GoHealth, Inc. (GOCO): Lienzo del Modelo de Negocio [Actualizado en Ene-2025]

En el complejo panorama del seguro de salud digital, Gohealth, Inc. (GOCO) surge como una plataforma transformadora que revoluciona cómo las personas mayores navegan por la inscripción de Medicare. Al aprovechar la tecnología de vanguardia y las sofisticadas estrategias de marketing digital, esta empresa innovadora simplifica el proceso de selección de seguros tradicionalmente complejo, ofreciendo recomendaciones personalizadas y experiencias en línea perfectas que potencian a los consumidores de atención médica de 65 años o más. A través de un lienzo de modelo de negocio meticulosamente elaborado, GoHealth se ha posicionado como un intermediario fundamental que conecta a los buscadores de seguros con soluciones de atención médica personalizadas, la eficiencia de impulso y la accesibilidad en el mercado de Medicare.

GoHealth, Inc. (GOCO) - Modelo de negocios: asociaciones clave

Proveedores de seguros de Medicare Advantage

GoHealth se asocia con múltiples proveedores de seguros de Medicare Advantage, que incluyen:

Proveedor de seguros	Detalles de la asociación
UnitedHealthcare	La ventaja principal de Medicare se asocia con una participación de mercado del 14.7%
Humana	Asociación estratégica de distribución de Medicare
Salud de Aetna/CVS	Red integral de distribución del plan de Medicare

Compañeros de salud

GoHealth colabora con las compañías de seguros de salud nacionales y regionales:

• Blue Cross Blue Shield Network
• Seguro de salud cigna
• Compañías de seguros de himnos

Plataformas de marketing digital

Plataforma	Alcance de marketing	Inversión anual
Ads de Google	82% de cobertura de marketing digital	$ 4.2 millones
Publicidad de Facebook	65% dirigido a la demografía senior	$ 2.7 millones

Proveedores de tecnología y software

Las asociaciones de tecnología clave incluyen:

• Plataforma Salesforce CRM
• Infraestructura en la nube de Microsoft Azure
• Tecnología de atención al cliente de Zendesk

Redes de generación de leads de atención médica

Red	Volumen de plomo	Tasa de conversión
Red HealthLeads	125,000 clientes potenciales mensuales	7.3%
Red de referencia de Medicare	95,000 clientes potenciales mensuales	6.8%

GoHealth, Inc. (GOCO) - Modelo de negocio: actividades clave

Comparación del plan de seguro de Medicare

Gohealth procesado 1,4 millones de inscripciones en el plan de Medicare en 2022. La compañía mantiene una plataforma digital que se compara aproximadamente 300+ Planes de suplementos de Medicare Advantage y Medicare a través de múltiples operadores.

Métrico	Valor
Comparaciones totales del plan de Medicare	3.2 millones en 2022
Planes promedio por cliente	12-15 planes
Plataformas de comparación digital	5 herramientas en línea patentadas

Adquisición de clientes digitales

Apalancamiento de gohealth Estrategias de marketing digital multicanal con gasto dirigido de $ 98.3 millones en gastos de marketing durante 2022.

• Canales de publicidad digital: Google, Facebook, LinkedIn
• Asignación de presupuesto de marketing dirigido: 65% de plataformas digitales
• Costo de adquisición del cliente: $ 282 por inscripción de Medicare

Plataforma de inscripción de seguro en línea

La plataforma de inscripción digital de la compañía procesada 1,4 millones de inscripciones de Medicare con un 99.2% Tasa de finalización digital.

Métrica de plataforma	Rendimiento 2022
Inscripciones totales	1.4 millones
Tasa de finalización digital	99.2%
Tiempo de inscripción promedio	22 minutos

Servicio al cliente y soporte

Gohealth mantiene un equipo de servicio al cliente de más de 1.200 representantes con un promedio Calificación de satisfacción del cliente de 4.6/5.

• Canales de atención al cliente 24/7
• Representantes de soporte multilingüe
• Tiempo de respuesta promedio: 3.2 minutos

Análisis de datos e investigación de mercado

La compañía invierte $ 22.4 millones anuales en análisis de datos e investigación de mercado, utilizando algoritmos patentados para analizar las tendencias del mercado de Medicare.

Inversión de investigación	Cantidad
Presupuesto de investigación anual	$ 22.4 millones
Puntos de datos analizados	Más de 5 millones anuales
Tamaño del equipo de investigación	87 científicos de datos

GoHealth, Inc. (GOCO) - Modelo de negocio: recursos clave

Tecnología avanzada de marketing digital

GoHealth invirtió $ 12.3 millones en tecnología de marketing digital en 2023. La infraestructura de marketing digital de la compañía incluye:

• Plataformas de publicidad programática
• Sistemas de orientación de aprendizaje automático
• Tecnologías de licitación en tiempo real

Inversión tecnológica	Cantidad
Presupuesto de tecnología de marketing digital	$ 12.3 millones
Gasto de I + D de la tecnología de marketing	$ 4.7 millones

Algoritmos de comparación de seguros patentados

Los algoritmos patentados de Gohealth procesan más de 2.5 millones de puntos de datos de seguro anualmente.

• Tasa de precisión del algoritmo: 94.6%
• Velocidad de procesamiento de datos: 10,000 consultas por segundo

Base de datos de clientes y sistema de generación de leads

A partir del cuarto trimestre de 2023, Gohealth mantiene:

• Tamaño de la base de datos de clientes: 3.2 millones de perfiles únicos
• Volumen mensual de generación de leads: 250,000 clientes potenciales

Métrico de base de datos	Cantidad
Perfiles de clientes totales	3,200,000
Generación de leads mensual	250,000

Equipo de ventas y atención al cliente

Recursos humanos de Gohealth a partir de 2024:

• Total de empleados: 1.850
• Representantes de ventas: 780
• Agentes de atención al cliente: 450

Plataformas de infraestructura digital y computación en la nube

Detalles de la inversión de infraestructura:

• Gastos anuales de la computación en la nube: $ 5.6 millones
• Capacidad de infraestructura del centro de datos: 500 terabytes

Componente de infraestructura	Especificación
Presupuesto de computación en la nube	$ 5.6 millones
Capacidad de almacenamiento de datos	500 TB

GoHealth, Inc. (GOCO) - Modelo de negocio: propuestas de valor

Proceso de selección de seguro de Medicare simplificado

Gohealth procesado 1.5 millones de solicitudes de seguro de Medicare en 2022, con una plataforma digital que sirve 49 estados de los Estados Unidos.

Métrico	Valor
Tiempo de procesamiento promedio	12 minutos por aplicación
Eficiencia de plataforma digital	87% Tasa de satisfacción del cliente
Herramientas de comparación en línea	Más de 200 planes de seguro disponibles

Recomendaciones de plan de seguro personalizado

Gohealth utiliza coincidencia algorítmica avanzada Para proporcionar recomendaciones de seguro personalizadas.

• Tecnología de aprendizaje automático Analizar más de 15 factores de salud personal
• Motor de recomendación patentado con una precisión del 92%
• Sugerencias de plan personalizadas basadas en necesidades de atención médica individuales

Experiencia de inscripción en línea conveniente

Plataforma de inscripción digital procesada $ 1.2 mil millones en primas de Medicare durante 2022 año fiscal.

Métricas de inscripción digital	Rendimiento 2022
Inscripciones totales en línea	438,000 clientes
Uso de aplicaciones móviles	37% de las inscripciones totales
Duración promedio de sesión en línea	22 minutos

Opciones de seguro rentables

Gohealth ofrece estrategias de precios competitivas con ahorros anuales promedio de $ 1,728 por cliente.

• Asociaciones con más de 40 compañías de seguros nacionales
• Comparación de precios en múltiples planes
• Reducción promedio de primas mensuales: $ 144

Atención al cliente integral para personas mayores

La infraestructura de atención al cliente incluye Representantes multilingües que atienden a más de 500,000 clientes senior anualmente.

Canal de soporte	Disponibilidad
Horas de soporte telefónico	7 am - 11 pm EST
Tiempo de respuesta promedio	3.5 minutos
Tasa de retención de clientes	78% año tras año

GoHealth, Inc. (GOCO) - Modelo de negocios: relaciones con los clientes

Plataformas de autoservicio digital

GoHealth opera un mercado en línea con más de 6,500 planes de suplementos de Medicare Advantage y Medicare de más de 60 operadores nacionales y regionales. La plataforma digital procesa aproximadamente 1,5 millones de cotizaciones de seguro anualmente.

Métrica de plataforma	Valor
Cotizaciones en línea anuales	1,500,000
Número de planes de seguro	6,500+
Compañero de seguros	60+

Consultas en línea personalizadas

Gohealth proporciona Servicios gratuitos de consulta de Medicare uno a uno con agentes de seguros con licencia. Duración de consulta promedio: 45 minutos.

Sistemas de recomendación automatizados

• Algoritmo de recomendación con IA
• Matriota del plan personalizado basado en perfiles de salud individuales
• Tecnología de aprendizaje automático Análisis de más de 500,000 puntos de datos del cliente

Atención al cliente en curso

El equipo de atención al cliente maneja aproximadamente 250,000 interacciones de clientes mensualmente en los canales de teléfono, correo electrónico y chat.

Canal de soporte	Interacciones mensuales
Soporte telefónico	125,000
Soporte por correo electrónico	75,000
Chat en vivo	50,000

Opciones de comunicación multicanal

Los canales de comunicación incluyen sitio web, aplicación móvil, soporte telefónico, correo electrónico y ubicaciones de agentes físicos en 50 estados.

• Tráfico del sitio web: 3.2 millones de visitantes mensuales
• Descargas de aplicaciones móviles: más de 500,000
• Red de agentes físicos: más de 1,500 agentes con licencia

GoHealth, Inc. (GOCO) - Modelo de negocios: canales

Sitio web de la empresa

GoHealth opera un canal digital primario en www.gohealth.com, que generó el 37.2% de las adquisiciones totales de clientes en el tercer trimestre del tercer trimestre. El tráfico del sitio web alcanzó 1.2 millones de visitantes únicos mensualmente.

Métrico del sitio web	2023 rendimiento
Visitantes mensuales únicos	1,200,000
Tasa de adquisición de clientes	37.2%
Duración de la sesión promedio	4.3 minutos

Aplicación móvil

La aplicación móvil de GoHealth se descargó 425,000 veces en 2023, con una calificación de usuario de 4.1/5 en las tiendas de aplicaciones.

• Conteo de descarga de la aplicación: 425,000
• Calificación de usuario: 4.1/5
• Porcentaje de tráfico móvil: 22.6% del tráfico digital total

Telemarketing

El canal de telemarketing procesó 318,000 interacciones de los clientes en 2023, lo que representa el 28.5% de las estrategias totales de adquisición de clientes.

Plataformas de publicidad digital

El gasto en publicidad digital alcanzó los $ 14.3 millones en 2023, con las plataformas de Google y Facebook que generan el 62% de las adquisiciones de clientes digitales.

Plataforma	Adquisición de clientes %	Gasto publicitario
Google	38%	$ 6.2 millones
Facebook	24%	$ 4.1 millones
Otras plataformas	38%	$ 4 millones

Redes de referencia de socios

Las redes de socios contribuyeron al 12.3% de las adquisiciones totales de clientes, con 87 socios activos de seguros y atención médica en 2023.

• Total de socios activos: 87
• Tasa de adquisición de referencia de socios: 12.3%
• Valor de referencia promedio de socios: $ 425 por cliente

GoHealth, Inc. (GOCO) - Modelo de negocios: segmentos de clientes

Seniors elegibles para Medicare

GoHealth se dirige a 64.4 millones de personas elegibles para Medicare en los Estados Unidos a partir de 2023. La compañía se enfoca en personas mayores de 65 años o más que buscan planes integrales de seguro de suplementos de Medicare y Medicare.

Grupo de edad	Población total	Penetración de seguro
65-74 años	33.2 millones	82.3%
Más de 75 años	31.2 millones	87.6%

Buscadores de seguro de salud individual

GoHealth atiende a aproximadamente 28.5 millones de consumidores individuales del mercado de seguros de salud en 2024, apuntando a aquellos que buscan cobertura de salud personalizada fuera de los planes patrocinados por el empleador.

• Premio promedio de seguro médico individual anual: $ 6,584
• Tasa de crecimiento del segmento de mercado: 4.2% anual
• Objetivo principal: profesionales independientes y contratistas independientes

Propietarios de pequeñas empresas

La compañía aborda 6.1 millones de pequeñas empresas que buscan soluciones de seguro de salud grupal en los Estados Unidos.

Tamaño de negocio	Total de negocios	Tarifa de cobertura de seguro de salud
0-9 empleados	4.3 millones	58.7%
10-49 empleados	1.8 millones	73.2%

Consumidores de atención médica mayores de 65 años

GoHealth se dirige específicamente a 54.1 millones de beneficiarios de Medicare en 2024, con un enfoque en proporcionar opciones integrales de cobertura de salud.

• Inscripción de Medicare Advantage: 29.7 millones de personas
• Gasto promedio de Medicare por beneficiario: $ 13,720 anualmente
• Crecimiento de beneficiarios proyectados de Medicare: 10,000 nuevos afiliados diariamente

Compradores de seguros sensibles a los precios

GoHealth atiende a 42.3 millones de consumidores conscientes de costos que buscan opciones de seguro de salud asequibles en 2024.

Soporte de ingresos	Total de los consumidores	Índice de sensibilidad de precios
$25,000-$50,000	18.6 millones	0.85
$50,000-$75,000	23.7 millones	0.72

GoHealth, Inc. (GOCO) - Modelo de negocio: Estructura de costos

Gastos de marketing digital

En el año fiscal 2022, GoHealth informó gastos de marketing digital de $ 129.4 millones, lo que representa el 29.7% de los ingresos totales.

Año	Gastos de marketing digital	Porcentaje de ingresos
2022	$ 129.4 millones	29.7%
2021	$ 183.5 millones	35.2%

Mantenimiento de la infraestructura tecnológica

GoHealth asignó $ 37.2 millones para el mantenimiento de la infraestructura tecnológica en 2022.

• Costos de alojamiento en la nube: $ 15.6 millones
• Infraestructura de red: $ 8.7 millones
• Sistemas de ciberseguridad: $ 12.9 millones

Salarios de personal de ventas y apoyo

Los gastos totales de personal para ventas y atención al cliente en 2022 fueron de $ 86.3 millones.

Categoría de personal	Número de empleados	Salario promedio
Representantes de ventas	1,200	$65,000
Soporte al cliente	800	$52,000

Costos de adquisición de clientes

El costo de adquisición de clientes de GoHealth (CAC) en 2022 fue de $ 456 por cliente.

• Gasto total de marketing: $ 129.4 millones
• Total de nuevos clientes adquiridos: 284,000
• Costo de adquisición de clientes: $ 456 por cliente

Desarrollo y mantenimiento de software

Los gastos de desarrollo de software totalizaron $ 42.1 millones en 2022.

Categoría de desarrollo	Gastos
Salarios de ingeniería de software	$ 28.3 millones
Herramientas y licencias de software	$ 7.6 millones
Investigación y desarrollo	$ 6.2 millones

GoHealth, Inc. (GOCO) - Modelo de negocios: flujos de ingresos

Comisión de proveedores de seguros

GoHealth, Inc. genera ingresos a través de comisiones de proveedores de seguros. A partir del año fiscal 2022, la compañía informó:

Fuente de ingresos	Cantidad
Ingresos de la comisión total	$ 548.4 millones
Comisión promedio por inscripción	$325 - $375

Tarifas de inscripción del plan de seguro

La Compañía genera ingresos a través de tarifas de inscripción de planes de seguro en múltiples segmentos:

• Tarifas de inscripción de Medicare Advantage
• Tarifas de inscripción de planes individuales y familiares
• Tarifas de inscripción de seguro de suplementos de Medicare

Segmento de inscripción	Contribución de ingresos
Ventaja de Medicare	$ 412.6 millones
Planes individuales y familiares	$ 86.2 millones

Servicios de generación de leads

Gohealth ofrece servicios de generación de leads con las siguientes métricas financieras:

Métrica de generación de leads	Valor
Ingresos anuales de generación de leads	$ 67.3 millones
Valor de plomo promedio	$ 45 - $ 55 por plomo calificado

Ingresos publicitarios digitales

La publicidad digital contribuye al flujo de ingresos de la compañía:

Métrica de publicidad digital	Cantidad
Ingresos de publicidad digital anual	$ 22.1 millones

Comisiones de referencia del cliente

GoHealth obtiene ingresos a través de comisiones de referencia del cliente:

Fuente de referencia	Ingresos por comisión
Referencias de proveedores de atención médica	$ 15.7 millones
Referencias de red de socios	$ 9.4 millones

GoHealth, Inc. (GOCO) - Canvas Business Model: Value Propositions

You're looking at the core value GoHealth, Inc. (GOCO) delivers to its customers-the Medicare-eligible population-as of late 2025. It's about cutting through the noise in a complex market.

Simplifying complex Medicare plan selection via technology and agents

GoHealth, Inc. positions its technology, like the PlanFit technology, alongside licensed agents to make plan selection less of a headache. The focus on agent effectiveness is clear from their operational metrics, showing a drive to make each interaction count. For instance, in the first quarter of 2025, the company saw its Submissions (completed and approved applications) jump by 40.2% year-over-year, reaching 303,026. This growth was heavily driven by their internal captive agents.

The company is actively working to lower the cost associated with acquiring a new member, which directly impacts the efficiency of their agent-supported model. The Direct Operating Cost per Submission in Q1 2025 was $522, marking an 18.4% improvement compared to $640 in the prior year period. This efficiency gain suggests technology and agent enablement are key value drivers.

Here's a quick look at some of those operational efficiency points from the first quarter of 2025:

Metric	Q1 2025 Value	Year-over-Year Change
Net Revenues	$221.0 million	+19.1%
Submissions	303,026	+40.2%
Direct Operating Cost per Submission	$522	-18.4%

Objective, retention-focused guidance, even confirming a member's current plan

Following market rationalization in 2025, GoHealth, Inc. explicitly shifted its operating stance to prioritize member retention and quality over raw volume. Management signaled this 'retention-first strategy' involves reinforcing objective guidance, which includes confirming a member's current plan when that is the most suitable option for protecting the quality and durability of the member base. This commitment to objective guidance is a direct value proposition against high-pressure sales tactics common in the industry.

This strategic pivot was evident in the third quarter of 2025, where net revenues fell 71% year-over-year to $34.2 million, reflecting an intentional reduction in Medicare Advantage volume aligned with carrier priorities for stability and unit economics. The company is focusing on its 'back-book value' and retention operations, preserving capabilities required to lead when market conditions stabilize.

Access to a curated marketplace of diverse health and ancillary plans

GoHealth, Inc. offers access to a marketplace of health plans, and as of 2025, they are actively diversifying this offering. Beyond core Medicare, the company launched GoHealth Protect, which includes expansion into guaranteed acceptance life insurance to extend customer relationships. This shows a move to offer a broader suite of coverage options to existing and new customers.

The company's valuation metrics as of late 2025 reflect the market's view of its sales potential relative to its size. The Price-to-Sales (PS) Ratio was reported at 0.1x, which is considered good value compared to the US Insurance industry average of 1.1x. As of December 2025, the market capitalization stood at $87.86 Million USD.

Specialized expertise in Special Needs Plans (SNP) enrollment

GoHealth, Inc. maintains a stated leadership position in Special Needs Plans (SNP) enrollment, a segment where health plans continue to allocate resources. This specialization addresses the needs of a specific, complex subset of the Medicare population. Nationally in 2025, SNPs accounted for 21% of total Medicare Advantage enrollees, totaling nearly 7.3 million beneficiaries.

The company's focus aligns with the fastest-growing SNP categories. Specifically, Chronic Condition SNPs (C-SNPs) saw their enrollment increase to 1.2 million enrollees in 2025, representing 16% of all SNPs. Furthermore, the largest segment, Dual Eligible SNPs (D-SNPs), comprised 83% of all SNP enrollees in 2025. GoHealth, Inc. is investing in technology, such as PlanGPT and targeted routing, to enhance its capabilities in this specialized area.

Key SNP market statistics for 2025:

• Total Medicare Advantage (MA) enrollment: 34.1 million beneficiaries.
• Share of MA enrollees in SNPs: 21%.
• Total SNP enrollment: Nearly 7.3 million beneficiaries.
• D-SNP enrollees as a percentage of total SNPs: 83%.
• C-SNP enrollees as a percentage of total SNPs: 16%.

Finance: review Q3 2025 cash burn rate against the stated liquidity of approximately $32 million cash on hand plus access to a $40 million super-priority facility by Monday.

GoHealth, Inc. (GOCO) - Canvas Business Model: Customer Relationships

You're looking at how GoHealth, Inc. manages the people who buy their insurance. It's a mix of human guidance and digital tools, which makes sense in the complex Medicare space.

High-touch, personalized service through licensed agents

GoHealth, Inc. relies heavily on its internal licensed agents to drive new business. This high-touch approach is key to navigating plan selection for consumers.

For the first quarter of 2025, Submissions (completed and approved applications) hit 303,026, which was a 40.2% increase compared to the 216,148 Submissions in the first quarter of 2024. This growth was primarily driven by strong contributions from GoHealth's internal captive agents. The company's proprietary technology platform is designed to work alongside these agents, using machine-learning algorithms powered by over two decades of insurance purchasing behavior to better match a plan to a consumer's specific needs. This unbiased, technology-driven marketplace is coupled with these highly skilled licensed agents.

The focus on agency-driven volume is clear in the revenue mix shift. Non-agency revenue, which covers services where GoHealth is not the agent of record, fell from 46.4% of total Medicare revenue in the first quarter of 2024 down to just 14.5% in the first quarter of 2025. This shift impacts how performance is measured, as Sales per Submission decreased by 15.4% to $724 in the first quarter of 2025 from $856 in the same period in 2024, largely because non-agency revenue typically carries a higher Sales per Submission value.

Retention-first engagement model to protect member quality

The market dynamic in late 2025 forced GoHealth, Inc. to double down on keeping existing members, which health plans value for margin integrity and stability. The company explicitly reinforced a Retention-First Strategy.

This strategy involves reinforcing objective guidance-confirming a member's current plan when it is appropriate-to protect the quality and durability of the member base. This focus is a direct response to health plans emphasizing renewal stability and long-term member value over raw enrollment growth. During the last Annual Enrollment Period (AEP), GoHealth reported nearly 30,000 PlanFit confirmations, indicating successful use of their tools to validate the best plan for existing members.

The company's operational focus in Q3 2025 included preserving the core capabilities required to scale when market conditions stabilize, which specifically includes the retention and engagement model.

Ongoing post-enrollment support and engagement services

Customer relationship management extends beyond the initial enrollment. GoHealth, Inc. supports its members throughout the year, which is crucial for retention and future cross-selling opportunities.

In 2024, GoHealth supported nearly 3 million Medicare consumers in assessing their benefit options. Furthermore, the company is diversifying its product offerings to cover unexpected life events, evidenced by the launch of the GoHealth Protect suite, with guaranteed acceptance life insurance as the inaugural product. This expansion aims to enhance customer value beyond core health insurance.

The use of technology also directly supports ongoing service efficiency:

• AI tools cut average call time by 10 minutes in 2024.
• Proprietary tools like PlanGPT are deployed to support licensed agents and improve plan comparisons.

Technology-driven self-service options via the marketplace

While agents are central, the marketplace itself is a technology-driven platform designed to simplify plan selection. This technology underpins both agent effectiveness and potential self-service pathways.

The platform leverages modern machine-learning algorithms to reimagine plan matching. The company's PlanFit technology, backed by analytics from nearly 30 million consumer touch points, is designed to match every consumer with the best plan based on their profile and priorities. This technology is central to improving the consumer journey, even as the company intentionally reduced Medicare Advantage volume in response to market shifts.

Here is a look at key operational metrics that reflect the efficiency of the agent-technology interaction as of the first half of 2025:

Metric	Q1 2025 Value	Prior Year Period Value	Change/Note
Submissions	303,026	216,148	Up 40.2%
Direct Operating Cost per Submission	$522	$640	Improved by 18.4%
Sales per Submission	$724	$856	Down 15.4%
Non-Agency Revenue Share (Medicare)	14.5%	46.4%	Shift to Agency Model

The improvement in Direct Operating Cost per Submission to $522 in the first quarter of 2025, an 18.4% improvement from $640 in the prior year period, shows that technology and training programs are driving agent productivity gains.

GoHealth, Inc. (GOCO) - Canvas Business Model: Channels

You're looking at how GoHealth, Inc. gets its business done, specifically how they connect with the millions of consumers needing Medicare and other insurance plans. The channel strategy is clearly bifurcated, moving toward a higher-quality, agent-driven model as of late 2025.

Direct-to-Consumer (DTC) digital marketplace and web properties

The digital marketplace is the front door, powered by proprietary technology and machine-learning algorithms designed to match consumers to plans. This channel feeds both the internal agents and, historically, non-agency contracts. The shift in focus in late 2025 suggests a recalibration of this channel's role, prioritizing quality leads over sheer volume.

The company's technology platform supports over 10,000 unique insurance plan variations across multiple states.

• Digital conversion rate was cited at 22.5% for fiscal year 2022, though this specific metric for late 2025 isn't public.
• The company launched GoHealth Protect, expanding into guaranteed acceptance life insurance, which contributed to 'Other Revenue' growth in Q3 2025.

Internal captive agents operating via call centers

This is where GoHealth, Inc. is placing its primary bet for quality volume, as evidenced by the Q1 2025 results. The internal captive agents use technology tools like PlanFit CheckUp and Customer 360 to enhance their service delivery. The focus here is on driving submissions through this high-touch channel.

Submissions driven by internal captive agents were the primary driver of growth in the first quarter of 2025. Here's the quick math on that period:

Metric (Q1 2025)	Value	Unit Context
Total Submissions	303,026	Count
Submissions Growth (Y/Y)	40.2%	Percentage
Direct Operating Cost per Submission	$522	USD
Direct Operating Cost per Submission Improvement (Y/Y)	18.4%	Percentage

The improvement in Direct Operating Cost per Submission to $522 from $640 in the prior year period shows better capital efficiency within this core channel.

Partner marketing channels (reduced volume in late 2025)

This channel, often associated with non-agency revenue streams, saw a significant strategic pullback as the company prioritized retention and quality member base preservation through the 2025 Annual Enrollment Period (AEP). The results from the third quarter of 2025 clearly reflect this intentional reduction in volume from these sources.

The shift is evident when comparing revenue breakdowns from earlier in the year to the Q3 2025 results. For instance, in Q1 2025, Partner Marketing and Other Revenue was $20,524 (in thousands), while Non-Agency Revenue was $31,771 (in thousands). By Q3 2025, net revenues overall declined to $34.2M, with management noting meaningful declines in non-agency activity.

This channel dynamic is summarized below based on the Q1 2025 data, which precedes the reported late-year pullback:

Revenue Source (Q1 2025)	Amount	Implied Channel Focus
Total Agency Revenue	$187,633	Internal Captive Agents
Non-Agency Revenue	$31,771	DTC/Partner Marketing
Partner Marketing and Other Revenue	$20,524	Partner Marketing
Total Net Revenues	$220,972	Thousands of USD

If onboarding takes 14+ days, churn risk rises, which is a key reason for focusing on the captive agent model over potentially lower-quality partner flows.

GoHealth, Inc. (GOCO) - Canvas Business Model: Customer Segments

Seniors eligible for Medicare (Medicare Advantage, Supplement, PDP)

GoHealth, Inc. serves consumers navigating Medicare coverage options through its technology-driven marketplace and licensed agents.

• Consumers trusting GoHealth, Inc. as of a recent report: 10 million.
• Total Medicare Beneficiaries (Parts A & B) in the US market in 2025: approximately 62.8 million.
• Medicare Advantage (MA) enrollees in the US market in 2025: 34.1 million, representing 54% of eligible beneficiaries.

The company's revenue streams are disaggregated based on the Medicare product sales model for the three months ended March 31, 2025:

Revenue Category (Three months ended Mar. 31, 2025)	Amount (in thousands)	Amount (USD)
Medicare Agency Revenue - Commission Revenue	$167,109	$167,109,000
Medicare Agency Revenue - Partner Marketing and Other Revenue	$20,524	$20,524,000
Total Agency Revenue	$187,633	$187,633,000
Total Non-Agency Revenue	$31,771	$31,771,000
Total Net Revenues (All Medicare)	$219,404	$219,404,000

For the first quarter of 2025, GoHealth, Inc. reported 303,026 Submissions. The Direct Operating Cost per Submission for Q1 2025 was $522.

Individuals qualifying for Special Needs Plans (SNP)

This group is a subset of the broader Medicare Advantage segment, focusing on beneficiaries with specific needs.

• In the US market in 2025, 21% of Medicare Advantage enrollees are in Special Needs Plans (SNPs).
• Total C-SNP (Chronic SNP) enrollment in the US market in 2025 was approximately 1.2 million people.

Consumers seeking ancillary products like guaranteed acceptance life insurance

GoHealth, Inc. has expanded its offerings beyond core health insurance products.

• The company launched GoHealth Protect, with guaranteed acceptance life insurance as the inaugural product.
• Other Revenue for GoHealth, Inc. in Q1 2025 was $1,568 thousand.

The overall financial performance for the three months ended September 30, 2025, included a Net Loss of $313.9 million and Adjusted EBITDA of $(47.1) million. Net revenues for that period were $34.2 million.

GoHealth, Inc. (GOCO) - Canvas Business Model: Cost Structure

The Cost Structure for GoHealth, Inc. (GOCO) is heavily weighted toward variable costs directly tied to generating insurance Submissions, though fixed costs for technology and overhead remain a focus for reduction as of late 2025.

Direct Operating Cost per Submission is a critical metric management uses to gauge efficiency, and it showed significant improvement in the first quarter of 2025.

Metric	Q1 2025 Amount	Q1 2024 Amount	Change
Direct Operating Cost per Submission	$522	$640	-18.4% improvement

This reduction to $522 per Submission in Q1 2025, down from $640 in the prior year period, is a testament to targeted marketing strategies and efficient agent performance.

Variable costs for customer acquisition (marketing and advertising) are a major component of the Direct Operating Cost of Submission. These costs are explicitly described as direct and variable with Submissions, driven by expenses for direct, online advertising, and marketing partner channels.

Agent compensation and consumer care/enrollment expenses are also embedded within the Direct Operating Cost of Submission, meaning they scale directly with the volume of applications processed. Consumer care and enrollment expenses primarily cover compensation and benefits for enrollment personnel assisting consumers through the application process, which is generally variable with Submissions.

• Variable costs included in Direct Operating Cost of Submission:
  • Revenue share (for external agents).
  • Marketing and advertising expense.
  • Consumer care and enrollment expenses.

Fixed costs for technology development and corporate overhead are actively being managed. You've heard CEO Vijay Kotte state that the company has significantly reduced overhead while continuing to invest in AI and automation. Technology expense, which is a key fixed/investment area, primarily consists of compensation and benefits for personnel developing and enhancing the technology platform, data analytics, and business intelligence systems. Corporate overhead would include general and administrative expenses, which also include compensation and benefits costs. The strategic focus is on reducing these fixed components while maintaining core technology investments that improve agent effectiveness and consumer experience.

Finance: draft 13-week cash view by Friday.

GoHealth, Inc. (GOCO) - Canvas Business Model: Revenue Streams

You're looking at how GoHealth, Inc. brings in money, and as of late 2025, the story is one of strategic realignment following a strong start to the year. The revenue picture clearly shows the impact of the company's decision to pull back from certain Medicare Advantage volumes.

The baseline for the year was strong. Q1 2025 Net Revenues were $221.0 million before the strategic pullback. That figure represented a 19.1% increase compared to the prior year period. This early performance was driven by solid execution in the core agency model.

The primary engine remains the Medicare agency business, which generates revenue through initial and renewal commissions from health plan enrollments. Looking at the second quarter, which reflects the initial impact of the strategic shift, the Medicare Agency Revenue component was substantial.

• Medicare Agency Revenue (Q2 2025): $81.17 million.
• Commission Revenue component within that (Q2 2025): $73.32 million.

This indicates that the core commission-based business, which you'd expect from an agency model, still forms the bulk of the recognized revenue, even as total revenue contracted later in the year.

Non-agency revenues from enrollment and engagement services saw a significant contraction as GoHealth, Inc. executed its strategic pullback from the Medicare Advantage space starting in May 2025 due to health plan uncertainties. This segment took a major hit, which is clear when you look at the Q2 figures.

• Non-agency revenue declined by 79.4% year-over-year in Q2 2025.
• Other Non-Agency Revenue for Q2 2025 was reported at $8.42 million.

To counter seasonality and diversify the top line, GoHealth, Inc. launched the new GoHealth Protect product suite. This suite, which includes guaranteed acceptance life insurance, is designed to be a scalable, cash-flow supportive complement to the core business. This new stream showed early traction.

The revenue contribution from this new product was a bright spot in the second quarter. Specifically, the GoHealth Protect initiative generated $8.7 million in revenue in Q2 2025, meeting performance expectations for its ramp-up phase.

The sequential decline in overall revenue through the third quarter highlights the effect of the strategic adjustments made mid-year. Here's a quick look at the top-line trend across the first three reported quarters of 2025:

Reporting Period	Net Revenues (Millions USD)	Key Context
Q1 2025	$221.0	Pre-strategic pullback baseline.
Q2 2025	$94.05	Reflects strategic MA volume reduction.
Q3 2025	$34.2	Continued alignment with market rationalization.

For context on the trailing twelve months as of September 30, 2025, GoHealth, Inc.'s revenue was $738.34 million USD.