Derrick Duke
Analyst · RBC Capital Markets
Good afternoon, everyone. In 2025, eHealth delivered strong results, achieving meaningful earnings growth in a complex and rapidly evolving environment. We consistently exceeded expectations, raising annual guidance 3x. We closed the year with another highly successful annual enrollment period, helping hundreds of thousands of seniors navigate one of the most disruptive Medicare Advantage cycles in recent memory, an outcome that speaks to the differentiated value of our platform, brand and the trust that we've built with consumers and carrier partners. We've also strengthened our balance sheet entering 2026 with enhanced financial flexibility and a longer-term commitment of capital to execute our strategic priorities. The Medicare Advantage market is in the midst of a structural reset. Carriers continue to experience elevated medical cost trends and regulatory pressure, which has resulted in meaningful benefit changes, plan eliminations, carrier market exits and a more targeted approach to growth. Millions of Medicare customers were impacted by these changes in '24 and again last year. eHealth has provided crucial help to these populations as they've been forced to reassess their coverage options. On the distribution side, these trends have introduced pockets of commission suppression and reshaped carriers marketing sponsorship programs, among other changes. At the same time, carriers have been narrowing their distribution relationships, placing greater emphasis on quality, retention and other key measures of consumer experience. They are severing ties with brokers not performing to their standards and deepening relationships with distributors that provide the most value. eHealth has consistently ranked high on key quality metrics that are important to our carrier partners. These shifts have challenged the industry, but they also affirmed an important theme. When consumers face complexity, they seek trusted guidance. And when carriers need targeted high-quality growth, they value partners that can support their objectives. eHealth operates uniquely at that intersection. Now let me turn to our 2025 operational review. In 2025, annual revenue grew 4%. GAAP net income was almost 4x 2024 net income and adjusted EBITDA increased by 40%. These strong results were driven by focused execution throughout the year, but especially during AEP. We were exceptionally well positioned to enter the 2025 annual enrollment period. This included a more tenured adviser force, stronger branded channels and an expanded member retention program. Our AI screener piloted earlier in the year was scaled during AEP, bringing additional efficiency to our model and helping to reduce customer wait times. This technology was well received by our consumers and performed on par or better than human screeners in terms of transfer rates and conversions. We believe this technology further differentiates eHealth in the marketplace and opens the door for further consumer-facing AI applications in health insurance distribution. As anticipated, this AEP generated substantial consumer activity on par with the prior year. Demand on our platform was strong as our Medicare Matchmaker value proposition resonated with consumers. eHealth also successfully navigated changes in carrier inventory that resulted from plan eliminations, commission suppression and other key factors impacting product selection. We continue to offer quality, affordable plans in our key markets. During AEP, our direct branded channels exceeded enrollment expectations. In response, we strategically reduced spend on third-party affiliate leads. Direct channels typically deliver higher enrollment margins and stronger retention. Their increased share of our marketing mix positively impacted in-period earnings, and we expect that they will continue to strengthen financial performance beyond '25 by increasing book persistency and supporting LTV growth. We delivered on our 2025 annual plan for enrollment volume and revenue while significantly exceeding earnings expectations, driven by favorable LTV to CAC dynamics in our Medicare business and disciplined fixed cost management. We also demonstrated continued strength in our commissions receivable, which ended the year at a record high. Beyond Medicare Advantage, we made progress towards diversifying our revenue base. Our hospital indemnity plan, or HIP sales achieved exceptional growth with approved application volume surging over 400% year-over-year in the fourth quarter of 2025. Medicare Supplement also performed well during AEP, delivering 39% approved application growth in the fourth quarter. While carrier dedicated revenue and sponsorships declined year-over-year in the fourth quarter, reflecting broader market pressures, our core agency platform more than absorbed this impact through strong operational execution. As planned, after AEP completion, I initiated a comprehensive strategic review of the organization. Our macro outlook suggests that many of the conditions that shaped the past 2 years will persist into 2026. While we anticipate growth mandates reemerging in 2027, we believe that this year, carriers will continue pursuing targeted strategies and emphasizing margin protection. We expect to see further exits on the distribution side, consolidating sector leadership with platforms that have scale and strong carrier relationships that are able to deliver high-quality book of business. Additionally, it is our belief that brokers who are able to deliver consumer value beyond onetime enrollment support will be at a material advantage. We continue to hold conviction in the longer-term growth potential of the Medicare Advantage market. The number of Americans turning 65 will be peaking at over 4 million per year with the Medicare eligible population reaching over 80 million by 2034. MA penetration is also expected to increase, reaching over 60% by 2030 compared to approximately 54% in 2025. We believe eHealth is well positioned to lead this growth on the distribution side by leveraging the strength of our brand, deep carrier partnerships and our differentiated omnichannel platform. Seniors are becoming increasingly tech savvy, and this administration is placing a particular emphasis on the role of technology in modernizing and improving Medicare. We believe eHealth already has a lead as an industry technology innovator, which will provide us with a competitive advantage in this environment for years to come. With that, we view 2026 as a bridge year, a year to become more focused in our execution, maximize the return on our platform and improving operating cash flow generation to ensure that when the market shifts back to growth, we are in a strong position to accelerate. More specifically, our 2026 focus will include developing our lifetime advisory engagement model, concentrating Medicare enrollment efforts on our highest margin and persistency marketing channels, broadening our non-MA portfolio, including ancillaries and ICHRA and continued cost discipline, including the optimization initiatives we implemented last month. Let me expand on the lifetime advisory model, which is a major element of our strategy going forward. We are providing our licensed advisers with additional opportunities to solve consumer needs through an ongoing trusted relationship. This model blends the relationship-driven approach of local field agents with the scale, breadth and technology advantage of an omnichannel model. Based on consumer focus groups we conducted, beneficiaries place high value on engagement-based models that combine choice with access to a trusted adviser, someone who understands their personal situation and coverage needs. This model leverages eHealth's brand proposition and valuable beneficiary base and aligns with exactly where carriers are placing value, high-quality enrollments that persist. The seasonal nature of our business provides meaningful opportunities for advisers to deepen member engagement throughout the year, conducting need assessments, identifying gaps in coverage, managing plan changes proactively and offering relevant ancillary products. As part of this strategy, eHealth will be expanding the portfolio of ancillary products and services we offer to our beneficiaries, building on meaningful growth we achieved with hospital indemnity plans last year. In '26, we expect to add critical illness, final expense and similar products while driving greater attach rates with our existing ancillaries such as dental, vision and hearing. We plan to build on this effort in 2027 and '28 by adding additional adjacent services that leverage eHealth's core competencies and help Medicare beneficiaries maximize the value of their coverage. This strategy is expected to drive increased member lifetime value, improved retention and most importantly, build on eHealth's brand equity and member loyalty. Furthermore, the favorable cash flow dynamics of these ancillary products make them an important element of our diversification and overall financial goals. What does this mean for this year's financial outlook? Because we're prioritizing operating cash flow and quality, we expect Medicare enrollment volumes and noncommission revenue to decline relative to 2025. Despite lower revenue and enrollment volume, earnings, excluding net adjustment or tail revenue are expected to remain roughly flat and EBITDA margin ex tail is expected to improve year-over-year. This reflects the positive impact of our cost reduction efforts as well as focusing member acquisition spend in the highest margin marketing channels. On cost savings, we enacted headcount and vendor consolidation in January of this year. We expect these actions to lower our 2026 fixed operating cost by approximately $30 million compared to 2025, a decrease of roughly 20%. We also plan to reduce our variable spend by over $60 million for an overall year-over-year spend reduction greater than $90 million. As a result of strategic changes and significant cost measures we have implemented, we believe we can drive meaningful improvement in operating cash flow in 2026. Cash flow is our North Star, and we are committed to reaching breakeven operating cash flow this year, a $25 million year-over-year improvement with positive operating cash flow targeted for 2027. John will share our guidance ranges and key drivers in his prepared remarks. In diversification, our approach will be similarly focused and disciplined. We are prioritizing ICHRA, including a partner-driven SaaS model, which allows us to extend our platform to brokers with strong employer relationships. This strategy is capital efficient, leverages our core capabilities and positions us in a growing market where employers are increasingly looking for greater control over benefit expense and a personalized approach to coverage selection. During 2026, we are taking important steps to position us for success once the reset cycle has been completed in Medicare Advantage and as ICHRA continues to gain adoption with employers. We expect to continue to invest strategically and in a focused way in key capabilities required to grow profitably in these areas. Our technology remains an important differentiator and growth enabler. We see significant potential to improve our operational and financial performance by further scaling of AI screening and introducing additional AI applications in both our back and front office. The goal is to prioritize revenue growth in 2027 on a profitable and operating cash flow positive basis. It's important to note that while we are taking a more measured approach to demand generation this year, we expect our commissions receivable to remain around current levels in the beginning of 2027, driven by favorable retention trends and our relationship-driven approach to managing our book of business. We have also taken a measured approach to our capital structure by first augmenting our liquidity, extending maturities and lowering our cost of capital with the revolving credit facility that we entered into at the end of 2025. Our next priority is to unlock value for all of our stakeholders by addressing our convertible preferred equity. Further, as we have discussed in the past, our industry is dynamic, and there have been significant developments over the past several quarters. We regularly evaluate these developments and the strategic opportunities that may present themselves to us. To that end, we have had discussions with others in our industry, and we expect to continue to have discussions. Those discussions may not result in any meaningful developments, but we think it is important for us to be active in this regard. To summarize, our 2026 strategy will be focused on 3 priorities: reset Medicare into a cash flow generative relationship-driven business, deliver a broader set of products to customers and the advisers who serve them and pursue measured partner-driven ICHRA growth, including a SaaS-based model. And now I'll turn the call over to John, who will discuss our '25 results in greater detail and provide our 2026 annual guidance.