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ALHC, Alignment Healthcare
For the 2025 plan year, Alignment offered Medicare Advantage plans in 45 markets across California, North Carolina, Nevada, Arizona and Texas.
We created Alignment after our own families faced frustrating experiences within the fragmented healthcare system.
Seniors across the country are systemically and disproportionately impacted by the lack of care coordination, transparency and clear information.
The business
What it sells, where the money comes from, the kind of company it is.
The business in brief
read the 10-K →What this business is and what moves its needle, from its own SEC filings.
- What moves the needle
- The medical loss ratio and membership. What decides it: keeping medical costs below the premiums collected, where a regulated floor sets how much must be paid out as care, so the spread is thin; membership growth across commercial, Medicare and Medicaid; and the cost discipline on what little is left. On its own account, the filing leans hardest on pricing power & competition, set against the numbers in what the filing emphasizes, below.
- Is it a good business?
- The split between premiums and medical costs is not cleanly tagged in the filings. That leaves a thin operating margin, a median of about −3.9%, the sign of a volume-and-cost-control business rather than a high-margin one, though turns that sliver over fast enough to earn roughly −69% on equity. Whether membership keeps growing and medical costs stay below premiums, especially as the Medicare Advantage and Medicaid mix shifts, is what the 10-K decides, not an earnings multiple.
Every line is arithmetic on the company's filings, shown in full in the sections below.
The record
Ten years of arithmetic, read across the cycle.
Revenue up 31.6% year over year; operating income up 85.1%
figures computed from the filing's XBRL
The record, 2019–2025
realized figures from each filing · older years to the left| 2019’19 | 2020’20 | 2021’21 | 2022’22 | 2023’23 | 2024’24 | 2025’25 | TTMTTMJun 2026 | |
|---|---|---|---|---|---|---|---|---|
| Income statement | ||||||||
| $757M | $959M | $1.2B | $1.4B | $1.8B | $2.7B | $3.9B | $4.6B | RevenueRevenue |
| $754M | $955M | $1.2B | $1.4B | $1.8B | $2.7B | $3.9B | $4.5B | Premiums earnedPremiums |
| −3.9% | −0.5% | −15.2% | −9.0% | −7.0% | −3.8% | 0.4% | 1.2% | Operating marginOp. mgn |
| ($45M) | ($23M) | ($195M) | ($149M) | ($148M) | ($128M) | ($958K) | — | Pretax incomePretax |
| ($45M) | ($23M) | ($195M) | ($150M) | ($148M) | ($128M) | ($724K) | $41M | Net incomeNet inc. |
| Cash flow & returns | ||||||||
| — | -75% | -64% | -63% | -94% | -128% | -0% | 15% | Return on equityROE |
| — | −75% | −64% | −63% | −94% | −128% | −0% | 15% | Retained to equityRetained/eq |
| ($10M) | ($16M) | ($21M) | ($28M) | ($147M) | $39M | ($15M) | — | Investing cash flowInv. cash |
| $53M | $130M | $360M | $17M | $105K | $156M | $18M | — | Financing cash flowFin. cash |
| $52M | $121M | $261M | ($57M) | ($206M) | $230M | $143M | — | Change in cashΔ cash |
| Balance sheet | ||||||||
| — | $339M | $631M | $634M | $592M | $782M | $1.1B | $1.3B | Total assetsAssets |
| — | $308M | $325M | $395M | $434M | $681M | $887M | — | Total liabilitiesTotal liab. |
| — | $0 | $15K | $1M | $1M | $1M | — | — | Noncontrolling interestsNCI |
| ($79M) | $31M | $306M | $238M | $157M | $100M | $179M | $265M | Shareholders’ equityEquity |
| Per share | ||||||||
| 0K | 0K | 182M | 181M | 186M | 191M | 198M | 214M | Shares out (diluted)Shares |
| — | — | $6.42 | $7.91 | $9.79 | $14.17 | $19.94 | $21.35 | Revenue / shareRev/sh |
| — | — | $-1.07 | $-0.83 | $-0.79 | $-0.67 | $-0.00 | $0.19 | EPS (diluted)EPS |
| — | — | $1.68 | $1.31 | $0.84 | $0.52 | $0.91 | $1.24 | Book value / shareBVPS |
| 6-yr | 5-yr | |
|---|---|---|
| Revenue / share | +32.8%/yr (4-yr) | +32.8%/yr (4-yr) |
| Capital spending / share | +1.0%/yr (3-yr) | +1.0%/yr (3-yr) |
| Book value / share | −14.3%/yr (4-yr) | −14.3%/yr (4-yr) |
Quality & stewardship
Returns, the balance sheet, capital allocation, and pay.
Owner’s Scorecard
Is it a good business?
- Not enough dataIndustry peers: median 86%
What this means
This filer's medical costs live only in its own extension tags, outside the standard taxonomy — the ratio is not honestly computable from structured data, and the absence is itself worth knowing.
- Operating margin 0.4%Very thin (<2%)Operating income $15M ÷ revenue $3.9BIndustry peers: median 4%
What this means
Health plans earn a sliver on enormous revenue, so a few points of margin is the norm and the business is really a volume-and-cost-control game. Because the margin is so thin, a small miss on medical costs swings profit hard, which is why membership scale and cost management matter more than price.
- Return on equity −0%Loss on equityNet income ($724K) ÷ equity $179MIndustry peers: median 13%
What this means
The thin margin turns over fast on a modest capital base, so a plan earning its keep still shows a good return on equity. Durably above the ~10% cost of equity is what compounds value; a year below it usually means medical costs outran premiums.
The claims and the reserves
- Not enough data
What this means
The claims liability or medical costs weren't cleanly tagged.
- Reserve development −$25MPast estimates heldPrior-year development, FY2025: favorable · record: 7 favorable, 0 unfavorable of 7In the filing’s words
“The favorable prior year development incurred in 2025, 2024 and 2023 was primarily due to better-than-expected claims recoveries and actual claims expense being less than expected.”
✓ direction matches the filed record · the words are the company’sWhat this means
Each year the plan restates what last year's claims actually cost once the bills finished arriving. Persistent favorable development means honest reserving; unfavorable means past profits were flattered. Signed as filed: negative favorable. On a book this fast the estimates resolve within a year, so the meter reads management's candor almost in real time.
- The estimated share, in the normal bandIBNR $297M ÷ claims payable $475M
What this means
The share of the claims liability that is an actuarial estimate of care already delivered but not yet billed. Health plans typically run 50-80%; the figure frames how much of the reserve is judgment rather than arithmetic — which is exactly where the development line above keeps score.
All figures as filed; the source filing is linked above.
Current Position
as of the latest quarter, Jun 30, 2026Can the business pay what it owes this year, off the freshest balance sheet: the quality of the assets, the debt actually coming due, and what a low ratio means here.
- Cash & short-term investments$702M
- Receivables$297M
- Other current assets$162M
- Accounts payable$32M
- Other current liabilities$651M
From the company's latest filing.
Management, ownership & pay
read the proxy →From the proxy: how much of the business the people running it own, and how they are paid, beside what the business earned for its owners in the same years.
| Fiscal year | Chief executive | Pay, as filed | “Actually paid” | Owner earnings |
|---|---|---|---|---|
| 2021 | Mr. Kao | $46.0M | $37.3M | — |
| 2022 | Mr. Kao | $34.1M | $25.8M | ($63M) |
| 2023 | Mr. Kao | $14.3M | −$2.7M | ($81M) |
| 2024 | Mr. Kao | $6.4M | $25.2M | $8M |
| 2025 | Mr. Kao | $11.3M | $52.3M | $113M |
Both pay figures are the company’s own, from the pay-versus-performance table its proxy statement files. “As filed” is the Summary Compensation Table total: salary, bonus, and equity awards at their value on the day of grant. “Actually paid” is the SEC’s prescribed recalculation, which re-marks those equity awards to what they became as they vested; it can swing far above or below the filed figure in either direction, and negative years occur. Owner earnings are the whole business's, from the record above, for the same fiscal years.
- Insider ownership5.2%
The stake all directors and executive officers hold together, per the 2026 proxy: skin in the game, the first thing Munger reads.
- CEO pay ratio158:1
What the chief earns for every dollar the median employee makes, per the 2026 proxy. A high ratio alone settles nothing; some businesses are genuinely top-heavy in scarce skill. A runaway figure is where Buffett starts asking whether the board is doing its job.
- Stock-based compensation$62M
The slice of the business handed to employees in shares in fiscal 2025, 1.6% of revenue, equal to 420.8% of operating profit. Buffett's oldest accounting fight: this is compensation, compensation is an expense, real whether or not the headline earnings admit it. One trap: the cash-flow statement adds SBC back, so the operating cash, and the owner earnings drawn from it, are flattered by exactly this amount; counted as the cost it is, what an owner keeps is lower.
What an owner would ask, FY2025
read the 10-K →- Which reported numbers are a judgment call?Management names Insurance reserves as critical estimates
each rests partly on management's judgment; the filing's note sets out the assumptionsverify →
The questions the record and the charts do not answer on their own; each carries the figure and the place to look.
Peers, Managed Care
The same industry, side by side on the medical-loss-ratio lens. Each column names the period it is read over; the group median at the foot is the line to read each figure against.
| Company | Revenuelatest FY, USD | Medical loss ratiomedian over the record | Op. marginmedian over the record | ROEmedian over the record |
|---|---|---|---|---|
| CIThe Cigna Group | $274.9B | 80% | 4.9% | 13% |
| ELVElevance Health Inc. | $199.1B | 87% | 5.3% | 14% |
| CNCCentene Corporation | $194.8B | 87% | 2.2% | 9% |
| HUMHumana Inc. | $129.7B | 86% | 3.9% | 17% |
| MOHMolina Healthcare | $45.4B | 88% | 3.9% | 26% |
| OSCROscar Health | $11.7B | 85% | -14.9% | -41% |
| ALHCAlignment Healthcare | $3.9B | — | -3.9% | -69% |
| CLOVClover Health Investments Corp. | $1.9B | 83% | -16.3% | -74% |
| Group median | — | — | 3.1% | 11% |
The price
What a price has to assume.
What the price implies
reverse-DCFType today's close and see the owner-earnings growth you'd have to believe to justify it, beside what Alignment Healthcare has delivered.
—
9.0% = the 4.68% 10-year Treasury (Jul 30, 2026) + 4.32 points of equity premium. The rate you require is yours to set.
Enter a price above to run it.
A dated snapshot of the price you typed, the assumptions you set, and what the page showed for them. A snapshot is never edited after it is saved. Your notebook is yours alone — the commitment states what is stored and what we will never do.
Graham capped the multiple at 15×; Buffett and Munger let that rule go: a wonderful business can deserve 50× if the thesis holds. The gate marks the bargain-hunter's floor.
Prefilled with the 10-year Treasury (4.68%, as of Jul 30, 2026). Edit it for today’s exact figure, or a AAA corporate yield.
Graham measured a stock against the bond you could own instead, the heart of his margin of safety. Enter a price above to weigh the owner-earnings yield against this bond.
Owner earnings $178M on 207M shares outstanding, per the 10-Q cover, as of 2026-07-27; net cash $378M. The if-converted diluted count is 214M, 3% above the shares outstanding: the dilution overhang (convertibles, options) a buyer inherits. The base is the latest year by default; Normalize values it on the through-cycle median owner-earnings margin (to avoid paying on a peak year). Net of stock comp treats option pay as the expense it is. The dials set the multiple a growth belief justifies; the price, and every dollar on this page, is yours.
Manual order: ← ALH its page in the Manual ALIT →
Industry order: the Managed Care chapter CI →