Clover Health Investments (NasdaqGS:CLOV) Q3 2025 Earnings Call November 04, 2025 05:00 PM ET Speaker2Hello and welcome to Clover Health's third quarter 2025 earnings call. We ask that you please hold all questions until the completion of the formal remarks, at which time you'll be given instructions for the question and answer session. Also, as a reminder, this conference is being recorded today. If you have any objections, please disconnect at this time. Ryan, you may begin.Speaker1Good afternoon, everyon ...

Core Insights - Clover Health Investments reported Q2 2025 results with significant revenue growth, achieving GAAP sales of $477.6 million, exceeding analyst expectations of $468.3 million [1][5] - Despite revenue gains, profitability metrics weakened compared to Q2 2024, with a net loss per share of $(0.02) and an insurance benefits expense ratio (BER) of 88.4% [1][2] Financial Performance - Revenue increased by 34.0% year-over-year from $356.3 million in Q2 2024 to $477.6 million in Q2 2025 [2][5] - Adjusted net income from continuing operations fell to $16.7 million, down 53.5% from $35.9 million in Q2 2024 [2][6] - Adjusted EBITDA decreased by 52.8% to $17.1 million compared to $36.2 million in the previous year [2][6] - The insurance BER rose from 76.1% to 88.4%, indicating increased medical costs relative to premiums [2][7] Membership Growth - Medicare Advantage membership grew by 32% year-over-year, reaching 106,323 members as of June 30, 2025, up from 80,261 in the previous year [5][11] - The company aims to expand its membership in underserved markets and enhance the Clover Assistant platform [4][9] Strategic Initiatives - Clover Health is focusing on three main areas: expanding the Clover Assistant platform, growing MA plan membership, and developing Counterpart Health, a new technology and services business [4][9] - Management highlighted the importance of balancing rapid membership growth with the need to control rising medical costs [4][6] Outlook - The company updated its fiscal 2025 guidance, expecting average Medicare Advantage membership to reach between 104,000 and 108,000 [11] - Insurance revenue forecast remains at $1.8 billion to $1.875 billion, with adjusted EBITDA and net income targets set at $50 million to $70 million each [11] - The updated forecast for the Insurance BER is now projected to be between 88.5% and 89.5% for the full year [11]

Core Insights - Clover Health Investments (CLOV) is expected to report second-quarter 2025 results on August 5, with earnings estimated at 3 cents per share and revenues at $482.5 million, reflecting a year-over-year growth of 200% and 35.4% respectively [1][5] - The consensus for 2025 revenues stands at $1.89 billion, indicating a 37.7% increase year-over-year, while the EPS estimate is 11 cents, suggesting a decline of 21.4% year-over-year [2] Financial Performance - Clover Health has consistently surpassed earnings estimates in the past four quarters, achieving an average surprise of 114.58% [2] - The company has a Zacks Rank of 3 (Hold), with an Earnings ESP of 0.00%, indicating no expected earnings surprise for the upcoming quarter [3][4] Growth Factors - The company reported a 30% growth in Medicare Advantage (MA) membership and a 279% increase in adjusted earnings year-over-year for the first quarter [5] - The Clover Assistant has demonstrated an 18% reduction in hospitalizations and 25% lower 30-day readmissions for congestive heart failure patients, contributing to cost efficiencies [6][7] Market Position - Member growth remains strong, particularly in key markets like New Jersey, supported by effective cohort management strategies [8] - Clover Health's Counterpart Health is expanding its technology reach, although the financial impact from non-insurance revenue in Q2 is expected to be limited [9] Valuation and Performance - Year-to-date, CLOV shares have declined by 8.2%, underperforming peers such as Alignment Healthcare and Oscar Health [10] - Clover Health trades at a forward 12-month price-to-sales ratio of 0.65, reflecting stronger growth expectations compared to its peers [11] Strategic Outlook - The company is focused on improving clinical outcomes and expanding its technology capabilities, with a cautious outlook on profitability and revenue contributions from Counterpart Health [15] - Investors are advised to monitor updates on utilization trends and the sustainability of operating leverage before making new investments [15]

Financial Data and Key Metrics Changes - In 2024, Clover Health achieved adjusted EBITDA profitability, marking a significant milestone for the company [4][19] - Insurance revenue grew by 9% in both Q4 and full year 2024, reaching $331 million and $1.345 billion respectively [15] - The insurance benefit expense ratio improved to 82.8% in Q4 2024 from 87.4% in Q4 2023, while the medical care ratio (MCR) improved to 73.5% from 82.4% year-over-year [15][16] - For the full year 2024, the benefit expense ratio (BER) was 81.2% and MCR was 75.1%, both showing improvements of over 500 basis points year-over-year [16][22] - Adjusted EBITDA for the full year 2024 was over $70 million, a $112 million improvement compared to 2023 [19] Business Line Data and Key Metrics Changes - Clover Health surpassed 100,000 Medicare Advantage members in 2024, achieving a 27% year-over-year growth and a 95% retention rate during the Annual Enrollment Period (AEP) [5][18] - The launch of Counterpart Health, a software business, has begun to show promise with a growing pipeline of external partners [6][11] Market Data and Key Metrics Changes - The company reported strong membership growth primarily from switchers from other Medicare Advantage plans, indicating a competitive advantage in capturing market share [24] - The Medicare Advantage membership is expected to average between 210,000 members in 2025, reflecting a 30% year-over-year growth [20] Company Strategy and Development Direction - Clover Health aims to maintain adjusted EBITDA profitability while investing in new member growth, Clover Assistant technology, and expanding home care services [12][24] - The company is focused on a technology-first care model that enhances care management and reduces costs, positioning itself favorably against traditional models [8][9] - Counterpart Health is seen as a strategic initiative to expand Clover's reach and improve value-based performance [11][29] Management Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to achieve profitable growth and improve clinical outcomes through technology-driven care management [7][8] - The company anticipates strong membership growth in the upcoming AEP season and expects to benefit from a four-star payment year in 2026 [30][31] - Management highlighted the importance of proactive care management in controlling total costs and improving member health outcomes [33] Other Important Information - Clover Health's SG&A expenses increased by 7% year-over-year in Q4 2024, driven by strategic investments for the AEP season [18] - The company ended Q4 2024 with cash and investments totaling $438 million, indicating a strong balance sheet position [19] Q&A Session Summary Question: When can revenue metrics from Counterpart Health be expected in financials? - Management is excited about Counterpart Health but has not provided a timeline for when revenue will be incorporated into financial results, focusing instead on expanding reach and partnerships [35][38] Question: How much of the SG&A increase is related to AEP growth, and what are the expectations for future SG&A? - The growth in SG&A is significantly tied to growth-related expenses, but management expects a 200 basis point improvement in SG&A as a percentage of revenue for 2025 [40][41] Question: Expectations for Q2 growth of the home care arm? - Management emphasized the importance of home care in their strategy and plans to invest more in this area, although specific guidance was not provided [43][45]