Key Takeaways CLOV is gaining share with 35% membership growth and nearly 50% revenue growth, backed by retention above 90%.CLOV sees higher margins as Clover Assistant drives profits and improves cost ratios for returning members.CLOV expands monetization through Counterpart Health, extending its platform beyond Medicare Advantage plans.Clover Health Investments (CLOV) is well poised for growth in the coming quarters, courtesy of its broad product spectrum. This optimism is primarily driven by its technolo ...

WILMINGTON, Del., Dec. 16, 2025 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today announced that its Chief Executive Officer, Andrew Toy, will present at the J.P. Morgan 2026 Healthcare Conference on Thursday, January 15, 2026, at 11:15 a.m. Eastern Time. A live webcast and replay of the presentation and Q&A session will be accessible on Clover Health's investor relations website at https://investors.cloverhealth.com/. About Clover Health ...

Financial Data and Key Metrics Changes - Clover Health reported a year-to-date membership growth of 33% as of September 30, 2025, with an adjusted EBITDA of $45 million, which is exceptional given the typical loss-making nature of new membership growth [4][8] - The company has improved its selling, general, and administrative (SG&A) expenses as a percentage of revenue by 370 basis points [15] - The normalized year-to-year cost trend, excluding pharmacy, is approximately 4%, while the company is growing membership by 35% [15][47] Business Line Data and Key Metrics Changes - The company focuses on the PPO side of Medicare Advantage, with nearly 100% of its members enrolled in PPO plans, allowing for greater freedom of choice in healthcare providers [3][5] - The contribution profit per member per month for new members is approximately $110, while returning members generate about $217 PMPM [19][53] Market Data and Key Metrics Changes - The Medicare Advantage market is valued at over $500 billion annually, with over 35 million seniors currently enrolled [3] - Clover Health's primary markets are New Jersey and Georgia, where it has a strong membership base and physician network [4][65] Company Strategy and Development Direction - Clover Health aims to leverage its proprietary AI-powered software platform, Clover Assistant, to improve healthcare outcomes and reduce costs by enabling earlier diagnosis and treatment of chronic diseases [2][12] - The company is focusing on priority markets with existing member bases and physician networks to manage growth effectively [4][17] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving GAAP net income profitability for fiscal 2026, driven by strong voluntary member retention and improved financial performance from returning members [16][74] - The company anticipates a four-star rating for its Medicare Advantage plans in the upcoming year, which would provide a financial boost [42][74] Other Important Information - Clover Health has developed a strong home care business unit that focuses on high-acuity patients, differentiating itself from traditional nurse-led home care models [8] - The company is in a growth phase for its Counterpart Health offering, which targets third-party payers and risk-based providers [14] Q&A Session Summary Question: How does the improvement in medical cost ratio (MCR) relate to the entire population versus Clover Assistant users? - The improvement includes the total population, but the impact for Clover Assistant users is expected to be higher [23] Question: What percentage of members are treated with Clover Assistant after year one? - Approximately two-thirds to 70% of the total membership base receives care under Clover Assistant technology [24] Question: How is Clover Assistant differentiated in its AI scribing capabilities? - The scribing capability is fully integrated into Clover Assistant, reducing administrative loads for physicians [28] Question: What headwinds does the company foresee for the upcoming year? - The company is closely monitoring cost trends, which are currently at 4%, compared to 7.5%-8% for larger managed care organizations [46][47] Question: What initiatives are being taken to improve Part D performance? - The company is working with its PBM to enhance performance and is integrating Part D into Clover Assistant for better medication management [50][52]

Financial Data and Key Metrics Changes - The company reported a 33% year-to-date growth in membership as of September 30, 2025, which is exceptional in the Medicare Advantage (MA) market [4][8] - Adjusted EBITDA for the year-to-date is $45 million, which is notable given the new membership growth typically incurs losses in the first year [4][8] - The company has reduced Selling, General and Administrative (SG&A) expenses as a percentage of revenue by 370 basis points [15] Business Line Data and Key Metrics Changes - The company focuses on the PPO side of Medicare Advantage, with nearly 100% of members enrolled in PPO plans, allowing freedom of choice for physicians and providers [3][5] - The company has a strong home care business unit that provides care for high-acuity patients, utilizing the same proprietary software for disease management [7][8] Market Data and Key Metrics Changes - The Medicare Advantage market is valued at over $500 billion annually, with more than 35 million seniors currently enrolled [3] - The company is primarily focused on its core markets of New Jersey and Georgia, where it has a significant member base and physician network [4][17] Company Strategy and Development Direction - The company aims to achieve GAAP net income profitability for fiscal 2026, driven by high member retention rates and improved financial performance from returning members [16][20] - The company is strategically managing growth by focusing on priority markets with existing member bases and physician networks [17][37] - The company plans to enhance its technology platform, Clover Assistant, to further improve care quality and operational efficiency [20][26] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in continued growth, citing a strong voluntary member retention rate of over 90%, which is likely the highest in the industry [16][20] - The company anticipates a favorable macroeconomic environment for 2026 and 2027, with expected improvements in profitability and cash flow [29][30] Other Important Information - The company has developed proprietary technology over the last decade, which is integral to its operations and differentiates it from traditional players in the market [2][6] - The company is experiencing strong interest from third-party payers and risk-based providers for its software platform, indicating a robust pipeline for future growth [14][26] Q&A Session Summary Question: How does the improvement in medical cost ratio (MCR) include the entire population? - The improvement in MCR is based on the total population, but the impact for Clover Assistant members is expected to be higher [23] Question: What percentage of members are treated with Clover Assistant after year one? - Approximately two-thirds to 70% of the total membership base receives care under Clover Assistant technology [24] Question: What differentiates Clover's AI scribing capabilities? - The integration of AI scribing into Clover Assistant reduces administrative burdens for physicians, allowing them to focus on clinical activities [25] Question: What prevents larger managed care plans from replicating Clover's model? - The company's unique vision, culture, and decade-long development of technology create a defensive mode against larger competitors [26] Question: How does Clover balance growth and profitability? - The company focuses on priority markets with existing strong membership bases and uses targeted marketing strategies to manage growth effectively [36][37]

Core Insights - Clover Health Investments, Corp. will have its CFO, Peter Kuipers, present at the 2025 Citi Global Healthcare Conference on December 4, 2025 [1] Company Overview - Clover Health is a physician enablement technology company focused on providing access to quality healthcare for Medicare recipients, particularly seniors who have historically faced challenges in accessing affordable healthcare [2] - The company's strategy is driven by its software platform, Clover Assistant, which aggregates patient data to support clinical decision-making and improve health outcomes by identifying and managing chronic diseases early [2] - Clover Health offers PPO and HMO Medicare Advantage plans across several states, emphasizing its wide-network, high-choice PPO plans [2] - The company extends its data-driven technology platform to healthcare providers outside its Medicare Advantage plan through its subsidiary, Counterpart Health, aiming to enhance patient outcomes and reduce healthcare costs nationwide [2] - Clover Health has published data showcasing the technology's effectiveness in improving Medication Adherence, managing Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and addressing the needs of Underserved Populations, as well as in the early identification and management of Diabetes and Chronic Kidney Disease [2]

Summary of Clover Health Investments Conference Call Company Overview - **Company**: Clover Health Investments (NasdaqGS:CLOV) - **Industry**: Medicare Advantage Insurance Key Points and Arguments Business Model and Technology - Clover Health aims to empower physicians with advanced technology to manage chronic diseases effectively, leading to better health outcomes and lower total care costs [2][3] - The company operates primarily in an open network (PPO) focusing on New Jersey and Georgia, expecting to grow membership by 33% while maintaining profitability [3][4] - Clover Assistant, an AI-enabled technology, is used at the point of care to integrate various medical records, enabling earlier identification and management of chronic diseases [4][5][6] Financial Performance - Clover Health anticipates a 33% growth in membership and nearly 40% increase in revenue year-to-date, achieving $45 million in EBITDA [11][12] - The company's Benefit Expense Ratio (BER) is projected at approximately 89%, which is competitive compared to industry averages [5][12] - New members typically incur higher costs initially but are expected to improve profitability over time as they become returning members [12][14] Clinical Outcomes - The technology has led to earlier diagnoses of chronic diseases, such as diabetes, which is diagnosed on average three years earlier, resulting in lower treatment costs and better health outcomes [9][10] - Clover Health has been ranked number one in the nation for PPO plans on clinical quality for two consecutive years [10] Market Trends and Growth Opportunities - The Medicare Advantage market is growing, with 35 million seniors in the U.S. participating [2] - Clover Health expects to benefit from a strong voluntary retention rate above 90% and a transition to a four-star payment year, which could add approximately 5% to revenue [16][17] - The company is also exploring opportunities with third-party payers and risk-bearing providers, leveraging its technology for broader market reach [10][11] Challenges and Future Outlook - The company faces challenges with higher-than-expected utilization rates among new members, which are being monitored for better management [12][19] - Clover Health is working on improving its STAR ratings, particularly in pharmacy metrics, which have seen a decline [28][30] - The company is focused on optimizing SG&A costs and leveraging AI to enhance operational efficiency [36][39] Additional Insights - Clover Health has made a mark in the precision medicine space through investments, such as a $10 million stake in Biochar Science [24] - The integration of AI scribing technology aims to enhance the efficiency of physician-patient interactions within the Clover Assistant platform [44] Conclusion Clover Health is positioned for significant growth in the Medicare Advantage market, driven by its innovative technology and strong clinical outcomes. While facing challenges related to new member utilization and STAR ratings, the company is optimistic about its future financial performance and market opportunities.

Investor Presentation November 2025 LGTMs: Date: Peter K. LGTM 11.10.25 Legal (Karen / Peter R.) LGTM Disclaimer This presentation and the accompanying oral presentation include forward-looking statements, including, without limitation, statements regarding future events and Clover Health Investments, Corp.'s ("Clover Health," "we," "our," or "us") expectations regarding Adjusted EBITDA, Adjusted Net income from continuing operations, Adjusted SG&A, Adjusted SG&A as a percentage of revenue, Insurance BER, N ...

Core Insights - Clover Health Investments, Corp. (CLOV) reported break-even adjusted quarterly earnings per share (EPS) for Q3 2025, missing the Zacks Consensus Estimate of earnings of 2 cents, compared to an adjusted loss of 2 cents in the same period last year [1][8] - The company experienced a significant revenue increase of 50.1% year over year, totaling $496.7 million, which exceeded the Zacks Consensus Estimate by 4.5% [2][8] Revenue Breakdown - Clover Health's revenues are primarily derived from two segments: Insurance and Other income. Insurance revenues reached $479.1 million, reflecting a year-over-year increase of 48.5%, driven by a 35% rise in Medicare Advantage membership and strong member retention [3][8] - Other income amounted to $17.5 million, marking a substantial increase of 108.4% from the previous year [5] Operational Performance - Net medical claims surged by 70.5% year over year to $428.9 million. Salaries and benefits expenses decreased by 12.4% to $48.2 million, while general and administrative expenses rose by 39.1% to $48.9 million. Total operating expenses increased by 53.3% to $521 million, resulting in an operating loss of $24.4 million compared to a loss of $8.9 million in the prior year [6][8] Financial Position - At the end of Q3 2025, Clover Health had cash and cash equivalents of $190.1 million, slightly up from $188.6 million at the end of Q1. Net cash provided by operating activities from continuing operations was $1.2 million, down from $129.5 million a year ago [7][8] Guidance and Outlook - The company raised its 2025 Insurance revenue outlook to a range of $1.85-$1.88 billion, suggesting a 39% year-over-year growth at the midpoint, while lowering the adjusted Net Income forecast to $15-$30 million from a previous estimate of $50-$70 million [9][10] - Insurance Benefit Expense Ratio (BER) is projected to be between 90-91%, up from the previous estimate of 88.5-89.5%. Average Medicare Advantage membership is expected to be between 106,000-108,000, indicating a 33% year-over-year growth at the midpoint [10] Market Reaction - Following the earnings report, CLOV shares fell by 17.9% in after-hours trading on November 4, attributed to lower-than-expected earnings and revenue guidance [12] - Year-to-date, CLOV shares have increased by 11.7%, compared to the industry growth of 26.8% and the S&P 500 Index's increase of 18.1% [12] Strategic Insights - Management outlined a path to profitability expansion in 2026, citing a larger base of returning Clover Assistant-managed members and favorable payment dynamics as key drivers [13] - Clover Assistant continues to demonstrate industry-leading clinical quality, with potential for significant long-term opportunities with external payers and providers [14]

Financial Data and Key Metrics Changes - Clover Health's Medicare Advantage membership grew 35% year-over-year to over 109,000 members, with insurance revenue of $479 million, an increase of 49% year-over-year [24] - Year-to-date insurance revenue reached $1.4 billion, up 39% year-over-year [24] - Adjusted EBITDA and adjusted net income for the third quarter were $2 million each, down $70 million year-over-year, while year-to-date adjusted EBITDA and adjusted net income remained positive at $45 million and $44 million, respectively [29][30] Business Line Data and Key Metrics Changes - The company experienced adjusted EBITDA profitability despite increased utilization and a higher proportion of new members, which negatively impacted overall profitability [19][24] - Returning member cohorts generated approximately $217 of contribution profit per member per month, while new member cohorts had a negative contribution of $110 per member per month [21] Market Data and Key Metrics Changes - The company anticipates adding roughly 44,000 gross new members in 2025, with an expected year-end population of approximately 113,000 net members [8] - The current year is expected to be the peak year for the impact of new member growth on profitability, with a larger contribution profit-positive base of returning members anticipated in 2026 and beyond [9] Company Strategy and Development Direction - Clover Health aims to maintain a comprehensive PPO portfolio that prioritizes open access with stable, predictable benefits, despite industry trends of narrowing networks [12] - The company is focused on increasing physician adoption of Clover Assistant, with more than half of new members having received a Clover Assistant visit this year [11] Management's Comments on Operating Environment and Future Outlook - Management acknowledged broad systemic utilization pressure and the need for adjustments to address lowered guidance for 2025 adjusted EBITDA profitability [4][6] - The company remains confident in its long-term trajectory, expecting to achieve sustained growth and expanding profitability, particularly with anticipated larger profitable returning member cohorts in 2026 [19][20] Other Important Information - Clover Health received a three and a half star rating for the 2026 ratings year, which management views as below their aspirations, but they believe their model can still perform well in this rating environment [12][14] - The company is actively engaging with CMS to improve how quality is measured and is committed to enhancing performance in pharmacy measures, which impacted star ratings [14][15] Q&A Session Summary Question: How should we think about 2026 from a BER perspective given the elevated utilization? - Management indicated that the underlying incurred cost trends are around 4%, and they believe this is solid performance despite higher utilization trends and a higher mix of new members [40] Question: Is there a mispricing issue for 2026 given the current pressures? - Management expressed confidence that the cost trends are baked into their bids and highlighted several tailwinds, including a four-star payment year and increased leverage from SD&A [40][41] Question: What should we expect for the fourth quarter regarding MCR? - Management suggested averaging the first three quarters to establish a baseline expectation for the fourth quarter, noting that intra-year PPD from the second half impacted the third quarter [42]

Financial Performance - 3Q25 Medicare Advantage membership increased by 35% year-over-year[8] - 3Q25 Insurance revenue increased by 49% year-over-year[8] - 3Q25 Adjusted EBITDA and Adjusted Net income were $2 million[8] - 3Q YTD Adjusted EBITDA was $45 million and Adjusted Net income was $44 million[8] - 3Q25 Adjusted SG&A as a % of Total revenues improved by 370 bps year-over-year[8] - Updated FY25 Guidance: Insurance Revenue is expected to be $1.85 billion - $1.88 billion[36], Adjusted SG&A is expected to be $325 million - $335 million[36], Adjusted EBITDA is expected to be $15 million - $30 million[36], and Average Medicare Advantage Membership is expected to be 106,000 - 108,000[36] Clinical Model and Technology - Clover Health's Medicare Advantage PPO plans received a score of 4.72 / 5 Stars on HEDIS Measures for Star Rating Year 2026[33] - Clover Assistant enables better care for patients from socioeconomically disadvantaged neighborhoods, with higher diagnosis rates of diabetes (75% higher), CKD (89% higher), CHF (89% higher) and COPD (70% higher)[29] Future Outlook - Clover Health expects to achieve FY26 GAAP Net income[8] - Clover Health is well-positioned for above-market growth & profitability expansion in 2026 & beyond[9]