilities

3 Months Ended

Mar. 31, 2022

Accrued Expenses and Other Current Liabilities

Accrued Expenses and Other Current Liabilities

Note 8. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Professional fees	$	5,485	$	5,373
Consulting fees/provider fees		18,029		19,292
Client performance guarantees		10,034		7,653
Interest payable		5,809		1,480
Income tax payable		5,131		3,098
Insurance		5,779		3,884
Marketing		6,104		3,471
Operating lease liabilities - current		13,052		12,687
Franchise and sales taxes		11,429		9,965
Device replacement cost		5,913		6,263
Other		29,924		29,767
Total	$	116,689	$	102,933

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Fair Value Measurements

3 Months Ended

Mar. 31, 2022

Fair Value Measurements

Fair Value Measurements

Note 9. Fair Value Measurements

The carrying value of the Company’s cash equivalents, short-term investments, accounts receivable, accounts payable, and accrued liabilities approximates fair value due to their short-term nature.

The Company measures its financial assets and liabilities at fair value at each reporting period using a fair value hierarchy that requires it to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. A financial instrument’s classification within the fair value hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Three levels of inputs may be used to measure fair value:

Level 1—Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active

markets.

Level 2—Include other inputs that are directly or indirectly observable in the marketplace.

Level 3—Unobservable inputs that are supported by little or no market activity.

The Company measures its cash equivalents at fair value on a recurring basis. The Company classifies its cash equivalents within Level 1 because they are valued using observable inputs that reflect quoted prices for identical assets in active markets and quoted prices directly in active markets.

The Company’s short-term investments held as of March 31, 2022 and 2021 consisted primarily of certificates of deposit held at financial institutions. The amortized cost of these investments, which are classified as Level 2, approximated their fair value.

The following tables present information about the Company’s assets and liabilities that are measured at fair value on a recurring basis using the above input categories (in thousands):

	March 31, 2022
	Level 1		Level 2		Total
Cash and cash equivalents	$	836,444	$	0	$	836,444
Short-term investments	$	0	$	2,544	$	2,544

	December 31, 2021
	Level 1		Level 2		Total
Cash and cash equivalents	$	893,480	$	0	$	893,480
Short-term investments	$	0	$	2,537	$	2,537

There were no transfers between fair value measurement levels during the quarters ended March 31, 2022 and December 31, 2021.

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Leases

3 Months Ended

Mar. 31, 2022

Leases.

Leases

Note 10. Leases

The Company has operating leases for facilities, hosting co-location facilities and certain equipment under non-cancelable leases in the U.S. and various international locations. The leases have remaining lease terms of 1 to 11 years, with options to extend the lease term from 1 to 6 years. At the inception of an arrangement, the Company determines whether the arrangement is or contains a lease based on the arrangement covering the right to use property, plant or equipment for a stated period of time. For new and amended leases beginning in 2020 and after, the Company separately allocates the lease (e.g., fixed lease payments for right-to-use land, building, etc.) and non-lease components (e.g., common area maintenance) for its leases.

Operating Leases

The Company leases office space under non-cancelable operating leases in the U.S. and various international locations. As of March 31, 2022, the future minimum lease payments under non-cancelable operating leases were as follows (in thousands):

	As of March 31,
Operating Leases:	2022
2022	$	15,023
2023		14,261
2024		9,634
2025		7,197
2026		5,822
2027 and thereafter		12,638
Total future minimum payments	$	64,575

The Company rents certain information systems to selected qualified customers under arrangements that qualify as either sales-type lease or operating lease arrangements. Leases have terms that generally range from 2 to 5 years.

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Convertible Senior Notes

3 Months Ended

Mar. 31, 2022

Convertible Senior Notes

Convertible Senior Notes

Note 11. Convertible Senior Notes

Outstanding Convertible Senior Notes

As of March 31, 2022, the Company had three series of convertible senior notes outstanding. The issuances of such notes originally consisted of (i) $1.0 billion aggregate principal amount of 1.25% convertible senior notes due 2027 (the “2027 Notes”), issued on May 19, 2020 for net proceeds to the Company of $975.9 million after deducting offering costs of approximately $24.1 million, (ii) $287.5 million aggregate principal amount of 1.375% convertible senior notes due 2025 (the “2025 Notes”), issued on May 8, 2018 for net proceeds to the Company of $279.1 million after deducting offering costs of approximately $8.4 million, and (iii) $550.0 million aggregate principal amount of 0.875% convertible senior notes due 2025 that were issued by Livongo on June 4, 2020 for which the Company has agreed to guarantee Livongo’s obligations (the “Livongo Notes;” and together with the 2027 Notes, the 2025 Notes and the 2022 Notes (as defined below), the “Notes”). On June 27, 2017, the Company issued, at par value, $275.0 million aggregate principal amount of 3% convertible senior notes due 2022 (the “2022 Notes”), which were redeemed during the quarter ended March 31, 2021 as described below.

The following table presents certain terms of the Notes that were outstanding as of March 31, 2022:

	2027 Notes			2025 Notes			Livongo Notes
Interest Rate Per Year		1.25	%		1.375	%		0.875	%
Fair Value as of March 31, 2022 (in millions) (1)	$	843.5		$	1.0		$	553.3
Fair Value as of December 31, 2021 (in millions) (1)	$	940.0		$	1.3		$	605.0
Maturity Date		June 1, 2027			May 15, 2025			June 1, 2025
Optional Redemption Date		June 5, 2024			May 22, 2022			June 5, 2023
Conversion Date		December 1, 2026			November 15, 2024			March 1, 2025
Share Conversion Rate Per $1,000 Principal Amount as of March 31, 2022		4.1258			18.6621			13.94
Remaining Contractual Life as of March 31, 2022		5.2 years			3.1 years			3.2 years

(1) The Notes are classified as Level 1 within the fair value hierarchy, as defined in Note 9.

All of the Notes are unsecured obligations of the Company and rank senior in right of payment to the Company’s indebtedness that is expressly subordinated in right of payment to such Notes; equal in right of payment to the Company’s liabilities that are not so subordinated; effectively junior in right of payment to any of the Company’s secured indebtedness to the extent of the value of the assets securing such indebtedness; and structurally junior to all indebtedness and other liabilities incurred by the Company’s subsidiaries.

Holders may convert all or any portion of their Notes in integral multiples of $1,000 principal amount, at their option, at any time prior to the close of business on the business day immediately preceding the applicable conversion date only under the following circumstances:

● during any quarter (and only during such quarter), if the last reported sale price of the shares of Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on the last trading day of the immediately preceding quarter is greater than or equal to 130% of the conversion price for the applicable Notes on each applicable trading day;

● during the five business day period after any ten consecutive trading day period (or five consecutive trading day period in the case of the Livongo Notes) in which the trading price was less than 98% of the product of the last reported sale price of Company’s common stock and the conversion rate for the applicable Notes on each such trading day;

● upon the occurrence of specified corporate events described under the applicable indenture; or

● if the Company calls the applicable Notes for redemption, at any time until the close of business on the second business day immediately preceding the redemption date.

On or after the applicable conversion date, until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of such Notes, regardless of the foregoing circumstances.

The 2027 Notes and the 2025 Notes are convertible into shares of the Company’s common stock at the applicable conversion rate shown in the table above. Upon conversion, the Company will pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and shares of the Company’s common stock or units of reference property, the amount of cash and shares of the Company’s common stock due upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 25 consecutive trading day observation period.

The Livongo Notes are convertible at the applicable conversion rate shown in the table above into “units of reference property,” each of which is comprised of 0.5920 of a share of the Company’s common stock and $4.24 in cash, without interest. Upon conversion, the Company will pay or deliver, as the case may be, cash, units of reference property, or a combination thereof, at the Company’s election. If the Company elects to satisfy the conversion obligation solely in cash or through payment and delivery, as the case may be, of a combination of cash and units of reference property, the amount of cash and units of reference property, if any, due upon conversion will be based on a daily conversion value calculated on a proportionate basis for each trading day in a 40 consecutive trading day observation period.

For each Note series, the Company may redeem for cash all or part of the Notes, at its option, on or after the applicable optional redemption date shown in the table above (and prior to the 41st scheduled trading day immediately preceding the maturity date in the case of the Livongo Notes) if the last reported sale price of its common stock exceeds 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading days ending on, and including, the trading day immediately preceding the date on which the Company provides notice of the redemption. The redemption price will be the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any. In addition, calling any 2027 Note or 2025 Note for redemption on or after the applicable optional redemption date will constitute a make-whole fundamental change with respect to that Note, in which case the conversion rate applicable to the conversion of that Note, if it is converted in connection with the redemption, will be increased in certain circumstances as described in the applicable indenture. If Livongo undergoes a fundamental change (as defined in the applicable indenture) at any time prior to the maturity date, holders will have the right, at their option, to require Livongo to repurchase for cash all or any portion of their Livongo Notes at a fundamental change repurchase price equal to 100% of the principal amount of the Livongo Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date.

Following the adoption of ASU 2020-06 on January 1, 2022 as described in Note 2, the Company accounts for each Note series at amortized cost within the liability section of its condensed consolidated balance sheets. The Company has reserved an aggregate of 8.7 million shares of common stock for the Notes.

The net carrying values of the Notes consisted of the following (in thousands):

	As of March 31,		As of December 31,
2027 Notes	2022		2021
Principal	$	1,000,000	$	1,000,000
Less: Debt discount, net (1)		(17,940)		(250,846)
Net carrying amount	$	982,060	$	749,154
2025 Notes
Principal	$	730	$	730
Less: Debt discount, net (1)		(10)		(166)
Net carrying amount	$	720	$	564
Livongo Notes
Principal	$	550,000	$	550,000
Less: Debt discount, net (1)		0		(74,047)
Net carrying amount	$	550,000	$	475,953

(1) Included in the accompanying condensed consolidated balance sheet within convertible senior notes and amortized to interest expense over the expected life of the Notes using the effective interest rate method.

The following table sets forth total interest expense recognized related to the Notes (in thousands):

		Quarter Ended
		March 31,
2027 Notes:		2022		2021
Contractual interest expense	$	3,125		$	3,125
Amortization of debt discount		831			9,059
Total	$	3,956		$	12,184
Effective interest rate		0.8	%		3.4	%
	Quarter Ended
	March 31,
2025 Notes:		2022		2021
Contractual interest expense	$	3		$	814
Amortization of debt discount		1			2,719
Total	$	4		$	3,533
Effective interest rate		0.9	%		3.9	%
	Quarter Ended
	March 31,
Livongo Notes:		2022		2021
Contractual interest expense	$	1,203		$	1,203
Amortization of debt discount		0			4,734
Total	$	1,203		$	5,937
Effective interest rate		0	%		5.2	%
	Quarter Ended
	March 31,
2022 Notes:		2022		2021
Contractual interest expense	$	0		$	104
Amortization of debt discount		0			316
Total	$	0		$	420
Effective interest rate		0	%		9.6	%

Conversions of Convertible Senior Notes Due 2025

Certain holders of the 2025 Notes converted their 2025 Notes in exchange for 1.1 million shares of the Company’s common stock during the quarter ended March 31, 2021. As a result, the Company recorded a charge associated with the loss on extinguishment of debt of $8.1 million during the quarter ended March 31, 2021.

Redemption of Convertible Senior Notes Due 2022

In March 2021, the Company completed a redemption of all of the then outstanding 2022 Notes in exchange for approximately $0.1 million in cash (including accrued and unpaid interest). Prior to that redemption, certain holders of the 2022 Notes converted their 2022 Notes in exchange for 1.1 million shares of the Company’s common stock during the quarter ended March 31, 2021. As a result of the redemption and conversions, the Company recorded a charge associated with the loss on extinguishment of debt of $3.4 million during the quarter ended March 31, 2021.

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Advances from Financing Companies

3 Months Ended

Mar. 31, 2022

Advances from Financing Companies

Advances from Financing Companies

Note 12. Advances from Financing Companies

The Company utilizes a third-party financing company to provide certain Clients with a rental option. The principal portion of these up-front payments are reported as advances from financing companies in the accompanying condensed consolidated balance sheet. Interest rates applicable to the outstanding advances as of March 31, 2022 ranged from 3.35% to 8.25%.

Client lease payments to third party financing companies will reduce the advances from financing companies as of March 31, 2022 by year as follows (in thousands):

	As of March 31,
	2022
2022	$	10,105
2023		8,024
2024		2,678
2025		109
Total	$	20,916

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Legal Matters

3 Months Ended

Mar. 31, 2022

Legal Matters

Legal Matters

Note 13. Legal Matters

From time to time, Teladoc Health is involved in various litigation matters arising in the normal course of business, including the matters described below. The Company consults with legal counsel on those issues related to litigation and seeks input from other experts and advisors with respect to such matters. Estimating the probable losses or a range of probable losses resulting from litigation, government actions and other legal proceedings is inherently difficult and requires an extensive degree of judgment, particularly where the matters involve indeterminate claims for monetary damages, may involve discretionary amounts, present novel legal theories, are in the early stages of the proceedings, or are subject to appeal. Whether any losses, damages or remedies ultimately resulting from such matters could reasonably have a material effect on the Company’s business, financial condition, results of operations, or cash flows will depend on a number of variables, including, for example, the timing and amount of such losses or damages (if any) and the structure and type of any such remedies. As of the date of these financial statements, Teladoc Health’s management does not expect any litigation matter to have a material adverse impact on its business, financial condition, results of operations or cash flows.

On May 14, 2018, a purported class action complaint (Thomas v. Best Doctors, Inc.) was filed in the United States District Court for the District of Massachusetts against the Company’s wholly owned subsidiary, Best Doctors, Inc. The complaint alleges that on or about May 16, 2017, Best Doctors violated the U.S. Telephone Consumer Protection Act (the “TCPA”) by sending unsolicited facsimiles to plaintiff and certain other recipients without the recipients’ prior express invitation or permission. The lawsuit seeks statutory damages for each violation, subject to trebling under the TCPA, and injunctive relief. The Company will vigorously defend the lawsuit and any potential loss is currently deemed to be immaterial.

On August 27, 2021, a purported securities class action complaint (City of Hialeah Employees’ Retirement System v. Teladoc Health, Inc., et.al.) was filed in the Circuit Court of Cook County, Illinois against the Company and

certain of the Company’s current and former officers and directors. The complaint was brought on behalf of a purported class consisting of all persons who acquired shares of Teladoc Health common stock issued in the Livongo merger. The complaint asserted violations of Sections 11, 12(a)(2) and 15 of the Securities Act of 1933 based on allegedly false or misleading statements and omissions with respect to the registration statement and prospectus filed in connection with the Livongo merger. The complaint sought certification as a class action, unspecified compensatory damages plus interest and attorneys’ fees, rescission or a rescissory measure of damages and equitable or other relief. On January 18, 2022, the case was voluntarily dismissed without prejudice in the Circuit Court of Cook County, Illinois and on January 26, 2022, was refiled in the Supreme Court of the State of New York. The refiled case includes substantially the same allegations. The Company believes that these claims are without merit, and the Company and its named current and former officers and directors intend to defend the Company vigorously.

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Common Stock and Stockholders' Equity

3 Months Ended

Mar. 31, 2022

Common Stock and Stockholders'Equity

Common Stock and Stockholders' Equity

Note 14. Common Stock and Stockholders’ Equity

Capitalization

Effective October 30, 2020, the authorized number of shares of the Company’s common stock was increased from 150,000,000 to 300,000,000 shares.

Warrants

The Company had no warrants outstanding as of March 31, 2022 or December 31, 2021.

Stock Plans

The Company’s 2015 Incentive Award Plan, 2017 Employment Inducement Incentive Award Plan and Livongo Acquisition Incentive Award Plan (collectively, the “Plans”) provide for the issuance of incentive and non-statutory options and other equity-based awards to its employees and non-employee service providers.

All stock-based awards to employees are measured based on the grant-date fair value or replacement grant date fair value in relation to the Livongo transaction, and are generally recognized on a straight line basis in the Company’s condensed consolidated statement of operations over the period during which the employee is required to perform services in exchange for the award (generally requiring a four-year vesting period for each stock option and a three-year vesting period for each restricted stock unit (“RSU”)).

Stock Options

Options issued under the Plans are exercisable for periods not to exceed ten years, and vest and contain such other terms and conditions as specified in the applicable award document. Options to buy common stock are issued under the Plans, with exercise prices equal to the closing price of shares of the Company’s common stock on the New York Stock Exchange on the date of award. The Company had 10,218,931 shares available for grant at March 31, 2022.

Activity under the Plans was as follows (in thousands, except share and per share amounts and years):

				Weighted-
		Weighted-		Average
	Number of	Average		Remaining	Aggregate
	Shares	Exercise		Contractual	Intrinsic
	Outstanding	Price		Life in Years	Value
Balance at December 31, 2021	3,426,978	$	22.88	5.32	$	242,569
Stock option grants	45,434	$	79.40	N/A
Stock options exercised	(267,586)	$	13.40	N/A	$	(15,090)
Stock options forfeited	(15,767)	$	19.63	N/A
Balance at March 31, 2022	3,189,059	$	24.50	5.16	$	160,501
Vested or expected to vest at March 31, 2022	3,189,059	$	24.50	8.35	$	2,352
Exercisable at March 31, 2022	3,011,138	$	20.36	4.97	$	158,148

The total grant-date fair value of stock options granted during the quarters ended March 31, 2022 and 2021 were $1.6 million and $0.4 million, respectively.

The Company estimates the fair value of stock options granted using the Black Scholes option pricing model.

The assumptions used in the Black-Scholes option-pricing model are determined as follows:

Volatility. The expected volatility was derived from the historical stock volatilities of the Company’s stock volatility over a period equivalent to the expected term of the stock option grants.

Expected Term. The expected term represents the period that the stock-based awards are expected to be outstanding. When establishing the expected term assumption, the Company utilizes historical data.

Risk-Free Interest Rate. The risk-free interest rate is based on U.S. Treasury zero-coupon issues with terms similar to the expected term on the options.

Dividend Yield. The Company has never declared or paid any cash dividends and does not plan to pay cash dividends in the foreseeable future, and therefore, it used an expected dividend yield of zero.

Forfeiture rate. The Company recognizes forfeitures as they occur.

The fair value of each option grant was estimated on the date of grant using the Black-Scholes option-pricing model with the following assumptions and fair value per share:

	Quarter Ended March 31,
	2022		2021
Volatility		56.69% - 57.86%		57.02% - 57.49%
Expected term (in years)		4.1		4.1
Risk-free interest rate		1.13% - 1.52%		0.31% - 0.51%
Dividend yield		0		0
Weighted-average fair value of underlying stock options	$	$35.94	$	$107.06

For the quarters ended March 31, 2022 and 2021, the Company recorded compensation expense related to stock options of $10.7 million and $28.2 million, respectively.

As of March 31, 2022, the Company had $10.9 million in unrecognized compensation cost related to non-vested stock options, which is expected to be recognized over a weighted-average period of approximately 1.9 years.

Restricted Stock Units

The fair value of RSUs is determined on the date of grant. The Company records compensation expense in the condensed consolidated statement of operations on a straight-line basis over the vesting period for RSUs. The vesting period for employees and members of the Board of Directors ranges from one to four years.

Activity under RSUs was as follows:

		Weighted-Average
		Grant Date
	RSUs	Fair Value Per RSU
Balance at December 31, 2021	2,133,501	$	168.43
Granted	2,433,620	$	74.74
Vested and issued	(499,486)	$	146.13
Forfeited	(153,581)	$	153.09
Balance at March 31, 2022	3,914,054	$	113.99
Vested and unissued at March 31, 2022	16,507	$	71.96
Non-vested at March 31, 2022	3,897,547	$	113.99

The total grant-date fair value of RSUs granted during the quarters ended March 31, 2022 and 2021 was $181.9 million and $88.0 million, respectively.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to RSUs of $44.5 million and $50.9 million, respectively.

As of March 31, 2022, the Company had $407.8 million in unrecognized compensation cost related to non-vested RSUs, which is expected to be recognized over a weighted-average period of approximately 2.3 years.

Performance Stock Units

Stock-based compensation costs associated with the Company’s performance stock units (“PSUs”) are initially determined using the fair market value of the Company's common stock on the date the awards are approved by the Compensation Committee of the Board of Directors (service inception date). The vesting of these PSUs is subject to certain performance conditions and a service requirement ranging from 1 to 3 years. Until the performance conditions are met, stock compensation costs associated with these PSUs are re-assessed each reporting period based upon the estimated performance attainment on the reporting date. The ultimate number of PSUs that are issued to an employee is the result of the actual performance of the Company at the end of the performance period compared to the performance targets and generally range from 25% to 200% of the initial grant. Stock compensation expense for PSUs is recognized on an accelerated tranche by tranche basis for performance-based awards. Forfeitures are accounted for at the time they occur consistent with Company policy.

Activity under PSUs was as follows:

		Weighted-Average
		Grant Date
	Shares	Fair Value Per PSU
Balance at December 31, 2021	356,249	$	140.01
Granted	420,274	$	74.21
Vested and issued	(197,849)	$	109.03
Balance at March 31, 2022	578,674	$	106.35
Vested and unissued at March 31, 2022	0	$	0
Non-vested at March 31, 2022	578,674	$	106.35

The total grant-date fair value of PSUs granted during the quarter ended March 31, 2022 and 2021 was $30.1 million and $67.9 million, respectively.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to PSUs of $7.3 million and $7.2 million, respectively.

As of March 31, 2022, the Company had $26.9 million in unrecognized compensation cost related to non-vested PSUs, which is expected to be recognized over a weighted-average period of approximately 2.3 years.

Employee Stock Purchase Plan

In July 2015, the Company adopted the 2015 Employee Stock Purchase Plan (“ESPP”) in connection with its initial public offering. A total of 1,019,726 shares of common stock were reserved for issuance under this plan as of March 31, 2022. The Company’s ESPP permits eligible employees to purchase common stock at a discount through payroll deductions during defined offering periods. Under the ESPP, the Company may specify offerings with durations of not more than 27 months and may specify shorter purchase periods within each offering. Each offering will have one or more purchase dates on which shares of its common stock will be purchased for employees participating in the offering. An offering may be terminated under certain circumstances. The price at which the stock is purchased is equal to the lower of 85% of the fair market value of the common stock at the beginning of an offering period or on the date of purchase.

During the quarters ended March 31, 2022 and 2021, the Company did not issue any shares under the ESPP. As of March 31, 2022, 570,661 shares remained available for issuance.

For the quarters ended March 31, 2022 and 2021, the Company recorded stock-based compensation expense related to the ESPP of $1.5 million and $2.2 million, respectively.

As of March 31, 2022, the Company had $0.6 million in unrecognized compensation cost related to the ESPP, which is expected to be recognized over a weighted-average period of approximately 0.1 year.

Total compensation costs for stock-based awards were recorded as follows (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Cost of revenue (exclusive of depreciation and amortization, which is shown separately)	$	2,196	$	2,362
Advertising and marketing		3,711		5,082
Sales		12,071		21,167
Technology and development		18,087		26,726
General and administrative		24,371		30,963
Total stock-based compensation expense (1)	$	60,436	$	86,300

(1) Excluding the amount capitalized related to internal software development projects.

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Income Taxes

3 Months Ended

Mar. 31, 2022

Income Taxes

Income Taxes

Note 15. Income Taxes

The Company recorded income tax expense of $0.4 million for the quarter ended March 31, 2022.

For the quarter ended March 31, 2022, the Company recognized a reversal of $15.3 million of the net deferred tax liability associated with the convertible senior notes upon the adoption of ASU 2020-06, recorded entirely through the balance sheet.

The Company’s income tax expense for the quarter ended March 31, 2021 of $87.0 million primarily was related to additional valuation allowance recorded on excess stock compensation associated with the Livongo merger.

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Basis of Presentation and Principles of Consolidations (Policies)

3 Months Ended

Mar. 31, 2022

Basis Of Presentation And Principles Of Consolidation

Basis of Presentation and Principles of Consolidation

The accompanying unaudited condensed consolidated financial statements for the three months ended March 31, 2022 and 2021, in the opinion of management, reflect all adjustments (consisting of normal recurring accruals) necessary for a fair presentation of the condensed consolidated results of operations, financial position and cash flows of Teladoc Health for the periods presented. However, the financial results for interim periods are not necessarily indicative of the results that may be expected for a full fiscal year or for any other future period.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles (“GAAP”) in the United States (“U.S.”) have been omitted or condensed pursuant to the rules and regulations of the U.S. Securities and Exchange Commission (“SEC”). The information in this report should be read in conjunction with the Company’s Annual Report on Form 10-K filed with the SEC for the fiscal year ended December 31, 2021 (the “2021 Form 10-K”), which includes a complete set of footnote disclosures, including the Company’s significant accounting policies.

These financial statements include the results of Teladoc Health, as well as three professional associations and twelve professional corporations (collectively, the “THMG Association”). All intercompany transactions and balances have been eliminated. Certain prior year amounts have been reclassified to conform to the current year presentation.

Teladoc Health Medical Group, P.A., formerly Teladoc Physicians, P.A. (“THMG”) is party to several Services Agreements by and among it and the professional associations and professional corporations pursuant to which each professional association and professional corporation provides services to THMG. Each professional association and professional corporation is established pursuant to the requirements of its respective domestic jurisdiction governing the corporate practice of medicine.

The Company holds a variable interest in the THMG Association which contracts with physicians and other health professionals in order to provide services to the Company. The THMG Association is considered a variable interest entity (“VIE”) since it does not have sufficient equity to finance its activities without additional subordinated financial support. An enterprise having a controlling financial interest in a VIE must consolidate the VIE if it has both power and benefits—that is, it has (1) the power to direct the activities of a VIE that most significantly impact the VIE’s economic performance (power) and (2) the obligation to absorb losses of the VIE that potentially could be significant to the VIE or the right to receive benefits from the VIE that potentially could be significant to the VIE (benefits). The Company has the power and rights to control all activities of the THMG Association and funds and absorbs all losses of the VIE and appropriately consolidates the THMG Association.

Total revenue and net income (loss) for the VIE were $60.1 million and $2.3 million, and $54.2 million and $1.2 million, for the quarters ended March 31, 2022 and 2021, respectively. The VIE’s total assets, all of which were current, were $33.1 million and $58.5 million at March 31, 2022 and December 31, 2021, respectively. The VIE’s total liabilities, all of which were current, were $71.5 million and $94.7 million at March 31, 2022 and December 31, 2021,

respectively. The VIE’s total stockholders’ deficit was $38.4 million and $36.1 million at March 31, 2022 and December 31, 2021, respectively.

Business Combinations

Business Combinations

The Company accounts for its business combinations using the acquisition method of accounting. The purchase price is attributed to the fair value of the assets acquired and liabilities assumed. Transaction costs directly attributable to the acquisition are expensed as incurred. Identifiable assets and liabilities acquired or assumed are measured separately at their fair values as of the acquisition date. The excess of the purchase price of acquisition over the fair value of the identifiable net assets of the acquiree is recorded as goodwill. The results of businesses acquired in a business combination are included in the Company’s condensed consolidated financial statements from the date of acquisition.

When the Company issues stock-based or cash awards to an acquired company’s stockholders, the Company evaluates whether the awards are consideration or compensation for post-acquisition services. The evaluation includes, among other things, whether the vesting of the awards is contingent on the continued employment of the acquired company’s stockholders beyond the acquisition date. If continued employment is required for vesting, the awards are treated as compensation for post-acquisition services and recognized as expense over the requisite service period.

Determining the fair value of assets acquired and liabilities assumed requires management to use significant judgment and estimates, including the selection of valuation methodologies, estimates of future revenue and cash flows, discount rates and selection of comparable companies. The estimates and assumptions used to determine the fair values and useful lives of identified intangible assets could change due to numerous factors, including market conditions, technological developments, economic conditions, and competition. In connection with determination of fair values, the Company may engage a third-party valuation specialist to assist with the valuation of intangible and certain tangible assets acquired and certain assumed obligations. Acquisition-related transaction costs incurred by the Company are not included as a component of consideration transferred but are accounted for as an operating expense in the period in which the costs are incurred.

Use of Estimates

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. The Company bases its estimates on historical experience, current business and economic factors, and various other assumptions that the Company believes are necessary to form a basis for making judgments about the carrying values of assets and liabilities, the recorded amounts of revenue and expenses, and the disclosure of contingent assets and liabilities. The Company is subject to uncertainties such as the impact of future events, economic and political factors, and changes in the Company’s business environment; therefore, actual results could differ from these estimates. Accordingly, the accounting estimates used in the preparation of the Company’s condensed consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained and as the Company’s operating environment evolves. The Company believes that estimates used in the preparation of these condensed consolidated financial statements are reasonable; however, actual results could differ materially from these estimates.

Changes in estimates are made when circumstances warrant. Such changes in estimates and refinements in estimation methodologies are reflected in reported results of operations; if material, the effects of changes in estimates are disclosed in the notes to the condensed consolidated financial statements.

Significant estimates and assumptions by management affect areas including the carrying value and useful life of long-lived assets (including intangible assets), the carrying value of goodwill, the capitalization and amortization of software development costs, deferred costs, the allowance for doubtful accounts, and the accounting for business combinations. Other significant areas include revenue recognition (including performance guarantees, the accounting for income taxes, contingences, litigation and related legal accruals, and the accounting for stock-based compensation awards, and other items as described in the Summary of Significant Accounting policies in this Quarterly Report and in the 2021 Form 10-K.

Recently Adopted Accounting Standards

Recently Adopted Accounting Standards

In August 2020, the financial accounting standards board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06—"Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity.” ASU 2020-06 simplifies the accounting for convertible instruments by eliminating the conversion option separation model for convertible debt that can be settled in cash and by eliminating the measurement model for beneficial conversion features. Convertible instruments that continue to be subject to separation models are (1) those with conversion options that are required to be accounted for as bifurcated derivatives and (2) convertible debt instruments issued with substantial premiums for which the premiums are recorded as paid-in capital. This ASU also requires entities to use the if-converted method for all convertible instruments in the diluted earnings per share calculation and include the effect of share settlement for instruments that may be settled in cash or shares, except for certain liability-classified share-based payment awards.

The Company adopted ASU 2020-06 as of January 1, 2022, under the modified retrospective transition method, and accordingly, its prior period financial statements were not restated. Upon adoption of ASU 2020-06, the conversion feature of the Company’s convertible senior notes is no longer reported as a component of equity. Instead, the previously-separated equity component is now combined with the liability component, thereby eliminating the amortization of the debt discount arising from the conversion option separation model. As such, the Company currently anticipates a reduction of approximately $58 million in non-cash interest to be recorded on its convertible senior notes for the year ended December 31, 2022, as compared to the year ended December 31, 2021. To reflect the adoption of ASU 2020-06, the Company recorded an increase to convertible senior notes of $306.3 million and decreases to additional paid-in capital, accumulated deficit and net deferred tax liabilities of $363.7 million, $72.7 million and $15.3 million, respectively, as of January 1, 2022.

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs (Tables)

3 Months Ended

Mar. 31, 2022

Revenue, Deferred Revenue, and Deferred Device and Contract Costs

Schedule of disaggregation of revenue

	Quarter Ended
	March 31,
	2022		2021
Access Fees Revenue
U.S.	$	421,146	$	327,553
International		70,191		54,553
Total		491,337		382,106
Visit Fee Revenue
U.S.		64,473		57,128
International		3,455		3,383
Total		67,928		60,511
Other
U.S.		5,581		10,671
International		504		387
Total		6,085		11,058
Total Revenues	$	565,350	$	453,675

Schedule of deferred device and contract costs

Deferred device and contract costs are classified as a component of Prepaid expenses and other current assets or Other assets depending on term, and consisted of the following as of March 31, 2022 (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Deferred device and contract costs, current	$	27,335	$	22,304
Deferred device and contract costs, noncurrent		7,636		6,249
Total deferred device and contract costs	$	34,971	$	28,553

Deferred costs and other activity were as follows (in thousands):

	Deferred Device and Contract Costs
Beginning balance as of December 31, 2021	$	28,553
Additions		13,986
Cost of revenue recognized		(7,568)
Ending balance as of March 31, 2022	$	34,971

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Inventories (Tables)

3 Months Ended

Mar. 31, 2022

Inventories

Schedule of inventories

Inventories consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Raw materials and purchased parts	$	25,006	$	26,164
Work in process		379		313
Finished goods		45,269		46,602
Total inventories	$	70,654	$	73,079

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Prepaid Expenses and Other Current Assets (Tables)

3 Months Ended

Mar. 31, 2022

Prepaid Expenses and Other Current Assets

Schedule Of Prepaid Expenses and Other Current Assets

	As of March 31,		As of December 31,
	2022		2021
Prepaid expenses	$	51,397	$	38,179
Deferred device and contract costs, current		27,335		22,304
Other receivables		22,817		21,170
Other current asset		5,326		5,734
Total prepaid expenses and other current assets	$	106,875	$	87,387

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Intangible Assets, Net (Tables)

3 Months Ended

Mar. 31, 2022

Intangible Assets, Net

Schedule of finite lived intangible assets

Intangible assets, net consist of the following (in thousands):

								Weighted
								Average
								Remaining
	Useful			Accumulated		Net Carrying		Useful Life
	Life	Gross Value		Amortization		Value		(Years)
March 31, 2022
Client relationships	2 to 20 years	$	1,463,335	$	(222,285)	$	1,241,050	14.3
Trademarks	2 to 15 years		325,958		(58,823)		267,135	7.4
Software	3 to 5 years		155,456		(45,101)		110,355	2.8
Technology	5 to 7 years		343,310		(77,953)		265,357	5.3
Intangible assets, net		$	2,288,059	$	(404,162)	$	1,883,897	11.4
December 31, 2021
Client relationships	2 to 20 years	$	1,465,926	$	(199,866)	$	1,266,060	14.5
Trademarks	3 to 15 years		326,392		(45,555)		280,837	9.5
Software	3 to 5 years		126,188		(40,767)		85,421	2.7
Technology	5 to 7 years		343,262		(65,302)		277,960	5.6
Intangible assets, net		$	2,261,768	$	(351,490)	$	1,910,278	12.0

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Goodwill (Tables)

3 Months Ended

Mar. 31, 2022

Goodwill

Summary of goodwill

Goodwill consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Beginning balance as of December 31, 2021 and 2020, respectively	$	14,504,174	$	14,581,255
Impairment		(6,600,000)		0
Additions associated with acquisitions		0		64,269
Purchase consideration adjustments net of deferred tax impacts		0		(122,306)
Currency translation adjustment		(4,379)		(19,044)
Ending balance as of March 31, 2022 and December 31, 2021	$	7,899,795	$	14,504,174

Schedule of significant inputs used in goodwill impairment analysis on each testing date

Testing dates	Discount Rate	Peer Group Revenue Multiples (current year/subsequent year)	% Excess of Reporting Unit Fair Value over Carrying Value
December 1, 2021	10.5%	7.0x/5.5x	15.0%
March 31, 2022	12.0%	3.0x/2.5x	0% post impairment

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Accrued Expenses and Other Current Liabilities (Tables)

3 Months Ended

Mar. 31, 2022

Accrued Expenses and Other Current Liabilities

Schedule of accrued expenses and other current liabilities

Accrued expenses and other current liabilities consisted of the following (in thousands):

	As of March 31,		As of December 31,
	2022		2021
Professional fees	$	5,485	$	5,373
Consulting fees/provider fees		18,029		19,292
Client performance guarantees		10,034		7,653
Interest payable		5,809		1,480
Income tax payable		5,131		3,098
Insurance		5,779		3,884
Marketing		6,104		3,471
Operating lease liabilities - current		13,052		12,687
Franchise and sales taxes		11,429		9,965
Device replacement cost		5,913		6,263
Other		29,924		29,767
Total	$	116,689	$	102,933

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Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2022

Fair Value Measurements

Schedule assets and liabilities measured at fair value on a recurring basis

The following tables present information about the Company’s assets and liabilities that are measured at fair value on a recurring basis using the above input categories (in thousands):

	March 31, 2022
	Level 1		Level 2		Total
Cash and cash equivalents	$	836,444	$	0	$	836,444
Short-term investments	$	0	$	2,544	$	2,544

	December 31, 2021
	Level 1		Level 2		Total
Cash and cash equivalents	$	893,480	$	0	$	893,480
Short-term investments	$	0	$	2,537	$	2,537

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Leases (Tables)

3 Months Ended

Mar. 31, 2022

Leases.

Schedule of future minimum lease payments

	As of March 31,
Operating Leases:	2022
2022	$	15,023
2023		14,261
2024		9,634
2025		7,197
2026		5,822
2027 and thereafter		12,638
Total future minimum payments	$	64,575

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Convertible Senior Notes (Tables)

3 Months Ended

Mar. 31, 2022

Convertible Senior Notes

Summary of the Notes

	2027 Notes			2025 Notes			Livongo Notes
Interest Rate Per Year		1.25	%		1.375	%		0.875	%
Fair Value as of March 31, 2022 (in millions) (1)	$	843.5		$	1.0		$	553.3
Fair Value as of December 31, 2021 (in millions) (1)	$	940.0		$	1.3		$	605.0
Maturity Date		June 1, 2027			May 15, 2025			June 1, 2025
Optional Redemption Date		June 5, 2024			May 22, 2022			June 5, 2023
Conversion Date		December 1, 2026			November 15, 2024			March 1, 2025
Share Conversion Rate Per $1,000 Principal Amount as of March 31, 2022		4.1258			18.6621			13.94
Remaining Contractual Life as of March 31, 2022		5.2 years			3.1 years			3.2 years

The net carrying values of the Notes consisted of the following (in thousands):

	As of March 31,		As of December 31,
2027 Notes	2022		2021
Principal	$	1,000,000	$	1,000,000
Less: Debt discount, net (1)		(17,940)		(250,846)
Net carrying amount	$	982,060	$	749,154
2025 Notes
Principal	$	730	$	730
Less: Debt discount, net (1)		(10)		(166)
Net carrying amount	$	720	$	564
Livongo Notes
Principal	$	550,000	$	550,000
Less: Debt discount, net (1)		0		(74,047)
Net carrying amount	$	550,000	$	475,953

Schedule of total interest expense recognized related to the Notes

The following table sets forth total interest expense recognized related to the Notes (in thousands):

		Quarter Ended
		March 31,
2027 Notes:		2022		2021
Contractual interest expense	$	3,125		$	3,125
Amortization of debt discount		831			9,059
Total	$	3,956		$	12,184
Effective interest rate		0.8	%		3.4	%
	Quarter Ended
	March 31,
2025 Notes:		2022		2021
Contractual interest expense	$	3		$	814
Amortization of debt discount		1			2,719
Total	$	4		$	3,533
Effective interest rate		0.9	%		3.9	%
	Quarter Ended
	March 31,
Livongo Notes:		2022		2021
Contractual interest expense	$	1,203		$	1,203
Amortization of debt discount		0			4,734
Total	$	1,203		$	5,937
Effective interest rate		0	%		5.2	%
	Quarter Ended
	March 31,
2022 Notes:		2022		2021
Contractual interest expense	$	0		$	104
Amortization of debt discount		0			316
Total	$	0		$	420
Effective interest rate		0	%		9.6	%

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Advances from Financing Companies (Tables)

3 Months Ended

Mar. 31, 2022

Advances from Financing Companies

Schedule of client lease payments to third party financing companies

Client lease payments to third party financing companies will reduce the advances from financing companies as of March 31, 2022 by year as follows (in thousands):

	As of March 31,
	2022
2022	$	10,105
2023		8,024
2024		2,678
2025		109
Total	$	20,916

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Common Stock and Stockholders' Equity (Tables)

3 Months Ended

Mar. 31, 2022

Common Stock and Stockholders'Equity

Summary of stock option activity under the Plan

Activity under the Plans was as follows (in thousands, except share and per share amounts and years):

				Weighted-
		Weighted-		Average
	Number of	Average		Remaining	Aggregate
	Shares	Exercise		Contractual	Intrinsic
	Outstanding	Price		Life in Years	Value
Balance at December 31, 2021	3,426,978	$	22.88	5.32	$	242,569
Stock option grants	45,434	$	79.40	N/A
Stock options exercised	(267,586)	$	13.40	N/A	$	(15,090)
Stock options forfeited	(15,767)	$	19.63	N/A
Balance at March 31, 2022	3,189,059	$	24.50	5.16	$	160,501
Vested or expected to vest at March 31, 2022	3,189,059	$	24.50	8.35	$	2,352
Exercisable at March 31, 2022	3,011,138	$	20.36	4.97	$	158,148

Assumptions used for estimate of fair value of options

	Quarter Ended March 31,
	2022		2021
Volatility		56.69% - 57.86%		57.02% - 57.49%
Expected term (in years)		4.1		4.1
Risk-free interest rate		1.13% - 1.52%		0.31% - 0.51%
Dividend yield		0		0
Weighted-average fair value of underlying stock options	$	$35.94	$	$107.06

Schedule of activity under the RSUs

Activity under RSUs was as follows:

		Weighted-Average
		Grant Date
	RSUs	Fair Value Per RSU
Balance at December 31, 2021	2,133,501	$	168.43
Granted	2,433,620	$	74.74
Vested and issued	(499,486)	$	146.13
Forfeited	(153,581)	$	153.09
Balance at March 31, 2022	3,914,054	$	113.99
Vested and unissued at March 31, 2022	16,507	$	71.96
Non-vested at March 31, 2022	3,897,547	$	113.99

Schedule of activity under the PSUs

Activity under PSUs was as follows:

		Weighted-Average
		Grant Date
	Shares	Fair Value Per PSU
Balance at December 31, 2021	356,249	$	140.01
Granted	420,274	$	74.21
Vested and issued	(197,849)	$	109.03
Balance at March 31, 2022	578,674	$	106.35
Vested and unissued at March 31, 2022	0	$	0
Non-vested at March 31, 2022	578,674	$	106.35

Components of operating expense charged for compensation cost expense

Total compensation costs for stock-based awards were recorded as follows (in thousands):

	Quarter Ended
	March 31,
	2022		2021
Cost of revenue (exclusive of depreciation and amortization, which is shown separately)	$	2,196	$	2,362
Advertising and marketing		3,711		5,082
Sales		12,071		21,167
Technology and development		18,087		26,726
General and administrative		24,371		30,963
Total stock-based compensation expense (1)	$	60,436	$	86,300

(1) Excluding the amount capitalized related to internal software development projects.

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Basis of Presentation and Principles of Consolidation - VIE (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($) item	Mar. 31, 2021 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Variable interest entity
Number of professional associations consolidated as VIEs | item	3
Number of professional corporations consolidated as VIEs | item	12
Revenue	$ 565,350	$ 453,675
Net (loss) income	(6,674,523)	(199,649)
Assets	11,092,337		$ 17,734,608
(Equity) deficit	(9,142,610)	(15,829,498)	(16,045,757)	$ (15,883,804)
Primary beneficiary
Variable interest entity
Revenue	60,100	54,200
Net (loss) income	2,300	$ 1,200
Assets	33,100		58,500
Liabilities	71,500		94,700
(Equity) deficit	$ 38,400		$ 36,100

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Basis of Presentation and Principles of Consolidation - Accounting Pronouncements (Details) - USD ($) $ in Thousands		3 Months Ended
	Jan. 01, 2022	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Recently Issued Accounting Pronouncements
Interest expense, net		$ 5,480	$ 22,125
Convertible senior notes, net		1,532,780		$ 1,225,671
Additional paid-in capital		(17,177,152)		(17,473,336)
Accumulated deficit		(8,023,279)		(1,421,454)
Net deferred tax liabilities		$ (57,516)		$ (75,777)
ASU 2020-06 | Cumulative effect adjustment due to adoption of ASU 2020-06
Recently Issued Accounting Pronouncements
Convertible senior notes, net	$ 306,300
Additional paid-in capital	363,700
Accumulated deficit	72,700
Net deferred tax liabilities	15,300
ASU 2020-06 | Cumulative effect adjustment due to adoption of ASU 2020-06 | Pro Forma
Recently Issued Accounting Pronouncements
Interest expense, net	$ 58,000

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs - Other Disclosures (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Product and Service Concentration Risk | Revenue from Contract with Customer | Access Fees Revenue
Revenue, Deferred Revenue, Deferred Costs and Other
Concentration risk (as a percent)	87.00%	84.00%

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs - Disaggregation and Other (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue
Revenue	$ 565,350	$ 453,675
Deferred revenue	87,100	73,200
Net increase in deferred revenue	7,600	18,400
Revenue recognized, included in deferred revenue balance at beginning of period	51,600	32,700
Access Fees Revenue
Revenue
Revenue	491,337	382,106
Access Fees Revenue | United States
Revenue
Revenue	421,146	327,553
Access Fees Revenue | Foreign.
Revenue
Revenue	70,191	54,553
Visit Fee Revenue
Revenue
Revenue	67,928	60,511
Visit Fee Revenue | United States
Revenue
Revenue	64,473	57,128
Visit Fee Revenue | Foreign.
Revenue
Revenue	3,455	3,383
Other
Revenue
Revenue	6,085	11,058
Other | United States
Revenue
Revenue	5,581	10,671
Other | Foreign.
Revenue
Revenue	$ 504	$ 387

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs - Revenue Remaining Performance Obligation (Details) $ in Millions	Mar. 31, 2022 USD ($)
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-04-01
Future Performance Obligations
Revenue recognized, performance obligation	$ 73.0
Period of performance obligation	9 months
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2023-01-01
Future Performance Obligations
Revenue recognized, performance obligation	$ 5.0
Period of performance obligation	1 year

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs - Deferred Cost and Other (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Deferred Device and Contract Costs
Deferred device and contract costs, current	$ 27,335	$ 22,304
Deferred costs and other, noncurrent	7,636	6,249
Total Deferred cost and other	$ 34,971	$ 28,553

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Revenue, Deferred Revenue, and Deferred Device and Contract Costs - Deferred Cost and Other Activity (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($)
Change in Deferred Costs And Other
Beginning balance	$ 28,553
Additions	13,986
Cost of revenue recognized	(7,568)
Ending Balance	$ 34,971

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Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Inventories
Raw materials and purchased parts	$ 25,006	$ 26,164
Work in process	379	313
Finished goods	45,269	46,602
Total inventories	$ 70,654	$ 73,079

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Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Prepaid Expenses and Other Current Assets
Prepaid expenses	$ 51,397	$ 38,179
Deferred device and contract costs, current	27,335	22,304
Other receivables	22,817	21,170
Other current asset	5,326	5,734
Total prepaid expenses and other current assets	$ 106,875	$ 87,387

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Intangible Assets, Net - Summary (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Intangible assets
Gross Value	$ 2,288,059		$ 2,261,768
Accumulated Amortization	(404,162)		(351,490)
Net Carrying Value	1,883,897		$ 1,910,278
Amortization expense for intangible assets	$ 56,600	$ 46,600
Weighted Average
Intangible assets
Weighted Average Remaining Useful Life	11 years 4 months 24 days		12 years
Client relationships
Intangible assets
Gross Value	$ 1,463,335		$ 1,465,926
Accumulated Amortization	(222,285)		(199,866)
Net Carrying Value	$ 1,241,050		$ 1,266,060
Client relationships | Minimum
Intangible assets
Useful life	2 years		2 years
Client relationships | Maximum
Intangible assets
Useful life	20 years		20 years
Client relationships | Weighted Average
Intangible assets
Weighted Average Remaining Useful Life	14 years 3 months 18 days		14 years 6 months
Trademarks
Intangible assets
Gross Value	$ 325,958		$ 326,392
Accumulated Amortization	(58,823)		(45,555)
Net Carrying Value	$ 267,135		$ 280,837
Trademarks | Minimum
Intangible assets
Useful life	2 years		3 years
Trademarks | Maximum
Intangible assets
Useful life	15 years		15 years
Trademarks | Weighted Average
Intangible assets
Weighted Average Remaining Useful Life	7 years 4 months 24 days		9 years 6 months
Capitalized software development costs
Intangible assets
Gross Value	$ 155,456		$ 126,188
Accumulated Amortization	(45,101)		(40,767)
Net Carrying Value	$ 110,355		$ 85,421
Capitalized software development costs | Minimum
Intangible assets
Useful life	3 years		3 years
Capitalized software development costs | Maximum
Intangible assets
Useful life	5 years		5 years
Capitalized software development costs | Weighted Average
Intangible assets
Weighted Average Remaining Useful Life	2 years 9 months 18 days		2 years 8 months 12 days
Technology
Intangible assets
Gross Value	$ 343,310		$ 343,262
Accumulated Amortization	(77,953)		(65,302)
Net Carrying Value	$ 265,357		$ 277,960
Technology | Minimum
Intangible assets
Useful life	5 years
Technology | Maximum
Intangible assets
Useful life	7 years
Technology | Weighted Average
Intangible assets
Weighted Average Remaining Useful Life	5 years 3 months 18 days		5 years 7 months 6 days

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Intangible Assets, Net - Additional information (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Intangible assets
Additional amortization expense related to two-year migration strategy	$ 5.8
Additional amortization expense related to two-year migration strategy, per share	$ 0.04
Weighted Average
Intangible assets
Weighted average remaining useful life	11 years 4 months 24 days	12 years
Trademarks | Weighted Average
Intangible assets
Weighted average remaining useful life	7 years 4 months 24 days	9 years 6 months

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Goodwill - Summary of Activity (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Goodwill
Beginning balance	$ 14,504,174	$ 14,581,255	$ 14,581,255
Impairment	(6,600,000)	$ 0	0
Additions associated with acquisitions	0		64,269
Purchase consideration adjustments	0		(122,306)
Currency translation adjustment	(4,379)		(19,044)
Ending balance	$ 7,899,795		$ 14,504,174

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Goodwill - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Goodwill
Goodwill impairment	$ 6,600,000	$ 0	$ 0
Goodwill impairment loss per share	$ 41.11

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Goodwill - Impairment Analysis (Details)	Mar. 31, 2022	Dec. 01, 2021
Discount Rate
Goodwill Impairment Testing
Goodwill Measurement Input	0.120	0.105
Peer Group Revenue Multiples | Peer Group Revenue Multiples, Current Year
Goodwill Impairment Testing
Goodwill Measurement Input	3.0	7.0
Peer Group Revenue Multiples | Peer Group Revenue Multiples, Subsequent Year
Goodwill Impairment Testing
Goodwill Measurement Input	2.5	5.5
Percentage Excess of Reporting Unit Fair Value over Carrying Value
Goodwill Impairment Testing
Goodwill Measurement Input	0	0.150
Market Approach
Goodwill Impairment Testing
Valuation approach, allocation percentage	25.00%
Income Approach
Goodwill Impairment Testing
Valuation approach, allocation percentage	75.00%
Goodwill Measurement Input	0.75

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Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Accrued Expenses and Other Current Liabilities
Professional fees	$ 5,485	$ 5,373
Consulting fees/provider fees	18,029	19,292
Client performance guarantees	10,034	7,653
Interest payable	5,809	1,480
Income tax payable	5,131	3,098
Insurance	5,779	3,884
Marketing	6,104	3,471
Operating lease liabilities - current	13,052	12,687
Acquisition & Integration	11,429	9,965
Device replacement cost	5,913	6,263
Other	29,924	29,767
Total	$ 116,689	$ 102,933
Current operating lease liabilities	Accrued expenses and other current liabilities	Accrued expenses and other current liabilities

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Fair Value Measurements - Recurring (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Fair Value
Short-term investments	$ 2,544	$ 2,537
Fair Value, Assets, Level 1 to Level 2 Transfers, Amount	0	0
Fair Value, Assets, Level 2 to Level 1 Transfers, Amount	0	0
Fair value assets level 3 net transfers	0	0
Recurring
Fair Value
Cash and cash equivalents	836,444	893,480
Short-term investments	2,544	2,537
Level 1 | Recurring
Fair Value
Cash and cash equivalents	836,444	893,480
Short-term investments	0	0
Level 2 | Recurring
Fair Value
Cash and cash equivalents	0	0
Short-term investments	$ 2,544	$ 2,537

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Leases - Other (Details)	3 Months Ended
	Mar. 31, 2022
Leases and Contractual Obligations
Options to extend	true
Minimum
Leases and Contractual Obligations
Remaining lease terms	1 year
Options to extend lease terms	1 year
Lessor lease term	2 years
Maximum
Leases and Contractual Obligations
Remaining lease terms	11 years
Options to extend lease terms	6 years
Lessor lease term	5 years

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Leases - Future Minimum Lease Payments (Details) $ in Thousands	Mar. 31, 2022 USD ($)
Future minimum lease payments under non cancelable operating leases:
2022	$ 15,023
2023	14,261
2024	9,634
2025	7,197
2026	5,822
2027 and thereafter	12,638
Sub-total	$ 64,575

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Convertible Senior Notes - Outstanding Convertible Senior Notes - Issuances (Details) - USD ($) $ in Thousands	May 19, 2020	May 08, 2018	Mar. 31, 2022	Dec. 31, 2021	Jun. 04, 2020	Jun. 27, 2017
2027 Notes
Convertible Senior Notes
Face amount	$ 1,000,000		$ 1,000,000	$ 1,000,000
Interest rate (as a percent)	1.25%
Net proceeds from issuance of Notes	$ 975,900
Offering costs	$ 24,100
2025 Notes
Convertible Senior Notes
Face amount		$ 287,500	730	730
Interest rate (as a percent)		1.375%
Net proceeds from issuance of Notes		$ 279,100
Offering costs		$ 8,400
Livongo Notes
Convertible Senior Notes
Face amount			$ 550,000	$ 550,000	$ 550,000
Interest rate (as a percent)					0.875%
2022 Notes
Convertible Senior Notes
Face amount						$ 275,000
Interest rate (as a percent)						3.00%

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Convertible Senior Notes - Certain terms of the Notes (Details)	3 Months Ended
	Mar. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
2027 Notes
Convertible Senior Notes
Interest Rate Per Year	1.25%
Fair value	$ 843,500,000	$ 940,000,000.0
Share conversion rate Per $1,000 principal amount	0.00413
Remaining contractual life	5 years 2 months 12 days
2025 Notes
Convertible Senior Notes
Interest Rate Per Year	1.375%
Fair value	$ 1,000,000.0	1,300,000
Share conversion rate Per $1,000 principal amount	0.01866
Remaining contractual life	3 years 1 month 6 days
Livongo Notes
Convertible Senior Notes
Interest Rate Per Year	0.875%
Fair value	$ 553,300,000	$ 605,000,000.0
Share conversion rate Per $1,000 principal amount	0.01394
Remaining contractual life	3 years 2 months 12 days
Notes
Convertible Senior Notes
Principal multiple amount used in the conversion of the debt instrument	$ 1,000

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Convertible Senior Notes - Terms (Details) $ / shares in Units, shares in Millions	3 Months Ended
	Mar. 31, 2022 USD ($) D $ / shares shares
2025 Notes
Convertible Senior Notes
Convertible debt, Reference property rate	0.5920
Convertible debt, Reference property , conversion price (in dollars per share) | $ / shares	$ 4.24
Livongo Notes
Convertible Senior Notes
Convertible debt, number of consecutive trading days, measurement period	5
Percentage of principal for repurchase price (as percent)	100
Notes
Convertible Senior Notes
Principal multiple amount used in the conversion of the debt instrument | $	$ 1,000
Convertible debt, threshold, trading days	20
Convertible debt, threshold, consecutive trading days	30
Minimum percentage of common stock price as a percentage of the conversion price	130.00%
Convertible debt, number of business days, measurement period	5
Convertible debt, number of consecutive trading days, measurement period	10
Trading price expressed as a percentage of the last reported sales price and conversion rate after the specified consecutive trading day period	98.00%
Shares reserved for issuance (in shares) | shares	8.7
2027 Notes, 2025 Notes and the 2022 Notes
Convertible Senior Notes
Trading day observation period used to determine the amount of cash and shares, if any, that are due upon conversion	25
2027 Notes, 2025 Notes and the 2022 Notes | 2025 Notes
Convertible Senior Notes
Trading day observation period used to determine the amount of cash and shares, if any, that are due upon conversion	40

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Convertible Senior Notes - Outstanding Convertible Senior Notes - Summary (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Jun. 04, 2020	May 19, 2020	May 08, 2018	Jun. 27, 2017
2027 Notes
Convertible Senior Notes
Principal	$ 1,000,000		$ 1,000,000		$ 1,000,000
Less: Debt discount, net	(17,940)		(250,846)
Net carrying amount	982,060		749,154
Interest Expense
Contractual interest expense	3,125	$ 3,125
Amortization of debt discount	831	9,059
Total	$ 3,956	$ 12,184
Effective interest rate of the liability component (as a percent)	0.80%	3.40%
2025 Notes
Convertible Senior Notes
Principal	$ 730		730			$ 287,500
Less: Debt discount, net	(10)		(166)
Net carrying amount	720		564
Interest Expense
Contractual interest expense	3	$ 814
Amortization of debt discount	1	2,719
Total	$ 4	$ 3,533
Effective interest rate of the liability component (as a percent)	0.90%	3.90%
Livongo Notes
Convertible Senior Notes
Principal	$ 550,000		550,000	$ 550,000
Less: Debt discount, net	0		(74,047)
Net carrying amount	550,000		$ 475,953
Interest Expense
Contractual interest expense	1,203	$ 1,203
Amortization of debt discount	0	4,734
Total	$ 1,203	$ 5,937
Effective interest rate of the liability component (as a percent)	0.00%	5.20%
2022 Notes
Convertible Senior Notes
Principal							$ 275,000
Interest Expense
Contractual interest expense	$ 0	$ 104
Amortization of debt discount	0	316
Total	$ 0	$ 420
Effective interest rate of the liability component (as a percent)	0.00%	9.60%

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Convertible Senior Notes - Exchange/Redemption of Convertible Senior Notes Due (Details) - USD ($) $ in Thousands, shares in Millions	1 Months Ended	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2022	Mar. 31, 2021
Convertible Senior Notes
Loss on extinguishment of debt		$ 0	$ 11,459
2025 Notes
Convertible Senior Notes
Shares issued for conversion/exchange of debt			1.1
Loss on extinguishment of debt			$ 8,100
2022 Notes
Convertible Senior Notes
Shares issued for conversion/exchange of debt	1.1
Cash exchanged, redemption of convertible notes	$ 100
Loss on extinguishment of debt			$ 3,400

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Advances from Financing Companies (Details) $ in Thousands	Mar. 31, 2022 USD ($)
2022	$ 10,105
2023	8,024
2024	2,678
2025	109
Total	$ 20,916
Minimum
Advances from financing companies, interest rate (as a percent)	3.35%
Maximum
Advances from financing companies, interest rate (as a percent)	8.25%

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Common Stock and Stockholders' Equity - Capitalization (Details) - shares	Mar. 31, 2022	Dec. 31, 2021	Oct. 30, 2020	Oct. 29, 2020
Common Stock and Stockholders'Equity
Number of common stock shares authorized	300,000,000	300,000,000	300,000,000	150,000,000

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Common Stock and Stockholders' Equity - Warrants (Details) - shares	Mar. 31, 2022	Dec. 31, 2021
Common stock warrants
Warrants
Warrants outstanding (in shares)	0	0

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Common Stock and Stockholders' Equity - Stock Plan and Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended
	Dec. 31, 2021	Mar. 31, 2022	Mar. 31, 2021
Stock options
Common Stock and Stockholders' Equity
Vesting period		4 years
Stock options | Maximum
Common Stock and Stockholders' Equity
Exercisable period (in years)		10 years
Shares available for grant		10,218,931
RSUs
Common Stock and Stockholders' Equity
Vesting period		3 years
RSUs | Maximum
Common Stock and Stockholders' Equity
Vesting period		4 years
2015 Incentive Award Plan
Number of Shares Outstanding
Balance, beginning of period (in shares)		3,426,978
Stock option grants and assumed awards (in shares)		45,434
Stock option exercised (in shares)		(267,586)
Stock options forfeited (in shares)		(15,767)
Balance, end of period (in shares)	3,426,978	3,189,059
Vested or expected to vest at end of period (in shares)		3,189,059
Exercisable as of end of period (in shares)		3,011,138
Weighted-Average Exercise Price
Balance, beginning of period (in dollars per share)		$ 22.88
Stock option grants and assumed awards (in dollars per share)		79.40
Stock option exercised (in dollars per share)		13.40
Stock options forfeited (in dollars per share)		19.63
Balance, end of period (in dollars per share)	$ 22.88	24.50
Vested or expected to vest at end of period (in dollars per share)		24.50
Exercisable as of end of period (in dollars per share)		$ 20.36
Weighted-average remaining contractual life in Years
Weighted-average remaining contractual life (in years)	5 years 3 months 25 days	5 years 1 month 28 days
Vested or expected to vest at end of period (in years)		8 years 4 months 6 days
Exercisable as of end of period (in years)		4 years 11 months 19 days
Aggregate Intrinsic Value
Balance, beginning of period		$ 242,569
Stock options exercised		(15,090)
Balance, end of period	$ 242,569	160,501
Vested or expected to vest at end of period		2,352
Exercisable as of end of period		158,148
Grant-date fair value of stock options granted during the period		$ 1,600	$ 400

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Common Stock and Stockholders' Equity - Fair Value Assumptions (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Other disclosures
Compensation expense	$ 60,436	$ 86,300
Stock options
Fair value assumptions
Volatility, minimum (as a percent)	56.69%	57.02%
Volatility, maximum (as a percent)	57.86%	57.49%
Expected term (in years)	4 years 1 month 6 days	4 years 1 month 6 days
Risk-free interest rate, minimum	1.13%	0.31%
Risk-free interest rate, maximum	1.52%	0.51%
Dividend yield (as a percent)	0.00%	0.00%
Weighted-average fair value of the underlying stock options	$ 35.94	$ 107.06
Other disclosures
Compensation expense	$ 10,700	$ 28,200
Unrecognized compensation cost	$ 10,900
Period over which unrecognized compensation cost is expected to be recognized	1 year 10 months 24 days

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Common Stock and Stockholders' Equity - Restricted Stock Units (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Other disclosures
Stock-based compensation	$ 60,436	$ 86,300
RSUs
Common Stock and Stockholders' Equity
Vesting period	3 years
Shares
Balance at December 31, 2020	2,133,501
Granted	2,433,620
Vested and issued (in shares)	(499,486)
Forfeited (in shares)	(153,581)
Balance at December 31, 2021	3,914,054
Vested and unissued (in shares)	16,507
Nonvested (in shares)	3,897,547
Weighted-Average Grant Date Fair Value Per Share
Outstanding at beginning of period (in dollars per share)	$ 168.43
Granted	74.74
Vested and issued (in dollars per share)	146.13
Forfeited (in dollars per share)	153.09
Outstanding at end of period (in dollars per share)	113.99
Vested and unissued (in dollars per share)	71.96
Non-vested (in dollars per share)	$ 113.99
Other disclosures
Grant date fair value of RSUs granted	$ 181,900	88,000
Stock-based compensation	44,500	$ 50,900
Unrecognized compensation cost related to non vested awards	$ 407,800
Period over which unrecognized compensation cost is expected to be recognized	2 years 3 months 18 days
Minimum | RSUs
Common Stock and Stockholders' Equity
Vesting period	1 year
Maximum | RSUs
Common Stock and Stockholders' Equity
Vesting period	4 years

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Common Stock and Stockholders' Equity - Performance Stock Units (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Other disclosures
Stock-based compensation	$ 60,436	$ 86,300
PSUs
Shares
Balance at December 31, 2020	356,249
Granted	420,274
Vested and issued (in shares)	(197,849)
Balance at December 31, 2021	578,674
Vested and unissued (in shares)	0
Nonvested (in shares)	578,674
Weighted-Average Grant Date Fair Value Per Share
Outstanding at beginning of period (in dollars per share)	$ 140.01
Granted (in dollars per share)	74.21
Vested and issued (in dollars per share)	109.03
Outstanding at end of period (in dollars per share)	106.35
Vested and unissued (in dollars per share)	0
Non-vested (in dollars per share)	$ 106.35
Other disclosures
Grant date fair value of PSUs granted	$ 30,100	67,900
Stock-based compensation	7,300	$ 7,200
Unrecognized compensation cost related to non vested awards	$ 26,900
Period over which unrecognized compensation cost is expected to be recognized	2 years 3 months 18 days
PSUs | Minimum
Common Stock and Stockholders' Equity
Vesting period	1 year
Actual performance compared to performance conditions percentage	25.00%
PSUs | Maximum
Common Stock and Stockholders' Equity
Vesting period	3 years
Actual performance compared to performance conditions percentage	200.00%

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Common Stock and Stockholders' Equity - Employee Stock Purchase Plan (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Other Disclosures
Stock-based compensation	$ 60,436	$ 86,300
ESPP
Other Disclosures
Shares reserved for issuance under the plan (in shares)	1,019,726
Maximum offering period	27 months
Stock purchase price as a percentage of fair value (as a percent)	85.00%
Remaining shares available for issuance under the plan (in shares)	570,661
Stock-based compensation	$ 1,500	$ 2,200
Unrecognized compensation cost	$ 600
Period over which unrecognized compensation cost is expected to be recognized	1 month 6 days

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Common Stock and Stockholders' Equity - Compensation Costs (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Compensation costs charged as an expense
Stock-based compensation	$ 60,436	$ 86,300
Cost of revenue (exclusive of depreciation and amortization, which is shown separately)
Compensation costs charged as an expense
Stock-based compensation	2,196	2,362
Advertising and marketing
Compensation costs charged as an expense
Stock-based compensation	3,711	5,082
Sales
Compensation costs charged as an expense
Stock-based compensation	12,071	21,167
Technology and development
Compensation costs charged as an expense
Stock-based compensation	18,087	26,726
General and administrative expenses
Compensation costs charged as an expense
Stock-based compensation	$ 24,371	$ 30,963

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Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Jan. 01, 2022	Dec. 31, 2021
Income taxes
Income tax expense	$ 388	$ 87,039
Net deferred tax liabilities	$ (57,516)			$ (75,777)
ASU 2020-06 | Cumulative effect adjustment due to adoption of ASU 2020-06
Income taxes
Net deferred tax liabilities			$ 15,300