WILMINGTON, Del., Oct. 19, 2026 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover Health” or “Clover”), a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare, today announced that it earned top distinctions across New Jersey, Georgia, and South Carolina in U.S. News & World Report's 2027 Best Insurance Companies for Medicare Advantage (“MA”) ratings. The recognition highlights key areas of Clover's approach to MA, including preventive care, continuity of care, and strong physician relationships.
“For beneficiaries, having a health plan they can rely on means being able to see the doctors they trust, get preventive care, and know someone is helping connect the dots across their healthcare,” said Jamie Reynoso, CEO of Medicare Advantage, Clover Health. “These ratings reflect the work our physicians and local teams do every day, supported by clinical insights from Counterpart Assistant, and reinforce the value of a MA model built around choice, continuity, and putting members first.”
In the 2027 U.S. News ratings, Clover Health plans were recognized as Best Medicare Advantage Plans in South Carolina, Georgia, and New Jersey, with the following distinctions:
Highest scores in the state of New Jersey for Best Medicare Advantage Plans for Care Continuity; recognized as Best Overall and Best for Screening & PreventionHighest scores in the state of Georgia for Best Medicare Advantage Plans Overall and Best for Care Continuity; tied as Best for Screening & PreventionHighest scores in the state of South Carolina in all three categories: Best Medicare Advantage Plans Overall, Best for Screening & Prevention, and Best for Care Continuity Supporting Physicians and More Connected Care
This designation follows the announcement of Clover’s market-leading performance on core Healthcare Effectiveness Data and Information Set (“HEDIS®”1) measures with a score of 4.82 out of 5 Stars2, ranking #1 among non-SNP PPO plans with over 2,000 members for the third year in a row.
Clover's wide-network PPO MA model is supported by Counterpart Assistant, its physician-facing technology platform, which provides data-driven clinical insights to help physicians identify care gaps, make informed decisions, and coordinate care. The technology supports physicians' independent clinical judgment and is also offered to external healthcare organizations through Clover's subsidiary, Counterpart Health.
The 2027 Annual Enrollment Period runs from October 15 through December 7, 2026. Clover Health plans are available to 5.2 million Medicare-eligible beneficiaries within 203 counties across five states. Plans available based on location are available to view here.
About Clover Health:
Clover Health (Nasdaq: CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and in Underserved Populations as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
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Clover Health is a PPO and HMO organization with a Medicare contract. Enrollment in Clover Health depends on contract renewal.
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1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
2 This analysis focuses on performance by non-SNP PPO plans with over 2,000 lives as of September 1, 2024, 2025, and 2026 on HEDIS measures applicable to non-SNPs that were used for CMS’s MY 2023, MY 2024, and MY 2025 Star ratings, applying the measure ranges used by CMS. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
CMS udělila PPO plánům Medicare Advantage společnosti Clover Health pro rok 2027 maximální pětihvězdičkové hodnocení, které umožní pojištěncům celoroční zápis.
WILMINGTON, Del., Oct. 08, 2026 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today announced that the Centers for Medicare & Medicaid Services (“CMS”) has awarded its PPO Medicare Advantage (“MA”) plans a rating of 5 Stars and its HMO MA plan a rating of 4.5 Stars for 2027, which will affect payment year 2028. Through the first half of 2026, Clover Health grew Medicare Advantage membership ~48% year-over-year to more than 157,000 members, with ~98% enrolled in its wide-network PPO plans. At 5 Stars, Clover’s PPO plans will be able to enroll beneficiaries year round.
Each year, CMS assigns Star ratings to Medicare Advantage and Part D contracts on its healthcare quality and drug plan, and issues a Star rating on a scale of 1 to 5 Stars. These ratings affect payments to Medicare Advantage plans. For the 2027 Star Ratings, Clover’s overall Star rating was driven by improvements across Stars domains.
In light of the decision in Clover Insurance Company v. Department of Health & Human Services, Civ. A. No. 25-142 (S.D. Ga.) issued on May 27, 2026, which is on appeal, CMS calculated Clover’s rating for its PPO plans removing the 20 measures included in the court decision, awarding Clover’s PPO plans 5 Stars. With the 20 measures included, Clover’s PPO plans would have received 4.5 Stars.
Additionally, for the third year in a row, Clover has continued its market-leading performance on core Healthcare Effectiveness Data and Information Set (“HEDIS®”1) measures with a score of 4.82 out of 5 Stars2, again ranking #1 among non-SNP PPO plans with over 2,000 members. HEDIS is a set of performance measures used to assess aspects of care quality, including preventive screenings and management of health issues such as diabetes, cancer, and heart disease. Clover’s HEDIS score remains consistent at 4.82 out of 5 Stars regardless of the CMS methodology used for 2027, demonstrating the strength of a care model powered by Counterpart Assistant that surfaces relevant information for physicians to identify care needs and support better-informed clinical decisions.
“Success in the Star ratings system means an enhanced ability to support our members and to continue to provide them market leading plans. We also continue to support reforms to the Stars program that more closely align these ratings with meaningful improvements in members’ health and value for the Medicare program,” said Andrew Toy, CEO of Clover Health. “We are particularly proud of our core HEDIS measures performance, which assess important aspects of preventive care and chronic disease management. Our focus remains on giving physicians the tools to deliver proactive care across our wide PPO network, supported by our Counterpart Assistant platform.”
“Our teams have worked incredibly hard over the last several years, and we’re excited about what this year’s Star rating means for our ability to keep delivering the benefits, affordability, and wide choice of providers that our members count on and trust,” said Jamie Reynoso, CEO of Medicare Advantage, Clover Health. “With a higher Star rating, we are able to further reinvest in even more competitive benefits. This milestone allows us to scale our impact to more people on Medicare without compromising our financial strength or commitment to care quality.”
“We founded Clover with the conviction that improving healthcare requires both the ambition to reimagine it coupled with the willingness to solve hard problems, on a first principles basis,” added Vivek Garipalli, Founder and Executive Chairman of Clover Health. “I’m proud to work closely with our teams on critical aspects of these efforts, and I have a ton of fun doing so as well. This Star rating reflects many, many years of persistence and disciplined execution and provides a strong opportunity to build on that foundation moving forward as we continue to seek much-needed reforms.”
To learn more about Clover Health and its Medicare Advantage plans, visit www.cloverhealth.com. For providers, health systems and plans interested in learning about how they can use Clover’s proprietary technology stack to succeed in value-based care, visit www.counterparthealth.com.
Federal Contracting Disclaimer: Clover Health is a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) with a Medicare contract. Enrollment in Clover Health depends on contract renewal.
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
Forward-Looking Statements:
Please note that this press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include statements regarding future events and Clover Health’s future results of operations, financial position, business strategy and future plans. Forward-looking statements are not guarantees of future performance, and you are cautioned not to place undue reliance on such statements. In some cases, you can identify forward looking statements because they contain words such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “going to,” “can,” “could,” “should,” “would,” “intends,” “target,” “projects,” “contemplates,” “believes,” “estimates,” “predicts,” “potential,” “outlook,” “forecast,” “guidance,” “objective,” “plan,” “seek,” “grow,” “target,” “if,” “continue” or the negative of these words or other similar terms or expressions that concern Clover’s expectations, strategy, priorities, plans or intentions. Forward-looking statements in this press release include, but are not limited to, its anticipated financial results associated with CMS’ 2027 Stars ratings of 5.0 for Clover’s PPO MA plans and its 2027 Stars rating of 4.5 for Clover’s HMO plan, future financial outlook, future membership growth and retention, Clover assistant usage and investment, and cost efficiency initiatives, as well as our expectations related to Clover’s GAAP and Adjusted EBITDA profitability, liquidity, future performance, future operations and future results. These statements are subject to known and unknown risks, uncertainties and other factors that may cause Clover Health’s actual results, levels of activity, performance or achievements to differ materially from results expressed or implied in this press release. Additional information concerning these and other risk factors is contained in Clover Health’s most recent Annual Report on Form 10-K, filed with the Securities and Exchange Commission (the “SEC”) on February 27, 2026, and in our subsequent filings with the SEC, in each case where relevant, including the Risk Factors sections therein, and in its other filings with the SEC. The forward-looking statements included in this press release are made as of the date hereof. Except as required by law, Clover Health undertakes no obligation to update any of these forward-looking statements after the date of this press release or to conform these statements to actual results or revised expectations.
About Clover Health:
Clover Health (Nasdaq: CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and in Underserved Populations as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
1 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
2 This analysis focuses on performance by non-SNP PPO plans with over 2,000 lives as of September 1, 2024, 2025, and 2026 on HEDIS measures applicable to non-SNPs that were used for CMS’s MY 2023, MY 2024, and MY 2025 Star ratings, applying the measure ranges used by CMS.
Clover Health oznámila nabídku plánů Medicare Advantage pro rok 2027 s důrazem na PPO s pojistným 0 USD, širší volbu poskytovatelů a preventivní péči. Plány budou dostupné pro 5,2 milionu oprávněných příjemců Medicare ve 203 okresech v pěti státech.
WILMINGTON, Del., Oct. 01, 2026 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare, today announced its 2027 Medicare Advantage (MA) plan offerings, with a continued focus on PPO choice, affordable access to preventive care and meaningful member value. Clover’s Medicare Advantage model is powered by Clover Assistant (CA), which is designed to give physicians across Clover’s broad provider network access to relevant patient information to identify care needs and support better-informed clinical decisions.
Clover Health’s 2027 portfolio provides options for members with different healthcare needs and financial circumstances including:
$0 to low premium PPO with broad provider choice and no referrals required*$0 primary care physician (PCP) in-network copaysSome of the lowest specialist copays in the industry$0 lab services at preferred providersRoutine dental, vision, OTC and gym benefits across all plansUp to $400 in LiveHealthy Rewards for eligible healthy activitiesOptions that pair well with Extra Help/PAAD as well as an MA only planClover Assistant-powered care model, designed to help physicians identify care needs and make better-informed clinical decisions “Medicare Beneficiaries are once again navigating a market where plans are changing, choices can be harder to understand, and affordability matters more than ever,” said Jamie Reynoso, CEO of Medicare Advantage at Clover Health. “Our teams have been deliberate about protecting meaningful PPO choice and access to care for our members, and our ability to pair that flexibility and value with top-ranked clinical quality shows what this model can deliver even as others in the industry pull back.”
High-Choice PPO Access in a Changing MA Market
As MA organizations reassess plan footprints, benefits and distribution strategies, Clover continues to emphasize PPO choice and flexibility. For 2027, Clover will offer a commissionable $0-premium PPO, making it one of relatively few plans to offer this combination in its markets.
Top-Ranked Clinical Quality, Powered by Clover Assistant
Powered by Clover Assistant, Clover’s flagship PPO has ranked #1 nationally among PPO plans on core HEDIS clinical quality measures for two consecutive years, demonstrating the strength of a care model designed to surface relevant information for physicians to identify care needs and support better-informed clinical decisions.1
Clover’s locally focused strategy complements this model. Its 2027 geographic footprint remains consistent with 2026, with New Jersey and Georgia continuing as core markets where Clover is focused on deepening relationships among members, physicians and local healthcare resources.
The 2027 Annual Enrollment Period runs from October 15 through December 7, 2026. Clover Health plans will be available to 5.2 million Medicare-eligible beneficiaries within 203 counties across five states. Plans available based on location are available to view here.
About Clover Health:
Clover Health (Nasdaq: CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and in Underserved Populations as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
*Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations.
Clover Health is a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) with a Medicare contract. Enrollment in Clover Health depends on contract renewal.
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1 This analysis focuses on performance by non-SNP PPO plans with over 2,000 lives as of September 1, 2025 on HEDIS measures applicable to non-SNPs that were used for CMS’s MY 2024 Star ratings, applying the measure ranges used by CMS.
Clover Health uvedla, že těží z přísnějšího oceňování v Medicare Advantage a z retence nad 95 %. Firma zároveň míří k prvnímu ziskovému roku podle GAAP.
MarketBeat Week in Review – 03/03 - 03/07Clover Health Investments NASDAQ: CLOV is positioning its Medicare Advantage business to benefit from industry pricing discipline, member retention and the maturation of member cohorts, Interim Chief Financial Officer Clay Thornton said at Jefferies’ Healthcare Services and Technology Conference in Nashville.
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Speaking with Jefferies Healthcare Equity Research’s Dave Windley, Thornton described Clover’s approach as contrarian within Medicare Advantage. The company uses its proprietary Clover System, including its Clover Assistant physician-enablement platform, to support both contracted physicians and its employed clinicians. Thornton said the technology reaches roughly two-thirds of Clover members through at least one technology-powered visit in a given year.
Missed the Hims & Hers Rally? Clover Health Could Be NextUnlike some Medicare Advantage competitors, Clover retains full financial risk for its entire member population rather than delegating risk to downstream value-based providers, Thornton said.
Industry Pricing and Utilization Trends Thornton said the Medicare Advantage industry has experienced several turbulent years, including changes related to V28 risk adjustment, elevated utilization, Part D redesign and Star Ratings volatility. While he said it is difficult to predict conditions beyond the near term, he has seen plans respond with more pricing discipline heading into 2026 and in early views of 2027 benefit offerings.
“We’ve seen a lot of that through the national players itself,” Thornton said, referring to pricing discipline. He said plans have increasingly moved away from PPO offerings, particularly zero-premium PPO products, while benefit designs have generally become less generous or remained stable rather than improving.
For Clover, utilization trends have been relatively favorable in inpatient and skilled nursing facility care, according to Thornton. He said outpatient utilization had created pressure, but those trends peaked around March and began moderating during the second quarter.
Thornton attributed Clover’s ability to manage certain areas of medical-cost trend to its clinical programs, including a longitudinal home-based primary care program focused on members with the greatest health needs. He said approximately 10% of members account for 60% of costs, a population that also has substantial inpatient utilization.
Retention and Cohort Economics Clover has reported retention above 95%, which Thornton said has been supported primarily by benefit stability. The company enhanced its benefit offering in 2025 and emphasized stability in 2026 while other plans made broader changes, he said.
High Clover Assistant engagement also contributes indirectly to retention, Thornton said, because it supports better cohort economics and helps Clover maintain stable benefits. The company’s historical results show insurance gross profit improving by about $70 per member per month when a member moves from the first year to the second year, followed by a further $85 per member per month increase from the second to third year.
Thornton said Clover is closely monitoring these patterns and that current cohort performance and technology engagement are tracking in line with historical results. He added that each additional year of member tenure has generally produced incremental margin, though the company has not quantified the point at which those gains may level off.
“What Clover Assistant is designed to do is to identify chronic disease earlier and then enable clinicians to manage that chronic disease,” Thornton said. “When you identify that chronic disease earlier and you manage it, you see those savings accrue over a period of years.”
PPO Positioning and 2027 Outlook Thornton said Clover expects continued disruption during the upcoming annual enrollment period, though he expects it to be selective across markets rather than uniform nationwide. He said the company continues to see competitors shift away from zero-premium PPO products and toward HMO offerings.
Clover believes its operating model is well suited for PPO plans because it does not depend heavily on traditional value-based contracts or capitation arrangements, Thornton said. Those arrangements are more difficult to manage in a PPO product than in an HMO, he said.
About 98% of Clover’s members are enrolled in PPO plans, Thornton said. While he did not provide survey data on why members choose those plans, he said Clover’s PPO benefit value is broadly consistent with its HMO offering in areas such as cost sharing, supplemental benefits and Part D coverage.
For 2027, Clover submitted bids assuming 4.5 Star Ratings for both its PPO and HMO contracts, Thornton said. He said the company’s benefit designs reflected expectations for continued competitive disruption, and early market observations have largely aligned with those assumptions.
Technology and AI Opportunities Thornton said Clover continues to invest materially in research and development for Clover Assistant, which has been in development for more than eight years. He said artificial intelligence can accelerate the platform’s impact, while the company also sees opportunities to apply AI to administrative functions such as claims processing, payment integrity and member-service calls.
On the clinical side, Thornton emphasized that Clover intends to maintain a “human-in-the-loop” model. Clover Assistant is designed to provide information at the point of care and support clinician decision-making rather than replace it, he said.
Thornton said Clover is tracking toward its first year of GAAP net income profitability, while noting that 49% of its members remain in their first or second year with the company. He identified Clover Assistant engagement and continued product development as the primary indicators of future financial performance.
About Clover Health Investments (NASDAQ:CLOV)Clover Health Investments, Inc is a healthcare technology and insurance company focused on providing Medicare Advantage plans to eligible Medicare beneficiaries. Its insurance business offers medical coverage and related healthcare benefits through plans available in select counties across the United States.
The company also develops and uses Clover Assistant, a technology platform designed to support physicians with patient information, clinical insights, care recommendations and tools intended to help improve healthcare outcomes.
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected].
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Clover Health uvedl, že v roce 2026 očekává první celý rok zisku podle GAAP a asi 50% růst počtu členů. Firma staví růst Medicare Advantage na platformě Clover Assistant s AI.
MarketBeat Week in Review – 03/03 - 03/07Clover Health Investments NASDAQ: CLOV is positioning its Medicare Advantage model around earlier identification and treatment of chronic conditions, Interim Chief Financial Officer Clay Thornton said during a Canaccord Genuity conference presentation.
Thornton said the company’s goal is to equip physicians with artificial intelligence-powered technology that can identify, manage and treat chronic disease earlier. He said earlier intervention can support higher-quality care and more affordable, accessible care for Medicare Advantage members.
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Missed the Hims & Hers Rally? Clover Health Could Be NextThe company’s approach differs from many Medicare Advantage peers in five areas, Thornton said: technology, care strategy, in-home services, risk retention and network design. Clover’s Clover Assistant platform is built on more than 100 patient data sources and uses more than 100 AI and machine-learning models to provide individualized clinical insights at the point of care, according to Thornton.
He said clinicians using the technology have been associated with lower hospitalizations and readmissions, while chronic kidney disease stage 3 diagnoses occurred 18 months earlier and diabetes treatment began 36 months earlier compared with cases where clinicians did not use the platform.
In-home care and member engagement Thornton said Clover reaches approximately two-thirds of its members in a given year through at least one visit from a Clover Assistant-powered clinician. The company deploys the technology through its provider network and through Clover Care Services, which includes in-home assessments, readmission-prevention services and longitudinal primary care for members with more complex needs.
In Medicare, about 10% of members can account for roughly 60% of costs, Thornton said. Clover seeks to manage that higher-cost population through its in-home care program, with multiple clinician visits during the year. Enrollment in the program increased 84% relative to 2025, compared with roughly 50% membership growth across the company’s full book of business, he said.
The company retains full economic risk for its membership rather than delegating risk to providers, a model commonly used by other Medicare Advantage insurers. Thornton said Clover may be at an economic disadvantage during a member’s first two years but expects returns to improve as members remain enrolled longer and the company’s clinical interventions compound.
About 49% of Clover’s membership remains within the first two years of that lifecycle, including roughly 28% in their first year and 21% in their second year, he said. Thornton said the company expects cohort maturation to become more meaningful in 2027 and 2028 as newer members move into later years of enrollment.
New Jersey growth and retention New Jersey remains Clover’s largest market. The company has doubled its overall membership over a two-year period, Thornton said, while its New Jersey market share increased to 31% from 20%. He said Clover had become the largest provider of non-special-needs Medicare Advantage plans in the state after surpassing United earlier this year.
Thornton said New Jersey offers both market-share and organic expansion opportunities, as Medicare Advantage penetration in the state is approximately 42%, compared with a national rate of a little more than 50%.
Clover’s network is 98% PPO, according to Thornton, allowing members to access lower-cost in-network benefits while also receiving care outside the network. He said the broader industry has increasingly shifted toward HMO products as a means of controlling costs, while Clover plans to remain “PPO first.”
The company retained more than 95% of members in the most recent annual enrollment period, Thornton said. He attributed retention in part to stable or improved benefits during a period when larger competitors have changed benefit offerings. He also said Clover has limited exposure to e-brokers, which he said can generate growth but may also contribute to weaker retention.
Profitability outlook and 2027 positioning Thornton said Clover has grown membership at a 40% compound annual growth rate over the past two years, sustained adjusted EBITDA profitability and improved operating leverage by 500 basis points. For 2026, the company is guiding for its first full year of GAAP net income profitability alongside approximately 50% membership growth.
Rather than focusing primarily on medical loss ratio in a given year, Thornton said Clover monitors contribution profits by member cohort and consolidated gross profit per member per month. He said the company expects effective cohort progression to result in lower medical loss ratios over time.
Looking toward 2027, Thornton said Clover expects further disruption in the Medicare Advantage annual enrollment period as competitors respond to industry pressures. He said the company believes its product design and stable benefit approach position it to capitalize on member shopping activity.
On Star Ratings, Thornton said Clover’s 2027 bids were submitted at 4.5 stars. He said the company expects greater clarity on payment-year 2028 ratings in coming months as the federal plan-preview process advances. Thornton also said Counterpart Health, Clover’s separate business, continues to expand testing in new markets.
About Clover Health Investments (NASDAQ:CLOV)Clover Health Investments is a technology-driven healthcare company specializing in Medicare Advantage plans for senior populations. The company combines insurance coverage with a proprietary software platform to improve care coordination, outcomes tracking and cost management. By leveraging data analytics, Clover Health aims to deliver personalized care pathways and preventive interventions for its members.
At the core of Clover's offering is its Clover Assistant platform, which aggregates clinical and claims data from multiple sources to create real-time insights for physicians and care teams.
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected].
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Clover Health Investments ve 2. čtvrtletí zvýšil tržby o 56 % na 743 milionů USD a vykázal čistý zisk 28 milionů USD. Zároveň zvýšil celoroční výhled pro rok 2026.
MarketBeat Week in Review – 03/03 - 03/07Clover Health Investments NASDAQ: CLOV reported second-quarter results that showed continued Medicare Advantage membership growth alongside profitability, while raising its full-year 2026 outlook across its key financial measures.
Chief Executive Officer Andrew Toy said the company views its Clover Assistant technology as the foundation of its clinical and financial strategy. The platform is designed to help physicians make care decisions using a more complete view of each patient, which Clover said can support earlier disease identification and more consistent management of chronic conditions.
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Missed the Hims & Hers Rally? Clover Health Could Be NextFor the first half of 2026, Clover said Medicare Advantage membership grew 48% year over year, total revenue rose by more than $550 million to $1.5 billion, and GAAP net income increased by $67 million from the prior-year period. Consolidated gross profit increased by $104 million, while operating leverage improved by more than 200 basis points, according to Toy.
Second-Quarter Financial Performance Interim Chief Financial Officer Clay Thornton said average Medicare Advantage membership reached 157,000 in the second quarter, up 48% from a year earlier. Revenue increased 56% year over year to $743 million.
Consolidated gross profit totaled $153 million, representing 54% growth from the same quarter last year. Adjusted selling, general and administrative expenses were $112 million, or 15% of revenue, an improvement of about 220 basis points from the second quarter of 2025.
The company generated adjusted EBITDA of $41 million and GAAP net income of $28 million during the quarter. Through the first six months of 2026, Clover generated $81 million in adjusted EBITDA and $55 million in GAAP net income.
Clover ended the quarter with $443 million in cash and investments and no debt outstanding. Cash flow from operations totaled $133 million through the first half, which Thornton said supports the company’s ability to self-fund future growth.
Higher 2026 Outlook Following its first-half performance, Clover raised its full-year 2026 guidance. The updated outlook calls for:
Average Medicare Advantage membership of 156,000 to 158,000; Total revenue of $2.92 billion to $3 billion; Consolidated gross profit of $525 million to $555 million; Adjusted EBITDA of $70 million to $85 million; and GAAP net income of $20 million to $35 million. Thornton said the outlook reflects confidence in the underlying business after six months of execution, though management is maintaining discipline because a large share of membership remains early in its care cycle and additional claims experience is still expected to emerge during the year.
The company expects gross profit to be stronger in the third quarter than in the fourth quarter because of typical Medicare Advantage seasonality. It also expects fourth-quarter investments to rise, including activities related to the annual enrollment period. Clover expects adjusted EBITDA to remain positive in the third quarter before returning to a seasonally typical loss in the fourth quarter.
Cohort Maturation and Medical-Cost Trends Management emphasized that it expects member cohorts to become more profitable as they spend more time under the company’s care model. Toy said Clover has historically seen cohorts improve by approximately $70 per member per month in gross profit as they move from their first year to their second year.
The company said its 2025 members, which represented about 21% of current membership, are now in their second year and showing stronger economics than in their first year. Members who joined in 2026 represented about 28% of membership and are following the expected early-stage pattern, Thornton said.
Clover said its 2025 cohort is expected to enter its third year in 2027, while the 2026 cohort will enter year two. Thornton said this progression is central to management’s confidence in 2027, although the company did not issue formal guidance for that year.
Medical-cost trends have also performed better than expected, according to Thornton. Inpatient utilization remained favorable, including among first-year members, while outpatient trends peaked in March and moderated during the second quarter. Outpatient utilization remained elevated relative to prior years but was within the company’s expectations.
Management also cited improved dental-cost performance following changes to out-of-network dental claims management, as well as better-than-expected Part D performance during the first half.
Four-and-a-Half-Star Rating and 2027 Plans Toy said that following a court order and a subsequent recalculation by the Centers for Medicare & Medicaid Services, all of Clover’s Medicare Advantage members are enrolled in plans rated 4.5 stars for payment year 2027. CMS has filed notice that it intends to appeal the District Court decision.
Toy said the higher rating provides added flexibility to reinvest in members, maintain a competitive product, support growth and expand profitability. However, he said the rating does not create the company’s underlying economics, which management attributes to Clover Assistant-driven cohort maturation.
The company said it bid for 2027 based on the 4.5-star payment year and expects to be paid at that rating next year. Thornton said Clover’s approach to 2027 bidding remained consistent with the prior two years: offering a product it believes can grow profitably. Management also said it assumed continued competitive disruption in its core New Jersey and Georgia markets.
Looking further ahead, Toy said Clover is expanding its use of artificial intelligence beyond clinical decision support into insurance operations. He said the company believes AI can improve claims-processing speed and accuracy, support members and lower administrative overhead over time.
About Clover Health Investments (NASDAQ:CLOV)Clover Health Investments is a technology-driven healthcare company specializing in Medicare Advantage plans for senior populations. The company combines insurance coverage with a proprietary software platform to improve care coordination, outcomes tracking and cost management. By leveraging data analytics, Clover Health aims to deliver personalized care pathways and preventive interventions for its members.
At the core of Clover's offering is its Clover Assistant platform, which aggregates clinical and claims data from multiple sources to create real-time insights for physicians and care teams.
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Clover Health Investments, Corp. zveřejnila výsledky za 2. čtvrtletí 2026. V přepisu hovoru ale nejsou uvedena žádná konkrétní čísla ani klíčové provozní údaje.
Clover Health Investments, Corp. (CLOV) Q2 2026 Earnings Call August 5, 2026 5:00 PM EDT
Company Participants
Ryan Schmidt - Investor Relations Analyst
Andrew Toy - Co-Founder, CEO & Director
Clay Thornton - Interim Chief Financial Officer
Conference Call Participants
Richard Close - Canaccord Genuity Corp., Research Division
Jonathan Yong - UBS Investment Bank, Research Division
Dean Rosales - Leerink Partners LLC, Research Division
Presentation
Operator
Hello, and welcome to Clover Health's Second Quarter 2026 Earnings Call. [Operator Instructions] Also as a reminder, this conference is being recorded today. If you have any objections, please disconnect at this time. Ryan, you may begin.
Ryan Schmidt
Investor Relations Analyst
Good afternoon, everyone. Joining me on our call today to discuss the company's second quarter 2026 results are Andrew Toy, Clover Health's Chief Executive Officer; and Clay Thornton, the company's Interim Chief Financial Officer.
You can find today's press release and the accompanying supplemental slides as well as the company's most recent investor deck in the Investor Events and Presentations section of our website at investors.cloverhealth.com. This webcast is being recorded, and a replay will be available in the Investor Relations section of the Clover Health website.
I'd also like to caution you that we may make forward-looking statements during today's call that are subject to risks and uncertainties, including expectations about future performance. Factors that may cause actual results to differ materially from expectations are detailed in our SEC filings, including in the Risk Factors section of our most recent annual report on Form 10-K and other SEC filings. Information about non-GAAP financial measures referenced, including a reconciliation of those measures to GAAP measures, can be found in the earnings materials available on our website.
Clover Health ve 1. čtvrtletí přešla do GAAP čistého zisku 27,33 mil. USD při tržbách 749,19 mil. USD, které meziročně vzrostly o 62,05 % a překonaly odhad.
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Clover Health (NASDAQ:CLOV) has spent years as a speculative bet on a technology-led Medicare Advantage model. The Q1 2026 report, released May 6, 2026, offered the first quarter that lets bulls make a numbers-based case rather than a narrative one.
The Bull Case: A Profitability Inflection The Nashville-based insurer swung to GAAP net income of $27.33 million, compared with a $1.27 million loss a year earlier, on revenue of $749.19 million, up 62.05% year over year and topping the $714.89 million estimate by 4.80%. Operating cash flow reached $107.89 million, a 762.22% jump, and adjusted EBITDA of $40 million rose 56% year over year.
Membership scale is the engine. Average Medicare Advantage membership grew 51.6% to 154,607, while adjusted SG&A improved 210 basis points to 15.9% of revenue. CEO Andrew Toy told investors: “Entering 2026, our first quarter results demonstrate how market-leading growth, GAAP net income profitability and full risk can scale together in Medicare Advantage.” He added that “over 1/3 of our members received Clover Assistant-powered care,” with Counterpart Health extending the platform to external payors and providers.
Management reaffirmed FY2026 guidance for revenue of $2.81 billion to $2.92 billion, adjusted EBITDA of $50 million to $70 million, and GAAP net income of $0 million to $20 million, which would mark the company’s first full fiscal year of GAAP profitability.
The Bear Case: Cost Trends and Regulatory Overhang The Insurance Benefit Expense Ratio rose 40 basis points to 86.5%, with net medical claims growing 65.8% versus premium growth of 62.9%. Unpaid claims climbed to $260.4 million from $153.3 million at year-end 2025. The reported EPS of $0.05 missed the $0.07 estimate by 28.57%.
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Valuation leaves little cushion. Trailing metrics show a forward P/E of 82, price-to-book of 6.5, and a beta of 2.42. Volatility is extreme: shares are up 77.5% year to date to $4.17, but down 20.4% over the past month. The net insider trading direction is selling, and Toy himself cautioned that outpatient utilization “continues to be elevated.” CMS rate policy, Star Ratings, and risk-model changes remain persistent overhangs.
Sentiment and the Verdict Wall Street coverage is thin. The mean price target is $4.58, and the composite prediction sentiment score is a neutral 49.34.
Clover is clearly turning a corner operationally: a real GAAP profit, expanding membership, and Clover Assistant reaching a meaningful share of members. Yet with medical cost trends creeping higher, reserves building, and the stock priced at about 82 times forward earnings, the corner has already been partly priced in. The turnaround is credible; the margin of safety is slim. Investors should monitor Q2 2026 results and any updated guidance for confirmation.
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CEO Clover Health Andrew Toy prodal 62 711 akcií kvůli daňovému zadržení při vestingu RSU. Po transakci drží 9 547 114 akcií v hodnotě 44,68 milionu USD.
Andrew Toy, Chief Executive Officer of Clover Health Investments, Corp. (CLOV -0.81%), sold 62,711 shares of Class A Common Stock on July 15, 2026, according to a recent SEC Form 4 filing.
Transaction summaryMetricValueTransaction value~$292,860Shares sold (directly held)62,711Post-transaction shares (directly held)9,547,114Post-transaction value$44.68 millionTransaction value based on SEC Form 4 weighted average sale price ($4.67); post-transaction value based on July 15, 2026 market close ($4.68).
Key questionsWhat was the primary driver of this insider transaction?
The sale was a non-discretionary action required to cover tax withholding obligations associated with the vesting of 6.25% of restricted stock units (RSUs) originally granted to Toy in October 2024. This transaction type does not reflect a discretionary change in the CEO's investment thesis or view of company valuation.What is the scale of the executive's remaining equity position?
Following the sale, Toy retains a substantial direct stake of ~9.5 million shares. This position, valued at $44.68 million as of the July 15, 2026 market close, represents an approximate 2% ownership interest in the $2.4 billion company.What is the anticipated cadence for future equity vesting?
The remaining RSUs from the October 2024 grant are scheduled to vest in equal quarterly installments of 6.25% through October 15, 2028. Investors should expect similar automated sell-to-cover transactions to occur periodically as these tranches vest, provided the executive remains in service.How does this move align with the company's recent operational profile?
Toy leads a firm that specializes in Medicare Advantage plans through its proprietary Clover Assistant software platform. While the company reported a trailing-12-month net loss of $56.9 million, it maintained a revenue base of $2.2 billion and has seen significant share price appreciation over the past year.Company OverviewMetricValueShare Price (as of market close 2026-07-15)$4.68Market Capitalization$2.4 billionRevenue (TTM)$2.2 billionNet Income (TTM)-$56.9 millionCompany SnapshotClover Health Investments specializes in Medicare Advantage insurance products, offering both Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) health plans to Medicare-eligible individuals, with supplementary non-insurance business ventures contributing to overall revenue.The company generates revenue primarily through insurance premiums from its Medicare Advantage plans while leveraging its proprietary Clover Assistant software platform to optimize operational efficiency and enhance member engagement across its insurance operations.Clover Health's primary customers are Medicare-eligible individuals in the United States, with the company positioning itself as a technology-driven healthcare insurer focused on serving this demographic through differentiated digital tools and integrated care delivery models.Clover Health Investments operates as a U.S.-based healthcare insurer with a $2.4 billion market capitalization and TTM revenue of $2.2 billion, leveraging proprietary software technology to differentiate its Medicare Advantage offerings. The company's competitive strategy centers on its Clover Assistant platform, which aims to enhance member outcomes and operational efficiency within the Medicare Advantage market. With 724 employees, Clover Health represents a technology-enabled approach to healthcare insurance serving a large and growing demographic of Medicare beneficiaries.
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What this transaction means for investorsCEO Andrew Toy recently sold shares to cover tax withholding obligations, so investors shouldn’t view the move as any material evidence of Toy’s conviction in the company or its stock. That said, the stock has performed well recently, delivering a 57% gain over the last year, with much of the action coming this spring and summer.
The stock hit record highs in June after Clover received a favorable court order related to a Medicare Star rating. The court’s decision raises expectations of increased bonus payments that would boost its revenue — potentially as much as $1.2 million.
However, on July 4, the healthcare technology company disclosed a data breach that impacted customers’ personal and health information. The stock dropped more than 20% in July. The company will release its second-quarter earnings results in early August. Analysts maintain a consensus neutral hold to buy rating on the stock. Investors should watch for news about the impact of the data breach as well as any upcoming changes related to its healthcare plans.
Sarah Sidlow has no position in any of the stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.
Clover Health uvedla, že hacker pomocí sociálního inženýrství získal přístup ke třem účtům zaměstnanců a mohl vidět část osobních a chráněných zdravotních údajů. Firma nečeká materiální dopad na výsledky ani finanční situaci.
A man holds a laptop computer as cyber code is projected on him in this illustration picture taken on May 13, 2017. Capitalizing on spying tools believed to have been developed by the U.S.... Purchase Licensing Rights, opens new tab Read more
CompaniesJuly 17 (Reuters) - Clover Health Investments (CLOV.O), opens new tab said in a regulatory filing on Friday that it detected unusual login activity on some of its information systems on July 4 and later found a hacker had gained access to three employee accounts through social engineering.
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The health insurer said the affected accounts belonged to non-managerial health plan employees who handled member visit scheduling and broker-facing sales work.
These accounts could access some personal and protected health information, according to the company, but not corporate financial or claims systems.
Clover began an investigation with external cybersecurity experts, took steps to contain the activity and notified law enforcement, it said.
The investigation is ongoing and the company is still reviewing what information may have been accessed or taken. Clover believes its response curbed and ended the unauthorized access.
It also said it does not believe the incident has had, or is likely to have, a material impact on its business, financial condition or results of operations.
Clover is reviewing legal and regulatory requirements and will notify affected members if needed, it added.
Clover Health Investments is a U.S. health insurer focused on providing Medicare Advantage plans and technology tools for doctors.
Reporting by Padmanabhan Ananthan in Bengaluru; Editing by Jonathan Ananda
Our Standards: The Thomson Reuters Trust Principles., opens new tab
Clover Health oznámila, že výsledky za 2. čtvrtletí 2026 zveřejní po uzavření trhu 5. srpna 2026. Téhož dne v 17:00 ET uspořádá webcast k hospodářským výsledkům.
WILMINGTON, Del., July 09, 2026 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today announced that it will release its financial results after the market closes on Wednesday, August 5, 2026. The Company’s management will host a webcast presentation at 5:00 p.m. Eastern Time on the same day to discuss the company’s business and financial performance for the quarter.
Second Quarter 2026 Conference Webcast Details:
What: Clover Health’s Second Quarter 2026 Earnings Conference CallWhen: Wednesday, August 5, 2026, at 5:00 p.m. Eastern TimeWebcast: To access the webcast, you may register at https://clover-health-2q-2026-earnings.open-exchange.net/.
A live and archived webcast of the conference call will also be accessible from the Investor Relations section of Clover Health’s website at https://investors.cloverhealth.com/ for 12 months.
About Clover Health:
Clover Health (Nasdaq: CLOV) is a physician enablement technology company committed to bringing access to great healthcare to everyone on Medicare. This includes a focus on seniors who have historically lacked access to affordable, high-quality healthcare. Our strategy is powered by our software platform, Clover Assistant, which is designed to aggregate patient data from across the healthcare ecosystem to support clinical decision-making and improve health outcomes through the early identification and management of chronic disease. For our members, we provide PPO and HMO Medicare Advantage plans in several states, with a differentiated focus on our flagship wide-network, high-choice PPO plans. For healthcare providers outside Clover Health's Medicare Advantage plan, we extend the benefits of our data-driven technology platform to a wider audience via our subsidiary, Counterpart Health, and aim to enable enhanced patient outcomes and reduced healthcare costs on a nationwide scale. Clover Health has published data demonstrating the technology’s impact on Medication Adherence, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, and in Underserved Populations as well as the earlier identification and management of Diabetes and Chronic Kidney Disease.
Generální ředitel Clover Health Andrew Toy prodal 313 476 akcií za zhruba 1,67 milionu USD. Šlo o nediskreční prodej kvůli daňovým povinnostem z vestingu RSU.
Andrew Toy, Chief Executive Officer of Clover Health Investments (CLOV 3.80%), reported the direct sale of 313,476 shares of Common Stock on July 1, 2026, for a transaction value of ~$1.67 million according to the SEC Form 4 filing.
Transaction summaryMetricValueShares sold (direct)313,476Transaction value$1.7 millionPost-transaction shares (direct)9,609,825Post-transaction value (direct ownership)$51.8 millionTransaction value based on SEC Form 4 reported price ($5.32); post-transaction value based on the July 1 closing price ($5.39).
Key questionsHow does this sale affect Toy's overall ownership in Clover Health Investments?
Direct holdings declined by 3.16%, with Toy retaining 9,609,825 shares of Class A Common Stock after the sale, and no indirect or derivative holdings reported.Is there any impact on Toy's capacity for further open-market sales?
Following this transaction, Toy holds approximately 96.8% of his pre-sale direct position, indicating substantial remaining capacity; future open-market trades may continue to be driven by restricted stock unit (RSU) vesting and related tax events.Does the transaction signal a change in sentiment or alignment with shareholders?
This sale was a non-discretionary "sell to cover" event tied to tax obligations, so it does not reflect a shift in executive sentiment or portfolio strategy; the CEO maintains a large direct equity stake.Company overviewMetricValueRevenue (TTM)$2.21 billionNet income (TTM)-$56.94 millionEmployees5701-year price change82.01%* 1-year performance calculated using July 1st, 2026 as the reference date.
Company snapshotClover Health offers Medicare Advantage insurance plans, including both PPO and HMO products, supported by the proprietary Clover Assistant software platform.It generates revenue primarily through insurance premiums and risk-adjusted payments from government healthcare programs, leveraging data-driven technology to manage medical costs and improve care outcomes.The company targets individuals eligible for Medicare, focusing on seniors and beneficiaries seeking value-driven healthcare coverage in the United States.Clover Health Investments operates at scale in the U.S. Medicare Advantage market, utilizing advanced analytics and its Clover Assistant platform to drive operational efficiency and member engagement.
The company’s technology-centric approach aims to deliver better health outcomes while managing costs, positioning it competitively within the healthcare plans sector. Its strategy centers on expanding its member base and deepening relationships with healthcare providers through data-driven insights.
What this transaction means for investorsClover Health CEO Andrew Toy’s July 1 sale of company stock came just days after shares hit a multi-year high of $5.59 on June 29. Even so, his disposition is not a cause for investor concern.
The shares were sold to fulfill tax withholding obligations incurred in connection with the vesting of RSUs, making this a non-discretionary transaction. Moreover, his post-sale holdings of 9.6 million shares represents a significant equity stake in the company, indicating his interests align with that of shareholders.
Clover Health stock soared after the company won a court case that mandated Medicare upgrade its rating in the government program. This helps to unlock additional revenue.
In addition, Clover reported an impressive 51% year-over-year increase in Medicare Advantage memberships in the first quarter of 2026. The rise in members contributed to strong 62% year-over-year growth in Q1 revenue to $749.2 million.
The excellent start to 2026 led Clover Health management to forecast full-year sales between $2.8 billion and $2.9 billion, an outstanding jump up from 2025’s $1.9 billion.
Robert Izquierdo has no position in any of the stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.
