Operating Segments

6 Months Ended

Jun. 30, 2023

Segment Reporting [Abstract]

Operating Segments

Operating SegmentsThe Company manages its operations based on two reportable operating segments: Insurance and Non-Insurance. Through the Insurance segment, the Company provides PPO and HMO plans to Medicare Advantage members in several states. The Company's Non-Insurance segment consists of its operations in connection with its participation in CMS' Global and Professional Direct Contracting and ACO REACH programs. All other clinical services and all corporate overhead not included in the Insurance or Non-Insurance segments are included within Corporate/Other. These segment groupings are consistent with information used by the Chief Executive Officer, the Company's CODM, to assess performance and allocate resources.

The operations of the Company are organized into the following two segments:

•Insurance Segment includes operations related to the Company's MA plans, which generally provide access to a wide network of primary care providers, specialists, and hospitals.

•Non-Insurance Segment includes the Company's operations relating to CMS' ACO REACH Model, which provides options aimed at reducing expenditures and preserving or enhancing quality of care for beneficiaries.

Corporate/Other includes other clinical services not included in Medicare Advantage and Global and Professional Direct Contracting Model and all other corporate overhead. Clinical services is comprised of Clover Home Care and other clinical services that are offered to eligible beneficiaries.

During the first quarter of 2022, the Company updated the names of its Medicare Advantage and Global and Professional Direct Contracting Model segments to the Insurance and Non-Insurance segments, respectively. The Company believes that this approach better reflects each segment's current role and contribution to its business. There has been no change to the existing composition of these segments, and previously reported consolidated and segment-level financial results of the Company were not impacted by these changes.

The table below summarizes the Company's results by operating segment:

	Insurance	Non-Insurance	Corporate/Other	Eliminations	Consolidated Total
Three months ended June 30, 2023	(in thousands)
Premiums earned, net (net of ceded premiums of $113)	314,383	—	—	—	314,383
Non-Insurance revenue	—	193,490	—	—	193,490
Other income	2,015	1,316	12,459	(10,035)	5,755
Intersegment revenues	—	—	45,654	(45,654)	—
Net medical claims incurred	242,839	192,692	3,682	(2,259)	436,954
Gross profit (loss)	73,559	2,114	54,431	(53,430)	76,674
Total assets	478,797	555,982	970,942	(747,724)	1,257,997
	Insurance	Non-Insurance	Corporate/Other	Eliminations	Consolidated Total
Six months ended June 30, 2023	(in thousands)
Premiums earned, net (net of ceded premiums of $235)	631,469	—	—	—	631,469
Non-Insurance revenue	—	399,273	—	—	399,273
Other income	3,854	1,744	29,770	(24,707)	10,661
Intersegment revenues	—	—	68,885	(68,885)	—
Net medical claims incurred	517,343	390,393	7,130	(5,422)	909,444
Gross profit (loss)	117,980	10,624	91,525	(88,170)	131,959
Total assets	478,797	555,982	970,942	(747,724)	1,257,997

	Insurance	Non-Insurance	Corporate/Other	Eliminations	Consolidated Total
Three months ended June 30, 2022	(in thousands)
Premiums earned, net (net of ceded premiums of $119)	268,505	—	—	—	268,505
Non-Insurance revenue	—	577,370	—	—	577,370
Other income	220	20	15,441	(14,856)	825
Intersegment revenues	—	—	27,029	(27,029)	—
Net medical claims incurred	247,275	612,122	2,547	(3,158)	858,786
Gross profit (loss)	21,450	(34,732)	39,923	(38,727)	(12,086)
Total assets	426,723	1,298,224	1,143,146	(804,887)	2,063,206
	Insurance	Non-Insurance	Corporate/Other	Eliminations	Consolidated Total
Six months ended June 30, 2022	(in thousands)
Premiums earned, net (net of ceded premiums of $238)	546,674	—	—	—	546,674
Non-Insurance revenue	—	1,172,268	—	—	1,172,268
Other income	491	20	42,840	(41,214)	2,137
Intersegment revenues	—	—	46,165	(46,165)	—
Net medical claims incurred	515,401	1,206,121	5,175	(6,189)	1,720,508
Gross profit (loss)	31,764	(33,833)	83,830	(81,190)	571
Total assets	426,723	1,298,224	1,143,146	(804,887)	2,063,206

A reconciliation of the reportable segments' gross profit to the Net loss included in the Consolidated Statements of Operations and Comprehensive Loss is as follows:

	Three months ended June 30,				Six months ended June 30,
	2023		2022		2023		2022
	(in thousands)
Gross profit	$	76,674	$	(12,086)	$	131,959	$	571
Salaries and benefits	62,437		70,491		132,644		139,582
General and administrative expenses	42,433		47,040		99,841		104,737
Premium deficiency reserve benefit	(5,138)		(27,476)		(6,948)		(54,952)
Depreciation and amortization	999		586		1,278		1,412
Restructuring costs	4,750		—		6,557		—
Interest expense	7		390		7		793
Amortization of notes and securities discounts	—		18		—		18
Gain on investment	—		1,227		—		(11,167)
Net loss	$	(28,814)	$	(104,362)	$	(101,420)	$	(179,852)