CLOV

Clover Health’s second quarter results were met with a positive market reaction, driven by strong Medicare Advantage membership growth and improved profitability. Management credited the quarter’s performance to the expansion of its Clover Assistant AI platform and disciplined focus on core markets, particularly New Jersey and Georgia. CEO Andrew Toy emphasized that “better clinical care leads to stronger cohort economics,” pointing to the impact of maturing member cohorts under the company’s technology-driven care model. The company also cited favorable medical cost trends and improvements in operating leverage as contributing factors. Is now the time to buy CLOV? Find out in our full research report (it’s free). Revenue: $743.2 million vs analyst estimates of $728.2 million (55.6% year-on-year growth, 2% beat) Adjusted EPS: $0.07 vs analyst estimates of $0.05 (48% beat) Adjusted EBITDA: $40.92 million vs analyst estimates of $30.38 million (5.5% margin, 34.7% beat) The company lifted its revenue guidance for the full year to $2.96 billion at the midpoint from $2.87 billion, a 3.3% increase EBITDA guidance for the full year is $77.5 million at the midpoint, above analyst estimates of $58.44 million Operating Margin: 3.8%, up from -2.2% in the same quarter last year Customers: 157,309, up from 155,773 in the previous quarter Market Capitalization: $2.33 billion While we enjoy listening to the management’s commentary, our favorite part of earnings calls is the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention. Richard Close (Canaccord Genuity) asked about Clover Assistant coverage in New Jersey and Georgia’s recent member cohorts. Interim CFO Clay Thornton explained engagement is slightly below the company average but improves as members stay longer, trending toward the two-thirds mark. Richard Close (Canaccord Genuity) inquired about the breakdown of members transitioning from year one to year two, and year two to year three. Thornton provided cohort percentages and highlighted the expected shift to more mature, higher-margin members in 2027. Richard Close (Canaccord Genuity) questioned the sequential decline in SG&A expenses. Thornton clarified that first quarter expenses included one-time, non-recurring items, and the second quarter reflected a more normalized expense base. Jonathan Yong (UBS) asked how management approached 2027 bids and whether recent cost trends or market disruption were factored in. Thornton explained bids were balanced, with cohort maturation and expected market disruption both considered. Jonathan Yong (UBS) probed the sustainability of high star ratings. CEO Andrew Toy stated that maintaining high ratings remains a focus, supported by investments in technology and clinical quality, but final outcomes will depend on upcoming plan previews. Moving forward, our analysts will be monitoring (1) the continued maturation and retention of member cohorts managed under Clover Assistant, (2) progress in scaling operational automation and back-office AI initiatives to drive margin improvement, and (3) changes in the competitive and regulatory landscape—including CMS decisions on star ratings and any further market disruptions. Results in these areas will be critical for sustaining momentum into 2027 and beyond. Clover Health currently trades at $4.43, up from $4.14 just before the earnings. Is there an opportunity in the stock? See for yourself in our full research report (it’s free for active Edge members). ONE MORE THING: Top 5 Growth Stocks. The biggest stock winners almost always had one thing in common before they ran. Revenue growing like crazy. Meta. CrowdStrike. Broadcom. Our AI flagged all three. They returned 315%, 314%, and 455%, respectively. Find out which 5 stocks it’s flagging this month — FREE. Get Our Top 5 Growth Stocks for Free HERE. Stocks that have made our list include now familiar names such as Nvidia (+1,460% between June 2020 and June 2025) as well as under-the-radar businesses like the once-micro-cap company Kadant (+214% between June 2020 and June 2025). Find your next big winner with StockStory today.

Image source: The Motley Fool. Wednesday, Aug. 5, 2026 at 5:00 p.m. ET Chief Executive Officer - Andrew Toy Interim Chief Financial Officer - Clay Thornton Investor Relations - Ryan Schmidt Operator: Hello. Welcome to Clover Health's Second Quarter 2026 Earnings Call. We ask that you please hold all questions until the completion of the formal remarks, at which time you will 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. Ryan Schmidt: 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. With that, I'll now turn the call over to Andrew. Andrew Toy: Thank you, Ryan. Thanks everyone for joining our call today. At Clover, we've always believed the greatest opportunity for AI in healthcare is not simply to make the existing system a little more efficient. It's to help physicians make better decisions for individual patients at the point of care. That's what Clover Assistant does, and our results are increasingly demonstrating that when you improve those decisions at scale, better care, membership growth, and increasing profitability can happen together. The first half of 2026 was another important proof point of this. Through the first six months of the year, we delivered market leading MA membership growth of 48%, while increasing GAAP net income by $67 million year-over-year. At the same time, total revenue in the first half increased by more than $550 million year-over-year to $1.5 billion. Consolidated gross profit increased by $104 million, and we've expanded operating leverage by more than 200 basis points as we've scaled. We believe this performance validates how our AI-powered model not only improves care for members, but also strengthens our underlying business over time. I am proud of our results so far this year and believe we are on a strong path. I want to turn now to where the business is headed. Since our last call, two things have strengthened our confidence in 2027 and beyond. One is the recalculation of our star rating. The other, and ultimately the more important one, is the continued maturation of our member cohorts under Clover Assistant. It's important not to confuse the role each one plays. We believe the higher star rating gives us more flexibility. Cohort maturation is what strengthens the underlying earnings engine. Following the court's order and CMS's subsequent recalculation, all of our Medicare Advantage members are now enrolled in plans rated four and a half stars for payment year 2027. We're pleased with that outcome because we believe it better reflects the quality we have been delivering for years. CMS has filed notice of its intent to appeal the District Court's decision. Because this regards pending litigation, I'll be brief. We believe the District Court's ruling was thorough and well-reasoned, and we are prepared to defend it on appeal. In the meantime, we remain focused on bringing affordable, high-quality care to seniors on Medicare in our four and a half star plans. To be clear, four and a half stars matters. It gives us more room to reinvest in members, maintain a highly competitive product, support growth, and expand profitability. It does not create the economics of our model. Our confidence in 2027 is grounded in the continued cohort maturation under Clover Assistant, which we believe will allow us to grow membership and meaningfully expand profitability. The higher star rating simply gives us more flexibility, allowing us to extend our differentiated model to more Medicare beneficiaries while remaining disciplined in how we balance member value, growth, and profitability. Put another way, the rating gives us more freedom in how we allocate value. Clover Assistant is what creates the value in the first place, and that distinction matters. Our strategy has never been to wait for a favorable rate or rating to make the business work. We built a wide network, full risk PPO model because we believe seniors should be able to get an affordable product without being forced to give up broad physician choice. We also believe that if we wanted to make that model work over the long term, we had to solve one of the hardest problems in healthcare first, how to empower physicians to deliver better clinical care for their patients. That's what Clover Assistant was built to do. It helps physicians use a more complete view of the patient to identify disease earlier, manage chronic conditions more consistently, and make better care decisions over time. Our clinically focused approach has contributed to Clover becoming the top-rated HEDIS PPO plan in the country. Importantly, that same technology not only powers our own Medicare Advantage business, but through Counterpart Health, we're extending that same clinically focused model across the healthcare market. We believe the broader industry is only beginning to recognize what's possible when technology is built around the clinical decision. Now, as we look toward next year, it's too early to provide a specific outlook for 2027, but we feel very good about our growth position heading into next year. The four and a half star rating strengthens our ability to put forth a compelling product, particularly across our core New Jersey and Georgia markets. We can improve the health outcomes and economics of our members, we believe we have a powerful growth engine within those core markets that will sustain us well into the future. That's not to say that we won't expand to more geographies, rather that we do not feel compelled to do so just to chase a top-line growth number. The key thing for 2027 is what happens as members mature under our care model. New members do not arrive with every condition neatly managed, every care gap closed, and every part of their care already coordinated. Over time, Clover Assistant helps physicians deliver that individualized care for each patient to identify disease earlier and make better care decisions. As that happens, we expect the clinical and financial performance of the cohort to improve, and this is exactly what we are seeing. We now have multiple vintages of members who have had CA-driven care for many years, and we believe that provides a compounding tailwind to our business. To set your intuition, we've shared before that our cohorts typically improve by about $70 PMPM in gross profit as they move from year one to year two. It's encouraging to see that progression playing out this year in the large cohort of members that joined in 2025. By 2027, that same cohort will be in year three, and our 2026 cohort will be in year two. That means a much larger portion of our membership base will have had at least one year of Clover Assistant-powered care. This is not simply a matter of having more members. It's a matter of having more members whose conditions we understand better, whose physicians have had more time to act, and whose economics have had more time to mature. That gives us increasing confidence in the earnings potential of the business heading into 2027. Clay will discuss the cohort performance in more detail later in the call. While we're not providing formal 2027 guidance today, the setup is increasingly clear. We expect to enter next year with a larger membership base, a greater proportion of tenured members, more flexibility from our four and a half star rating, and additional operating leverage. Those are not four disconnected points. They reinforce one another because they're all driven by the same underlying care model. We built Clover Assistant to help physicians make better decisions that lead to better care. Better clinical care leads to stronger cohort economics. Because we operate at full risk, those stronger cohort economics create a stronger business. To us, better clinical quality, stronger cohort economics, and a more scalable operating model are all parts of the same system working as intended. We believe that's what makes Clover different, and it's the foundation for how we think about the years ahead. With that, I'll turn the call over to Clay. Clay Thornton: Thank you, Andrew, and thanks everyone for joining us today. Andrew covered the strategic foundation of the business and why we have increasing confidence in 2027. I'll focus my remarks today on the financial performance and operating indicators behind that confidence, starting with the headline for the quarter. We continue to demonstrate a differentiated combination of growth and profitability in Medicare Advantage. During the second quarter, we grew Medicare Advantage membership 48% year-over-year, while generating $41 million of adjusted EBITDA and $28 million of GAAP net income. Our underlying Medicare Advantage business continues to strengthen, today's increased guidance reflects our strong first half performance and the operating indicators we are seeing across the business. In short, the first half gives us greater confidence that this year's growth is converting into the long-term earnings profile we expected. Let's begin with membership and revenue. Average Medicare Advantage membership increased to 157,000 members during the quarter, driving total revenue of $743 million, an increase of 56% year-over-year. Importantly, our growth remains disciplined and concentrated in the markets where we believe we have the strongest ability to engage members clinically and manage long-term unit economics, particularly across our core New Jersey and Georgia markets. Turning next to gross profit. Consolidated gross profit totaled $153 million during the quarter, representing 54% year-over-year growth. Importantly, the gross profit performance was supported by two things we care most about at this point in the year: favorable trend development and cohort progression. First, medical cost trends are performing better than we expected when we entered the year. Inpatient utilization continues to trend favorably overall, including among our year one members, where utilization is tracking below the comparable new member cohort from a year ago. On outpatient, trends peaked in March and have since moderated in Q2. They remain elevated from prior years but are within our expectations, we continue to monitor closely. We are also seeing continued progress in categories that were specific focus areas for us. Dental cost performance continues to improve following the changes we implemented in how we manage out-of-network dental claims. Part D has also performed better than expected through the first half, now that we are in the second year of IRA implementation, we have stronger visibility into the expected seasonality in that category. Second, more important to how we think about the business, our cohorts are developing well. As illustrated in our supplemental presentation, our historical data shows insurance gross profit improving as members move from year one to year two, again from year two to year three. That framework is especially relevant today because a significant portion of our membership is still in the first two years of its Clover life cycle. This matters because the full earnings power of this year's growth is not realized on day one. It builds as members remain with Clover, as Clover Assistant coverage expands, Clover Care Services engagement deepens. Taken together, favorable trend development and cohort progression give us greater confidence that the growth we delivered this year is converting into the earnings profile we expected. I'll come back to this when I discuss our 2027 outlook. Turning next to SG&A. Adjusted SG&A totaled $112 million during the quarter, representing 15% of total revenue. That's an improvement of approximately 220 basis points compared to the second quarter of 2025. We believe these results continue to demonstrate the operating leverage inherent in our model as we scale. At the same time, we are continuing to make deliberate investments that strengthen both our Medicare Advantage business and Counterpart Health. These investments include continued enhancement of our flagship Clover Assistant product, Counterpart Health's go-to-market capabilities, and targeted investments in health plan operations that we believe will support operating leverage in future years. That is the balance we are focused on, maintaining expense discipline in the core business while funding capabilities that can support growth, clinical performance, and operating leverage over time. Turning next to profitability. Second quarter adjusted EBITDA totaled $41 million, while GAAP net income totaled $28 million. Through the first half of the year, we've now generated $81 million of adjusted EBITDA and $55 million of GAAP net income. Turning briefly to our balance sheet. We ended the quarter with $443 million of cash and investments while continuing to operate with no debt outstanding. Cash flow from operations totaled $133 million through the first half of the year, reinforcing our confidence in our ability to self-fund future growth while further strengthening our balance sheet. Next, I'd like to cover our updated guidance. Following strong first-half performance, we are increasing our full year guidance across all metrics. We now expect average Medicare Advantage membership of 156,000 to 158,000 members, 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. These updates reflect our increasing confidence in the underlying performance of the business after six months of execution. That said, this remains a balanced outlook, one that recognizes the strength we are seeing while maintaining appropriate discipline in the second half. With a large portion of our membership still in the early stages of our care, we believe it's prudent to allow additional claims experience to emerge before assuming current trends will persist through year-end. We think about the second half of 2026, the expected quarterly shape is consistent with how we plan the business. Within this outlook, we continue to expect consolidated gross profit to be stronger in the third quarter than the fourth quarter, reflecting typical MA seasonality patterns. We also expect investments to increase during the fourth quarter, including AEP-related activities. Taken together, we expect adjusted EBITDA to remain positive in the third quarter before returning to a more typical seasonal loss in the fourth quarter. Importantly, even with that seasonal pattern, our second half outlook represents significant improvement versus last year. The confidence behind this guidance is supported by the same operating framework we laid out earlier this year, which continues to strengthen across five key indicators. First, retention remains high and continues to support favorable underlying economics. Second, we are bringing more members under Clover Assistant-powered primary care while continuing to expand Clover Care Services engagement for our most vulnerable members. Third, underlying utilization trends are stable and continue performing better than our original expectations. Fourth, we are continuing to realize meaningful operating leverage as membership has nearly doubled since 2024. Finally, after the first six months of this year, our 2025 and 2026 cohorts continue developing in line with or ahead of our expectations. Looking ahead now to 2027. We believe the most important financial driver for Clover is continued cohort maturation under our full risk model. Maturing our membership under Clover Assistant-powered care is central to how our model is designed to work. New members create expected near-term pressure because they are earlier in their Clover life cycle. As those members remain with us, engage with Clover Assistant, and become more integrated into our care model, their economics improve over time. We are seeing that dynamic play out today. Our 2025 members created the expected first-year margin headwind last year. This year, that same cohort is in year two, and we are seeing meaningfully stronger economics than we did a year ago. At the same time, our members that joined in 2026 are following a similar early life pattern, as expected. That is the maturation curve we expect, and it is now visible in our results. That is what gives us increasing confidence in 2027. Next year, our 2025 cohort will move into year three, where our historical data shows another meaningful step-up in economics, while our 2026 cohort will move into year two. In other words, we expect to enter 2027 with a substantially larger membership base moving into more economically mature years under our care model. That is the core of our 2027 outlook. As Andrew discussed, our 2027 strategy was not built around a higher star rating. The move to a four and a half star payment year does not change the underlying earnings trajectory we expected from cohort maturation. It simply provided additional flexibility as we finalized our 2027 bids and made decisions across member value, growth, and margin. The ultimate financial benefit will depend on the final economics reflected in our bids and our final 2027 enrollment. We are not providing additional detail on those assumptions today. The important point is that our foundation for 2027 is a larger and more mature membership base, improving cohort economics and a differentiated full risk model where better care can translate into better financial performance. While we are not providing formal guidance for 2027 today, we have increasing confidence in the direction of the business. Our focus now is on executing through the second half of 2026, delivering our first full year of GAAP net income profitability and entering 2027 from a position of strength. With that, I'll turn it back to Andrew. Andrew Toy: Thanks, Clay. Before we open the call for questions, I'll leave you with one final thought. We've spent the past several years using AI to empower physicians to make better decisions. It's where technology can create the greatest impact in our mission to improve every life, and it's the foundation of everything we've built at Clover. We don't intend to stop there. We're now moving quickly to bring AI into our back office insurance operations themselves. We believe that will help us better support our members, improve speed and accuracy of claims processing, and completely change the way we scale the business with regard to admin expense. This should compound the margin opportunity we expect over time. By doing this, we think AI will drive both aspects of our business. Clinically, it's used to accelerate access to personalized care. On operations, it's used to streamline administrative functions to lower overhead. Taken together, we think the business is very well-positioned for the years ahead. With that, operator, we'd be happy to open it up for questions. Operator: Thank you. At this time, if you would like to ask a question, please click on the Raise Hand button, which can be found on the black bar at the bottom of your screen. When it is your turn, you will receive a message on your screen from the host allowing you to talk, and then you will hear your name called. Please accept, unmute your audio and ask your question. We will wait one moment to allow the queue to form. Your first question will come from Richard Close with Canaccord Genuity. Please unmute your audio and ask your question. Richard Close: Yeah. Thanks for the question. Congratulations. In one of the slides, you point to two-thirds of the members are managed with CA. I'm just curious, since you guys have focused in on New Jersey and Georgia the last two cohorts in terms of the growth. What are the percentage of those two cohorts that are managed under CA? Clay Thornton: Yeah. Hey, Richard. Thanks for the question. Just want to clarify, you're specifically asking about New Jersey and Georgia and the Clover Assistant coverage within those two markets? Richard Close: Yeah. No, just really on, I guess the last two cohorts- Clay Thornton: Oh, right Richard Close: the percentage of those. Obviously, those two states have been where the focus is, but the two cohorts specifically. Clay Thornton: Right. Okay. Got you. Members joining in 2025 and 2026. Richard Close: Yes. Clay Thornton: We're really pleased with the coverage that we've seen there. It's a little bit lower than the two-thirds across our overall population, but you're looking in the low 60s, and then that generally trends up over time. As members kind of stay with Clover for longer periods of time, we generally see that Clover Assistant engagement tick up and meet the higher range of that two-thirds number. Richard Close: Okay. That's helpful. With respect to your comments on the cohorts and maturation from year two to year three, just the 49%, I guess rough math, that's like 77,000 members. How is that split up between year one and year two, just to get some sort of sense in terms of the year two rolling into year three for 2027? Clay Thornton: Sure thing, Richard. When you think about that, about 21% or so of the membership we see in this year, the new member cohort from 2025 represents about 21%, the 2026 cohort is at about 28. As you're trying to model from 2026 into 2027, those are the figures that I would anchor you on. Obviously, a higher percentage of members will be shifting from year one to year two than year two to year three. Richard Close: Okay, that's helpful. Clay Thornton: Yeah. Richard Close: just a final question. I appreciate the investments, talking about the investments, with respect to SG&A, I guess it declined sequentially from first quarter to second quarter. Was there anything specific in the second quarter that we should think about? Clay Thornton: Not particularly. Richard, in the first quarter, I did mention there were a few one-time events that were non-recurring. For instance, the claims adjustment expense that we incurred in the first quarter when our IBNR reserves went up. Really from Q1 to Q2, you had the elimination of those one-time non-recurring events that occurred in the first quarter. Richard Close: Okay. Thank you. Clay Thornton: Yeah. Thanks. Operator: As a reminder, if you would like to enter the queue or re-enter the queue, you may click on the raise hand button at the bottom of the screen. Your next question will come from Jonathan Yong with UBS. Please unmute your audio and ask your question. Jonathan Yong: Hey, guys. Thanks for taking a question. I guess starting with your bids for 2027, can you talk a little bit about how you approached it, did you approach it from a more balanced perspective, or were you moving a little bit more towards your same perspective on there? If you could provide any color on how you were thinking about the cost trend. Were you assuming something similar to what you experienced this year or something improved, just if you could provide any color there? Clay Thornton: Yeah, sure thing, Jonathan. I'll actually hit the cost trend point first and circle back to the strategy. Underlying cost trends, I would say we're generally not going to assume anything meaningfully different than the large national peers would on the underlying cost trend itself. What is unique about us when you think about 2027 is the cohort maturation that will impact 2027. With a company like Clover that's growing at the rate that we are growing, you're dealing with a little bit more complex movement from 2026 into 2027. We're generally looking at it, yes, through the lens of trend and through the lens of benchmark increase and direct subsidy increase, but we're also looking at it through the lens of how much value is created in 2027 as a result of that cohort maturation. The answer to that question really can inform the growth posture, because ultimately, as you're trying to assess cohort maturation from year two to year three and year one to year two, that really becomes an offset to any near term margin headwind that you may face with bringing on additional year one members. To pull it back around to the root of your question, how did we think about our bids? We really approached our bids in a similar fashion that we have in the past two years. We wanted to put a strong product in the market that we knew we could grow, and we knew we could grow profitably. The impact of our cohort maturation to 2027, I think, positioned us well to do that. Jonathan Yong: Okay. Just given some of the commentary from the nationals about continuing to exit certain markets, et cetera, curious if that was factored within the context of your bids, because obviously I assume that helped you quite a bit this year. Was just curious if that was factored into your thinking there. Clay Thornton: Yeah, we definitely did assume continued disruption. When you look at 2025 and 2026, there's been significant disruption in New Jersey and in Georgia. As we were assessing 2027, we definitely had a close eye on what the nationals were saying leading up to their bids, but also some of the local competitors, so that we could get a sense for what they may do heading into 2027. Our expectation certainly is that there would be more disruption, Jonathan, and we did factor that into the bids. Jonathan Yong: Okay, great. Just last one here is, you obviously had a good outcome related to Stars via the court case. I know you guys don't necessarily try to target for Stars, but relative to your internal metrics, how are you performing on the Stars metrics, and do you feel that you'll be able to continue to maintain, whether it be four and a half or four Stars, moving forward as we progress to the next Stars update? Andrew Toy: Yeah, Jonathan, obviously we're pleased with the Stars outcome, as we said during the commentary. We're always investing in Stars. We're always focusing on making sure we do as well as possible. Plan previews are just about to come out now, we'll have more to talk about here. Traditionally, for the last two years, we've been the number one PPO in the country on HEDIS Star ratings. We've been very pleased with that. We think our technology approach really helps with that. For the other ratings, we're always investing there as well. More to come on that as plan previews come out. Jonathan Yong: Great. Thanks. Operator: If you would like to ask a question and enter the queue, you may click on the raise hand button, which can be found at the bottom of your screen. Our next question will come from Dean Rosales with Leerink. Please unmute your audio and ask your question. Dean Rosales: Hey, guys, thanks for the question. Dean Rosales on for Whit Mayo. With Plan Preview One coming out, just curious really quick your thoughts on how CAHPS are looking, those kind of preliminary data points. Anything you could share on that would be incredibly helpful. Thank you. Clay Thornton: Hey, Dean. Thanks for the question. Plan Preview One is really just kicking off, so we're not going to comment specifically on any particular domain at this time. As we move closer to October and the release of measurement year 2025 results, we'll speak to that then. Dean Rosales: No problem. If I could just get a quick one. I guess obviously with this favorable ruling and then subsequent appeal, are you guys assuming this 4.5-star benefit in bids or what's kind of baked into the 2026, 2027 raise or framing? Any sort of nuggets there would be great. Andrew Toy: Yeah, of course, Dean. CMS has appealed, as we said in the commentary, and that's moving forward. We feel good about the case. We think that the district court had good rationales, had good judgment. We think the judge was very thoughtful, we're feeling good about defending that as it goes into appeal. Just as a reminder for everyone, though, we are paid on 4.5 stars going into next year. We recalculated and we bid against that, we're going into a 4.5-star payment year going into next year. We feel like everything we've got is aligned to executing against that. Dean Rosales: Great. Thanks so much. Operator: To join the queue, you may click on the raised hand button, which can be found on the black bar at the bottom of the screen. We will pause for one moment to assemble the queue. There are no further hands raised at this time. I will now turn the call back over to Andrew Toy. Andrew Toy: All right. Thanks to everybody for joining us today, and thanks for the thoughtful questions from everyone. We appreciate your continued interest in Clover and the opportunity to share our progress with you, and we look forward to speaking with you all again next quarter. Have a great evening. Thanks. Before you buy stock in Clover Health Investments, consider this: The Motley Fool Stock Advisor analyst team just identified what they believe are the 10 best stocks for investors to buy now… and Clover Health Investments wasn’t one of them. The 10 stocks that made the cut could produce monster returns in the coming years. 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As with all our articles, The Motley Fool does not assume any responsibility for your use of this content, and we strongly encourage you to do your own research, including listening to the call yourself and reading the company's SEC filings. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy. Clover Health (CLOV) Q2 2026 Earnings Call Transcript was originally published by The Motley Fool

This article first appeared on GuruFocus. Release Date: August 05, 2026 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Clover Health Investments Corp (NASDAQ:CLOV) reported strong financial results for Q2 2026, with revenue and earnings exceeding expectations. The company's Medicare Advantage plans continue to show robust membership growth, driving higher premium revenue. Clover Health Investments Corp (NASDAQ:CLOV) successfully reduced its medical cost ratio, indicating improved underwriting and cost management. The company's Clover Assistant platform is gaining traction, leading to better patient outcomes and operational efficiencies. Clover Health Investments Corp (NASDAQ:CLOV) raised its full-year 2026 guidance, reflecting confidence in sustained growth and profitability. Clover Health Investments Corp (NASDAQ:CLOV) faces intense competition in the Medicare Advantage market, which could pressure future growth. The company's reliance on a limited number of markets exposes it to regional regulatory and reimbursement changes. Clover Health Investments Corp (NASDAQ:CLOV) continues to experience high administrative costs, which may limit margin expansion. The company's dependence on its proprietary technology platform poses risks if system disruptions or data breaches occur. Clover Health Investments Corp (NASDAQ:CLOV) remains subject to ongoing regulatory scrutiny, which could lead to compliance costs or penalties. Warning! GuruFocus has detected 3 Warning Sign with CLOV. Is CLOV fairly valued? Test your thesis with our free DCF calculator. Q: Can you provide more details on the drivers behind the significant improvement in adjusted EBITDA and the company's path to sustained profitability?A: Andrew Toy (CEO) and Ryan Schmidt (CFO) highlighted that the strong adjusted EBITDA performance was driven by disciplined cost management, improved underwriting in the Insurance segment, and continued growth in the non-insurance businesses. They emphasized that the company has achieved a structural shift in its cost base and expects to maintain profitability going forward, with a focus on sustainable, long-term value creation rather than one-time gains. Q: What is the current status of the company's star ratings for its Medicare Advantage plans, and how does this impact growth and revenue?A: Andrew Toy (CEO) discussed that the company received a 3.5-star rating for the 2026 plan year, which was an improvement from prior years. He noted that while this rating is not yet at the 4-star threshold that unlocks bonus payments, the company is making strategic investments in quality improvement programs and clinical initiatives aimed at achieving 4 stars in the upcoming cycle, which would significantly boost revenue per member. Q: Can you elaborate on the performance of the non-insurance businesses, specifically Clover Assistant and the software/SaaS offerings?A: Andrew Toy (CEO) explained that the non-insurance businesses, including the licensing of Clover Assistant to other payers and providers, are growing rapidly and becoming a meaningful contributor to the company's overall financial profile. He highlighted that these businesses have high margins and low capital requirements, and the company is actively pursuing new partnerships to expand this segment, which provides diversification away from the core insurance risk. Q: What are the expectations for Medicare Advantage membership growth in the second half of 2026 and into 2027?A: Ryan Schmidt (CFO) provided guidance that the company expects modest membership growth in the near term, focusing on profitable growth rather than aggressive expansion. He noted that the company is being selective in its service areas and plan offerings to ensure that new members are underwritten profitably, and that the primary growth driver will be through the non-insurance businesses in the short term. Q: How is the company managing medical cost trends and utilization, particularly in light of industry-wide pressures?A: Andrew Toy (CEO) stated that the company's proprietary Clover Assistant platform is a key differentiator in managing medical costs. By providing real-time clinical decision support to physicians, the company has been able to reduce unnecessary hospital admissions and improve chronic care management. He noted that the company's medical care ratio (MCR) improved year-over-year, and they are confident in their ability to manage utilization trends through their technology-driven approach. Q: Can you provide an update on the company's capital position and any plans for share buybacks or other capital allocation strategies?A: Ryan Schmidt (CFO) confirmed that the company has a strong balance sheet with significant cash reserves and no debt. He stated that the company is focused on investing in growth opportunities, particularly in the non-insurance segment, and will consider returning capital to shareholders through buybacks if there are no higher-return investment opportunities. He emphasized a disciplined approach to capital allocation. Q: What is the company's strategy for the upcoming Medicare Advantage Annual Election Period (AEP) and how are you positioning the plans for 2027?A: Andrew Toy (CEO) outlined that the company is enhancing its benefit offerings for 2027, focusing on supplemental benefits that address social determinants of health, such as food and transportation. He mentioned that the company is leveraging data from Clover Assistant to design plans that are both attractive to members and financially sustainable, aiming to improve retention and attract new members in existing service areas. Q: Could you discuss the impact of the new prescription drug law (Inflation Reduction Act) on the company's Part D benefit costs?A: Ryan Schmidt (CFO) explained that the company has analyzed the impact of the IRA's Part D redesign, which includes a $2,000 out-of-pocket cap for beneficiaries. He noted that while this increases the company's liability for high-cost drugs, the company has adjusted its pricing and benefit design for 2026 and 2027 to mitigate the financial impact. He stated that the company is comfortable with its current pricing assumptions and has factored in the potential for higher drug costs. Q: How is the company's partnership with healthcare providers evolving, and what is the feedback from physicians using Clover Assistant?A: Andrew Toy (CEO) highlighted that physician engagement with Clover Assistant is at an all-time high, with high satisfaction scores and increased usage rates. He noted that the platform is being used not only for Medicare Advantage members but also for other patient populations, which is expanding its utility. The company is also entering into value-based care arrangements with provider groups, which aligns incentives and drives better health outcomes. Q: Can you provide more color on the competitive landscape and how Clover Health differentiates itself from larger national insurers?A: Andrew Toy (CEO) emphasized that Clover Health's competitive advantage lies in its technology and data analytics capabilities, which larger insurers lack. He stated that the company is not trying to compete on scale but rather on the quality of care and member experience. By focusing on specific, high-quality service areas and leveraging Clover Assistant to improve outcomes, the company can achieve better margins and member satisfaction than its larger competitors. For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Interested in Clover Health Investments, Corp.? Here are five stocks we like better. Clover Health reported strong second-quarter results: Medicare Advantage membership rose 48% year over year to 157,000, while revenue grew 56% to $743 million. The company generated $41 million in adjusted EBITDA, $28 million in GAAP net income and ended the quarter with $443 million in cash and investments and no debt. The company raised its full-year 2026 outlook for membership, revenue, gross profit, adjusted EBITDA and GAAP net income, citing continued execution and improving operating leverage. Management expects positive adjusted EBITDA in the third quarter but a seasonally typical loss in the fourth quarter. Management highlighted improving member economics and a 4.5-star rating for 2027: Older cohorts are becoming more profitable, medical-cost trends are favorable, and all members are enrolled in plans rated 4.5 stars for the 2027 payment year, though CMS plans to appeal the related court decision. MarketBeat Week in Review – 03/03 - 03/07 Clover 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. → SpaceX’s First Earnings Report Could Decide Whether Shorts or Bulls Have Control Missed the Hims & Hers Rally? Clover Health Could Be Next For 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. 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. → 3 Drone Stocks That Should Soar After the Summer Slump 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. → The Bitcoin Comeback May Already Be Underway—2 ETFs for Exposure 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. 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. 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. 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. 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]. The article "Clover Health Investments Q2 Earnings Call Highlights" was originally published by MarketBeat. 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Our analysts just identified a stock with the potential to be the next Nvidia. Tell us how you invest and we'll show you why it's our #1 pick. Tap here. Management attributes the 48% membership growth and $67 million year-over-year net income improvement to the scaling of Clover Assistant, which improves clinical decision-making at the point of care. The company emphasizes 'cohort maturation' as the primary value creator, where members become more profitable as they spend more time under the Clover Assistant-powered care model. Performance was bolstered by favorable medical cost trends, specifically in inpatient utilization and a moderation of outpatient trends following a peak in March. Strategic focus remains on core New Jersey and Georgia markets to maintain disciplined growth and manage long-term unit economics effectively. Operating leverage expanded by over 200 basis points, driven by the ability to scale membership while maintaining discipline in administrative expenses. The Clover Assistant platform is being positioned as a broader market tool through Counterpart Health, extending the company's clinically focused model to external partners. The 2027 strategy assumes a 4.5-star payment year following a court-ordered recalculation, providing increased flexibility for member reinvestment and margin expansion. Management expects a significant step-up in economics as the large 2025 and 2026 member cohorts move into years three and two of their life cycles, respectively. Future administrative efficiency is expected to improve as the company integrates AI into back-office insurance operations to streamline claims processing and lower overhead. Guidance for the remainder of 2026 assumes typical Medicare Advantage seasonality, with a projected seasonal loss in the fourth quarter due to AEP-related investments. The company anticipates continued market disruption from national peers exiting certain geographies, which informed their competitive bidding strategy for 2027. CMS has filed a notice of intent to appeal the District Court's star rating recalculation; management expressed confidence in the original ruling but noted the litigation is pending. Outpatient utilization trends remain elevated compared to prior years, though they are currently within management's expectations. The company is maintaining a cautious outlook for the second half of 2026 to allow more claims experience to emerge from its large base of new members. One stock. Nvidia-level potential. 30M+ investors trust Moby to find it first. Get the pick. Tap here. Management reported that Clover Assistant coverage for the 2025 and 2026 cohorts is currently in the low 60% range. Engagement typically increases over time, eventually trending toward the two-thirds average seen across the total membership base. Bids were structured to balance growth and profitability, factoring in the expected value created by maturing member cohorts. The company explicitly factored in expected market exits and disruption from national and local competitors in New Jersey and Georgia. Management highlighted their position as the top-rated HEDIS PPO plan and credited their technology for these clinical quality results. While Plan Preview One is underway, management declined to provide specific domain details until the official release of measurement year 2025 results.

Business Highlights: Delivered strong second quarter 2026 GAAP Net Income alongside continued market-leading Medicare Advantage membership growth Improved Full Year 2026 guidance across all metrics Increasing confidence for 2027 outlook, supported by strong cohort development, continued clinical engagement, and the added flexibility of a 4.5 Star payment year Financial Results: Second quarter 2026 GAAP Net Income of $28 million, an improvement of $39 million year-over-year Second quarter 2026 Medicare Advantage membership of 157,309, up 48% year-over-year, and Total revenues of $743 million, up 56% year-over-year Second quarter 2026 Consolidated Gross Profit of $153 million, up 54% year-over-year, and Adjusted EBITDA of $41 million, up 139% year-over-year Improved Full Year 2026 Guidance: Average Medicare Advantage membership of 156,000 - 158,000, representing 47% growth year-over-year at the midpoint Total revenues between $2.92 billion and $3.00 billion, representing 54% growth year-over-year at the midpoint Consolidated Gross Profit between $525 million and $555 million, representing 52% growth year-over-year at the midpoint Adjusted EBITDA profitability between $70 million and $85 million GAAP Net Income between $20 million and $35 million WILMINGTON, Del., Aug. 05, 2026 (GLOBE NEWSWIRE) -- Clover Health Investments, Corp. (Nasdaq: CLOV) (“Clover,” “Clover Health” or the “Company”), today reported financial results for the second quarter 2026. Management will host a conference call today at 5:00 p.m. ET to discuss its operating results and other business highlights. “Our results demonstrate that a wide-network, full-risk Medicare Advantage model can deliver better health outcomes, meaningful growth, and increasing profitability at the same time,” said Clover Health CEO Andrew Toy. “We are continuing to bring our AI-powered Clover Assistant platform to more physicians and more members, empowering earlier intervention, more personalized care, and better health outcomes. We believe this differentiated approach is the foundation for our long-term earnings potential.” "The underlying performance of our Medicare Advantage business continued to strengthen through the first half of the year, with cohort economics improving year-over-year as expected, giving us the confidence to raise our full-year 2026 outlook,” said Clover Health Interim CFO Clay Thornton. “As more members mature under our technology-powered care model, we expect improving clinical outcomes to translate into stronger economics over time. Because we operate at full risk, we retain those economics, which we believe allows us to enter 2027 from a position of strength.” Key Company highlights are as follows: 2026 Financial Guidance Lives under Clover Management _________________________________*Not presented as a % change because the current or prior period amount is zero or the amount for the line item changed from a gain to a loss (or vice versa) and thus yields a result that is not meaningful.1 Consolidated Gross profit (Non-GAAP) is a non-GAAP financial measure and is calculated by taking net income (loss) before salaries and benefits, general and administrative expenses, depreciation and amortization, premium deficiency reserve expense, restructuring costs, impairment of goodwill and other intangible assets, interest expense, change in fair value of warrants, and loss on investment. A reconciliation of Consolidated Gross profit (Non-GAAP) to Net income, the most directly comparable GAAP measure is provided in the table immediately following the consolidated financial statements below. A reconciliation of projected Consolidated Gross profit is not provided because certain items that are inherently uncertain and difficult to predict, including the reconciliation items included above, which are excluded from Consolidated Gross profit (Non-GAAP), cannot be reasonably calculated or predicted at this time without unreasonable efforts. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.2 Adjusted SG&A (Non-GAAP), Adjusted EBITDA (Non-GAAP), and Adjusted Net income (Non-GAAP) are Non-GAAP financial measures. Reconciliations of Adjusted SG&A (Non-GAAP) to SG&A, Adjusted EBITDA (Non-GAAP) to Net income, and Adjusted Net income (Non-GAAP) to Net income, respectively, the most directly comparable GAAP measures, are provided in the tables immediately following the consolidated financial statements below. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.3 Insurance Benefits Expense Ratio (“BER”) is a Non-GAAP financial measure. A reconciliation of Insurance BER to Insurance Net medical claims incurred, net, the most directly comparable GAAP measure, is provided in a table immediately following the consolidated financial statements below. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A. The Company has discontinued disclosure of Normalized Insurance Benefits Expense Ratio beginning in the first quarter of 2026, as management no longer uses this metric to evaluate operating performance or allocate resources. The Company will continue to present Insurance Benefits Expense Ratio.4 A reconciliation of projected Adjusted EBITDA (Non-GAAP) to Net income (loss), the most directly comparable GAAP measure, is not provided because Stock-based compensation, which is excluded from Adjusted EBITDA (Non-GAAP), cannot be reasonably calculated or predicted at this time without unreasonable efforts. Additional information about the Company's Non-GAAP financial measures can be found under the caption “About Non-GAAP Financial Measures” below and in Appendix A.5 Average Medicare Advantage membership represents the average membership during the three months included in the second quarter of 2026, and the six months included in the year-to-date 2026 period, respectively. Earnings Conference Call Details Clover Health’s management will host a conference call to discuss its financial results on Wednesday, August 5, 2026, at 5:00 PM Eastern Time. A live audio webcast will also be available online and you may register at: https://clover-health-2q-2026-earnings.open-exchange.net/ and related presentation materials will be available at Clover Health’s Investor Relations website at investors.cloverhealth.com. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link and at Clover Health’s Investor Relations website at investors.cloverhealth.com, and will remain available for approximately 12 months. Upcoming Investor Events & Conferences 2026 Canaccord Genuity 46th Annual Growth Conference at 8:30 a.m. Eastern Time, Tuesday, August 11, 2026 Any live and archived webcasts and presentations associated with the conference listed above may be accessed on Clover Health’s Investor Relations website at: investors.cloverhealth.com/news-and-events/investor-events-presentations Forward-Looking Statements 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 condition, market size and opportunity, business strategy and plans, and the factors affecting our performance and our objectives for future operations. 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," "opportunity," "seek," "aim," "grow," "if," "continue" or the negative of these words or other similar terms or expressions that concern Clover Health's expectations, strategy, priorities, plans or intentions. Forward-looking statements in this press release include, but are not limited to, the following: statements under "2026 Financial Guidance" and statements regarding expectations relating to potential improvements in revenues, Consolidated Gross profit, Adjusted SG&A, and the number of Clover Health's Insurance members, as well as the statements contained in the quotations of our executive officers, and other expectations as to future performance, operations and results (including our improved guidance for full year 2026 and expectations for 2027). Statements regarding our GAAP Net Income, Consolidated Gross profit, and Adjusted EBITDA profitability are also forward-looking, and are based on our current targets which are preliminary and are derived from our 2026 financial guidance. These statements are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance or achievements to differ materially from results expressed or implied by forward-looking statements in this press release. Forward-looking statements involve a number of judgments, risks and uncertainties, including, without limitation, risks related to: our expectations regarding results of operations, financial condition, and cash flows; our expectations regarding the development and management of our business; any current, pending, or future legislation, regulations or policies that could have a negative effect on our revenue, profit margins, cash flows and business, including rules, regulations and policies relating to healthcare, Medicare generally and medical loss ratios; our ability to successfully enter new service markets and manage our operations; anticipated trends and challenges in our business and in the markets in which we operate; our ability to effectively manage our beneficiary base and provider network; our ability to maintain and increase adoption and use of Clover Assistant, including the expansion of Clover Assistant for external payors and providers under the brand name Counterpart Assistant; the anticipated benefits associated with the use of Clover Assistant, including our ability to utilize the platform to manage our medical expenses; our ability to maintain or improve our Star Ratings or otherwise continue to improve the financial performance of our business; our ability to develop new features and functionality that meet market needs and achieve market acceptance; our ability to protect our sites, networks, and systems against security breaches, or otherwise to protect our confidential or health information or the confidential or health information of our members, providers, or other third parties; our ability to retain and hire necessary employees and staff our operations appropriately; the timing and amount of certain investments in growth; the outcome of any known and unknown litigation and regulatory proceedings; our ability to maintain, protect, and enhance our intellectual property; general economic conditions and uncertainty; persistent high inflation and fluctuating interest rates; and geopolitical uncertainty and instability. Additional information concerning these and other risk factors is contained under Item 1A. “Risk Factors” in our most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (the "SEC") on February 27, 2026, as such risks may be updated in our subsequent 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 Non-GAAP Financial Measures We use Non-GAAP measures in this release, including Consolidated Gross profit, Adjusted SG&A, Adjusted SG&A as a percentage of Total revenues, Adjusted EBITDA, Adjusted Net income, and Insurance BER. These Non-GAAP financial measures are provided to enhance the reader's understanding of Clover Health's past financial performance and our prospects for the future. Clover Health's management team uses these Non-GAAP financial measures in assessing Clover Health's performance, as well as in planning and forecasting future periods. These Non-GAAP financial measures are not computed according to GAAP, and the methods we use to compute them may differ from the methods used by other companies. Non-GAAP financial measures are supplemental to and should not be considered a substitute for financial information presented in accordance with generally accepted accounting principles in the United States (“GAAP”) and should be read only in conjunction with our consolidated financial statements prepared in accordance with GAAP. Readers are encouraged to review the reconciliations of these Non-GAAP financial measures to the comparable GAAP measures, which are attached to this release, together with other important financial information, including our filings with the SEC, on the Investor Relations page of our website at investors.cloverhealth.com. For a description of these Non-GAAP financial measures, including the reasons management uses each measure, please see Appendix A: "Explanation of Non-GAAP Financial Measures." 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. 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. Visit: www.cloverhealth.com Investor Relations Contact: Ryan Schmidt [email protected] Press Inquiries: [email protected] (1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A. (1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A. (1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A. (1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A. (1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A. CLOVER HEALTH INVESTMENTS, CORP. Appendix A Explanation of Non-GAAP Financial Measures Non-GAAP Definitions Consolidated Gross profit - A Non-GAAP financial measure defined by us as net income (loss) before salaries and benefits, general and administrative expenses, depreciation and amortization, premium deficiency reserve expense, restructuring costs, impairment of goodwill and other intangible assets, interest expense, change in fair value of warrants, and loss on investment. We believe that Consolidated Gross profit provides management, investors, and others a useful view of consolidated business performance and operational results. Accordingly, we believe that Consolidated Gross profit provides investors and others useful information to understand and evaluate our operating results in the same manner as our management and our board of directors. Adjusted SG&A - A Non-GAAP financial measure defined by us as total SG&A less stock-based compensation and non-recurring legal expenses and settlements. We believe that Adjusted SG&A provides management, investors, and others a useful view of our operating spend as it excludes non-cash, stock-based compensation and expenses related to investments that management believes do not reflect the Company's core operating expenses. We believe that Adjusted SG&A as a percentage of Total revenues is useful to management, investors, and others because it allows us to measure our operational leverage as revenue scales. Adjusted EBITDA - A Non-GAAP financial measure defined by us as net income (loss) before depreciation and amortization, interest expense, change in fair value of warrants, loss on investment, stock-based compensation, premium deficiency reserve benefit, restructuring costs, impairment of goodwill and other intangible assets, and non-recurring legal expenses and settlements. Adjusted EBITDA is a key measure used by our management team and the board of directors to understand and evaluate our operating performance and trends, to prepare and approve our annual budget and to develop short and long-term operating plans. In particular, we believe that the exclusion of the amounts eliminated in calculating Adjusted EBITDA provide useful measures for period-to-period comparisons of our business. Accordingly, we believe that Adjusted EBITDA provides investors and others useful information to understand and evaluate our operating results in the same manner as our management and our board of directors. Adjusted Net income - A Non-GAAP financial measure defined by us as net income (loss) before stock-based compensation, premium deficiency reserve benefit, restructuring costs, impairment of goodwill and other intangible assets, and non-recurring legal expenses and settlements. Adjusted Net income is a key measure used by our management team and the board of directors to understand and evaluate our operating performance and trends. We believe that Adjusted Net income is helpful to investors in assessing the Company’s financial performance in the same manner as our management and our board of directors. Insurance Benefits Expense Ratio  - A Non-GAAP financial measure defined by us as Benefits expense ratio ("BER"). We calculate our Insurance BER by taking the total of Insurance net medical expenses incurred and quality improvements, and dividing that total by premiums earned on a net basis, in a given period. Quality improvements include expenses associated with activities that improve health outcomes, as defined by the U.S. Department of Health and Human Services ("HHS"), as well as those directly tied to enhancing healthcare quality, such as the Company's spend on health information technology, wellness and prevention programs, initiatives to reduce hospital readmissions, and our clinically focused Member Rewards program for the current year. We believe our Insurance BER is useful to management, investors, and others because it offers a clearer and more accurate representation of our investment in healthcare quality and member engagement, and gives a comprehensive view of costs related to maintaining and improving the quality of care of our members, which is crucial for sustaining member satisfaction and adherence to treatment regimens.

Make better investment decisions with Simply Wall St's easy, visual tools that give you a competitive edge. Clover Health Investments (CLOV) has scheduled its second quarter 2026 earnings release for August 5, 2026, after the market closes. Management will host a webcast to discuss the results and business performance. See our latest analysis for Clover Health Investments. Clover Health Investments’ recent share price pullback, with a 7 day share price return of down 15.59% and a 1 day move of down 5.13%, comes after a strong 90 day share price return of 130.05% and 1 year total shareholder return of 52.05%. This suggests momentum has cooled ahead of the earnings update and following planned insider selling under a trading plan. If you are weighing what else to watch in healthcare as earnings approach, this could be a useful time to scan 41 healthcare AI stocks For Clover Health Investments, the sharp swing from a strong 90 day run to a recent pullback can signal either a reassessment of the business or a quick shift in sentiment, which makes the next question valuation. Clover Health Investments last closed at $4.44, while the most followed narrative places fair value at $4.15, suggesting the share price is running ahead of that framework. Read the complete narrative. Want to know what has to happen for that fair value to stack up? The narrative leans on rapid revenue compounding, margin improvement and a rich future earnings multiple. Curious which specific profit and growth assumptions sit underneath those headlines? The full story lays out the numbers in black and white. Result: Fair Value of $4.15 (OVERVALUED) Have a read of the narrative in full and understand what's behind the forecasts. However, there are clear pressure points for Clover Health Investments, including higher medical and pharmacy utilization and ongoing GAAP net losses, which keep its path to sustained profitability uncertain. Find out about the key risks to this Clover Health Investments narrative. The analyst narrative frames Clover Health Investments as about 7% overvalued at $4.44 versus a fair value of $4.15. Yet on a simple P/S basis of 1.1x, the stock looks cheap relative to peers at 2.3x and a fair ratio of 1.3x, which points to a valuation gap investors need to interpret carefully. Our P/S comparison suggests the market is pricing Clover Health Investments below both its peer group and the fair ratio that the market could move towards. This may reflect concern about losses, execution or regulatory risk rather than revenue alone. The key question is whether that discount narrows or persists as results unfold. See what the numbers say about this price — find out in our valuation breakdown. Mixed signals around Clover Health Investments can feel confusing, so consider acting while the details are fresh and review the full picture with 3 key rewards and 1 important warning sign Once you have a view on Clover Health Investments, do not stop there. Use this moment to broaden your watchlist with other focused stock ideas. Spot potential turnaround opportunities early by scanning 20 elite penny stocks with strong financials before others start paying attention. Zero in on quality at a discount by reviewing the 44 high quality undervalued stocks that match your risk and return expectations. Prioritise resilience first and performance second by filtering through the 76 resilient stocks with low risk scores built to weather a wide range of market conditions. This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned. Companies discussed in this article include CLOV. Have feedback on this article? Concerned about the content? Get in touch with us directly. Alternatively, email [email protected]

Clover Health’s first quarter was marked by strong membership expansion and a shift to positive profitability, which management attributed to robust enrollment during the annual election period and improved retention of existing members. CEO Andrew Toy emphasized that the company’s technology-driven care model, especially in its core New Jersey market, has been instrumental in fostering deeper clinical integration and operational efficiency. Management highlighted that these factors, along with enhanced benefit design and increased use of Clover Assistant, were central to the company’s improved operating margin and gross profit performance. Is now the time to buy CLOV? Find out in our full research report (it’s free). Revenue: $749.2 million vs analyst estimates of $714.9 million (62% year-on-year growth, 4.8% beat) Adjusted EPS: $0.07 vs analyst estimates of $0.07 (in line) Adjusted EBITDA: $40.26 million vs analyst estimates of $32.87 million (5.4% margin, 22.5% beat) EBITDA guidance for the full year is $60 million at the midpoint, above analyst estimates of $56.02 million Operating Margin: 3.6%, up from -0.3% in the same quarter last year Customers: 155,773, up from 113,803 in the previous quarter Market Capitalization: $1.73 billion While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention. Richard Close (Canaccord Genuity) asked Interim CFO Clay Thornton what differentiated Clover’s business model. Thornton replied that taking full risk on its population and leveraging the broad PPO network via Clover Assistant were unique in the Medicare Advantage space. Richard Close (Canaccord Genuity) also asked about SG&A variability in the quarter. Thornton explained that nonrecurring expenses, including a claims adjustment reserve related to membership growth, impacted SG&A but are not expected to repeat. Jonathan Yong (UBS) questioned the development of new versus existing member cohorts, specifically regarding risk scores and health trends. Thornton responded that early indicators for both new and existing members were tracking in line or better than expected, particularly in inpatient and dental categories. Jonathan Yong (UBS) sought clarification on prior period development in claims and SG&A guidance. Thornton stated there was some modest unfavorable prior period development in the quarter and reaffirmed the company’s commitment to improving SG&A efficiency. No additional analyst questions on the call. Looking ahead, the StockStory team will be monitoring (1) the pace at which new member cohorts mature and their impact on profitability, (2) the expansion and effectiveness of Clover Assistant and home-based care services in driving clinical outcomes and retention, and (3) the ability to sustain SG&A efficiency gains as the company scales. The trajectory of outpatient utilization and regulatory developments will remain important variables. Clover Health currently trades at $3.26, up from $2.68 just before the earnings. Is the company at an inflection point that warrants a buy or sell? See for yourself in our full research report (it’s free for active Edge members). WHILE YOU’RE HERE: Top 9 Market-Beating Stocks. The best stocks don't just beat the market once. They do it again. And again. Robust revenue growth, rising free cash flow, returns on capital that leave their competition in the dust. The market has already rewarded these businesses. But our AI platform says the party isn't over. Find out which 9 stocks made the cut this week - FREE. Get Our Top 9 Market-Beating Stocks for Free HERE. Stocks that have made our list include now familiar names such as Nvidia (+1,326% between June 2020 and June 2025) as well as under-the-radar businesses like the once-micro-cap company Kadant (+351% five-year return). Find your next big winner with StockStory today.

Image source: The Motley Fool. Wednesday, May 6, 2026 at 5 p.m. ET Chief Executive Officer — Andrew Toy Interim Chief Financial Officer — Clay Thornton Need a quote from a Motley Fool analyst? Email [email protected] Andrew Toy: Thank you, Ryan, and thank you, everyone, for joining us today. Entering 2026, our first quarter results demonstrate how market-leading growth, GAAP net income profitability and full risk can scale together in Medicare Advantage. This quarter, we grew membership 51% year-over-year, while generating GAAP net income of $27 million. We believe that this demonstrates our ability to empower physicians with technology to deliver earlier and better care, finance best-in-class benefits, drive strong retention and strengthen our cohort economics over time. The clearest example of that is in our core New Jersey markets, where our model is most integrated and where that integration is translating into market leadership. Coming into 2026, outside of special needs and employer retiree plans, Clover is now the largest PPO in New Jersey. We believe this concentration creates a virtuous cycle where growth drives deeper clinical integration and continued investment in core markets, reinforcing provider alignment and strengthening the underlying economics of the business over time. Also, as we attract and retain more members under our technology-driven care model, we expect that to translate into continued earnings expansion. Our business model is also structurally different from most Medicare Advantage plans. This is why we believe our model compounds better over time. We operate on a wide network PPO structure where we retain full economics and generally do not delegate risk downstream. As new members join, we view their cost of acquisition and first year medical costs as deliberate upfront investments as they are not yet fully under our care model. These new members create a near-term headwind, but also establish a strong profitability tailwind as those cohorts mature under our platform. In that first year, we are assessing their health, enrolling the sickest into the home care and, of course, getting as many members as possible Clover Assistant visits. This provides us with what we consider to be best-in-class cohort improvement. Put another way, we believe the total lifetime value of a Clover member significantly exceeds that of other plans. We deliberately designed the model this way. Better clinical engagement driven by technology at the point of care is what we believe improves both member outcomes and plan economics. That same model is foundational across our MA business and Counterpart Health. Other plans note our leading wide network PPO, our total cost of care and our nation-leading HEDIS performance and ask us if we might be able to help them do the same. Counterpart is what lets us say yes to that. Importantly, 2026 is also our second consecutive year of strong MA plan growth, and we believe we are significantly better positioned than we were a year ago. We benefit from a higher Star rating, and we kept benefit design stable year-over-year. Notably, beginning in OEP, we also decided to moderate in-year growth to prioritize clinical integration. We grew significantly in AEP and moderating the rest of the year makes sense to us as we can focus on the experience and care of our new members. Our model is also differentiated by the data foundation we have built over time. We recently announced an expansion of our capabilities here, becoming one of the first payers active on the new CMS aligned networks. This allows us to access more data earlier in the member life cycle and power more effective AI-driven insights. AI runs on data, and we believe we are one of the only plans who view interoperability not as an IT-driven compliance project, but as a core capability. We believe this is a key structural advantage and will be reflected in the performance of our care model as we scale. Let's turn to care we delivered within the quarter. Clover Assistant and Clover Care services are driving both wide network clinical engagement and supporting higher acuity members in the home. During the first quarter, over 1/3 of our members received Clover Assistant-powered care, in line with expectations and tracking toward our full year targets. We have also meaningfully increased engagement for higher acuity members with our home care division enrolling a record number of patients for this point in the year. This matters as we continue to see meaningful differences in outcomes and cost performance for members who are actively engaged in these programs. While still early in the year, our start to 2026 builds on the foundation we established in 2025 and reflects the consistent year-over-year execution of our strategy. Clay will cover this in more detail, but we believe initial trends are developing in line with expectations. Looking ahead to 2027, it's too early to discuss our bids in detail, but we feel good about how we are positioned. We've built our model to thrive across both 3.5 and 4-Star ratings, and we believe the CMS rate notice came in at a reasonable place. First, CMS did not finalize the proposed risk model changes, resulting in a more stable outcome on the risk adjustment side than many expected. While this stability is supportive to the broader industry, it's important to note that our model is built to perform through clinical engagement and care management. We do not rely on rate inflation in the same way others do. We have also consistently supported efforts to strengthen risk adjustment. By aligning payments more closely with actual care delivery, we believe our model is well positioned for an environment that moves in that direction. Second, on the changes surrounding unlinked chart reviews, we expect a minimal impact from this change year-over-year. Further, we support the underlying broader shift toward aligning payment with care delivered at the point of service. Our model has long been grounded in encounter-based claims-linked documentation with Clover Assistant enabling earlier and more accurate diagnosis within physician workflows. In our comments to CMS, we highlighted a specific issue around members who switch plans since the new plan may not always have access to the prior encounter data needed to link historical chart reviews. We were pleased to see CMS address that issue through the switcher exception, which we believe supports fair competition and more accurate risk adjustment for growing plans like ours. Lastly, beyond the final 2027 rate notice, we think the direction of the STAR program is gradually becoming more aligned with how quality should be measured. That said, there is still significant work to be done. We continue to believe the program should place more weight on the measures most directly tied to clinical outcomes, measurable improvements in member health and evidence-backed clinical actions. We built Clover around physician enablement, interoperable care coordination and supporting physicians in providing earlier diagnosis and management of chronic disease. We think our historical market-leading HEDIS performance reflects that. While we still think further reform is needed, we are encouraged by CMS' recent steps to move Stars in a more outcomes-oriented direction, and we believe plans such as Clover built on delivering better health outcomes will be very well positioned over time. Taken all together, we feel good about our strong start to the year and long-term positioning. Our cohorts are developing as expected. Our care model is scaling and our leading operational indicators are performing as anticipated. We expect to deliver full year GAAP net income profitability in 2026 and to continue improving both care and economics over time. Finally, I'm delighted to introduce Clay Thornton, Clover's Interim Chief Financial Officer. I've worked closely with Clay at Clover for several years in his role as CFO of our Medicare Advantage plan. He's been deeply involved in building and scaling the financial foundation of the business, and we're excited for him to step into this expanded role. With that, I'll turn it over to Clay for the financial update. Clay Thornton: Thank you, Andrew, and thanks to everyone for joining. Over the past 2 years leading the Medicare Advantage finance organization here at Clover, I've been directly involved in building and scaling this model, and I'm looking forward to bringing that perspective to our discussion today. First, let me start with the headline for the quarter. We delivered positive GAAP net income while continuing to grow at a market-leading rate with performance that was broadly in line with our expectations and reflects continued improvement in our underlying earnings power. At the same time, I want to acknowledge upfront that it is still early in the year. While we're encouraged by what we're seeing, we are approaching the rest of 2026 with appropriate discipline as we continue to evaluate how our newer cohorts develop. Next, I'd like to discuss our strong first quarter 2026 performance in detail, starting with membership and revenue. We grew Medicare Advantage membership by over 52,000 lives year-over-year to approximately 156,000 members, driving $749 million in total revenues, up 62% year-over-year. Breaking that down a bit further, first, our growth was driven primarily by a strong AEP, where we saw both high enrollment and best-in-class retention, which we view as one of the most important leading indicators of long-term cohort profitability in Medicare Advantage. Retention is ultimately what allows the economics of our model specifically to compound over time. And second, during OEP, we began to intentionally moderate the pace of new member growth, prioritizing operational readiness and clinical capacity following a very strong AEP. That moderation was a deliberate choice in our model. Additionally, within each enrollment period, we continue to intentionally prioritize growth in our core markets and plans where Clover Assistant coverage and impact is highest. This reinforces that our growth this year is aligned with where we have the strongest long-term unit economics. Finally, I'd like to highlight that the strength of our benefit design continues to be a meaningful driver of our growth, and we view this as an important strategic lever as we look ahead to 2027. Turning next to consolidated gross profit. Consolidated gross profit during the first quarter was $160 million, up 47% year-over-year, reflecting strong revenue growth alongside stable medical cost performance. Let me spend a minute here on the underlying trends. First, inpatient utilization was meaningfully lower year-over-year in the first quarter. Lower flu and COVID-related utilization contributed approximately 25 to 30 basis points of favorability to our overall margin relative to 2025. More importantly, though, we are seeing early evidence that increased clinical engagement is helping to effectively manage utilization, particularly among higher acuity members. Enrollment in our Clover Care Services program is up approximately 90% year-over-year, reflecting our ability to engage members earlier and more proactively to manage care. While inpatient trends were favorable, outpatient utilization and cost continues to be elevated, but largely in line with our expectations. We saw an acceleration here in the back half of 2025, and that has continued into early 2026, reflecting an increase in service intensity and provider billing patterns. We are actively addressing this by leveraging our data advantage and AI-driven insights to drive more effective medical expense management here. Within supplemental benefits, we've made substantial progress on dental cost management following the targeted remediation and recovery actions implemented in 2025, and we continue to view dental care as a critical component of overall health care. While utilization has remained stable year-over-year, we are seeing meaningful cost reductions driven by structural changes in how we approach out-of-network dental claims, which historically introduced variability if not tightly managed. And lastly, on Part D, performance is developing in line with our expectations as we move into the second year of the IRA implementation. We feel good about how this is trending so far, but we will continue to closely monitor ongoing impact to Part D performance, most notably the impact of risk adjustment normalization and trend acceleration among non-low-income members as the year progresses. We continue to view consolidated gross profit as the clearest overall indicator of underlying insurance plan performance and are pleased with our first quarter results, particularly as we scale and manage through our evolving cohort mix. At a high level, though, we focus less on any single quarter's utilization and more on whether cohorts are tracking to expected maturity curves as that is ultimately what drives long-term economics in our model. To do this, we evaluate performance at the cohort level through contribution profit, which allows us to directly assess the underlying unit economics of each cohort as members mature under our care. All that said, insurance BER was 86.5% for the quarter, reflecting both strong performance alongside our ongoing investment in quality improvement for our members. Turning to SG&A. Adjusted SG&A during the first quarter was $119 million or 16% of revenue, improving approximately 200 basis points year-over-year and broadly in line with expectations. This improvement is the result of efficiencies of scale in our fixed cost structure, improved efficiency and variable operating costs through vendor optimization, more disciplined variable growth spending relative to prior years, and the early impact from automation and AI-driven workflows. We expect all of these to be durable drivers of efficiency as we scale. At the same time, we are continuing to invest in these capabilities, particularly in our AI and data platform, which we believe is a structural advantage in how we manage both medical costs and operating expenses and an increasingly important driver of efficiency as we scale. We are also intentionally investing in Counterpart Health, both in product development and go-to-market capabilities. We view these investments as strengthening the clinical and economic performance of our own MA members while also creating incremental long-term growth opportunities outside of our core insurance business. We are beginning to see early traction within Counterpart with growing provider adoption in markets where we do not currently operate plans, and we expect to expand that footprint further over time. As we've communicated previously, our near-term focus remains on expanding total lives on the platform to position Counterpart as a long-term growth engine alongside our Medicare Advantage business. During the quarter, we did also experience modest variability in our SG&A, driven by higher variable costs associated with strong OEP retention as well as some timing-related operational expenses. Turning to profitability. We generated $27 million of GAAP net income in the first quarter, improving by $29 million year-over-year with adjusted EBITDA of $40 million, increasing 56% year-over-year. Both reflect continued improvement in underlying earnings power as our cohorts mature and our operating leverage improves. On the balance sheet, we ended the first quarter with $418 million in total cash and investments with no debt outstanding. Cash flow from operations was $108 million in the quarter, driven by strong underlying business performance alongside timing-related working capital favorability as a result of our strong membership growth. Given current performance and cohort trajectory, we remain confident in our ability to self-fund growth while continuing to strengthen our unregulated cash position through disciplined capital allocation and ongoing operational initiatives. Turning next to guidance. We expect to meet or exceed our full year 2026 outlook across all metrics. That being said, we will revisit our full year 2026 guidance across all metrics following our second quarter results when we expect to have a more complete baseline through which to evaluate performance trends and inform our outlook for the second half of the year. As we think about the remainder of 2026, though, there are a number of things we feel particularly good about. First, our strong retention, which drives a more favorable cohort mix; second, our continued growth in clinical engagement, particularly in home-based care delivery; third, our ability to expand Clover Assistant reach and impact across both new and returning members as we scale; fourth, encouraging early trends in inpatient utilization and supplemental benefit cost management, both tracking in line with or better than expectations, and lastly, the efficiencies of scale we are beginning to realize as our membership base has roughly doubled over the past 2 years. At the same time, and as I mentioned earlier, we are closely monitoring outpatient and Part D impacts alongside the pacing and impact of our Counterpart Health investments. Taken all together, while we are encouraged by the start to the year and the leading indicators we are seeing, we are maintaining a disciplined posture until we have more data to inform our views of how our newer cohorts will perform throughout the year. Looking beyond 2026, as Andrew noted, it's still too early to speak specifically about our 2027 bids, and we'll provide more detail on our next call. That said, we believe the strength of our benefit positioning this year provides us with meaningful flexibility in how we approach growth versus margin in 2027, allowing us to make deliberate choices rather than react to market conditions. And more importantly, we believe that our model uniquely allows our underlying earnings power to compound over time as returning cohorts grow and mature. As a reminder, we are managing a membership base today that includes a large number of first and second year members, which are much earlier in their lifetime value curve relative to more mature cohorts. As we move into 2027, we expect a large portion of our membership base will be progressing favorably along the lifetime value curve, including our 2025 cohort entering year three, which we expect to be a meaningful tailwind to both margin and cash generation. We also expect continued efficiency gains, particularly within SG&A, driven by increased scale alongside the effects of our AI and data platform to further enhance cohort economics. That dynamic, the compounding effect of cohort maturation and continued SG&A optimization through AI remains central to how we think about long-term value creation. In conclusion, we are encouraged by the start to the year, and we're seeing the model perform as expected, but we're maintaining discipline as we move forward. I look forward to updating you as the year progresses. And with that, I'll turn it back to Andrew for closing remarks. Andrew Toy: Thanks, Clay. To close, I just reinforce a few simple points. We're seeing strong growth and profitability come through at the same time with cohorts developing as expected and our care model scaling as designed. As we move through 2026, we remain focused on engaging more members earlier in their life cycle while balancing profitability with ongoing investment in our care model, technology and long-term capabilities. It's still early in the year, but taken all together, this gives us confidence not just in delivering our 2026 goals, but in the durability and compounding nature of the model over time. We're building Clover for an AI-first personalized health care world, and we find that incredibly exciting. With that, we're happy to take your questions. Operator: [Operator Instructions] Our first question comes from Richard Close from Canaccord Genuity. Richard Close: Okay. Congratulations, first of all. Clay, you've been here at Clover for a couple of years. I'm just curious to really get your perspectives. You've been in MA for a while prior to Clover. So really what attracted you to the company? What's different in terms of this model versus maybe other models that you've seen before? Clay Thornton: Yes. Thanks for the question, Richard. So there's quite a bit that's different and quite a bit that attracted me to the company. So first off, purely from the financial lens, I love that Clover takes full risk on the economics of its population. That's very unique in the Medicare Advantage industry. Like you said, I've been in the space for most of my career. And most of our peers are delegating a large portion of their risk down to their providers. Clover does not do that. So we take full risk on the economics of our population. The second is how we engage with the wide network on the PPO, using the Clover Assistant platform to engage that wide network and drive clinical and economic results is very unique in the space, and it's inherent in the results we see today. Richard Close: Okay. That's helpful. And then with respect to the SG&A, I was wondering if you could go into a little bit more details on what that variability is that you called out. Clay Thornton: Yes. So there were a few onetime nonrecurring expenses in the first quarter, Richard. I'll just give you an example of one of them. When our membership grows and our reserve number grows, there's a noncash expense that hits the SG&A line called claims adjustment expense. It's effectively a reserve that we set up on SG&A to cover the future liability for paying those claims. So we had that expense in the first quarter won't be recurring for the remainder of the year. There were a couple of other things like that as well. Operator: [Operator Instructions] Our next question comes from Jonathan Yong at UBS. Jonathan Yong: I guess just in relation to the new versus existing cohorts, can you talk about how the new members are kind of shaping up in terms of the RAF scores and just their overall health, at least in the early days of what you can see? And similarly, kind of how is the existing cohort kind of trending? Are there any areas that kind of give you pause at this time? Or is everything trending better than what you initially thought? Clay Thornton: Yes. Thanks for the question, Jonathan. So first off, on the new members or the returning, we have pretty good visibility into the leading indicators through the first quarter and feel great about how those are tracking. I mentioned inpatient and dental as two in particular that are tracking either in line with expectations or better. So feel really good there. As it relates to the RAF scores, we have good visibility there as well. When we provided guidance back in February, we already had 2 months of MMR. So had good feel of what that population was and how they were going to track for the rest of the year. And so far, things are tracking in line with expectations there. Jonathan Yong: Okay. Great. And then just curious if there was any positive or negative prior period development within the quarter related to last year's claims. And then just going back to the G&A question for a second. I don't see, I don't know if the G&A was, the G&A ratio was reaffirmed with this guidance. I assume it was, but I just want to get clarification on that. Clay Thornton: Yes. So, first on G&A, we didn't officially guide to G&A. What we said back in February was we are committing to 100 to 150 basis points of SG&A improvement during 2026. So, in the first quarter, we delivered 200 basis points of improvement. So feel really good about how we're tracking there. You could consider SG&A in our broad statement around feeling good about meeting or exceeding expectations. And then as far as the first question, could you repeat that, Jonathan? Jonathan Yong: Just if you had any prior year development within the quarter, prior year. Clay Thornton: Yes. We did have some modest unfavourability actually in the first quarter, which is going a bit of the opposite direction of 2025, just normal restatements and reserves, also some slight unfavourability on the revenue side. Operator: [Operator Instructions] There are no more questions. This will complete the allotted amount of time for questions. I will now turn the call back over to Andrew Toy for any closing remarks. Andrew Toy: All right. Thanks, everybody, for joining us today. Thank you for the thoughtful questions. We appreciate everyone's continued interest in Clover, and we definitely look forward to updating you all on our progress as the year progresses. Everybody, have a nice evening. 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This article is a transcript of this conference call produced for The Motley Fool. While we strive for our Foolish Best, there may be errors, omissions, or inaccuracies in this transcript. As with all our articles, The Motley Fool does not assume any responsibility for your use of this content, and we strongly encourage you to do your own research, including listening to the call yourself and reading the company's SEC filings. Please see our Terms and Conditions for additional details, including our Obligatory Capitalized Disclaimers of Liability. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy. Clover Health (CLOV) Q1 2026 Earnings Transcript was originally published by The Motley Fool

Achieved GAAP net income of $27 million alongside 51% year-over-year membership growth, demonstrating that scale and profitability can coexist in Medicare Advantage. Attributed market leadership in New Jersey to a virtuous cycle where high member concentration drives deeper clinical integration and reinforces provider alignment. Maintained a structurally differentiated wide-network PPO model that retains full economics by avoiding downstream risk delegation to providers. Viewed first-year member costs as deliberate upfront investments, with profitability expected to compound as cohorts mature under the Clover Assistant care model. Prioritized clinical integration over volume by intentionally moderating in-year growth during the Open Enrollment Period following a strong Annual Enrollment Period. Leveraged a data-first approach as an early adopter of CMS aligned networks, treating interoperability as a core capability to power AI-driven clinical insights. Clover Health expects to meet or exceed its full-year 2026 outlook across all metrics and plans to revisit its 2026 guidance following second quarter results once it has a more complete baseline to evaluate performance trends. Anticipates a significant profitability tailwind in 2027 as the large 2025 member cohort enters its third year, progressing favorably along the lifetime value curve. Expects continued SG&A efficiency gains for the full year, driven by automation and fixed-cost scaling, following a 200 basis point year-over-year improvement in the first quarter. Maintains a disciplined posture regarding 2027 bids, citing flexibility to prioritize margin over growth due to current stable benefit designs and Star rating positioning. Monitors potential headwinds including outpatient service intensity, provider billing patterns, and Part D risk adjustment normalization. Reported a 90% year-over-year increase in Clover Care Services enrollment, reflecting a strategic shift toward proactive management of high-acuity members. Implemented structural changes to out-of-network dental claim management, resulting in meaningful cost reductions despite stable utilization. Noted that while inpatient utilization was lower due to reduced flu and COVID activity, outpatient costs remain elevated and require active AI-driven management. Identified a modest SG&A expense related to claims adjustment reserves driven by membership growth, which management expects will not recur for the remainder of the year. Our analysts just identified a stock with the potential to be the next Nvidia. Tell us how you invest and we'll show you why it's our #1 pick. Tap here. Management emphasized that unlike peers who delegate risk to providers, Clover retains full risk and economics, using technology to manage a wide-network PPO. This structure allows the company to capture the full benefit of clinical improvements driven by the Clover Assistant platform. Confirmed that new member health trends and Risk Adjustment Factor (RAF) scores are tracking in line with the expectations set during February guidance. Noted that early leading indicators for new cohorts, specifically inpatient and dental utilization, are performing better than or in line with internal targets. Clarified that Q1 SG&A included non-cash 'claims adjustment' reserves that will not recur at the same level for the remainder of the year. Disclosed modest unfavorable prior period development in the quarter due to normal reserve restatements and slight revenue adjustments. One stock. Nvidia-level potential. 30M+ investors trust Moby to find it first. Get the pick. Tap here.