0001628280-26-068247 | 10-Q | XBRL Viewer

Summary of Significant Accounting Policies - Schedule of Computation of Basic and Diluted Net Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Numerator:
Net income (loss)	$ (8,052)	$ 3,729	$ 39,924	$ 10,028
Less: Net loss attributable to noncontrolling interests	0	0	0	(254)
Net income (loss) attributable to Alignment Healthcare, Inc.	$ (8,052)	$ 3,729	$ 39,924	$ 10,282
Denominator:
Total weighted-average common shares outstanding (in shares)	208,556,942	199,026,808	207,132,468	197,022,500
Less: Restricted shares of common stock (in shares)	0	0	0	(15,359)
Total weighted-average common shares outstanding, net of restricted shares of common stock - basic (in shares)	208,556,942	199,026,808	207,132,468	197,007,141
Dilutive effect of:
Shares used to compute diluted income per common share (in shares)	208,556,942	208,927,980	214,815,296	208,439,200
Net income (loss) per share:
Basic income (loss) per share (in dollars per share)	$ (0.04)	$ 0.02	$ 0.19	$ 0.05
Diluted income (loss) per share (in dollars per share)	$ (0.04)	$ 0.02	$ 0.19	$ 0.05
Stock options
Dilutive effect of:
Dilutive effect of common shares (in shares)	0	309,030	703,054	354,209
RSUs
Dilutive effect of:
Dilutive effect of common shares (in shares)	0	7,297,588	6,081,003	8,057,026
PSUs
Dilutive effect of:
Dilutive effect of common shares (in shares)	0	2,294,554	898,771	3,020,824

Organization	9 Months Ended
Organization	Sep. 30, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	Organization Alignment Healthcare, Inc. (collectively, “we” or “us” or “our” or the “Company”), is a next generation, consumer-centric and clinically focused platform designed to improve the healthcare experience for seniors enrolled in Medicare who choose a private Medicare Advantage plan. Our goal is to provide seniors with easier access to care, better coordination among providers, fewer gaps in care and avoidable hospital visits, and support that meets them where they are—at home, online, or in their community. We deliver this experience through our wide variety of Medicare Advantage plans, which offer varied benefits tailored to the diverse needs, preferences, and lifestyles of seniors. The Company’s operations primarily consist of Medicare Advantage Plans in the states of California, North Carolina, Nevada, Arizona and Texas.

Equity-Based Compensation - Schedule of RSU Transactions (Details) - RSUs - $ / shares	3 Months Ended
	Sep. 30, 2026	Jun. 30, 2026	Mar. 31, 2026
Restricted Stock Units
Unvested and outstanding, beginning balance (in shares)	8,881,326	8,984,157	9,356,689
Granted (in shares)	173,689	284,324	2,613,707
Vested (in shares)	(1,780,347)	(275,453)	(2,699,553)
Forfeited (in shares)	(70,500)	(111,702)	(286,686)
Unvested and outstanding, ending balance (in shares)	7,204,168	8,881,326	8,984,157
Weighted-Average Grant Date Fair Value
Unvested and outstanding, beginning balance (in dollars per share)	$ 12.93	$ 12.87	$ 10.49
Granted (in dollars per share)	19.76	15.02	17.21
Vested (in dollars per share)	14.89	13.40	8.91
Cancelled/forfeited (in dollars per share)	19.58	12.31	11.97
Unvested and outstanding, ending balance (in dollars per share)	$ 12.55	$ 12.93	$ 12.87

Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2026

Accounting Policies [Abstract]

Schedule of Significant Segment Expenses

In addition to net income, the CODM is also provided information on certain significant segment expenses which are presented below:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Revenues:	$	1,358,290	$	993,695	$	3,929,120	$	2,935,915
Expenses:
Medical expenses (less depreciation and equity-based compensation)	1,216,085		866,239		3,458,148		2,566,067
Selling, general, and administrative expenses (less equity-based compensation)	120,397		95,563		343,649		273,197
Other segment expenses (1)	25,580		24,214		74,782		74,773
Interest expense	4,280		3,950		12,617		11,850
Net income (loss)	$	(8,052)	$	3,729	$	39,924	$	10,028

(1) Other segment items included in segment net income include equity-based compensation, depreciation and amortization, other income, and provision for income taxes.

Schedule of Earned Revenue

Earned premium revenue consisted of premium revenue and capitation revenue for the three and nine months ended September 30, 2026 and 2025 were as follows:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Premium	$	1,348,028	$	982,634	$	3,900,680	$	2,903,836
Capitation	228		1,047		767		4,091
Total	$	1,348,256	$	983,681	$	3,901,447	$	2,907,927

Schedule of Property and Equipment

Depreciation expense is computed using the straight-line method generally based on the following estimated useful lives:


Description			Estimated Service Lives (years)
Computer and equipment			5
Office equipment and furniture			5-7
Software			3-5
Leasehold improvements			15 (or lease term, if shorter)

Property and equipment consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Computers and equipment	$	15,745	$	13,815
Office equipment and furniture	4,551		4,338
Software	241,273		218,023
Leasehold improvements	6,253		6,224
Construction in progress	1,522		983
Subtotal	269,344		243,383
Less accumulated depreciation	(202,905)		(179,132)
Property and equipment-net	$	66,439	$	64,251

Schedule of Computation of Basic and Diluted Net Income (Loss) Per Share

The following table sets forth the computation of basic and diluted net income (loss) per share for the three and nine months ended September 30, 2026 and September 30, 2025:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Numerator:
Net income (loss)	$	(8,052)	$	3,729	$	39,924	$	10,028
Less: Net loss attributable to noncontrolling interests	—		—		—		(254)
Net income (loss) attributable to Alignment Healthcare, Inc.	$	(8,052)	$	3,729	$	39,924	$	10,282
Denominator:
Total weighted-average common shares outstanding	208,556,942		199,026,808		207,132,468		197,022,500
Less: Restricted shares of common stock	—		—		—		(15,359)
Total weighted-average common shares outstanding, net of restricted shares of common stock - basic	208,556,942		199,026,808		207,132,468		197,007,141

Dilutive effect of:
Stock options	—		309,030		703,054		354,209
RSUs	—		7,297,588		6,081,003		8,057,026
PSUs	—		2,294,554		898,771		3,020,824

Shares used to compute diluted income per common share	208,556,942		208,927,980		214,815,296		208,439,200

Net income (loss) per share:
Basic income (loss) per share	$	(0.04)	$	0.02	$	0.19	$	0.05
Diluted income (loss) per share	$	(0.04)	$	0.02	$	0.19	$	0.05

- Definition

Tabular disclosure of segment reporting. Includes, but is not limited to, reconciliation of reportable segment amount to corresponding consolidated total.

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+ Details

Medical Expenses Payable (Tables)

9 Months Ended

Sep. 30, 2026

Insurance [Abstract]

Schedule of Medical Expenses Payable

The following table is a detail of medical expenses payable as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Claims incurred but not paid	$	295,230	$	297,368
Capitation and risk-sharing payable	82,551		85,083
Part D subsidies and other	243,965		92,118
Medical expenses payable	$	621,746	$	474,569

Schedule of Components of Change in Medical Expenses Payable

The following table presents components of the change in medical expenses payable as of September 30, 2026 and 2025:


	September 30, 2026		September 30, 2025
Claims incurred but not paid - beginning balance	$	297,368	$	168,357
Incurred related to:
Current year	1,233,132		848,585
Prior years	(19,141)		(26,163)
Total incurred, net of reinsurance	1,213,991		822,422
Payments related to:
Current year	956,346		563,755
Prior years	259,783		128,848
Total payments, net of reinsurance	1,216,129		692,603
Claims incurred but not paid - ending balance	295,230		298,176
Capitation payable, risk-sharing payable, and other	326,516		230,620
Total medical expenses payable	$	621,746	$	528,796

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Income Taxes (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025	Dec. 31, 2025
Operating Loss Carryforwards [Line Items]
Income tax (benefit) expense	$ (22)	$ 2	$ 1,269	$ 3,247
NOL carryforwards indefinite life					$ 95,332
United States
Operating Loss Carryforwards [Line Items]
Taxable income deduction limit percentage			80.00%
Carryforward offset percentage of taxable income	100.00%		100.00%
NOL carryforwards					617,001
United States \| Subsidiaries
Operating Loss Carryforwards [Line Items]
Carryforward offset percentage of taxable income	100.00%		100.00%
Income Tax Jurisdiction, Domestic State and Local
Operating Loss Carryforwards [Line Items]
NOL carryforwards					$ 531,012

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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+ Details

Summary of Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2026

Accounting Policies [Abstract]

Basis of Presentation

The accompanying condensed consolidated financial statements and accompanying notes have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). The balance sheet as of December 31, 2025, included herein, was derived from audited financial statements, but does not include all disclosures required by GAAP. In accordance with the rules and regulations of the U.S. Securities and Exchange Commission ("SEC"), the Company has omitted certain footnote disclosures that would substantially duplicate the disclosures contained in its annual audited consolidated financial statements. Therefore, these condensed consolidated financial statements should be read in conjunction with the Company's Annual Report on Form 10-K for the year-ended December 31, 2025 as filed with the SEC. Management believes that the accompanying condensed consolidated financial statements include all normal and recurring adjustments necessary to present the interim financial statements fairly. Furthermore, the condensed consolidated financial statements include the accounts of the Company, our subsidiaries, and three immaterial variable interest entities in which we are the primary beneficiary. All intercompany transactions have been eliminated in consolidation.

We have no components of other comprehensive income, and accordingly, comprehensive income is the same as the net income for all periods presented.

Use of Estimates

The preparation of the condensed consolidated financial statements requires management to make estimates and judgments that affect the amounts reported in the condensed consolidated financial statements. Our significant estimates include, but are not limited to, the determination of medical expenses payable; the impact of risk adjustment provisions related to our Medicare contracts; collectability of receivables; valuation of related impairment recognition of long-lived assets, including goodwill and intangible assets; equity-based compensation expense; and contingent liabilities. Estimates and judgments are based upon historical information and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could differ materially from those estimates and the impact of any change in estimates is included in earnings in the period in which the estimate is adjusted.

Segments

We have determined that our chief executive officer is the chief operating decision maker (“CODM”) who regularly reviews financial operating results on a consolidated basis for purposes of allocating resources and evaluating financial performance. We operate and manage the business as one reportable segment and one operating segment, which is to provide healthcare services to our seniors. Factors used in determining the reportable segment include the nature of operating activities, our organizational and reporting structure, and the type of information reviewed by the CODM to allocate resources and evaluate financial performance. All of our assets are located in the United States.

The CODM assesses the Company's performance by using consolidated net income which is reported on the condensed consolidated statements of operations as net income. This measure is used predominantly by the CODM in the annual budget and forecasting process. The CODM considers budget-to-actual variances on a quarterly basis when making decisions about the allocation of operating and capital resources for the Company.

Fair Value Measurements

Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Our current assets and current liabilities approximate fair value because of the short-term nature of these financial instruments. Financial instruments measured at fair value on a recurring basis were based upon a three-tier hierarchy as follows:

Level 1 - Quoted prices in active markets for identical assets or liabilities

Level 2 - Other inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability

Level 3 - Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date

The fair value of cash, cash equivalents, restricted cash and U.S. Treasury bills was determined based on Level 1 inputs. The fair value of certificate of deposits, which are recorded in other assets in the condensed consolidated balance sheets, and long-term debt was determined based on Level 2 inputs. There were no assets or liabilities measured at fair value using Level 3 inputs as of September 30, 2026 and December 31, 2025.

Revenue and Accounts Receivable and Revenue Adjustments and Part D Subsidies

Premium revenue is derived monthly from the federal government based on our contracts with the Centers for Medicare and Medicaid Services (“CMS”). In accordance with these arrangements, we assume the responsibility for the outcomes and the economic risk of funding our members’ health care, supplemental benefits and related administration costs. We recognize premium revenue in the month that members are entitled to receive health care services, and premiums collected in advance are deferred. The monthly reimbursement includes a fixed payment per member per month (“PMPM”), which is adjusted based on certain risk factors derived from medical diagnoses and conditions of our members. The adjustments are

estimated by projecting the ultimate annual premium and are recognized ratably during the year, with adjustments each period to reflect changes in the estimated ultimate premium. Premiums are also recorded net of estimated uncollectible amounts and retroactive membership adjustments.

In 2025, capitation revenue consisted primarily of capitated fees for medical care services provided by us under arrangements with third-party payors.

Under those arrangements with third-party payors, we received a PMPM payment for a defined member population, and we were responsible for providing health care services to the member population over the contract period. We were solely responsible for the cost of health care services related to the member population and in some cases, we were financially responsible for the supplemental benefits provided by us to the members. We acted as a principal in arranging for and controlling the services provided by our provider network and we were at risk for arranging and providing health care services.

As of January 1, 2026, we no longer have these capitation arrangements with third-party payors.

The premium and capitation payments we receive monthly from CMS for our members are determined from our annual bid or similarly from third-party payors under our capitation arrangement. These payments represent revenues for providing health care coverage, including Medicare Part D benefits. Under the Medicare Part D program, our members and the members of the third-party payors receive standard drug benefits. We may also provide enhanced benefits at our own expense. We recognize premium or capitation revenue for providing this insurance coverage in the month that members are entitled to receive health care services and any premium or capitation collected in advance is deferred. Our CMS payment related to Medicare Part D is subject to risk sharing through the Medicare Part D risk corridor provisions.

In 2025, we also participated in the CMS “ACO Realizing Equity, Access, and Community Health Model” or “ACO REACH” model, formerly the Direct Contracting Model ("DCE"). CMS served as the claim adjudicator for institutional and specialists care, and directly paid for such fee for service claims. The ACO REACH entity ("ACO") was responsible for the cost of health care services related to the patient population attributed to the ACO by participating in 100% savings/losses via the risk share model and in some cases, were financially responsible for the supplemental benefits provided to the patients. The Company acted as an agent in an arrangement where it was not responsible for arranging and controlling the health care services provided to the ACO members, and for providing certain management and support services with respect to ACO operations. The principal assumed the specified upside and downside financial risks relative to the ACO’s performance. As a result of this arrangement, ACO revenue was recorded on a net basis within other revenue on the condensed consolidated statement of operations. We discontinued our participation in the ACO REACH model as of December 31, 2025. This did not have a material impact to our financial results.

Payments by CMS to health plans are determined via a competitive bidding process with CMS and are based upon the cost of care in a local market and the average utilization of services by the member enrolled. These payments are subject to periodic adjustments under CMS’ “risk adjustment model,” which compensates health plans based on the health severity and certain demographic factors of each individual member. Members diagnosed with certain conditions are paid at a higher monthly payment than members who are healthier. Under this risk adjustment model, CMS calculates the risk adjustment payment using diagnosis data from hospital inpatient, hospital outpatient, and physician treatment settings. The Company and health care providers collect, capture, and submit the necessary and available diagnosis data to CMS within prescribed deadlines. Premium revenues are subject to adjustments under the risk adjustment model.

Throughout the year, we estimate risk adjustment payments based upon the diagnosis data submitted and expected to be submitted to CMS. Those estimated risk adjustment payments are recorded as an adjustment to premium and capitation revenue. Our risk adjustment data is also subject to review by the government, including audit by regulators.

Our recognized premium revenue for our Medicare Advantage Plans are each subject to a minimum annual medical loss ratio (“MLR”) of 85%. The MLR represents medical costs as a percentage of premium revenue. The Code of Federal Regulations defines what constitutes medical costs and premium revenue, including certain additional expenses related to

improving the quality of care provided, and the exclusion of certain taxes and fees, in each case as permitted or required by CMS and applicable regulatory requirements. If the minimum MLR is not met, we are required to remit a portion of the premiums back to the federal government. The amount remitted, if any, is recognized as an adjustment to premium revenues in the condensed consolidated statements of operations. The amounts payable under this provision were immaterial at September 30, 2026 and December 31, 2025.

Medicare Part D payments are also subject to a federal risk corridor program, which limits a health plan’s overall losses or profit if actual spending for basic Medicare Part D benefits is much higher or lower than what was anticipated. Risk corridor adjustments are recorded within premium revenue. The risk corridor provisions compare costs targeted in our bids to actual prescription drug costs, limited to actual costs that would have been incurred under the standard coverage as defined by CMS. Variances exceeding certain thresholds may result in CMS making additional payments to us or require us to refund a portion of the premiums we received. We estimate and recognize an adjustment to premium revenue related to these provisions based upon pharmacy claims experience. We record a receivable or payable at the contract level and classify the amount as current or long-term in our condensed consolidated balance sheets based on the timing of expected settlement.

Receivables, including risk adjusted premium due from the government, pharmacy rebates, and other receivables, are shown net of allowances for credit losses and retroactive membership adjustments.

We also receive advance payments each month from CMS related to Catastrophic Reinsurance, Manufacturer Discount Program, the Low-Income Member Cost Sharing Subsidy (“Part D Subsidies”), and Select Drug Prepayments related to the Maximum Fair Price Program. Reinsurance subsidies represent funding from CMS for our portion of prescription drug costs that exceed the member’s out-of-pocket threshold or the catastrophic coverage level. Low-income cost sharing subsidies represent funding from CMS for all or a portion of the deductible, the coinsurance and co-payment for low-income beneficiaries. Additionally, the Inflation Reduction Act mandates consumer discounts on most brand-name prescription drugs for Part D plan participants in the initial coverage and catastrophic phases. These discounts are ultimately funded by the pharmaceutical manufacturers. In 2025, the IRA retired the Coverage Gap Discount Program, introduced the Manufacturer Discount Program, and changed the members' cost thresholds for the catastrophic phase. New in 2026, CMS is providing prepayment to cover liabilities associated with the Maximum Fair Price Program. These program changes and the corresponding changes in prepayments are reflected in our 2026 experience.

These Part D Subsidies represent cost reimbursements under the Medicare Part D program and are recorded as deposits or payables. These Subsidies received in excess of, or less than, actual subsidized benefits paid are refundable to or recoverable from CMS through an annual reconciliation process following the end of the contract year.

Property and Equipment—Net

Depreciation expense is computed using the straight-line method generally based on the following estimated useful lives:


Description			Estimated Service Lives (years)
Computer and equipment			5
Office equipment and furniture			5-7
Software			3-5
Leasehold improvements			15 (or lease term, if shorter)

Depreciation expense related to property and equipment used to service our members or at our clinics are included within medical expenses in the condensed consolidated statements of operations.

Medical Expenses and Medical Expenses Payable

Medical Expenses

Medical expenses include claim payments, capitation payments, pharmacy costs net of rebates, allocations of certain centralized expenses, internal care delivery expenses and various other costs incurred to provide health insurance coverage and care to members, as well as estimates of future payments to hospitals and others for medical care and other supplemental benefits provided.

We have contracts with a network of hospitals, physicians, and other providers and compensate those providers and ancillary organizations based on contractual arrangements or CMS Medicare compensation guidelines. We pay these contracting providers either through fee-for-service arrangements in which the provider is paid negotiated rates for specific services provided or a capitation payment, which represent monthly contractual fees disbursed for each member regardless of medical services provided to the member. We are responsible for the entirety of the cost of health care services related to the member population, in addition to supplemental benefits provided by us to our seniors.

Capitation-related expenses are recorded on an accrual basis during the coverage period. Expenses related to fee-for-service contracts are recorded in the period in which the related services are dispensed.

Pharmacy costs represent payments for members’ prescription drug benefits, net of rebates from drug manufacturers. Receivables for such pharmacy rebates are included in accounts receivable in the condensed consolidated balance sheet.

In August 2022, the Inflation Reduction Act ("IRA") was signed into law. The law intends to increase tax revenue and reduce Medicare costs through lower prescription drug prices, inflation-based rebates, and increased financial responsibility for certain drug manufacturers. The provisions of the law are set to take effect over seven years from 2023 to 2029. For the three and nine months ended September 30, 2026 and September 30, 2025, we experienced an increase in both Part D premium revenues and medical expenses as a result of the IRA. Our 2026 bid pricing (submitted to CMS in June 2025) and budget reflect the expected impact the IRA will have on our business for fiscal year 2026.

Medical Expenses Payable

Medical expenses payable includes estimates of our obligations for medical care services that have been rendered on behalf of our members, but for which claims have either not yet been received or processed, loss adjustment expense reserve for the expected costs of settling these claims, and for liabilities related to physician, hospital, and other medical cost disputes.

We develop estimates for medical expenses incurred but not yet paid (“IBNP”), which includes an estimate for claims incurred but not reported (“IBNR”) and a payable for adjudicated claims. IBNR is estimated using an actuarial process that is consistently applied and centrally controlled. Medical expenses payable also includes an estimate for the costs necessary to process unpaid claims at the end of each period. We estimate the IBNR liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors, such as cost trends and completion factors that are assessed based on historical data for payment patterns, product mix, seasonality, utilization of health care services, and other relevant factors. Each period, we re-examine previously established IBNR estimates based on actual claim submissions and other changes in facts and circumstances. As the IBNR estimates recorded in prior periods develop, we adjust the amount of the estimates and include the changes in estimates in medical expenses in the period in which the change is identified.

Actuarial Standards of Practice generally require that the IBNP estimates be adequate to cover obligations under moderately adverse conditions. Moderately adverse conditions are situations in which the actual claims are expected to be higher than the otherwise estimated value of such claims at the time of estimate. In many situations, the claims amount ultimately settled will be different than the estimate that satisfies the Actuarial Standards of Practice. We include in our IBNP an estimate for medical claims liability under moderately adverse conditions, which represents the risk of adverse deviation of the estimates in our actuarial method of reserving. We believe that medical expenses payable is adequate to cover future claims payments required. However, such estimates are based on knowledge of current events and anticipated future events. Therefore, the actual liability could differ materially from the amounts provided.

We reassess the profitability of contracts for providing coverage to members when current operating results or forecasts indicate probable future losses. A premium deficiency reserve is established in current operations to the extent that the sum of expected future costs, claim adjustment expenses, and maintenance costs exceed related future premiums under contract and investment income. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing, and measuring the profitability of such contracts. Losses recognized as a premium deficiency result in a beneficial effect in subsequent periods as operating losses under these contracts are charged to the liability previously established.

Shared Risk Reserve Arrangements

We established a fund (also referred to as “a pool”) for risk and profit-sharing with various independent physician associations (“IPAs”). The pool enables us and our IPAs to share in the financial responsibility and/or upside associated with providing covered medical expenses to our members. The risk pool is based on a contractually agreed upon medical budget, typically based upon a percentage of revenue. If actual medical expenses are less than the budgeted amount, this

results in a surplus. Conversely, if actual medical expenses are greater than the budgeted amount, this results in a deficit. We will distribute the surplus, or a portion thereof, to each IPA based upon contractual terms. Deficits are charged to shared risk providers’ risk pool as per the contractual term and evaluated for collectability at each reporting period.

We record risk-sharing receivables and payables on a gross basis on the condensed consolidated balance sheets. Throughout the year, we evaluate expected losses on risk-sharing receivables and record the resulting expected losses to the reserve. We systematically build and release reserves based on adequacy and its assessment of expected losses on a monthly basis. Credit loss associated with risk share deficit receivables are recorded within medical expense in the condensed consolidated statements of operations. As of September 30, 2026 and December 31, 2025, we recorded an allowance for credit losses for substantially all of the risk-sharing receivable balance due to collection risk related to the balance. The risk-sharing payable is included within medical expenses payable on the condensed consolidated balance sheets.

Concentrations of Credit Risk

Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash deposits and current and restricted investments with financial institutions. Accounts at each financial institution are insured by the Federal Deposit Insurance Corporation (“FDIC”) up to certain limits.

Equity-Based Compensation

Equity-based compensation expense is measured and recognized based on the grant date fair value of the awards. The grant date fair value of stock options is estimated using the Black-Scholes option pricing model. The grant date fair value of restricted stock units (“RSUs”) and performance stock units ("PSUs") is generally estimated based on the fair value of our underlying common stock on the date of grant. For PSUs with market-based performance conditions, the fair value is determined using a Monte Carlo simulation.

The Black-Scholes option pricing model requires the use of highly subjective assumptions, including the award’s expected term, the fair value of the underlying common stock, the expected volatility of the price of the common stock, risk-free interest rates, and the expected dividend yield of the common stock. The assumptions used to determine the fair value of the stock-based awards are management’s best estimates and involve inherent uncertainties and the application of judgment. The expected term represents the period the stock-based awards are expected to be outstanding. As we did not have sufficient historical experience for determining the expected term of the stock option awards granted, we utilized the simplified method available under GAAP. As we did not have a substantial trading history, volatility assumptions were developed using a combination of the Company's historical volatility and the historical volatilities of a set of peer companies, adjusted for debt-equity leverage. Equity-based compensation expense for awards with service-based vesting only is recognized on a graded vesting schedule over the requisite service period of the awards, which is generally three or four years.

Equity-based compensation expense for PSU awards with Company performance-based vesting is recognized over the requisite service period on a graded vesting schedule and is only recognized when the Company concludes that it is probable that the performance condition(s) will be achieved. At each reporting period, the Company reassesses the probability of achieving the performance criteria. Determining whether the performance criteria will be achieved involves judgment, and the estimate of share-based compensation expense may be revised periodically based on changes in the probability of achieving the performance criteria. Revisions are reflected in the period in which the estimate is changed. We account for forfeitures as they occur. For PSU awards with market-based performance conditions, equity-based compensation expense for each performance tranche is recognized on a straight-line basis over the requisite service period. As the grant date fair value is derived using a Monte Carlo simulation, the probability of meeting the market-based performance conditions is factored into the fair value and no reassessment is required.

Equity-based compensation is recorded within selling, general and administrative expenses, and medical expenses based on the function of the applicable employee and non-employee.

Net Income (loss) per Share

Net income (loss) per share is calculated based on net income (loss) attributable to Alignment Healthcare, Inc.'s stockholders. Potentially dilutive common stock equivalents for the Company include stock options, unvested RSUs, unvested PSUs, and convertible senior notes.

Diluted net income (loss) per share includes the components of basic net income (loss) per share and also gives effect to dilutive common stock equivalents. Diluted net income (loss) per share reflects the potential dilution that could occur if securities or other instruments that are convertible into common stock were exercised or could result in the issuance of common stock. For the purposes of computing diluted net income (loss) per share, weighted average shares outstanding do not include potentially dilutive securities that are anti-dilutive under the treasury stock method or if-converted method, and performance-based equity awards are included based on the attainment of the applicable performance metrics as of the end of the reporting period.

Recent Accounting Pronouncements Issued

In December 2025, the FASB issued ASU 2025-11 "Interim Reporting (Topic 270): Narrow-Scope Improvements", which clarifies and reorganizes existing U.S. GAAP guidance for interim financial reporting without changing the underlying disclosure requirements. The update refines the scope of Topic 270 to apply to entities that present a complete set of interim financial statements (or condensed financial statements with accompanying notes) and introduces a more principles-based disclosure objective focused on reporting material changes since the most recent annual reporting period. It also consolidates and streamlines interim disclosure guidance—previously dispersed across various topics—into a more accessible framework within Topic 270, with the goal of improving consistency and usability in practice while avoiding

unnecessary repetition of annual disclosures. ASU 2025-11 is effective for public business entities for interim periods beginning after December 15, 2027, with early adoption permitted. The Company is currently evaluating the impact of this ASU on its financial statements.

In September 2025, the FASB issued ASU 2025-06 "Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software", which removes the multi-stage model when determining internal-use software development cost capitalization. Under the new ASU, such software costs are capitalized when management has authorized and committed to funding the software project, and if it is probable that the project will be completed and the software will be used to perform the function intended. If a project is still subject to major uncertainty, capitalization is prohibited. ASU 2025-06 is effective for annual periods beginning after December 15, 2027 (and interim reporting periods within those annual reporting periods). The Company is currently evaluating the impact of this ASU on its financial statements.

In November 2024, the FASB issued ASU 2024-03 “Disaggregation of Income Statement Expenses”, which improves income statement presentation and disclosures related to expenses. It requires a public entity to disaggregate key expense categories such as employee compensation, depreciation and intangible asset amortization within its financial statements. ASU 2024-03 is effective for annual periods beginning after December 15, 2026, and interim periods within the Company's fiscal year 2027, with early adoption permitted. The Company is currently evaluating the impact of this ASU on its disclosures of income statement expenses.

Long-Term Debt

9 Months Ended

Sep. 30, 2026

Debt Disclosure [Abstract]

Long-Term Debt

Long-term debt is recorded at carrying value in the condensed consolidated balance sheets. The carrying value of long-term debt outstanding, net of unamortized debt issuance costs, consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Long-term debt	$	330,000	$	330,000
Less unamortized debt issuance costs	(5,503)		(6,824)
Long-term debt-net of amortization	324,497		323,176
Less current maturities of long-term debt	—		—
Long-term debt - net of current portion	$	324,497	$	323,176

Convertible Senior Notes

On November 22, 2024 the Company completed the sale of $330,000 of our 4.25% Convertible Senior Notes (the “Notes”). The Notes were issued pursuant to an indenture (the “Indenture”), dated as of November 22, 2024, between the Company and U.S. Bank Trust Company, National Association, as trustee (the “Trustee”). The Notes are senior, unsecured obligations of the Company, and interest will be payable semi-annually in arrears at a rate of 4.25% per annum beginning on May 15, 2025. The Notes will mature on November 15, 2029, unless earlier repurchased, redeemed or converted in accordance with their terms. The net cash proceeds from the sale of the Notes was approximately $321,100, after subtracting fees, discounts and estimated expenses in connection with the transaction.

Prior to the close of business on the business day immediately preceding August 15, 2029, the Notes will be convertible at the option of holders during certain periods, upon satisfaction of certain conditions. On or after August 15, 2029, the Notes will be convertible at any time until the close of business on the second scheduled trading day immediately preceding the maturity date. Upon conversion, the Notes may be settled in shares of Company common stock, cash or a combination of cash and shares of Company common stock, at the Company's election.

The Notes have an initial conversion rate of approximately 62.4 shares of Company common stock per $1 principal amount of the Notes. The conversion rate will be subject to adjustment in certain events, including adjustment in the event of certain significant corporate transactions. This represents an initial conversion price of approximately $16.04 per share. The initial conversion price of the Notes represents a premium of approximately 25% to the closing price of the Company's common stock on November 14, 2024. The Company has used the proceeds from the sale of the Notes to repay in full the $215,000 aggregate principal amount, accrued interest and fees related to the Company's previous term loans with a separate financing company, as well as certain fees and expenses incurred in connection with the transaction.

The Indenture contains customary terms and covenants, including that upon certain events of default occurring and continuing, either the Trustee or the holders of at least 25% in principal amount of the outstanding notes may declare 100% of the principal of, and accrued and unpaid special interest, if any, on, all the notes to be due and payable.

The Company has recognized the Notes in their entirety as a liability on the condensed consolidated balance sheet and no portion of the proceeds from the issuance of the convertible debt instrument was accounted for separately as an embedded conversion feature within stockholders’ equity.

Future maturities under the Notes for each of the next five years ending September 30, are as follows:


	Amount
Remainder of 2026	$	—
2027	—
2028	—
2029	330,000
2030	—
	$	330,000

Revolving Credit Facility

On February 26, 2026 (the “Effective Date”), the Company, Alignment Healthcare USA, LLC, an indirect wholly owned subsidiary of the Company (the “Borrower”) and certain other subsidiaries of the Company (together with the Company and the Borrower, the “Borrower Parties”) entered into a Credit Agreement with Citibank, N.A., as administrative agent, and the lenders party thereto (the “Credit Agreement”). The Credit Agreement matures on February 26, 2029, and provides for a $200,000 senior secured revolving credit facility (the “Credit Facility”), with sublimits of up to $20,000 for the issuance of letters of credit and $5,000 for swingline loans. Subject to meeting certain customary conditions, the Borrower may request an increase to the commitments under the Credit Facility or to establish one or more new term loan facilities by up to an amount equal to the greater of $50,000 or 100% of the Borrower Parties’ Consolidated EBITDA (as defined in the Credit Agreement) for the most recently completed four fiscal quarters of the Borrower Parties for which financial statements have been delivered.

Borrowings under the Credit Facility may be used for permitted acquisitions, working capital, the payment of fees, costs and expenses incurred in connection with the Credit Agreement and other general corporate purposes. The Borrower did not borrow any amounts under the Credit Facility as of September 30, 2026.

Loans under the Credit Facility will bear interest at a floating rate, which can be either, at the Borrower’s option, (a) Term SOFR (as defined in the Credit Agreement) plus an applicable margin that ranges from 2.0% to 2.5% per annum with respect to Term SOFR loans or (b) a Base Rate (as defined in the Credit Agreement) plus an applicable margin that ranges from 1.0% to 1.5% per annum with respect to Base Rate loans, based on the consolidated senior secured leverage ratio for the Borrower Parties and their affiliates, as calculated in accordance with the Credit Agreement. The Borrower is also required to pay certain fees in connection with the Credit Agreement, including commitment fees on a quarterly basis in respect of the unutilized portion of the commitments under the Credit Agreement and certain fees to each of the lenders upon the effectiveness of the Credit Agreement. The Borrower may voluntarily repay outstanding borrowings under the Credit Facility at any time, without premium or penalty.

The Credit Agreement includes financial covenants that require us to maintain, as of the last day of each fiscal quarter (commencing with the fiscal quarter ending June 30, 2026), (i) a ratio of senior secured indebtedness that is not subordinated in right of payment to the obligations under the Credit Agreement to Consolidated EBITDA (as defined in the Credit Agreement) for the period of four consecutive fiscal quarters ended on such date, of not more than 2.5 to 1.0 and (ii) Consolidated EBITDA for the period of four consecutive fiscal quarters ended on such date, of amounts specified in the Credit Agreement starting from $60,000 as of June 30, 2026, increasing to $70,000 as of June 30, 2027, and $80,000 as of June 30, 2028 and each fiscal quarter thereafter.

The Borrower’s obligations under the Credit Agreement are guaranteed by the Company and certain subsidiaries of the Company and secured by substantially all of the assets of the Borrower, the Company and such subsidiaries of the Company, subject to customary exceptions. None of the Company’s health plan subsidiaries or other regulated entities are guarantors under the Credit Agreement and the equity in such subsidiaries was not pledged. The Credit Agreement contains customary representations and warranties, as well as affirmative and negative covenants. Negative covenants include, among others, customary covenants that restrict the ability of the Company and its subsidiaries, without the approval of requisite lenders, to engage in certain fundamental transactions, incur debt and liens, enter into transactions with affiliates and make certain restricted payments and restricted investments, in each case, as set forth in the Credit Agreement and subject to certain thresholds and exceptions. The Credit Agreement also contains other customary covenants and events of default for secured credit facilities of this type. Upon an event of default that is not cured or waived within any applicable cure periods, in addition to other remedies that may be available to the lenders, the obligations under the Credit Agreement may be accelerated. As of September 30, 2026, there was no outstanding debt under the credit facility and we were in compliance with all financial covenants.

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2026
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Current Assets:
Cash and cash equivalents	$ 727,694	$ 575,817
Accounts receivable (less allowance for credit losses of $699 at September 30, 2026 and $833 at December 31, 2025)	242,545	253,207
Investments - current	15,260	28,413
Prepaid expenses and other current assets	192,808	94,140
Total current assets	1,178,307	951,577
Property and equipment, net	66,439	64,251
Right of use asset, net	7,206	7,019
Goodwill	32,060	32,060
Intangible assets, net	4,550	4,550
Other assets	8,301	6,329
Total assets	1,296,863	1,065,786
Current Liabilities:
Medical expenses payable	621,746	474,569
Accounts payable and accrued expenses	34,562	33,284
Accrued compensation	32,744	49,013
Total current liabilities	689,052	556,866
Long-term debt, net of debt issuance costs	324,497	323,176
Long-term portion of lease liabilities	6,202	6,467
Total liabilities	1,019,751	886,509
Commitments and Contingencies (Note 12)
Stockholders' Equity:
Preferred stock, $0.001 par value; 100,000,000 shares authorized as of September 30, 2026 and December 31, 2025, respectively; no shares issued and outstanding as of September 30, 2026 and December 31, 2025	0	0
Common stock, $0.001 par value; 1,000,000,000 shares authorized as of September 30, 2026 and December 31, 2025; 209,152,387 and 204,153,619 shares issued and outstanding as of September 30, 2026 and December 31, 2025, respectively	209	205
Additional paid-in capital	1,245,996	1,188,089
Accumulated deficit	(969,093)	(1,009,017)
Total stockholders' equity	277,112	179,277
Total liabilities and stockholders' equity	$ 1,296,863	$ 1,065,786

Medical Expenses Payable - Schedule of Medical Expenses Payable (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025	Sep. 30, 2025	Dec. 31, 2024
Insurance [Abstract]
Claims incurred but not paid	$ 295,230	$ 297,368	$ 298,176	$ 168,357
Capitation and risk-sharing payable	82,551	85,083
Part D subsidies and other	243,965	92,118
Medical expenses payable	$ 621,746	$ 474,569	$ 528,796

Medical Expenses Payable

9 Months Ended

Sep. 30, 2026

Insurance [Abstract]

Medical Expenses Payable

The following table is a detail of medical expenses payable as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Claims incurred but not paid	$	295,230	$	297,368
Capitation and risk-sharing payable	82,551		85,083
Part D subsidies and other	243,965		92,118
Medical expenses payable	$	621,746	$	474,569

Each period, we re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. As more complete claim information becomes available, we adjust the amount of the estimates and include the changes in estimates in claim costs in the period in which the change is identified. Substantially all of the total claims paid by us are known and settled within the first year from the date of service, and substantially all remaining claim amounts are paid within a three-year period.

The following table presents components of the change in medical expenses payable as of September 30, 2026 and 2025:


	September 30, 2026		September 30, 2025
Claims incurred but not paid - beginning balance	$	297,368	$	168,357
Incurred related to:
Current year	1,233,132		848,585
Prior years	(19,141)		(26,163)
Total incurred, net of reinsurance	1,213,991		822,422
Payments related to:
Current year	956,346		563,755
Prior years	259,783		128,848
Total payments, net of reinsurance	1,216,129		692,603
Claims incurred but not paid - ending balance	295,230		298,176
Capitation payable, risk-sharing payable, and other	326,516		230,620
Total medical expenses payable	$	621,746	$	528,796

We re-examine previously established outstanding claims reserve estimates based on actual claims submissions and other changes in facts and circumstances. We recognized a favorable prior year development, excluding provision for adverse deviation of $89 and $1,936 for the three and nine months ended September 30, 2026. The favorable prior year development was primarily due to better-than-expected claims recoveries and actual claims expense being less than expected.

Medical Expenses Payable - Schedule of Components of Change in Medical Expenses Payable (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Dec. 31, 2025
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Claims incurred but not paid - beginning balance	$ 297,368	$ 168,357
Incurred related to:
Current year	1,233,132	848,585
Prior years	(19,141)	(26,163)
Total incurred, net of reinsurance	1,213,991	822,422
Payments related to:
Current year	956,346	563,755
Prior years	259,783	128,848
Total payments, net of reinsurance	1,216,129	692,603
Claims incurred but not paid - ending balance	295,230	298,176
Capitation payable, risk-sharing payable, and other	326,516	230,620
Medical expenses payable	$ 621,746	$ 528,796	$ 474,569

Fair Value - Schedule of Carrying Value and Fair Value of Financial Instruments (Details) - USD ($)	Sep. 30, 2026	Dec. 31, 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
U.S. Treasury bills	$ 16,289,000	$ 29,456,000
Certificate of deposits	2,360,000	2,345,000
Total	18,649,000	31,801,000
Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
U.S. Treasury bills	16,286,000	29,465,000
Certificate of deposits	0	0
Total	16,286,000	29,465,000
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
U.S. Treasury bills	0	0
Certificate of deposits	2,360,000	2,345,000
Total	2,360,000	2,345,000
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
U.S. Treasury bills	0	0
Certificate of deposits	0	0
Total	$ 0	$ 0

- Definition

Amount, after allowance for credit loss, of investment in debt security measured at amortized cost (held-to-maturity).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
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-Paragraph 2
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-URI https://asc.fasb.org/1943274/2147477268/942-320-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477268/942-320-50-2

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 210
-Name Accounting Standards Codification
-Section S45
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477657/942-210-S45-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 210
-Name Accounting Standards Codification
-Section S50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478478/942-210-S50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 210
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-03(6))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478546/942-210-S99-1

Reference 14: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 860
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 1A
-Subparagraph (b)(1)(i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481420/860-30-50-1A

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481800/320-10-50-5

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 320
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481830/320-10-45-1

+ Details

Regulatory Requirements and Restricted Funds	9 Months Ended
Regulatory Requirements and Restricted Funds	Sep. 30, 2026
Regulated Operations [Abstract]
Regulatory Requirements and Restricted Funds	Regulatory Requirements and Restricted Funds Our health plans or risk-bearing entities are required to maintain minimum capital requirements prescribed by various regulatory authorities in each of the states in which it operates. Risk-Based Capital The National Association of Insurance Commissioners has adopted rules, which, if implemented by the states, set minimum capitalization requirements for insurance companies, health maintenance organizations ("HMOs"), and other entities bearing risk for health care coverage. The requirements take the form of risk-based capital ("RBC") rules, which may vary from state to state. Certain states in which our health plans or risk-bearing entities operate have adopted the RBC rules. Our health plans or risk-bearing entities were in compliance with the RBC requirements as of September 30, 2026. Tangible Net Equity Our health plans in California are required to comply with the tangible net equity ("TNE") requirements. The required amount is 150% of the larger of: (1) $1,000; (2) the sum of 2% of the first $150,000 of annualized premium revenue and 1% of annualized premium revenue in excess of $150,000; or (3) 8% of the first $150,000 of annualized health care expenditures except those paid on a capitated or managed hospital payment basis, plus 4% of the annualized health care expenditures in excess of $150,000, except those paid on a capitated or managed hospital payment basis, plus 4% of annualized hospital expenditures paid on a managed hospital payment basis. For newer health plans, through the first three years immediately following the health plan’s operational start date, the required amount is 200% of the larger of the TNE calculation described above. We were in compliance with the TNE requirements as of September 30, 2026. Certain states regulate the payment of dividends, loans, or other cash transfers from our regulated subsidiaries to our non-regulated subsidiaries and parent company. Such payments may require approval by state regulatory authorities and are limited based on certain financial criteria, such as the entity’s level of statutory income and statutory capital and surplus, or the entity’s level of tangible net equity or net worth, amongst other measures. These regulations vary by state. We have the ability to provide additional capital to each of our health plans or risk-bearing entities when necessary to ensure that the RBC and TNE requirements are met. Restricted Assets Pursuant to the regulations governing our subsidiaries, we maintain certain deposits required by the government authorities in the form of cash, certificate of deposit and Treasury bills as protection in the event of insolvency. The use of funds from these investments is limited as required by regulation in the various states in which we operate, or as needed in the event of insolvency. Therefore, these deposits are reported within other assets on the condensed consolidated balance sheets. We hold these assets until maturity, at which time these assets will renew or are invested in a similar type of investment instrument. Given the regulatory requirements, we expect to hold these investments for long-term. As a result, we do not expect the value of these investments to decline significantly due to a sudden change in market interest rates. These investments are carried at amortized cost, which approximates fair value. See Note 3, Fair Value, for further discussion.

Goodwill and Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2026

Intangible Asset, Goodwill and Other [Abstract]

Schedule of Intangible Assets

Intangible assets consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Life
Goodwill	$	32,060	$	—	$	32,060	—
License (indefinite lived)	4,550		—		4,550		—
Plan member relationships	2,700		(2,700)		—		9 years
Other	633		(633)		—		2 - 10 years
Total	$	39,943	$	(3,333)	$	36,610


	December 31, 2025
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Life
Goodwill	$	32,060	$	—	$	32,060	—
License (indefinite lived)	4,550		—		4,550		—
Plan member relationships	2,700		(2,700)		—		9 years
Other	633		(633)		—		2 - 10 years
Total	$	39,943	$	(3,333)	$	36,610

Equity-Based Compensation - Schedule of Equity-based Compensation Expense on Statement of Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total equity-based compensation expense	$ 17,487	$ 16,227	$ 49,680	$ 48,967
Income Statement Location: alhc:MedicalExpenses
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total equity-based compensation expense	1,511	1,775	4,815	4,521
Income Statement Location: us-gaap:SellingGeneralAndAdministrativeExpense
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total equity-based compensation expense	$ 15,976	$ 14,452	$ 44,865	$ 44,446

Equity-Based Compensation - Schedule of PSUs Transactions (Details) - PSUs - $ / shares	3 Months Ended
	Sep. 30, 2026	Jun. 30, 2026	Mar. 31, 2026
Performance-based restricted stock units
Unvested and outstanding, beginning balance (in shares)	3,688,458	3,477,932	1,685,407
Granted (in shares)	87,719	210,526	1,792,525
Vested (in shares)	0	0	0
Cancelled/forfeited (in shares)	0	0	0
Unvested and outstanding, ending balance (in shares)	3,776,177	3,688,458	3,477,932
Weighted-Average Grant Date Fair Value
Unvested and outstanding, beginning balance (in dollars per share)	$ 12.68	$ 12.58	$ 9.35
Granted (in dollars per share)	24.01	14.25	15.62
Vested (in dollars per share)	0	0	0
Cancelled/forfeited (in dollars per share)	0	0	0
Unvested and outstanding, ending balance (in dollars per share)	$ 12.94	$ 12.68	$ 12.58

Equity-Based Compensation - Schedule of Earned PSUs in Volume Weighted Average Price Per Share (Details) - PSUs	Feb. 24, 2026 $ / shares shares
First Stock Price Hurdle
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Price Per Share Goals (in dollars per share) \| $ / shares	$ 33.75
Number of Earned PSUs (in shares) \| shares	333,333
Second Stock Price Hurdle
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Price Per Share Goals (in dollars per share) \| $ / shares	$ 44
Number of Earned PSUs (in shares) \| shares	333,333
Third Stock Price Hurdle
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Price Per Share Goals (in dollars per share) \| $ / shares	$ 55.25
Number of Earned PSUs (in shares) \| shares	333,334

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(v)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(iii)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(iv)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(ii)
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Subparagraph (l)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
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-Section 50
-Paragraph 2
-Subparagraph (d)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 35
-Paragraph 1D
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480483/718-10-35-1D

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 35
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480483/718-10-35-3

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(i)
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-Paragraph 2
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-Subparagraph (c)(1)(iv)
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(2)(iii)(02)
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 29: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Subparagraph (e)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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+ Details

Long-Term Debt - Schedule of Future Maturities Under the Term Loan (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Debt Disclosure [Abstract]
Remainder of 2026	$ 0
2027	0
2028	0
2029	330,000
2030	0
Total	$ 330,000	$ 330,000

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025
Operating Activities:
Net income	$ 39,924	$ 10,028
Adjustments to reconcile net income to net cash provided by operating activities:
Provision for credit loss	699	548
Gain on sale of property and equipment	(1)	(72)
Depreciation and amortization	23,834	22,648
Amortization-investment discount	(478)	(1,041)
Amortization-debt issuance costs	1,790	1,321
Equity-based compensation	49,680	48,967
Non-cash lease expense	1,439	1,178
Changes in operating assets and liabilities:
Accounts receivable	9,963	(66,451)
Prepaid expenses and other current assets	(98,668)	(84,326)
Other assets	(9)	(47)
Medical expenses payable	147,177	239,008
Accounts payable and accrued expenses	1,004	11,185
Accrued compensation	(16,269)	8,349
Lease liabilities	(1,690)	(993)
Net cash provided by operating activities	158,395	190,302
Investing Activities:
Purchase of investments	(32,510)	(45,194)
Sale of property and equipment	0	75
Maturities of investments	46,135	57,995
Sale of business	0	1,065
Acquisition of property and equipment	(25,952)	(21,752)
Net cash used in investing activities	(12,327)	(7,811)
Financing Activities:
Debt issuance costs	(2,397)	(26)
Proceeds from stock option exercises	8,231	2,771
Net cash provided by financing activities	5,834	2,745
Net increase in cash	151,902	185,236
Cash, cash equivalents and restricted cash at beginning of period	577,937	434,942
Cash, cash equivalents and restricted cash at end of period	729,839	620,178
Supplemental disclosure of cash flow information:
Cash paid for interest	7,013	6,740
Supplemental non-cash investing and financing activities:
Acquisition of property in accounts payable	9	79
Reconciliation of cash, cash equivalents and restricted cash as shown in the statement of cash flows:
Cash and cash equivalents	727,694	618,067
Restricted cash in other assets	2,145	2,111
Total	$ 729,839	$ 620,178

Accounts Receivable - Schedule of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Accounts Receivable, after Allowance for Credit Loss [Abstract]
Government receivables	$ 75,903	$ 52,411
Pharmacy rebate receivables	150,330	179,196
Other receivables	17,011	22,433
Total accounts receivable	243,244	254,040
Allowance for credit losses	(699)	(833)
Accounts receivable, net	$ 242,545	$ 253,207

Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2026

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation

We have no components of other comprehensive income, and accordingly, comprehensive income is the same as the net income for all periods presented.

Use of Estimates

Segments

In addition to net income, the CODM is also provided information on certain significant segment expenses which are presented below:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Revenues:	$	1,358,290	$	993,695	$	3,929,120	$	2,935,915
Expenses:
Medical expenses (less depreciation and equity-based compensation)	1,216,085		866,239		3,458,148		2,566,067
Selling, general, and administrative expenses (less equity-based compensation)	120,397		95,563		343,649		273,197
Other segment expenses (1)	25,580		24,214		74,782		74,773
Interest expense	4,280		3,950		12,617		11,850
Net income (loss)	$	(8,052)	$	3,729	$	39,924	$	10,028

(1) Other segment items included in segment net income include equity-based compensation, depreciation and amortization, other income, and provision for income taxes.

Fair Value Measurements

Level 1 - Quoted prices in active markets for identical assets or liabilities

Level 2 - Other inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the asset or liability

Level 3 - Unobservable inputs that reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date

Revenue and Accounts Receivable

Earned premium revenue consisted of premium revenue and capitation revenue for the three and nine months ended September 30, 2026 and 2025 were as follows:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Premium	$	1,348,028	$	982,634	$	3,900,680	$	2,903,836
Capitation	228		1,047		767		4,091
Total	$	1,348,256	$	983,681	$	3,901,447	$	2,907,927

In 2025, capitation revenue consisted primarily of capitated fees for medical care services provided by us under arrangements with third-party payors.

As of January 1, 2026, we no longer have these capitation arrangements with third-party payors.

Interest income earned on our cash deposits and short-term investments is included within other revenue on the condensed consolidated statements of operations. Interest income for the three and nine months ended September 30, 2026 was $8,911 and $25,010, respectively. Interest income for the three and nine months ended September 30, 2025 was $8,177 and $21,407, respectively.

Revenue Adjustments

Receivables, including risk adjusted premium due from the government, pharmacy rebates, and other receivables, are shown net of allowances for credit losses and retroactive membership adjustments.

Property and Equipment—Net

Depreciation expense is computed using the straight-line method generally based on the following estimated useful lives:


Description			Estimated Service Lives (years)
Computer and equipment			5
Office equipment and furniture			5-7
Software			3-5
Leasehold improvements			15 (or lease term, if shorter)

Depreciation expense related to property and equipment used to service our members or at our clinics are included within medical expenses in the condensed consolidated statements of operations.

Medical Expenses

Medical Expenses Payable

Part D Subsidies

Shared Risk Reserve Arrangements

Concentrations of Credit Risk

Equity-Based Compensation

Equity-based compensation is recorded within selling, general and administrative expenses, and medical expenses based on the function of the applicable employee and non-employee.

Net Income (loss) per Share

The following table sets forth the computation of basic and diluted net income (loss) per share for the three and nine months ended September 30, 2026 and September 30, 2025:


	Three Months Ended September 30,				Nine Months Ended September 30,
	2026		2025		2026		2025
Numerator:
Net income (loss)	$	(8,052)	$	3,729	$	39,924	$	10,028
Less: Net loss attributable to noncontrolling interests	—		—		—		(254)
Net income (loss) attributable to Alignment Healthcare, Inc.	$	(8,052)	$	3,729	$	39,924	$	10,282
Denominator:
Total weighted-average common shares outstanding	208,556,942		199,026,808		207,132,468		197,022,500
Less: Restricted shares of common stock	—		—		—		(15,359)
Total weighted-average common shares outstanding, net of restricted shares of common stock - basic	208,556,942		199,026,808		207,132,468		197,007,141

Dilutive effect of:
Stock options	—		309,030		703,054		354,209
RSUs	—		7,297,588		6,081,003		8,057,026
PSUs	—		2,294,554		898,771		3,020,824

Shares used to compute diluted income per common share	208,556,942		208,927,980		214,815,296		208,439,200

Net income (loss) per share:
Basic income (loss) per share	$	(0.04)	$	0.02	$	0.19	$	0.05
Diluted income (loss) per share	$	(0.04)	$	0.02	$	0.19	$	0.05

Basic net loss per share is the same as diluted net loss per share for the three months ended September 30, 2026 as the inclusion of all potentially dilutive shares would have been anti-dilutive.

Options outstanding that are antidilutive and therefore not factored into the weighted average common shares above were 2,059,731 for the nine months ended September 30, 2026. RSUs outstanding that are antidilutive and therefore not factored into the weighted average common shares above were 46,462 for the nine months ended September 30, 2026. Shares used to compute diluted income per common share for the nine months ended September 30, 2026 also excludes 23,768,341 of potentially outstanding shares related to our convertible senior notes, as these had an antidilutive effect on diluted income per share. Additionally, for the nine months ended September 30, 2026, we excluded 3,776,177 PSUs as the performance targets have not yet been achieved as of September 30, 2026. See Note 10, Equity-Based Compensation.

Recent Accounting Pronouncements Issued

Accounts Receivable (Tables)

9 Months Ended

Sep. 30, 2026

Accounts Receivable, after Allowance for Credit Loss [Abstract]

Schedule of Accounts Receivable

Accounts receivable consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Government receivables	$	75,903	$	52,411
Pharmacy rebate receivables	150,330		179,196
Other receivables	17,011		22,433
Total accounts receivable	243,244		254,040
Allowance for credit losses	(699)		(833)
Accounts receivable, net	$	242,545	$	253,207

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Revenues:
Earned premiums	$ 1,348,256	$ 983,681	$ 3,901,447	$ 2,907,927
Other	10,034	10,014	27,673	27,988
Total revenues	1,358,290	993,695	3,929,120	2,935,915
Expenses:
Medical expenses	1,217,603	868,022	3,462,996	2,570,662
Selling, general, and administrative expenses	136,373	110,015	388,514	317,643
Depreciation and amortization	8,108	7,977	23,801	22,574
Total expenses	1,362,084	986,014	3,875,311	2,910,879
Income (loss) from operations	(3,794)	7,681	53,809	25,036
Other expenses:
Interest expense	4,280	3,950	12,617	11,850
Other income, net	0	0	(1)	(89)
Total other expense	4,280	3,950	12,616	11,761
Income (loss) before income taxes	(8,074)	3,731	41,193	13,275
Provision (benefit) for income taxes	(22)	2	1,269	3,247
Net income (loss)	(8,052)	3,729	39,924	10,028
Less: Net loss attributable to noncontrolling interest	0	0	0	(254)
Net income (loss) attributable to Alignment Healthcare, Inc.	$ (8,052)	$ 3,729	$ 39,924	$ 10,282
Net income (loss) per share attributable to Alignment Healthcare, Inc.:
Basic (in dollars per share)	$ (0.04)	$ 0.02	$ 0.19	$ 0.05
Diluted (in dollars per share)	$ (0.04)	$ 0.02	$ 0.19	$ 0.05
Weighted-average common shares outstanding:
Basic (in shares)	208,556,942	199,026,808	207,132,468	197,007,141
Diluted (in shares)	208,556,942	208,927,980	214,815,296	208,439,200

Equity-Based Compensation

9 Months Ended

Sep. 30, 2026

Share-Based Payment Arrangement [Abstract]

Equity-Based Compensation

Equity Awards

Stock Options

Our outstanding stock options generally vest 25% annually over four years and generally expire 10 years from the date of the grant. The 2021 Equity Incentive Plan (“Plan”) provides that stock option grants will be made with an exercise price at no less than the estimated fair value of common stock at the date of the grant.

The following is a summary of the stock option transactions as of and for the three and nine months ended September 30, 2026:


	Stock Options Outstanding
(amounts in thousands, except shares and per share amount)	Shares Subject to Options Outstanding	Weighted- Average Exercise Price per Option		Weighted- Average Remaining Contractual Terms (in years)	Aggregate Intrinsic Value
Balances as of December 31, 2025	7,408,212	$	17.05	5.28	$	20,001
Options granted	—	—
Options exercised	(137,087)	15.85
Options forfeited / expired	(216,537)	18.00
Balances as of March 31, 2026	7,054,588	17.05		5.03	6,477
Options granted	—	—
Options exercised	(231,672)	16.96
Options forfeited / expired	(3,400)	18.00
Balances as of June 30, 2026	6,819,516	17.05		4.78	46,106
Options granted	—	—
Options exercised	(193,847)	10.99
Options forfeited / expired	(6,690)	18.00
Balances as of September 30, 2026	6,618,979	$	17.23	4.51	39
Vested and Exercisable as of September 30, 2026	6,610,025	$	17.23	4.51	$	39

Aggregate intrinsic value represents the difference between the exercise price of the option and the closing price of our common stock. The aggregate intrinsic value of options exercised for the three and nine months ended September 30, 2026 was $0 and $1, respectively. No options were granted during the three and nine months ended September 30, 2026.

Restricted Stock Units

Our outstanding Restricted Stock Units ("RSU") generally vest 33% annually over three years or 25% annually over four years.

The following is a summary of RSU transactions as of and for the three and nine months ended September 30, 2026:


	Restricted Stock Units	Weighted-Average Grant Date Fair Value
Unvested and outstanding as of December 31, 2025	9,356,689	$	10.49
Granted	2,613,707	17.21
Vested	(2,699,553)	8.91
Forfeited	(286,686)	11.97
Unvested and outstanding as of March 31, 2026	8,984,157	$	12.87
Granted	284,324	15.02
Vested	(275,453)	13.40
Cancelled/forfeited	(111,702)	12.31
Unvested and outstanding as of June 30, 2026	8,881,326	$	12.93
Granted	173,689	19.76
Vested	(1,780,347)	14.89
Cancelled/forfeited	(70,500)	19.58
Unvested and outstanding as of September 30, 2026	7,204,168	$	12.55

Performance-based Restricted Stock Units ("PSUs")

Generally, for our outstanding PSUs, each grantee is eligible to vest in a number of PSUs ranging from 0% to 200% of the target number of PSUs granted, based on the aggregated achievement by the Company of certain performance metrics during the applicable performance period. The achievement of PSUs relative to the approved target is based on the following performance metrics and relative weighting: Revenue (50% weighting) and Adjusted EBITDA (50% weighting). 100% of the total number of earned PSUs will become vested upon certification of achievement of the performance metrics by the Compensation Committee on or about March 1st following the end of the applicable performance period, subject to continued service to the Company through such date.

Market-based PSUs

On February 24, 2026 (the “Grant Date”), the Board of Directors of the Company approved the grant of certain PSUs to John Kao, the Company’s Chief Executive Officer (the “PSU Award”), under the Company’s 2021 Equity Incentive Plan.

Tranches of the PSU Award will be earned and vest only upon both (i) the achievement of pre-determined price per share goals (described below) over the period commencing on the Grant Date and ending on the fifth anniversary of the Grant Date (the “Measurement Period”); and (ii) Mr. Kao’s continued employment or service as the Company’s Chief Executive Officer through the third anniversary of the Grant Date, unless otherwise agreed to (the “Service Requirement”).

The PSUs will become earned (“Earned PSUs”) in three tranches based on the achievement of the following volume-weighted average price per share goals during the Measurement Period (the “Stock Price Hurdles”):


	Price Per Share Goals	Number of Earned PSUs
First Stock Price Hurdle	$33.75	333,333
Second Stock Price Hurdle	$44.00	333,333
Third Stock Price Hurdle	$55.25	333,334

A Stock Price Hurdle is achieved if the volume-weighted average price per share over any 30-consecutive-trading-day period during the Measurement Period equals or exceeds the applicable price. Any tranche of PSUs that Mr. Kao has earned will become vested upon the later of (i) the date on which the applicable Stock Price Hurdle has been achieved or (ii) the date on which the Service Requirement has been met, subject to his continued service through such later date. PSUs for which the relevant Stock Price Hurdle has not been achieved by the end of the Measurement Period will be forfeited.

The following is a summary of PSU transactions for the three and nine months ended September 30, 2026:


	Performance-based restricted stock units	Weighted-Average Grant Date Fair Value
Unvested and outstanding as of December 31, 2025	1,685,407	$	9.35
Granted	1,792,525	15.62
Vested	—	—
Forfeited	—	—
Unvested and outstanding as of March 31, 2026	3,477,932	$	12.58
Granted	210,526	14.25
Vested	—	—
Cancelled/forfeited	—	—
Unvested and outstanding as of June 30, 2026	3,688,458	$	12.68
Granted	87,719	24.01
Vested	—	—
Cancelled/forfeited	—	—
Unvested and outstanding as of September 30, 2026	3,776,177	$	12.94

Equity-Based Compensation Expense

Total equity-based compensation expense was presented on the statement of operations as follows:


	Three Months Ended September 30,				Nine Months Ended September 30,
(amounts in thousands)	2026		2025		2026		2025
Selling, general and administrative expenses	$	15,976	$	14,452	$	44,865	$	44,446
Medical expenses	1,511		1,775		4,815		4,521
Total equity-based compensation expense	$	17,487	$	16,227	$	49,680	$	48,967

As of September 30, 2026, there was $81,760 in unrecognized compensation expense related to all non-vested awards (Options, RSUs and PSUs) that will be recognized over the weighted-average period of 1.77 years.

Fair Value - Additional Information (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt, fair value	$ 325,675	$ 514,164
Outstanding debt	324,497	323,176
Treasury securities investments	15,260	28,413
Money market funds	275,554	216,155
Balance Sheet Location [Axis]: us-gaap:ShortTermInvestments
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Treasury securities investments	15,260
US Treasury Bill Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Restricted investments	1,029	1,043
Certificates of Deposit
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Restricted investments	$ 2,360	$ 2,345

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

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- Definition

The fair value amount of long-term debt whether such amount is presented as a separate caption or as a parenthetical disclosure. Additionally, this element may be used in connection with the fair value disclosures required in the footnote disclosures to the financial statements. The element may be used in both the balance sheet and disclosure in the same submission.

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+ Details

Equity-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2026

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Option Activity Transactions

The following is a summary of the stock option transactions as of and for the three and nine months ended September 30, 2026:


	Stock Options Outstanding
(amounts in thousands, except shares and per share amount)	Shares Subject to Options Outstanding	Weighted- Average Exercise Price per Option		Weighted- Average Remaining Contractual Terms (in years)	Aggregate Intrinsic Value
Balances as of December 31, 2025	7,408,212	$	17.05	5.28	$	20,001
Options granted	—	—
Options exercised	(137,087)	15.85
Options forfeited / expired	(216,537)	18.00
Balances as of March 31, 2026	7,054,588	17.05		5.03	6,477
Options granted	—	—
Options exercised	(231,672)	16.96
Options forfeited / expired	(3,400)	18.00
Balances as of June 30, 2026	6,819,516	17.05		4.78	46,106
Options granted	—	—
Options exercised	(193,847)	10.99
Options forfeited / expired	(6,690)	18.00
Balances as of September 30, 2026	6,618,979	$	17.23	4.51	39
Vested and Exercisable as of September 30, 2026	6,610,025	$	17.23	4.51	$	39

Schedule of Restricted Stock Transactions

The following is a summary of RSU transactions as of and for the three and nine months ended September 30, 2026:


	Restricted Stock Units	Weighted-Average Grant Date Fair Value
Unvested and outstanding as of December 31, 2025	9,356,689	$	10.49
Granted	2,613,707	17.21
Vested	(2,699,553)	8.91
Forfeited	(286,686)	11.97
Unvested and outstanding as of March 31, 2026	8,984,157	$	12.87
Granted	284,324	15.02
Vested	(275,453)	13.40
Cancelled/forfeited	(111,702)	12.31
Unvested and outstanding as of June 30, 2026	8,881,326	$	12.93
Granted	173,689	19.76
Vested	(1,780,347)	14.89
Cancelled/forfeited	(70,500)	19.58
Unvested and outstanding as of September 30, 2026	7,204,168	$	12.55

Schedule of Earned PSUs in Volume Weighted Average Price Per Share


	Price Per Share Goals	Number of Earned PSUs
First Stock Price Hurdle	$33.75	333,333
Second Stock Price Hurdle	$44.00	333,333
Third Stock Price Hurdle	$55.25	333,334

Schedule of PSUs Transactions

The following is a summary of PSU transactions for the three and nine months ended September 30, 2026:


	Performance-based restricted stock units	Weighted-Average Grant Date Fair Value
Unvested and outstanding as of December 31, 2025	1,685,407	$	9.35
Granted	1,792,525	15.62
Vested	—	—
Forfeited	—	—
Unvested and outstanding as of March 31, 2026	3,477,932	$	12.58
Granted	210,526	14.25
Vested	—	—
Cancelled/forfeited	—	—
Unvested and outstanding as of June 30, 2026	3,688,458	$	12.68
Granted	87,719	24.01
Vested	—	—
Cancelled/forfeited	—	—
Unvested and outstanding as of September 30, 2026	3,776,177	$	12.94

Schedule of Equity-Based Compensation Expense of Operation

Total equity-based compensation expense was presented on the statement of operations as follows:


	Three Months Ended September 30,				Nine Months Ended September 30,
(amounts in thousands)	2026		2025		2026		2025
Selling, general and administrative expenses	$	15,976	$	14,452	$	44,865	$	44,446
Medical expenses	1,511		1,775		4,815		4,521
Total equity-based compensation expense	$	17,487	$	16,227	$	49,680	$	48,967

Fair Value (Tables)

9 Months Ended

Sep. 30, 2026

Fair Value Disclosures [Abstract]

Schedule of Carrying Value and Fair Value of Financial Instruments

The following tables present the carrying value and fair value of these financial instruments as of September 30, 2026 and December 31, 2025:


	September 30, 2026
			Fair Value
	Carrying Value		Level 1		Level 2		Level 3
U.S. Treasury bills	$	16,289	$	16,286	$	—	$	—
Certificate of deposits	2,360		—		2,360		—
Total	$	18,649	$	16,286	$	2,360	$	—


	December 31, 2025
			Fair Value
	Carrying Value		Level 1		Level 2		Level 3
U.S. Treasury bills	$	29,456	$	29,465	$	—	$	—
Certificate of deposits	2,345		—		2,345		—
Total	$	31,801	$	29,465	$	2,345	$	—

Fair Value

9 Months Ended

Sep. 30, 2026

Fair Value Disclosures [Abstract]

Fair Value

The following tables present the carrying value and fair value of these financial instruments as of September 30, 2026 and December 31, 2025:


	September 30, 2026
			Fair Value
	Carrying Value		Level 1		Level 2		Level 3
U.S. Treasury bills	$	16,289	$	16,286	$	—	$	—
Certificate of deposits	2,360		—		2,360		—
Total	$	18,649	$	16,286	$	2,360	$	—


	December 31, 2025
			Fair Value
	Carrying Value		Level 1		Level 2		Level 3
U.S. Treasury bills	$	29,456	$	29,465	$	—	$	—
Certificate of deposits	2,345		—		2,345		—
Total	$	31,801	$	29,465	$	2,345	$	—

The Company estimates the fair value of its convertible senior notes based on valuations provided by third-party pricing services. Fair value of the long-term debt as of September 30, 2026 was approximately $325,675. The Company's fair value of long-term debt disclosure is classified within Level 2 of the valuation hierarchy. As of December 31, 2025, the fair value of our long-term debt was approximately $514,164.

The carrying value of long-term debt represents the outstanding balance, net of unamortized debt issuance costs which was $324,497 and $323,176 as of September 30, 2026 and December 31, 2025, respectively.

Our nonfinancial assets and liabilities, which include goodwill, intangible assets, property, and equipment, are not required to be measured at fair value on a recurring basis. However, on a periodic basis, or whenever events or changes in circumstances indicate that their carrying value may not be recoverable, we assess these assets for impairment. No such impairment resulted during the nine months ended September 30, 2026. We recorded an impairment charge related to goodwill as of December 31, 2025. See Note 6, Goodwill and Intangible Assets.

U.S. Treasury Securities Investments

As of September 30, 2026 and December 31, 2025, the Company had $15,260 and $28,413, respectively, of investments in U.S. Treasury bills, which were classified as held to maturity and carried at amortized cost. As of September 30, 2026, $15,260 of the investments are included in short-term investments in the condensed consolidated balance sheets as the original maturities are greater than three months and less than twelve months. As of December 31, 2025, the entire balance was included in short-term investments as the original maturities were greater than three months and less than twelve months. The Company has the intent and ability to hold these securities to maturity and gross unrecognized gains and losses were immaterial.

Restricted Investments

Restricted investments are composed of investments in U.S. Treasury bills and certificates of deposits and are included within other assets in the condensed consolidated balance sheets. As of September 30, 2026 and December 31, 2025, the Company had $1,029 and $1,043 of restricted investments in U.S. Treasury bills and $2,360 and $2,345 of restricted investments in certificates of deposits, respectively. The Company has the intent and ability to hold these investments until maturity; therefore, these investments are stated at amortized cost. Restricted investments are required to be maintained at a financial institution within certain states. As of September 30, 2026 and December 31, 2025, these investments had maturities with less than 12 months. Due to the nature of the state's requirements, these assets are classified as noncurrent assets regardless of the contractual maturity date.

Money Market Funds

As of September 30, 2026 and December 31, 2025, the Company had $275,554 and $216,155, respectively, in money market funds, which are recorded at fair value and included in cash and cash equivalents in the consolidated condensed balance sheet.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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+ Details

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2026
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Legal Proceedings We record a liability and accrue the costs for a loss when an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings. While the liability and accrued costs reflect our best estimate, the actual amounts may materially be different. Whistleblower Complaint On July 7, 2026, a former executive officer filed a lawsuit against the Company and certain officers in the U.S. District Court for the Central District of California alleging whistleblower retaliation, constructive discharge, breach of contract and compensation-related claims. The plaintiff alleges that these actions were taken after he reported concerns of accounting irregularities. The Company believes the claims are without merit and intends to defend the matter vigorously. No accrual has been included in the accompanying condensed consolidated financial statements with respect to this lawsuit. We may be involved in various litigation matters in the ordinary course of business. In the opinion of management, the ultimate resolution of legal proceedings is not expected to have a material adverse effect on the condensed consolidated financial statements. Amounts accrued for legal proceedings were not material as of September 30, 2026 and December 31, 2025. Risk Adjustment Data Validation Audit On June 25, 2025, the Company was notified that its California HMO plan had been selected for an audit of Medicare Advantage contract-specific risk adjustment data validation (“RADV”) with respect to payment year 2019. CMS conducts RADV audits in order to validate the coding practices of and supporting documentation maintained by health care providers and such audits may result in retrospective adjustments to payments made to the Company’s health plans. Under CMS’s final rule issued in 2023, CMS announced its intent to apply a revised methodology, including extrapolated audit findings to estimate contract-wide overpayments and without application of the previously employed “fee-for-service adjuster” that accounted for the error rate in the original Medicare data that CMS used to develop the risk adjustment model. Additionally, in May 2025, CMS announced a significant expansion to its RADV audit program, stating, among other things, that it intended to conduct RADV audits with extrapolation on all eligible MA plans on an annual basis and that it would accelerate the timetable for clearing its backlog of audits with respect to payment years 2018-24. However, on September 25, 2025, a Federal District Court in Texas vacated CMS’s final rule regarding extrapolation of results of RADV audits for payment years beginning with payment year 2018. As of September 30, 2026, the Company is in the process of collecting and reviewing medical records with respect to the member cohort selected for the RADV audit. The Company is continuing to monitor developments with respect to these audits and continuing to assess their potential impact.

Equity-Based Compensation - Additional Information (Details)		3 Months Ended	9 Months Ended
	Feb. 24, 2026 tranche	Sep. 30, 2026 USD ($)	Sep. 30, 2026 USD ($)
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Aggregate intrinsic value, options exercised		$ 0	$ 1,000
Options granted, fair value		$ 0	$ 0
Stock Options
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Award vesting period			4 years
Award expiration period			10 years
Stock Options \| Share-Based Payment Arrangement, Tranche One
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Stock Options \| Share-Based Payment Arrangement, Tranche Two
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Stock Options \| Share-Based Payment Arrangement, Tranche Three
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Stock Options \| Share-Based Payment Arrangement, Tranche Four
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Restricted Stock Units (RSUs), Three Year Vesting
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Award vesting period			3 years
Restricted Stock Units (RSUs), Three Year Vesting \| Share-Based Payment Arrangement, Tranche One
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			33.00%
Restricted Stock Units (RSUs), Three Year Vesting \| Share-Based Payment Arrangement, Tranche Two
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			33.00%
Restricted Stock Units (RSUs), Three Year Vesting \| Share-Based Payment Arrangement, Tranche Three
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			33.00%
Restricted Stock Units (RSUs), Four Year Vesting
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Award vesting period			4 years
Restricted Stock Units (RSUs), Four Year Vesting \| Share-Based Payment Arrangement, Tranche One
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Restricted Stock Units (RSUs), Four Year Vesting \| Share-Based Payment Arrangement, Tranche Two
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Restricted Stock Units (RSUs), Four Year Vesting \| Share-Based Payment Arrangement, Tranche Three
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
Restricted Stock Units (RSUs), Four Year Vesting \| Share-Based Payment Arrangement, Tranche Four
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			25.00%
PSUs
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			100.00%
Performance target, health plan revenue growth percentage		50.00%	50.00%
Performance target, adjusted earnings before interest		50.00%	50.00%
Number of tranches \| tranche	3
Number of consecutive trading period	30 days
PSUs \| Minimum
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			0.00%
PSUs \| Maximum
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Annual award vesting rights, percentage			200.00%
Non Vested Awards, Options, RSUs and PSUs
Share Based Compensation Arrangement by Share Based Payment Award [Line Items]
Share based compensation expense, unrecognized		$ 81,760,000	$ 81,760,000
Weighted average period			1 year 9 months 7 days

Medical Expenses Payable - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2026	Sep. 30, 2026
Insurance [Abstract]
Remaining claim amounts payment period		3 years
Favorable claims reserve estimates, excluding provision	$ 89	$ 1,936

Long-Term Debt (Tables)

9 Months Ended

Sep. 30, 2026

Debt Disclosure [Abstract]

Schedule of Long-Term Debt Outstanding, Net of Unamortized Debt Issuance Costs


	September 30, 2026		December 31, 2025
Long-term debt	$	330,000	$	330,000
Less unamortized debt issuance costs	(5,503)		(6,824)
Long-term debt-net of amortization	324,497		323,176
Less current maturities of long-term debt	—		—
Long-term debt - net of current portion	$	324,497	$	323,176

Schedule of Future Maturities Under the Term Loan

Future maturities under the Notes for each of the next five years ending September 30, are as follows:


	Amount
Remainder of 2026	$	—
2027	—
2028	—
2029	330,000
2030	—
	$	330,000

Commitments and Contingencies (Details)	Jul. 07, 2026 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Loss accrual	$ 0

Summary of Significant Accounting Policies - Schedule of Earned Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Disaggregation of Revenue [Line Items]
Total	$ 1,348,256	$ 983,681	$ 3,901,447	$ 2,907,927
Premium
Disaggregation of Revenue [Line Items]
Total	1,348,028	982,634	3,900,680	2,903,836
Capitation
Disaggregation of Revenue [Line Items]
Total	$ 228	$ 1,047	$ 767	$ 4,091

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

- Definition

Amount, after premiums ceded to other entities and premiums assumed by the entity, of premiums earned.

+ References

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+ Details

Accounts Receivable - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Accounts Receivable, after Allowance for Credit Loss [Abstract]
Credit loss related to accounts receivable	$ 434	$ 286	$ 699	$ 548

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Statement of Financial Position [Abstract]
Allowance for credit losses	$ 699	$ 833
Preferred stock par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	100,000,000	100,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	1,000,000,000	1,000,000,000
Common stock, shares issued (in shares)	209,152,387	204,153,619
Common stock, shares outstanding (in shares)	209,152,387	204,153,619

Goodwill and Intangible Assets

9 Months Ended

Sep. 30, 2026

Intangible Asset, Goodwill and Other [Abstract]

Goodwill and Intangible Assets

Intangible assets consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Life
Goodwill	$	32,060	$	—	$	32,060	—
License (indefinite lived)	4,550		—		4,550		—
Plan member relationships	2,700		(2,700)		—		9 years
Other	633		(633)		—		2 - 10 years
Total	$	39,943	$	(3,333)	$	36,610


	December 31, 2025
	Gross Carrying Value		Accumulated Amortization		Net Carrying Value		Weighted Average Life
Goodwill	$	32,060	$	—	$	32,060	—
License (indefinite lived)	4,550		—		4,550		—
Plan member relationships	2,700		(2,700)		—		9 years
Other	633		(633)		—		2 - 10 years
Total	$	39,943	$	(3,333)	$	36,610

Amortization expense relating to intangible assets for the three months ended September 30, 2026 and 2025 was $0. Amortization expense relating to intangible assets for the nine months ended September 30, 2026 and 2025, was $0 and $634, respectively. Included within the amortization balance for the nine months ended September 30, 2025 was $634 in impairment charges related to the remeasurement of goodwill associated with one of our subsidiaries.

Summary of Significant Accounting Policies - Schedule of Property and Equipment Estimated Useful Lives (Details)	Sep. 30, 2026
Computer and equipment
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	5 years
Office equipment and furniture \| Minimum
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	5 years
Office equipment and furniture \| Maximum
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	7 years
Software \| Minimum
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	3 years
Software \| Maximum
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	5 years
Leasehold improvements
Property Plant and Equipment [Line Items]
Estimated Service Lives (years)	15 years

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

Summary of Significant Accounting Policies - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2026 USD ($)	Sep. 30, 2025 USD ($)	Sep. 30, 2026 USD ($) entity segment shares	Sep. 30, 2025 USD ($)	Dec. 31, 2025 USD ($)
Accounting Policies [Line Items]
Number of consolidated variable interest entities \| entity			3
Number of reporting segments \| segment			1
Number of operating segments \| segment			1
Assets, fair value disclosure \| $	$ 18,649,000		$ 18,649,000		$ 31,801,000
Interest income earned \| $	8,911,000	$ 8,177,000	$ 25,010,000	$ 21,407,000
Stock Options
Accounting Policies [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares) \| shares			2,059,731
RSUs
Accounting Policies [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares) \| shares			46,462
Convertible senior notes
Accounting Policies [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares) \| shares			23,768,341
PSUs
Accounting Policies [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares) \| shares			3,776,177
Minimum
Accounting Policies [Line Items]
Loss ratio			85.00%
Award requisite service period			3 years
Maximum
Accounting Policies [Line Items]
Award requisite service period			4 years
Level 3
Accounting Policies [Line Items]
Assets, fair value disclosure \| $	0		$ 0		0
Liabilities, fair value disclosure \| $	$ 0		$ 0		$ 0

Long-Term Debt - Additional Information (Details)	Feb. 26, 2026 USD ($)	Nov. 22, 2024 USD ($) $ / shares	Jun. 30, 2028 USD ($)	Jun. 30, 2027 USD ($)	Sep. 30, 2026 USD ($)	Jun. 30, 2026 USD ($)	Dec. 31, 2025 USD ($)
Debt Instrument [Line Items]
Outstanding debt					$ 324,497,000		$ 323,176,000
Convertible senior notes \| Convertible senior notes
Debt Instrument [Line Items]
Debt instrument, face amount		$ 330,000,000
Debt instrument, interest rate, stated percentage		4.25%
Proceeds from long-term debt		$ 321,100,000
Conversion ratio		0.0624
Debt instrument, convertible, conversion price (in dollars per share) \| $ / shares		$ 16.04
Debt instrument, initial conversion price premium percentage		25.00%
Estimated principal amount percentage		25.00%
Accrued and unpaid special interest		100.00%
Oxford Term Loan \| Secured Debt
Debt Instrument [Line Items]
Repayment of long-term debt		$ 215,000
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility
Debt Instrument [Line Items]
Line of credit agreement	$ 200,000,000
Covenant, senior secured indebtedness to consolidated EBITDA ratio, maximum						2.5
Covenant, consolidated EBITDA						$ 60,000,000
Outstanding debt					$ 0
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility \| Scenario Forecast
Debt Instrument [Line Items]
Covenant, consolidated EBITDA			$ 80,000,000	$ 70,000,000
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility \| Minimum \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt interest rate spread	2.00%
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility \| Minimum \| Base Rate
Debt Instrument [Line Items]
Debt interest rate spread	1.00%
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility \| Maximum \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt interest rate spread	2.50%
Senior Secured Revolving Credit Facility \| Line of Credit \| Revolving Credit Facility \| Maximum \| Base Rate
Debt Instrument [Line Items]
Debt interest rate spread	1.50%
Senior Secured Revolving Credit Facility \| Line of Credit \| Letter of Credit
Debt Instrument [Line Items]
Line of credit agreement	$ 20,000,000
Senior Secured Revolving Credit Facility \| Line of Credit \| Bridge Loan
Debt Instrument [Line Items]
Line of credit agreement	5,000,000
Senior Secured Revolving Credit Facility \| Line of Credit \| Secured Debt
Debt Instrument [Line Items]
Option to increase commitments through term loan	$ 50,000,000
Option to increase commitments by consolidated EBITDA percentage	100.00%

Summary of Significant Accounting Policies - Schedule of Significant Segment Expenses (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Segment Reporting [Line Items]
Total revenues	$ 1,358,290	$ 993,695	$ 3,929,120	$ 2,935,915
Expenses:
Medical expenses (less depreciation and equity-based compensation)	1,217,603	868,022	3,462,996	2,570,662
Selling, general, and administrative expenses (less equity-based compensation)	136,373	110,015	388,514	317,643
Interest expense	4,280	3,950	12,617	11,850
Net income (loss)	(8,052)	3,729	39,924	10,028
Reportable Segment
Segment Reporting [Line Items]
Total revenues	1,358,290	993,695	3,929,120	2,935,915
Expenses:
Medical expenses (less depreciation and equity-based compensation)	1,216,085	866,239	3,458,148	2,566,067
Selling, general, and administrative expenses (less equity-based compensation)	120,397	95,563	343,649	273,197
Other segment expenses	25,580	24,214	74,782	74,773
Interest expense	4,280	3,950	12,617	11,850
Net income (loss)	$ (8,052)	$ 3,729	$ 39,924	$ 10,028

- Definition

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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+ Details

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

+ Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

- Definition

The aggregate total costs related to selling a firm's product and services, as well as all other general and administrative expenses. Direct selling expenses (for example, credit, warranty, and advertising) are expenses that can be directly linked to the sale of specific products. Indirect selling expenses are expenses that cannot be directly linked to the sale of specific products, for example telephone expenses, Internet, and postal charges. General and administrative expenses include salaries of non-sales personnel, rent, utilities, communication, etc.

+ References + Details

Property and Equipment - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Property Plant and Equipment [Line Items]
Subtotal	$ 269,344	$ 243,383
Less accumulated depreciation	(202,905)	(179,132)
Property and equipment-net	66,439	64,251
Computers and equipment
Property Plant and Equipment [Line Items]
Subtotal	15,745	13,815
Office equipment and furniture
Property Plant and Equipment [Line Items]
Subtotal	4,551	4,338
Software
Property Plant and Equipment [Line Items]
Subtotal	241,273	218,023
Leasehold improvements
Property Plant and Equipment [Line Items]
Subtotal	6,253	6,224
Construction in progress
Property Plant and Equipment [Line Items]
Subtotal	$ 1,522	$ 983

- Definition

Amount of accumulated depreciation, depletion, and amortization of property, plant, and equipment. Includes, but is not limited to, land and land improvement; building; machinery and equipment; furniture and fixture; and work of art, historical treasure, or similar asset classified as collection.

+ References + Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

- Definition

Amount, after accumulated depreciation, depletion, and amortization, of property, plant, and equipment. Includes, but is not limited to, land and land improvement; building; machinery and equipment; furniture and fixture; and work of art, historical treasure, or similar asset classified as collection.

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+ Details

Property and Equipment (Tables)

9 Months Ended

Sep. 30, 2026

Property, Plant, and Equipment [Abstract]

Schedule of Property and Equipment

Depreciation expense is computed using the straight-line method generally based on the following estimated useful lives:


Description			Estimated Service Lives (years)
Computer and equipment			5
Office equipment and furniture			5-7
Software			3-5
Leasehold improvements			15 (or lease term, if shorter)

Property and equipment consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Computers and equipment	$	15,745	$	13,815
Office equipment and furniture	4,551		4,338
Software	241,273		218,023
Leasehold improvements	6,253		6,224
Construction in progress	1,522		983
Subtotal	269,344		243,383
Less accumulated depreciation	(202,905)		(179,132)
Property and equipment-net	$	66,439	$	64,251

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Noncontrolling interest
Beginning balance (in shares) at Dec. 31, 2024		191,778,639
Beginning balance at Dec. 31, 2024	$ 100,955	$ 192	$ 1,107,952	$ (1,008,293)	$ 1,104
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	10,028			10,282	(254)
Issuance of common stock upon vesting of restricted stock units (in shares)		7,981,928
Forfeitures (in shares)		(277)
Equity-based compensation	48,967	$ 8	48,959
Stock options exercised (in shares)		228,225
Stock options exercised	2,771		2,771
Sale of consolidated subsidiary	(850)				(850)
Ending balance (in shares) at Sep. 30, 2025		199,988,515
Ending balance at Sep. 30, 2025	161,871	$ 200	1,159,682	(998,011)	0
Beginning balance (in shares) at Jun. 30, 2025		197,958,237
Beginning balance at Jun. 30, 2025	140,967	$ 198	1,142,509	(1,001,740)	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	3,729			3,729
Issuance of common stock upon vesting of restricted stock units (in shares)		1,925,632
Equity-based compensation	16,227	$ 2	16,225
Stock options exercised (in shares)		104,646
Stock options exercised	948		948
Ending balance (in shares) at Sep. 30, 2025		199,988,515
Ending balance at Sep. 30, 2025	$ 161,871	$ 200	1,159,682	(998,011)	0
Beginning balance (in shares) at Dec. 31, 2025	204,153,619	204,153,619
Beginning balance at Dec. 31, 2025	$ 179,277	$ 205	1,188,089	(1,009,017)	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	39,924			39,924
Issuance of common stock upon vesting of restricted stock units (in shares)		4,436,162
Equity-based compensation	49,680	$ 4	49,676
Stock options exercised (in shares)		562,606
Stock options exercised	$ 8,231		8,231
Ending balance (in shares) at Sep. 30, 2026	209,152,387	209,152,387
Ending balance at Sep. 30, 2026	$ 277,112	$ 209	1,245,996	(969,093)	0
Beginning balance (in shares) at Jun. 30, 2026		207,178,193
Beginning balance at Jun. 30, 2026	265,131	$ 207	1,225,965	(961,041)	0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(8,052)			(8,052)
Issuance of common stock upon vesting of restricted stock units (in shares)		1,780,347
Equity-based compensation	$ 17,487	$ 2	17,485
Stock options exercised (in shares)	193,847	193,847
Stock options exercised	$ 2,546		2,546
Ending balance (in shares) at Sep. 30, 2026	209,152,387	209,152,387
Ending balance at Sep. 30, 2026	$ 277,112	$ 209	$ 1,245,996	$ (969,093)	$ 0

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2026	Dec. 31, 2025
Intangible Asset, Goodwill and Other [Abstract]
Goodwill, Gross Carrying Value	$ 32,060	$ 32,060
Goodwill, Net Carrying Value	32,060	32,060
Intangible Asset, Finite-Lived [Line Items]
Accumulated Amortization	(3,333)	(3,333)
Intangible Asset, Including Goodwill, after Accumulated Amortization [Abstract]
Total	39,943	39,943
Accumulated Amortization	(3,333)	(3,333)
Goodwill	36,610	36,610
Plan member relationships
Intangible Asset, Finite-Lived [Line Items]
Gross Carrying Value	2,700	2,700
Accumulated Amortization	(2,700)	(2,700)
Net Carrying Value	$ 0	$ 0
Weighted Average Life	9 years	9 years
Intangible Asset, Including Goodwill, after Accumulated Amortization [Abstract]
Accumulated Amortization	$ (2,700)	$ (2,700)
Other
Intangible Asset, Finite-Lived [Line Items]
Gross Carrying Value	633	633
Accumulated Amortization	(633)	(633)
Net Carrying Value	0	0
Intangible Asset, Including Goodwill, after Accumulated Amortization [Abstract]
Accumulated Amortization	$ (633)	$ (633)
Minimum \| Other
Intangible Asset, Finite-Lived [Line Items]
Weighted Average Life	2 years	2 years
Maximum \| Other
Intangible Asset, Finite-Lived [Line Items]
Weighted Average Life	10 years	10 years
License (indefinite lived)
Indefinite Lived Intangible Assets By Major Class [Line Items]
License (indefinite lived)	$ 4,550	$ 4,550

Accounts Receivable

9 Months Ended

Sep. 30, 2026

Accounts Receivable, after Allowance for Credit Loss [Abstract]

Accounts Receivable

Accounts receivable consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Government receivables	$	75,903	$	52,411
Pharmacy rebate receivables	150,330		179,196
Other receivables	17,011		22,433
Total accounts receivable	243,244		254,040
Allowance for credit losses	(699)		(833)
Accounts receivable, net	$	242,545	$	253,207

The allowance for expected credit losses for accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due. However, when available evidence reasonably supports an assumption that future economic conditions will differ from current and historical payment collections, an adjustment is reflected in the allowance for expected credit losses. We record pharmacy rebates and other receivables based on contractual terms and expected collections and our estimation process for contractual allowances for such balances generally results in an allowance for balances outstanding greater than 90 days or if expected credit risks are known.

Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted. Because substantially all of our receivable amounts are readily determinable and a large portion of our creditors are governmental authorities, our allowance for credit losses is insignificant.

We recorded credit loss related to accounts receivable of $434 and $286 during the three months ended September 30, 2026 and 2025, respectively, and $699 and $548 during the nine months ended September 30, 2026 and 2025, respectively.

The amounts were recorded in selling, general and administrative expenses in the condensed consolidated statements of operations.

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2026
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes For the three and nine months ended September 30, 2026, we recorded income tax (benefit) expense of $(22) and $1,269. For the three and nine months ended September 30, 2025 we recorded income tax expense of $2 and $3,247. The change in tax for the three months ended September 30, 2026 when compared to the three months ended September 30, 2025 is primarily attributable to a change in state taxes. Our future effective tax rate may vary from the statutory tax rate primarily due to changes in our valuation allowance, state taxes, and excess executive compensation. We have federal and state cumulative net operating losses ("NOLs") as of September 30, 2026 and December 31, 2025. Given the history of losses, and after consideration for the risk associated with estimates of future taxable income, we established a full valuation allowance against net deferred tax assets at September 30, 2026 and 2025. Under the Tax Cuts and Jobs Act (“TCJA”), federal NOLs generated after 2017 will be carried forward indefinitely but are limited to an 80% deduction of taxable income. NOLs generated prior to 2018 have a 20-year carryforward period and can be used to offset 100% of taxable income. An exception to the TCJA federal NOL rule applies to certain of our subsidiaries and requires all NOLs generated from those entities to have a 20-year carryforward period and offset 100% of taxable income. For the year ended December 31, 2025, federal and state NOL carryforwards were $617,001 and $531,012, respectively. $95,332 of the total federal net operating loss carryforwards have an indefinite life while the remaining federal and state net operating loss carryforwards begin to expire in 2033 if not utilized. On June 27, 2024, California Senate Bill 167 (“SB 167”) was enacted into law, suspending California NOL utilization for taxpayers with more than $1 million of taxable income, effective for tax years 2024, 2025, and 2026. SB 167 includes an extended carryover period for the suspended NOLs with an additional year carryforward for each year of suspension. The Company will continue to monitor this legislation and its impact on our deferred tax assets. An “ownership change” as defined under Section 382 of the Internal Revenue Code ("IRC"), could potentially limit the ability to utilize certain tax attributes including the Company’s substantial NOLs. Ownership change is generally defined as any significant change in ownership of more than 50% of the Company's stock over a three-year testing period. If, as a result of current or future transactions involving our common stock, we undergo cumulative ownership changes which exceed 50% over a testing period, our ability to utilize our NOL carryforwards would be subject to additional limitations under IRC Section 382. We continue to monitor changes in ownership with respect to these income tax provisions. The One Big Beautiful Bill Act (“OBBB Act”) was enacted on July 4, 2025 in the United States. The OBBB Act includes several significant provisions, including re-establishing a 100% bonus depreciation deduction, re-establishing rules in calculating business interest expense limitations pursuant to §163(j), and removing the capitalization requirements for domestic research or experimental (“R&E”) expenditures paid or incurred in tax years beginning after December 31, 2024. We have considered the applicable tax impact of the OBBB Act within the 2026 financial statements.

- Definition

The entire disclosure for income tax.

+ References

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+ Details

Long-Term Debt - Schedule of Long-Term Debt Outstanding, Net of Unamortized Debt Issuance Costs (Details) - USD ($) $ in Thousands	Sep. 30, 2026	Dec. 31, 2025
Debt Disclosure [Abstract]
Long-term debt	$ 330,000	$ 330,000
Less unamortized debt issuance costs	(5,503)	(6,824)
Long-term debt-net of amortization	324,497	323,176
Less current maturities of long-term debt	0	0
Long-term debt - net of current portion	$ 324,497	$ 323,176

- Definition

Amount of unamortized debt discount (premium) and debt issuance costs.

+ References + Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References

+ Details

Equity-Based Compensation - Schedule of Stock Option Activity Transactions (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended			9 Months Ended	12 Months Ended
	Sep. 30, 2026	Jun. 30, 2026	Mar. 31, 2026	Sep. 30, 2026	Dec. 31, 2025
Shares Subject to Options Outstanding
Options outstanding, beginning balance (in shares)	6,819,516	7,054,588	7,408,212	7,408,212
Options granted (in shares)	0	0	0
Options exercised (in shares)	(193,847)	(231,672)	(137,087)
Options forfeited / expired (in shares)	(6,690)	(3,400)	(216,537)
Options outstanding, ending balance (in shares)	6,618,979	6,819,516	7,054,588	6,618,979	7,408,212
Options outstanding, vested and exercisable (in shares)	6,610,025			6,610,025
Weighted- Average Exercise Price per Option
Options outstanding, beginning balance (in dollars per share)	$ 17.05	$ 17.05	$ 17.05	$ 17.05
Options granted (n dollars per share)	0	0	0
Options exercised (in dollars per share)	10.99	16.96	15.85
Options forfeited / expired (in dollars per share)	18.00	18.00	18.00
Options outstanding, ending balance (in dollars per share)	17.23	$ 17.05	$ 17.05	17.23	$ 17.05
Options outstanding, vested and exercisable (in dollars per share)	$ 17.23			$ 17.23
Stock Option Activity, Additional Disclosures
Weighted-average remaining contractual terms, outstanding	4 years 6 months 3 days	4 years 9 months 10 days	5 years 10 days		5 years 3 months 10 days
Weighted-average remaining contractual terms, vested and exercisable				4 years 6 months 3 days
Aggregate intrinsic value	$ 39	$ 46,106	$ 6,477	$ 39	$ 20,001
Aggregate intrinsic value, vested and exercisable	$ 39			$ 39

Property and Equipment

9 Months Ended

Sep. 30, 2026

Property, Plant, and Equipment [Abstract]

Property and Equipment

Property and equipment consisted of the following as of September 30, 2026 and December 31, 2025:


	September 30, 2026		December 31, 2025
Computers and equipment	$	15,745	$	13,815
Office equipment and furniture	4,551		4,338
Software	241,273		218,023
Leasehold improvements	6,253		6,224
Construction in progress	1,522		983
Subtotal	269,344		243,383
Less accumulated depreciation	(202,905)		(179,132)
Property and equipment-net	$	66,439	$	64,251

Depreciation expense for the three months ended September 30, 2026 and 2025 was $8,115 and $7,985, respectively, of which $7 and $8, respectively, were included in medical expenses. Depreciation expense for the nine months ended September 30, 2026 and 2025 was $23,834 and $22,014, respectively, of which $33 and $74, respectively, were included in medical expenses.

- Definition

The entire disclosure for property, plant, and equipment. Includes, but is not limited to, land and land improvement; building; machinery and equipment; furniture and fixture; and work of art, historical treasure, or similar asset classified as collection.

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+ Details

Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Property Plant and Equipment [Line Items]
Depreciation expense	$ 8,115	$ 7,985	$ 23,834	$ 22,014
Income Statement Location: alhc:MedicalExpenses
Property Plant and Equipment [Line Items]
Depreciation expense	$ 7	$ 8	$ 33	$ 74

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2026	Sep. 30, 2025	Sep. 30, 2026	Sep. 30, 2025
Intangible Asset, Goodwill and Other [Abstract]
Amortization expense	$ 0	$ 0	$ 0	$ 634
Impairment charges				$ 634

- Definition

Amount of amortization expense for finite-lived intangible asset. Excludes goodwill and capitalized cost for software to be sold, leased, or marketed.

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+ Details

- Definition

Amount of impairment loss from asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References + Details

Cover - shares	9 Months Ended
Cover - shares	Sep. 30, 2026	Oct. 26, 2026
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2026
Document Transition Report	false
Entity File Number	001-40295
Entity Registrant Name	ALIGNMENT HEALTHCARE, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	46-5596242
Entity Address, Address Line One	1100 W. Town and Country Road
Entity Address, Address Line Two	Suite 1600
Entity Address, City or Town	Orange
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92868
City Area Code	844
Local Phone Number	310-2247
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	ALHC
Security Exchange Name	NASDAQ
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		209,268,394
Amendment Flag	false
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001832466
Document Fiscal Year Focus	2026