XML 36 R23.htm IDEA: XBRL DOCUMENT v3.23.1
Operating Segments
3 Months Ended
Mar. 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' 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 and DC 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 Direct Contracting 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 Direct Contracting 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:
InsuranceNon-InsuranceCorporate/OtherEliminationsConsolidated Total
Three months ended March 31, 2023(in thousands)
Premiums earned, net (net of ceded premiums of $122)
$317,086 $— $— $— $317,086 
Non-Insurance revenue— 205,783 — — 205,783 
Other income 1,839 428 17,310 (14,671)4,906 
Intersegment revenues — — 23,231 (23,231)— 
Net medical claims incurred274,504 197,701 3,448 (3,163)472,490 
Gross profit (loss)$44,421 $8,510 $37,093 $(34,739)$55,285 
Total assets$467,392 $716,104 $936,903 $(666,810)$1,453,589 
InsuranceNon-InsuranceCorporate/OtherEliminationsConsolidated Total
Three months ended March 31, 2022(in thousands)
Premiums earned, net (net of ceded premiums of $119)
$278,169 $— $— $— $278,169 
Non-Insurance revenue— 594,898 — — 594,898 
Other income271 — 27,399 (26,358)1,312 
Intersegment revenues— — 19,136 (19,136)— 
Net medical claims incurred268,126 593,999 2,628 (3,031)861,722 
Gross profit (loss)$10,314 $899 $43,907 $(42,463)$12,657 
Total assets$406,167 $1,859,741 $1,113,735 $(699,749)$2,679,894 
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 March 31,20232022
(in thousands)
Gross profit$55,285 $12,657 
Salaries and benefits70,207 69,091 
General and administrative expenses59,215 57,697 
Premium deficiency reserve benefit(1,810)(27,476)
Depreciation and amortization279 826 
Interest expense— 403 
Gain on investment— (12,394)
Net loss$(72,606)$(75,490)