Exhibit 10.1
EXECUTION VERSION
AMENDMENT NO. 3 dated as of November 8, 2022 (this “Amendment”), among BRIGHT HEALTH GROUP, INC. (the “Company”), the other LOAN PARTIES party hereto, the LENDERS party hereto and JPMORGAN CHASE BANK, N.A., in its capacity as administrative agent (the “Administrative Agent”).
Reference is made to the Credit Agreement dated as of March 1, 2021 (as amended by the First Amendment dated as of August 2, 2021, Second Amendment dated as of November 20, 2021 and as further amended, supplemented or otherwise modified from time to time prior to the date hereof, the “Credit Agreement”), among the Company, the Lenders party thereto and the Administrative Agent. Capitalized terms used and not otherwise defined herein shall have the meanings assigned to them in the Credit Agreement.
The Company has requested, and the Administrative Agent and the Lenders party hereto agree, in accordance with Section 15.1 of the Credit Agreement, to amend the Credit Agreement on the terms and subject to the conditions set forth herein.
NOW, THEREFORE, in consideration of the premises and covenants contained herein and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto, intending to be legally bound hereby, agree as follows:
Section 1.Amendments. Subject to the satisfaction of the conditions precedent set forth in Section 3 hereof:
(a)Section 1.1 of the Credit Agreement is hereby amended to add the following defined term in correct alphabetical order:
“Covenant Waiver Period” means the period commencing with and including the Computation Period ending on September 30, 2022, and ending on and including the Computation Period ending on September 30, 2023.
(b)Section 11.12.1 of the Credit Agreement is hereby amended to read as follows:
“Not permit the Total Debt to Total Capitalization Ratio as of the last day of each Computation Period, beginning with the Computation Period ending June 30, 2021, to exceed 0.25 to 1.00; provided that the foregoing shall not apply to any Computation Period ending during the Covenant Waiver Period.”
(c)Section 11.12.2 of the Credit Agreement is hereby amended to read as follows:
“Not permit the Minimum Liquidity to be less than $150,000,000 (or, from November 8, 2022 through September 30, 2023, less than $200,000,000) at any time.
(d)Section 10.1 of the Credit Agreement is hereby amended to add Section 10.1.9 as follows:
“10.1.9 Additional Reporting During the Covenant Waiver Period
(a) No later than January 31, 2023, a business and financial plan for Fiscal Year 2023 prepared by management of the Company and in form substantially similar to the financial projections delivered to the Administrative Agent immediately prior to Amendment Effective Date (which plan shall include, in any event, a projected consolidated balance sheet, statement of operations and a statement of cash flow of the Company and its Subsidiaries on a consolidated basis, a reasonably detailed description of the assumptions used in the preparation thereof and reconciliation information between the unrestricted cash forecast at a consolidated level and at a subsidiary level).
(b) On or prior to the last day of each Fiscal Quarter ending during the Covenant Waiver Period (beginning with the Fiscal Quarter ending on or about December 31, 2022), a projected 13-week cash flow statement in form substantially similar to the form agreed between the Company and the Administrative Agent immediately prior to Amendment Effective Date and covering the 13-week period beginning on the first day of the immediately subsequent Fiscal Quarter.”
Section 2.Collateral Default Waiver. The Required Lenders hereby agree to waive, permanently, each of the Collateral Defaults.
As used in this Section 2, “Collateral Defaults” means any Defaults and/or Events of Default existing on the Amendment Effective Date and arising from or relating to (i) the failure of the Company to furnish to the Administrative Agent prompt written notice of a change in the legal names of the Loan Parties formerly known as “Physicians Plus, LLC”, “Physicians Plus of Florida, LLC” and Physicians Plus of California, LLC”, and each now known, respectively, as “NeueHealth Partners, LLC”, “NeueHealth Partners of Florida, LLC” and “NeueHealth Partners of California, LLC”, in accordance with the requirements of Section 10.13(a) of the Credit Agreement and Section 4.03(a) of the Collateral Agreement, (ii) the failure to notify the Administrative Agent of and cause the Collateral and Guarantee Requirement to be satisfied with respect to the designation of NeueHealth Partners Florida RBE, LLC and NeueHealth Partners Texas RBE, LLC as Loan Parties and the pledging of Equity Interests owned by the Loan Parties as set forth on Schedule 4 to the perfection certificate delivered pursuant to Section 4(c) hereof in accordance with Section 10.11(a) of the Credit Agreement and Sections 3.01, 3.02 and 4.03 of the Collateral Agreement, (iii) the failure of the Company to deliver to the Administrative Agent, at the time of delivery of the financial statements for the Computation Period ending December 31, 2021 pursuant to Section 10.1.1 of the Credit Agreement, a certificate of the Company required to be delivered pursuant to Section 10.13(b) and (iv) the failure to notify the Administrative Agent of any of the foregoing failures in accordance with Section 10.1.5 (a) of the Credit Agreement.
Section 3.Representations and Warranties. The Company represents and warrants that as of the date hereof and the Amendment Effective Date:
(a)After giving effect to this Amendment, the representations and warranties contained in Section 9 of the Credit Agreement are true and correct (i) in the case of the representations and warranties qualified as to materiality, in all respects and (ii) otherwise, in all material respects; except in the case of any such representation and warranty that expressly relates to a prior date, in which case such representation and warranty shall be so true and correct on and as of such prior date.
(b)After giving effect to this Amendment, no Default or Event of Default has occurred and is continuing.
Section 4.Conditions to Effectiveness.
This Amendment shall become effective on the first date (the “Amendment Effective Date”) on which the Administrative Agent shall have received (a) a certificate, dated the Amendment Effective Date and signed by a Responsible Officer of the Company, confirming that the representations and warranties set forth in Section 3 hereof are true and correct in all respects, (b) executed counterparts of this Amendment by (i) the Company, (ii) each of the other Loan Parties, (iii) the Administrative Agent and (iv) the Required Lenders, (c) an updated perfection certificate with respect to the Company and its Subsidiaries and (d) an amendment fee for the account of each Lender that consents to this Amendment and delivers its executed signature page hereto at or prior to 5:00 p.m., New York time, on November 8, 2022, in an amount equal to 0.025% of the amount of such Lender’s Commitment (whether used or unused) on the date on which this Amendment becomes effective in accordance with its terms immediately prior to giving effect to this Amendment.
The Administrative Agent shall notify the Company and the Lenders of the Amendment Effective Date and such notice shall be conclusive and binding.
Section 5.Fees and Expenses.
The Company agrees to reimburse the Administrative Agent for its reasonable and documented out-of-pocket expenses incurred by it in connection with this Amendment, including the reasonable fees, charges and disbursements of Cravath, Swaine & Moore LLP, counsel for the Administrative Agent.
Section 6.Counterparts.
This Amendment may be executed in any number of counterparts and by different parties hereto in separate counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement. The words “execution”, “signed”, “signature”, “delivery”, and words of like import in or relating to this Amendment and/or any document to be signed in connection with this Amendment and the transactions contemplated hereby shall be deemed to include Electronic Signatures, deliveries or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature, physical delivery thereof or the use of a paper-based recordkeeping system, as the case may be.
Section 7.Reaffirmation by Loan Parties.
Each of the Loan Parties, as debtor, grantor, pledgor, guarantor, assignor, or in any other similar capacity in which such Loan Party grants liens or security interests in its property or acts as a guarantor, hereby (a) ratifies and reaffirms all of its payment and performance obligations, contingent or otherwise, under each of the Loan Documents to which it is a party (after giving effect hereto) and (b) to the extent such Loan Party granted liens on or security interests in any of its property pursuant to any such Loan Document as security for, or guaranteed, the Obligations
under the Loan Documents, ratifies and reaffirms such grant of security interests and liens and such guarantee and confirms and agrees that such security interests and liens hereafter secure all of the Obligations as amended hereby.
Section 8.Governing Law; Amendment of Right to Trial by Jury, Etc.
THIS AMENDMENT AND ANY CLAIM, CONTROVERSY, DISPUTE OR CAUSE OF ACTION ARISING UNDER OR RELATED TO THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE SUBSTANTIVE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO CHOICE OF LAW DOCTRINES. The provisions of Sections 15.4, 15.6, 15.7, 15.15, 15.20 and 15.24 of the Credit Agreement are hereby incorporated by reference as if set forth in full herein, mutatis mutandis.
Section 9.Headings.
The headings of this Amendment are for purposes of reference only and shall not be deemed to limit, amplify or modify the terms of this Amendment, nor affect the meaning hereof.
Section 10.Effect of Amendment; References to the Credit Agreement.
Except as expressly set forth herein, this Amendment shall not by implication or otherwise limit, impair, constitute a waiver of or otherwise affect the rights and remedies of the Administrative Agent, any Lender or any Issuing Bank under the Credit Agreement or any agreement or document relating thereto, and except as expressly provided in this Amendment, shall not alter, modify, amend or in any way affect any of the terms, conditions, obligations, covenants or agreements contained in the Credit Agreement or any such other agreement or document, all of which are ratified and affirmed in all respects and shall continue in full force and effect. This Amendment shall constitute a Loan Document for all purposes of the Credit Agreement and the other Loan Documents. On and after the Amendment Effective Date, each reference in the Credit Agreement to “this Agreement”, “hereunder”, “hereof” or words of like import referring to the Credit Agreement shall mean and be a reference to the Credit Agreement as amended hereby. Nothing herein shall entitle the Company to a consent to, or a waiver, extension, amendment, modification or other change of, any of the terms, conditions, obligations, covenants or agreements contained in the Credit Agreement or any agreement or document relating thereto in any similar or different circumstances.
[Remainder of page left intentionally blank]
IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed as of the date first above written.
BRIGHT HEALTH GROUP, INC.,
as the Company
By: /s/ Cathy Smith_____________________
Name: Cathy Smith
Title: Executive Vice President and Chief Financial Officer
BRIGHT HEALTH MANAGEMENT, INC. BRIGHT HEALTH SERVICES, INC.
MEDICAL PRACTICE HOLDING
COMPANY, LLC
BRIGHTHEALTH NETWORKS, LLC
PHYSICIANS PLUS ACO, LLC
PINEAPPLE ACO, LLC
NEUEHEALTH PARTNERS, LLC
NEUEHEALTH PARTNERS OF FLORIDA, LLC
NEUEHEALTH PARTNERS OF CALIFORNIA, LLC
NEUEHEALTH LLC
DOCSQUAD, LLC
NEUEHEALTH COMMUNITY ACO, LLC
NEUEHEALTH PARTNERS FLORIDA RBE, LLC
NEUEHEALTH PARTNERS TEXAS RBE, LLC,
as Guarantors
By: /s/ Cathy Smith______________________
Name: Cathy Smith
Title: Executive Vice President and Chief Financial Officer
[Signature Page to Amendment No. 3 to Credit Agreement]
JPMORGAN CHASE BANK, N.A.,
as Administrative Agent and Lender
By: /s/ Joon Hur_______________________
Name: Joon Hur
Title: Executive Director
MAN SACHS LENDING PARTNERS LLC,
as Lender
By: /s/ Keshia Leday_____________________
Name: Keshia Leday
Title: Authorized Signatory
[Signature Page to Amendment No. 3 to Credit Agreement]
BANK OF AMERICA, N.A.,
as Lender
By: /s/ Joseph L. Corah_________________
Name: Joseph L. Corah
Title: Director
[Signature Page to Amendment No. 3 to Credit Agreement]
Exhibit 99.1
BRIGHT HEALTH GROUP REPORTS THIRD QUARTER 2022 RESULTS
•Revenue of $1.6 billion, up 51.3% from Q3'21, GAAP Net Loss of $259.4 million, Adjusted EBITDA Loss of $82.9 million
•Q2’22 Enterprise Medical Cost Ratio of 90.6%, a strong improvement from the prior year
•Lowering Full Year 2022 Enterprise Medical Cost Ratio guidance range to 90% to 92%
•Positively revising Full Year 2022 Adjusted EBITDA loss guidance range to $550 to $700 million
MINNEAPOLIS, MN (November 9, 2022) (BUSINESSWIRE) – Bright Health Group, Inc. (“Bright Health Group” or the “Company”) (NYSE: BHG), the technology enabled, value-driven healthcare company serving aging and underserved consumers with unmet clinical needs, today reported financial results for its third quarter ended September 30, 2022.
“Bright Health Group continued to deliver against our financial targets in the Third Quarter and we have confidence in our improved guidance for the year,” said Mike Mikan, President and CEO of Bright Health Group. “Our Medicare Advantage and NeueHealth businesses continued to outperform our expectations in the quarter. With our strengthened capital position and transition to a more focused business model, we expect to reach Adjusted EBITDA profitability in 2023 and continue to drive our differentiated Fully Aligned Care Model.”
Key Metrics
| | | | | | | | | | | |
| As of September 30, |
| 2022 | | 2021 |
Consumer and Patient Metrics | | | |
Bright HealthCare Commercial Consumers | 1,025,000 | | 600,000 |
Medicare Advantage Consumers | 125,000 | | 110,000 |
NeueHealth Value-Based Patients | 520,000 | | 170,000 |
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended | | Nine Months Ended |
($ in thousands) | September 30, | | September 30, |
| 2022 | | 2021 | | 2022 | | 2021 |
Financial Metrics | | | | | | | |
Revenue | $ | 1,632,292 | | $ | 1,078,657 | | $ | 5,044,495 | | $ | 3,067,055 |
Medical Cost Ratio (1) | 90.6 | % | | 103.0 | % | | 87.9 | % | | 90.3 | % |
Operating Cost Ratio | 18.2 | % | | 28.7 | % | | 22.3 | % | | 25.4 | % |
GAAP Net Loss (2) | $ | (259,361) | | $ | (296,722) | | $ | (691,320) | | $ | (364,990) |
Adjusted EBITDA (non-GAAP) | $ | (82,929) | | $ | (292,176) | | $ | (352,620) | | $ | (399,769) |
(1)Medical Cost Ratio for the three months ended September 30, 2022 and 2021, include a 140 basis point and 540 basis point, respectively, unfavorable impact from COVID-19 related costs. Medical Cost Ratio for the
six months ended September 30, 2022 and 2021, include a 200 basis point and 420 basis point, respectively, unfavorable impact from COVID-19 related costs.
(2)GAAP Net Loss for the three months ended September 30, 2022 includes Goodwill impairment of $74.2 million and Intangibles Assets impairment of $42.6 million. GAAP Net Loss for the nine months ended September 30, 2022 includes Goodwill impairment of $74.2 million and Intangibles Assets impairment of $49.3 million. The Goodwill and Intangible Assets impairments are primarily due to macro and strategic factors.
See the table at the end of this release for additional information and a reconciliation of the non-GAAP measure used in the table above.
Financial Outlook
For full year 2022, Bright Health Group is providing the following guidance and commentary:
•Bright Health Group’s total Revenue is expected to be $6.8 billion with an expected enterprise Medical Cost Ratio between 90% and 92%.
•On a segment basis, Bright HealthCare combined Commercial and Medicare Advantage end-of-year membership is expected to be over 1,000,000, while NeueHealth Revenue is expected to be approximately $2.2 billion.
•Intercompany Revenue elimination, comprised of payments from Bright HealthCare to NeueHealth for managing patient care and for network services, is expected to be approximately $1.2 billion.
•Adjusted EBITDA for 2022 is expected to be a loss of between $500.0 million and $700.0 million†.
Earnings Conference Call
As previously announced, Bright Health Group will discuss the Company’s results, strategy, and outlook on a conference call with investors at 8:00 a.m. Eastern Time today. Bright Health Group will host a live webcast of this conference call which can be accessed from the Investor Relations page of the company’s website (investors.brighthealthgroup.com). Following the call, a webcast replay will be available on the same site. This earnings release and the Form 8-K filed November 9, 2022, can be accessed on the Investor Relations page of the Company’s website. We routinely post important information on our website, including corporate and investor presentations and financial information. We intend to use our website as a means of disclosing material, non-public information and for complying with our disclosure obligations under Regulation FD. Such disclosures will be included in the Investor Relations section of our website. Accordingly, investors should monitor this portion of our website, in addition to following our press releases, U.S. Securities and Exchange Commission (“SEC”) filings and public conference calls and webcasts.
About Bright Health Group
Bright Health Group is a technology enabled, value-driven healthcare company that organizes and operates networks of affiliate care providers to be successful at managing population risk. We focus on serving aging and underserved consumers that have unmet clinical needs through our Fully Aligned Care Model in Florida, Texas and California, some of the largest markets in healthcare where 26% of the U.S. aging population call home. We believe everyone should have access to personal, affordable, and high-quality healthcare. Our mission is to Make healthcare right. Together. For more information, visit www.brighthealthgroup.com.
Notes
† A reconciliation of the projected Adjusted EBITDA, which is a forward-looking non-GAAP financial measure, to the most directly comparable GAAP financial measures, is not provided because the Company is unable to provide such reconciliation without unreasonable effort. The inability to provide a reconciliation is due to the uncertainty and inherent difficulty predicting the occurrence, the financial impact and the periods in which the non-GAAP adjustments may be recognized. These GAAP measures may include the impact of such items as interest expense,
income tax expense, depreciation and amortization, impairment of goodwill or intangible assets, share-based compensation expense, transaction costs, changes in the fair value of contingent consideration, changes in the fair value of equity securities, contract termination costs, restructuring costs; and the tax effect of all such items. Historically, the Company has excluded these items from non-GAAP financial measures. The Company currently expects to continue to exclude these items in future disclosures of non-GAAP financial measures and may also exclude other items that may arise (collectively, “non-GAAP adjustments”). The decisions and events that typically lead to the recognition of non-GAAP adjustments, such as a decision to exit part of the business, are inherently unpredictable as to if or when they may occur. For the same reasons, the Company is unable to address the probable significance of the unavailable information, which could be material to future results.
Forward-Looking Statements
Statements made in this release 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 “anticipate,” “expect,” “plan,” “believe,” “intend,” “project,” “forecast,” “estimates,” “projections,” “outlook,” and other similar expressions. These forward-looking statements include any statements regarding our plans and expectations with respect to Bright Health Group, Inc. Such forward-looking statements are subject to various risks, uncertainties and assumptions. Accordingly, there are or will be important factors that could cause actual outcomes or results to differ materially from those indicated in these statements. Factors that might materially affect such forward-looking statements include: our ability to continue as a going concern; our ability to quickly and efficiently wind down our IFP businesses and MA businesses outside of California; our ability to accurately estimate and effectively manage the costs relating to changes in our businesses offerings and models; a delay or inability to withdraw regulated capital from our subsidiaries; a lack of acceptance or slow adoption of our business model; our ability to retain existing consumers and expand consumer enrollment; our ability to obtain and accurately assess, code, and report Individual and Family Plan and Medicare Advantage risk adjustment factor scores for consumers; our ability to contract with care providers and arrange for the provision of quality care; our ability to accurately estimate our medical expenses, effectively manage our costs and claims liabilities or appropriately price our products and charge premiums; our ability to obtain claims information timely and accurately; the impact of the ongoing COVID-19 pandemic on our business and results of operations; the risks associated with our reliance on third-party providers to operate our business; the impact of modifications or changes to the U.S. health insurance markets; our ability to manage the growth of our business; our ability to operate, update or implement our technology platform and other information technology systems; our ability to retain key executives; our ability to successfully pursue acquisitions and integrate acquired businesses; the occurrence of severe weather events, catastrophic health events, natural or man-made disasters, and social and political conditions or civil unrest; our ability to prevent and contain data security incidents and the impact of data security incidents on our members, patients, employees and financial results; our ability to comply with requirements to maintain effective internal controls; our ability to adapt to the new risks associated with our expansion into Direct Contracting; and the other factors set forth under the heading “Risk Factors” in the Company’s reports on Form 10-K, Form 10-Q, and Form 8-K (including all amendments to those reports) and our other filings with the SEC. Except as required by law, we undertake no obligation to update publicly any forward-looking statements for any reason after the date of this release to conform these statements to actual results or changes in our expectations.
###
Investor Contact:
Stephen Hagan
IR@brighthealthgroup.com
Media Contact:
media@brighthealthgroup.com
Bright Health Group, Inc. and Subsidiaries
Condensed Consolidated Balance Sheets
(in thousands, except share and per share data)
(Unaudited)
| | | | | | | | | | | |
| September 30, 2022 | | December 31, 2021 |
Assets | | | |
Current assets: | | | |
Cash and cash equivalents | $ | 1,605,525 | | $ | 1,061,179 |
Short-term investments | 299,897 | | 193,835 |
Accounts receivable, net of allowance of $7,129 and $4,074, respectively | 120,489 | | 113,474 |
Direct contracting performance year receivable | 234,776 | | — |
Prepaids and other current assets | 377,214 | | 291,712 |
Total current assets | 2,637,901 | | 1,660,200 |
Other assets: | | | |
Long-term investments | 865,677 | | 675,192 |
Property, equipment and capitalized software, net | 47,938 | | 38,344 |
Goodwill | 761,285 | | 835,140 |
Intangible assets, net | 263,265 | | 343,860 |
Other non-current assets | 36,061 | | 45,603 |
Total other assets | 1,974,226 | | 1,938,139 |
Total assets | $ | 4,612,127 | | $ | 3,598,339 |
Liabilities, Redeemable Noncontrolling Interest, Redeemable Preferred Stock and Shareholders’ Equity (Deficit) | | | |
Current liabilities: | | | |
Medical costs payable | $ | 975,126 | | $ | 817,975 |
Accounts payable | 111,272 | | 118,140 |
Unearned revenue | 195,892 | | 53,295 |
Risk adjustment payable | 1,308,959 | | 931,170 |
Direct contracting performance year obligation | 155,145 | | — |
Short-term borrowings | 303,947 | | 155,000 |
Other current liabilities | 201,014 | | 207,238 |
Total current liabilities | 3,251,355 | | 2,282,818 |
Other liabilities | 33,121 | | 41,994 |
Total liabilities | 3,284,476 | | 2,324,812 |
Commitments and contingencies (Note 11) | | | |
Redeemable noncontrolling interests | 211,026 | | 128,407 |
Series A redeemable preferred stock, $0.0001 par value; 100,000,000 shares authorized in 2022 and 2021; 750,000 and — shares issued and outstanding in 2022 and 2021, respectively | 747,481 | | — |
Shareholders’ equity (deficit): | | | |
Common stock, $0.0001 par value; 3,000,000,000 shares authorized in 2022 and 2021; 629,915,081 and 628,622,872 shares issued and outstanding in 2022 and 2021, respectively | 63 | | 63 |
Additional paid-in capital | 2,939,820 | | 2,861,243 |
Accumulated deficit | (2,476,822) | | (1,700,851) |
Accumulated other comprehensive loss | (81,917) | | (3,335) |
Treasury Stock | (12,000) | | (12,000) |
Total shareholders’ equity (deficit) | 369,144 | | 1,145,120 |
Total liabilities, redeemable noncontrolling interests, redeemable preferred stock and shareholders’ equity (deficit) | $ | 4,612,127 | | $ | 3,598,339 |
Bright Health Group, Inc. and Subsidiaries
Condensed Consolidated Statements of Income (Loss)
(in thousands, except per share data)
(Unaudited)
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
| 2022 | | 2021 | | 2022 | | 2021 |
Revenue: | | | | | | | |
Premium revenue | $ | 1,463,011 | | $ | 1,020,233 | | $ | 4,580,790 | | $ | 2,922,950 |
Direct contracting revenue | 145,433 | | — | | 465,435 | | — |
Service revenue | 12,117 | | 11,079 | | 37,390 | | 31,602 |
Investment income (loss) | 11,731 | | 47,345 | | (39,120) | | 112,503 |
Total revenue | 1,632,292 | | 1,078,657 | | 5,044,495 | | 3,067,055 |
Operating expenses: | | | | | | | |
Medical costs | 1,456,862 | | 1,050,943 | | 4,435,624 | | 2,640,143 |
Operating costs | 297,445 | | 309,790 | | 1,122,964 | | 779,090 |
Goodwill impairment | 74,165 | | — | | 74,165 | | — |
Intangible assets impairment | 42,611 | | — | | 49,331 | | — |
Depreciation and amortization | 13,904 | | 14,205 | | 40,173 | | 25,981 |
Total operating expenses | 1,884,987 | | 1,374,938 | | 5,722,257 | | 3,445,214 |
Operating loss | (252,695) | | (296,281) | | (677,762) | | (378,159) |
Interest expense | 4,905 | | 1,594 | | 6,435 | | 6,282 |
Other income | (2) | | (1,226) | | (784) | | (1,226) |
Loss before income taxes | (257,598) | | (296,649) | | (683,413) | | (383,215) |
Income tax (benefit) expense | 1,763 | | 73 | | 7,907 | | (18,225) |
Net loss | (259,361) | | (296,722) | | (691,320) | | (364,990) |
Net earnings attributable to noncontrolling interests | (46,710) | | (3,942) | | (84,651) | | (5,354) |
Series A preferred stock dividend accrued | (9,684) | | — | | (28,083) | | — |
Net loss attributable to Bright Health Group, Inc. common shareholders | $ | (315,755) | | $ | (300,664) | | $ | (804,054) | | $ | (370,344) |
Basic and diluted loss per share attributable to Bright Health Group, Inc. common shareholders | $ | (0.50) | | $ | (0.48) | | $ | (1.28) | | $ | (1.19) |
Basic and diluted weighted-average common shares outstanding | 629,718 | | 630,378 | | 629,231 | | 312,294 |
Bright Health Group, Inc. and Subsidiaries
Condensed Consolidated Statements of Cash Flows
(in thousands)
(Unaudited)
| | | | | | | | | | | |
| Nine Months Ended September 30, |
| 2022 | | 2021 |
Cash flows from operating activities: | | | |
Net loss | $ | (691,320) | | $ | (370,344) |
Adjustments to reconcile net loss to net cash provided by operating activities: | | | |
Depreciation and amortization | 40,173 | | 25,981 |
Impairment of intangible assets | 49,331 | | — |
Impairment of goodwill | 74,165 | | — |
Share-based compensation | 77,263 | | 43,234 |
Deferred income taxes | 1,590 | | (17,946) |
Unrealized gains on equity securities | 58,821 | | (109,012) |
Other, net | 9,612 | | 14,555 |
Changes in assets and liabilities, net of acquired assets and liabilities: | | | |
Accounts receivable | (7,015) | | (18,683) |
Direct contracting performance year receivable | (234,776) | | — |
Other assets | (77,551) | | (86,836) |
Medical cost payable | 157,151 | | 342,531 |
Risk adjustment payable | 377,789 | | 359,257 |
Accounts payable and other liabilities | (21,188) | | 53,853 |
Unearned revenue | 142,597 | | (3,476) |
Direct contracting performance year obligation | 155,145 | | — |
Net cash provided by operating activities | 111,787 | | 233,114 |
Cash flows from investing activities: | | | |
Purchases of investments | (1,422,025) | | (736,838) |
Proceeds from sales, paydown, and maturities of investments | 980,763 | | 536,110 |
Purchases of property and equipment | (21,579) | | (20,682) |
Business acquisitions, net of cash acquired | (310) | | (431,718) |
Net cash used in investing activities | (463,151) | | (653,128) |
Cash flows from financing activities: | | | |
Net proceeds from short-term borrowings | 148,947 | | — |
Proceeds from issuance of preferred stock | 747,481 | | — |
Proceeds from issuance of common stock | 1,314 | | 10,581 |
Distributions to noncontrolling interest holders | (2,032) | | — |
Payments for debt issuance costs | — | | (3,391) |
Proceeds from IPO | — | | 887,328 |
Payments for IPO offering costs | — | | (6,686) |
Net cash provided by financing activities | 895,710 | | 887,832 |
Net increase in cash and cash equivalents | 544,346 | | 467,818 |
Cash and cash equivalents – beginning of year | $ | 1,061,179 | | $ | 488,371 |
Bright Health Group, Inc. and Subsidiaries
Segment Information
(in thousands)
(Unaudited)
| | | | | | | | | | | | | | | | | | | | | | | |
Bright HealthCare - Commercial | Three Months Ended | | Nine months ended |
($ in thousands) | September 30, | | September 30, |
Statements of income (loss) data: | 2022 | | 2021 | | 2022 | | 2021 |
| | | | | | | |
Revenue: | | | | | | | |
Premium revenue | $ | 976,568 | | $ | 625,926 | | $ | 3,085,066 | | $ | 1,930,925 |
Investment income | 6,849 | | 1,058 | | 13,103 | | 3,386 |
Total revenue | 983,417 | | 626,984 | | 3,098,169 | | 1,934,311 |
Operating costs | | | | | | | |
Medical costs | 896,645 | | 673,679 | | 2,646,265 | | 1,682,380 |
Operating costs | 161,913 | | 181,808 | | 701,374 | | 465,680 |
Goodwill impairment | 4,148 | | — | | 4,148 | | — |
Intangible assets impairment | — | | — | | 6,720 | | — |
Depreciation and amortization | — | | 145 | | 145 | | 290 |
Total operating costs | 1,062,706 | | 855,632 | | 3,358,652 | | 2,148,350 |
Operating loss | $ | (79,289) | | $ | (228,648) | | $ | (260,483) | | $ | (214,039) |
| | | | | | | |
Medical Cost Ratio (MCR) | 91.8 | % | | 107.6 | % | | 85.8 | % | | 87.1 | % |
| | | | | | | | | | | | | | | | | | | | | | | |
Medicare Advantage | Three Months Ended | | Nine months ended |
(in thousands) | September 30, | | September 30, |
Statements of income (loss) and operating data: | 2022 | | 2021 | | 2022 | | 2021 |
| | | | | | | |
Revenue: | | | | | | | |
Premium revenue | $ | 408,939 | | $ | 368,599 | | $ | 1,258,846 | | $ | 929,374 |
Investment income | 36 | | 29 | | 83 | | 105 |
Total revenue | 408,975 | | 368,628 | | 1,258,929 | | 929,479 |
Operating costs | | | | | | | |
Medical costs | 362,527 | | 345,402 | | 1,157,528 | | 905,816 |
Operating costs | 43,291 | | 50,434 | | 127,986 | | 119,111 |
Goodwill impairment | 70,017 | | — | | 70,017 | | — |
Depreciation and amortization | 4,416 | | 3,781 | | 13,291 | | 9,903 |
Total operating costs | 480,251 | | 399,617 | | 1,368,822 | | 1,034,830 |
Operating loss | $ | (71,276) | | $ | (30,989) | | $ | (109,893) | | $ | (105,351) |
| | | | | | | |
Medical Cost Ratio (MCR) | 88.7 | % | | 93.7 | % | | 92.0 | % | | 97.5 | % |
| | | | | | | | | | | | | | | | | | | | | | | |
NeueHealth | Three Months Ended | | Nine months ended |
(in thousands) | September 30, | | September 30, |
Statements of income (loss) and operating data: | 2022 | | 2021 | | 2022 | | 2021 |
| | | | | | | |
Revenue: | | | | | | | |
Premium revenue | $ | 328,135 | | $ | 156,990 | | $ | 1,059,597 | | $ | 221,836 |
Direct Contracting revenue | 145,433 | | — | | 465,435 | | — |
Service revenue | 23,615 | | 19,556 | | 72,387 | | 54,809 |
Investment income (loss) | 4,846 | | 46,258 | | (52,306) | | 109,012 |
Total revenue | 502,029 | | 222,804 | | 1,545,113 | | 385,657 |
Operating costs | | | | | | | |
Medical costs | 447,604 | | 163,279 | | 1,453,985 | | 211,176 |
Operating costs | 42,448 | | 38,650 | | 133,926 | | 86,008 |
Intangible assets impairment | 42,611 | | — | | 42,611 | | — |
Depreciation and amortization | 6,913 | | 9,563 | | 20,572 | | 14,362 |
Total operating costs | 539,576 | | 211,492 | | 1,651,094 | | 311,546 |
Operating loss | $ | (37,547) | | $ | 11,312 | | $ | (105,981) | | $ | 74,111 |
| | | | | | | |
Medical Cost Ratio (MCR) | 94.5 | % | | 104.0 | % | | 95.3 | % | | 95.2 | % |
Non-GAAP Financial Measures
We use the non-GAAP financial measure Adjusted EBITDA. We define Adjusted EBITDA as Net Loss excluding Interest Expense, Income Taxes, Depreciation and Amortization, adjusted for the impact of impairment of goodwill or intangible assets, acquisition and financing-related transaction costs, share-based compensation, changes in the fair value of contingent consideration, changes in the fair value of equity securities, contract termination costs and restructuring costs. This non-GAAP measure has been presented in this quarterly Earnings Release as a supplemental measure of financial performance that is not required by or presented in accordance with GAAP because we believe it assists management and investors in comparing our operating performance across reporting periods on a consistent basis by excluding and including items that we do not believe are indicative of our core operating performance. Management believes this measure is useful to investors in highlighting trends in our operating performance, while other measures can differ significantly depending on long-term strategic decisions regarding capital structure, the tax jurisdictions in which we operate and capital investments. Management uses Adjusted EBITDA to supplement GAAP measures of performance in the evaluation of the effectiveness of our business strategies, to make budgeting decisions, to establish discretionary annual incentive compensation and to compare our performance against that of other peer companies using similar measures. Management supplements GAAP results with non-GAAP financial measures to provide a more complete understanding of the factors and trends affecting the business than GAAP results alone.
Adjusted EBITDA is not a recognized term under GAAP and should not be considered as an alternative to Net Income (Loss) as a measure of financial performance or any other performance measure derived in accordance with GAAP. Additionally, Adjusted EBITDA is not intended to be a measure of free cash flow available for management’s discretionary use as it does not consider certain cash requirements such as interest payments, tax payments and debt service requirements. The presentation of Adjusted EBITDA has limitations as analytical tools and should not be considered in isolation or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentation of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company.
The following table provides a reconciliation of net loss to Adjusted EBITDA for the periods presented:
| | | | | | | | | | | | | | | | | | | | | | | |
| Three Months Ended September 30, | | Nine Months Ended September 30, |
($ in thousands) | 2022 | | 2021 | | 2022 | | 2021 |
Net loss | $ | (259,361) | | | $ | (296,722) | | | $ | (691,320) | | | $ | (364,990) | |
Interest expense | 4,905 | | | 1,594 | | | 6,435 | | | 6,282 | |
Income tax (benefit) expense | 1,763 | | | 73 | | | 7,907 | | | (18,225) | |
Depreciation and amortization | 13,904 | | | 14,205 | | | 40,173 | | | 25,981 | |
Goodwill impairment | 74,165 | | | — | | | 74,165 | | | — | |
Intangible assets impairment | 42,611 | | | — | | | 49,331 | | | — | |
Transaction costs (a) | 7 | | | 448 | | | 417 | | | 5,598 | |
Share-based compensation expense (b) | 24,122 | | | 24,180 | | | 77,263 | | | 43,234 | |
Change in fair value of equity securities (c) | 12,189 | | | (46,258) | | | 69,340 | | | (109,012) | |
Change in fair value of contingent consideration (d) | — | | | 304 | | | — | | | 1,363 | |
Contract termination costs (e) | — | | | 10,000 | | | 1,241 | | | 10,000 | |
Restructuring costs (f) | 2,766 | | | — | | | 12,428 | | | — | |
Adjusted EBITDA | $ | (82,929) | | | $ | (292,176) | | | $ | (352,620) | | | $ | (399,769) | |
(a)Transaction costs include accounting, tax, valuation, consulting, legal and investment banking fees directly relating to business combinations and certain costs associated with our initial public offering. These costs can vary from period to period and impact comparability, and we do not believe such transaction costs reflect the ongoing performance of our business.
(b)Represents non-cash compensation expense related to stock option and restricted stock unit award grants, which can vary from period to period based on a number of factors, including the timing, quantity and grant date fair value of the awards.
(c)Beginning in 2022, Adjusted EBITDA excludes the impact of changes in unrealized gains and losses on equity securities. The comparable period in 2021 has been recast to exclude changes in unrealized gains and losses on equity securities.
(d)Represents the non-cash change in fair value of contingent consideration from business combinations, which is remeasured at fair value each reporting period.
(e)Represents amounts paid for early termination of existing vendor contracts.
(f)Restructuring costs represents severance costs as part of a workforce reduction in 2022 and impairment of capitalized software as a result of our decision to exit the Commercial business for the 2023 plan year.