Operating Segments

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

Operating Segments

Operating Segments

The 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. On December 1, 2023, the Company notified CMS that it will no longer participate as a REACH ACO in connection with the 2024 performance year. The Company’s exit from the ACO REACH Program was made after the Company determined that it is in the Company's best interest to fully exit the ACO REACH Program, and follows its November 2022 announcement of a strategic reduction in the number of ACO REACH participating physicians in 2023.

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
Year ended December 31, 2023	(in thousands)
Premiums earned, net (net of ceded premiums of $444)	1,235,769	—	—	—	1,235,769
Non-Insurance revenue	—	773,177	—	—	773,177
Other income	10,336	5,267	59,569	(50,398)	24,774
Intersegment revenues	—	—	155,089	(155,089)	—
Net medical claims incurred	1,003,683	771,798	17,432	(16,525)	1,776,388
Gross profit (loss)	242,422	6,646	197,226	(188,962)	257,332
Total assets	401,812	71,878	873,971	(776,990)	570,671

	Insurance	Non-Insurance	Corporate/Other	Eliminations	Consolidated Total
Year ended December 31, 2022	(in thousands)
Premiums earned, net (net of ceded premiums of $470)	1,084,869	—	—	—	1,084,869
Non-Insurance revenue	—	2,380,135	—	—	2,380,135
Other income	2,577	1,311	74,610	(66,815)	11,683
Intersegment revenues	—	—	108,249	(108,249)	—
Net medical claims incurred	996,410	2,460,879	9,042	(12,379)	3,453,952
Gross profit (loss)	91,036	(79,433)	173,817	(162,685)	22,735
Total assets	354,748	156,754	957,483	(660,365)	808,620

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

	Year ended December 31,
	2023		2022
	(in thousands)
Gross profit	$	257,332	$	22,735
Salaries and benefits	257,157		278,725
General and administrative expenses	187,571		207,917
Impairment of goodwill and other intangible assets	15,945		—
Premium deficiency reserve benefit	(7,239)		(93,517)
Depreciation and amortization	2,509		1,187
Restructuring costs	9,931		—
Other expense	—		70
Change in fair value of warrants	86		(900)
Interest expense	7		1,333
Amortization of notes and securities discounts	—		30
Loss (gain) on investment	4,726		(9,217)
Gain on debt extinguishment on note payable	—		(23,326)
Net loss	$	(213,361)	$	(339,567)