Clover Health Investments, Corp. · NASDAQ:CLOV
Clover Health Investments — Q4 2025 Earnings Presentation
47 slides from Clover Health Investments's earnings presentation, Feb 26, 2026
Slide 1: Fourth Quarter & Full Year 2025 Earnings Conference Call
Fourth Quarter & Full Year 2025 Earnings Conference Call February 26, 2026
Slide 2: Disclaimer
Disclaimer This presentation and the accompanying oral presentation include forward-looking statements, including, without limitation, statements regarding future events and Clover Health Investments, Corp.’s (“Clover Health,” “we,” “our,” or “us”) expectations regarding GAAP Net Income, Adjusted EB
Slide 3: Investment Highlights
Investment Highlights Empowers Any Doctor on Wide Network PPO AI Leader in Model Drives Medicare Advantage Sustainable Growth Models trained to support +53% AEP Growth, >95% improved clinical outcomes retention, stable YoY benefits Platform built AI-first to enable Strong & improving cohort physicia
Slide 4: Leader in AI Enabled Clinical Improvement
Leader in AI Enabled Clinical Improvement Diabetes CKD Earlier Diagnosis Earlier Diagnosis CHF COPD Fewer Hospitalizations Fewer Hospitalizations HEDIS Socioeconomically #1 PPO Nationwide(1) Disadvantaged Impact Clover is at the forefront of applying AI in practice to drive real-world clinical resul
Slide 5: 2025 Accomplishments
2025 Accomplishments 2026 AEP Growth +53%, #1 PPO Plan Nationally up from +27% in 2025(1) on HEDIS Quality(3) High retention in core markets, MA ~97% of members in current 4 Star switchers, minimal e-broker exposure payment year PPO Anticipating FY26 GAAP Net Income Profitability Sustained Adjusted
Slide 6: Fourth Quarter 2025 Business Update
Fourth Quarter 2025 Business Update Growth + Profitability Medicare Advantage Performance ● 4Q Medicare Advantage membership of ~114K ● FY25 meaningfully above-market MA growth, at year-end, +38% YoY sustained profitability & nation-leading quality ● 4Q Total revenues +45% YoY ● Delivered 5% underly
Slide 7: Differentiated Clinical Model Drives Strong & Predictable Cohort Performance
Differentiated Clinical Model Drives Strong & Predictable Cohort Performance Contribution Profit (Loss) ($PMPM)(1) 2024 2025 2026 2024 2025 2026 Strong returning cohort performance expected to improve, reinforcing confidence to drive future earnings growth & margin expansion in 2026 & beyond (1) Rep
Slide 8: Drivers Reinforcing Expected Better 2026 Cohort Economics
Drivers Reinforcing Expected Better 2026 Cohort Economics Financial impact of 4.0 Star 2026 payment year Favorable 2026 CMS final rate update Strong returning member retention Increasing Clover Assistant coverage Continued operating leverage as SG&A efficiency improves with scale 8
Slide 9: Validated 2025 Strategy and Stable Benefits YoY Reinforce 26 Underwriting Confidence & Growth
Validated 2025 Strategy and Stable Benefits YoY Reinforce 2026 Underwriting Confidence & Growth Proven MA Membership Growth Replicated Growth Strategy (1) Year 2 of Above-Market Growth +46% Same 2025 strategy; accelerated in 2026 Growth YoY Stable Benefits Year-over-Year +33% Predictable growth; hig
Slide 10: Clinical Model Increases Member Lifetime Value
Clinical Model Increases Member Lifetime Value Insurance Gross Profit ($PMPM) Clover Assistant MCR Differential by Year(1) Differential by Tenure(2) Cohorts perform increasingly better over time, establishing foundation for long-term MA success (1) Clover Health cohort information represents incurre
Slide 11: Anticipate Sustained Improvement as Cohorts Mature
Anticipate Sustained Improvement as Cohorts Mature Average MCR Differential by Cohort Year(1) (1) Clover Health cohort information represents incurred membership data from dates of service including 2021 through 2025. Within any given performance year, MCR differential represents the member weighted
Slide 12: Guidance
Guidance On the following slides, Clover Health presents an overview of its full year 2026 guidance, including certain non-GAAP financial measures.
Slide 13: Full Year 2026 Guidance Review
Full Year 2026 Guidance Review Full-Year 2026 Guidance (2/26/26) Total Revenues $2.81B - $2.92B Consolidated Gross Profit(1) $470M - $510M Adjusted EBITDA(1) $50M - $70M GAAP Net Income $0M - $20M Average Medicare Advantage 154,000 - 158,000 Membership (1) Adjusted EBITDA and Consolidated Gross Prof
Slide 14: Full Year 2026 Profitability Drivers
Full Year 2026 Profitability Drivers Illustrative – Not to Scale FY25 FY26 Adj. EBITDA(1) Adj. EBITDA(1) Results Guidance More profitable Non-recurring returning cohort Favorable 4 Star Increasing abnormal DME / Part D Continued base via strong 2026 Rate financial CA dental activity optimization SG&
Slide 15: Fourth Quarter & Full-Year 2025 Financial Supplement
Fourth Quarter & Full-Year 2025 Financial Supplement
Slide 16: Financial Summary
Financial Summary Growth & ● Year-end 2025 MA membership of 113,803, up 38% YoY Profitability ● FY25 GAAP Net loss of ($86M), Adj. EBITDA(1) of $22M, and Adj. Net income(2) of $20M ● 4Q25 Insurance revenue of $486M, bringing FY25 Insurance revenue to $1.9B, up 41% YoY ● FY25 underlying incurred medi
Slide 17: 4Q25 Financial Performance: Insurance Revenue
4Q25 Financial Performance: Insurance Revenue In millions, except BER Insurance Revenue +41% +47% Insurance BER:(1) 82.8% 95.0% Insurance BER:(1) 81.2% 90.9% Consolidatedttt Consolidatedttt $94M $74M $365M $356M Gross Profit:(2) Gross Profit:(2) ● 4Q & FY25 revenue, Consolidated gross profit, and BE
Slide 18: 4Q25 Financial Performance: Adjusted SG&A
4Q25 Financial Performance: Adjusted SG&A(1) In millions, except % Adjusted SG&A as % of Total Revenues (6%) (4%) Adj. SG&A: $86M $98M $295M $334M ● 4Q & FY25 Adjusted SG&A reflects our ability to gain operating leverage amidst increased variable & growth SG&A to support new member growth & our cont
Slide 19: 4Q25 Financial Performance: Profitability Metrics
4Q25 Financial Performance: Profitability Metrics In millions, except MA membership Adjusted Net (loss) Income(1) 4Q25 Avg. MA: 82,209 112,654 80,561 107,084 Membership: ● 4Q & FY25 Adjusted Net (loss) Income is a result of well controlled underlying medical cost trend, strong cohort management, mea
Slide 20: 4Q25 Financial Performance: Profitability Metrics
4Q25 Financial Performance: Profitability Metrics In millions, except MA membership Adjusted EBITDA(1) 4Q25 Avg. MA: 82,209 112,654 80,561 107,084 Membership: ● 4Q & FY25 Adjusted EBITDA a result of well controlled underlying medical cost trend, strong cohort management, meaningfully above-market MA
Slide 21: Appendix
Appendix
Slide 22: Our Vision
Our Vision Empower Every Physician with Technology to Identify, Manage & Treat Chronic Diseases Earlier Earlier Diagnosis Earlier Disease Higher Quality Affordable & & Treatment Management Clinical Care Accessible Care 22
Slide 23: Our Company
Our Company Leading Medicare Advantage physician enablement technology company focused on wide network PPO AI-Powered Differentiated Clover Assistant(1) Home Care Significant TAM & Strategic Market Market Runway Leading Growth 23 (1) Backed by strong IP portfolio with dozens of active / pending pate
Slide 24: Differentiated, Tech-Centric Model Focused on Improving Clinical Care Outcomes via Software
Differentiated, Tech-Centric Model Focused on Improving Clinical Care Outcomes via Software Clover’s Approach Traditional MA Approaches Clinical, physician enablement, Technology InsurTech, back-office & administrative AI-Powered technology Earlier disease identification & management Delayed / react
Slide 25: Having Supported Clinical Decision-Making for Thousands of Practitioners
Having Supported Clinical Decision-Making for Thousands of Practitioners Captures & synthesizes Novel clinical insights data from 100+ sources at point-of-care Enhanced care coordination 100+ AI / ML models powering treatment Generating millions of recommendations clinically oriented and personalize
Slide 26: Our Technology-Driven Approach is Working
Our Technology-Driven Approach is Working Grow Membership & Clover Assistant Usage 1 Reinvest in Deliver Better AI Driven Member Benefits 5 2 Clinical Recommendations Reduce the Improve Health Outcomes 4 3 Total Cost of Care & Quality of Life 26
Slide 27: Improving Cohorts + Growing Membership = Compounding Profitability Over Time
Improving Cohorts + Growing Membership = Compounding Profitability Over Time Improving Cohort Membership Differentiated Economics Growth Layering Effect Growing Membership Layered Cohort Profitability Note: Illustrative, Not to Scale. 27
Slide 28: Bringing Clover's Care Model to More Plans & Providers Nationwide
Bringing Clover’s Care Model to More Plans & Providers Nationwide Proven SaaS & Rapidly Extensive AI-Powered Tech-Enabled Expanding Nationwide Clinical Software Services User Base Opportunity #1 Nation PPO HEDIS(1) New revenue model CA beyond core MA markets Scaling CPH alongside (2) (3) Improves MC
Slide 29: Better Health Outcomes Across Chronic Conditions
Better Health Outcomes Across Chronic Conditions Clover Assistant Whitepapers and Case Studies(1) Using proprietary AI & ML models, Clover Assistant improves care coordination for doctors and is correlated with improved patient health outcomes Diabetes: Earlier diagnosis, leading to earlier treatmen
Slide 30: Clover Assistant Enables Better Care for Patients from Socioeconomically Disadvantaged Neighborhoods
Clover Assistant Enables Better Care for Patients from Socioeconomically Disadvantaged Neighborhoods Higher Diagnosis Rates(1) of diabetes (75% higher), CKD (89% higher), CHF (89% higher) and COPD (70% higher) Diagnosis at Earlier Stages: Patients from this population with CKD first diagnosed on ave
Slide 31: Kidney Function (GFR)
Clover Health Whitepaper Earlier Diagnosis Leads to Earlier Treatment CKD is diagnosed earlier and disease trajectory improves in patients seen by providers using Clover Assistant(1) Example: Chronic Kidney Disease Kidney Function (GFR) Diagnosed CKD Stage 3 CA Patients Diagnosed CKD Stage 3 ~1.5 ye
Slide 32: Diabetes Medication Fills Members Newly Diagnosed with Diabetes
Clover Health Whitepaper Earlier Diagnosis Leads to Earlier Treatment Patients started on oral diabetic medications Members Newly Diagnosed with Diabetes (1) after Clover Assistant raised potential diabetes diagnosis for physician Example: Diabetes consideration(2) Diabetes Medication Fills Days Sin
Slide 33: Hypoglycemia Event
Clover Health Whitepaper Earlier Diabetes Treatment Leads to: Oral Meds Started Blood Sugar Indicator Non-CA Patients (HbA1c) Diabetes Diagnosed & Managed ~3 Years Earlier(1) Oral Meds Started CA Patients Time (Years) Percentage Taking Non-CA Patients Insulin Lower Use of Insulin(1) CA Patients Hypo
Slide 34: Congestive Heart Failure Hospitalization & Readmissions
Clover Health Whitepaper Non-CA CHF Cohort CA CHF Cohort Clover Assistant Clover Assistant PCP relationship associated with Supports Better better clinical outcomes, including a lower average number of all-cause hospitalizations and 30-day Clinical Outcomes readmissions for members with CHF(1) (18%)
Slide 35: COPD Hospitalization & Readmissions
Clover Health Whitepaper Non-CA COPD Cohort CA COPD Cohort Chronic Obstructive Clover Assistant PCP relationship associated with Pulmonary Disease better clinical outcomes, including a lower average number of all-cause hospitalizations and 30-day (“COPD”) readmissions for members with COPD(1) Averag
Slide 36: Percent with Medication Fill
Clover Health Whitepaper Clover Assistant Correlated with Medication fills increased by ~5% on the day of the Clover Assistant visit and remained ~3% higher 90 days post-visit among patients previously non-adherent to Improved Medication their medications for diabetes, high blood pressure, and high
Slide 37: Clover Top Rated PPO Plan in the Nation on HEDIS Measures for the Second Consecutive Year
Clover Top Rated PPO Plan in the Nation on HEDIS Measures for the Second Consecutive Year(1) Clover Health 4.72 / 5 Stars on HEDIS Measures for Star Rating Year 2026, continuing to drive exceptional clinical quality for members(1) (1) Clover Health’s Medicare Advantage PPO plans received a score of
Slide 38: Financial Statements: Consolidated Balance Sheets
Financial Statements Consolidated Balance Sheets (Dollars in thousands, except share amounts) (unaudited) 38
Slide 39: Financial Statements: Statements of Operations and Comprehensive Loss
Financial Statements Consolidated Statements of Operations and Comprehensive Loss (Dollars in thousands, except per share and share amounts) (unaudited) 39
Slide 40: Financial Statements: Statements of Cash Flows
Financial Statements Consolidated Statements of Cash Flows (Dollars in thousands) (unaudited) 40
Slide 41: Financial Statements: Operating Segments
Financial Statements Operating Segments (Dollars in thousands) (unaudited) 41
Slide 42: Non-GAAP Financial Measures
Non-GAAP Financial Measures CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES CONSOLIDATED GROSS PROFIT (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-GAAP financial measures. Non-GAAP financial measures are supplemental and shou
Slide 43: Non-GAAP Financial Measures (continued)
Non-GAAP Financial Measures (continued) CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES ADJUSTED SG&A (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-GAAP financial measures. Non-GAAP financial measures are supplemental and shou
Slide 44: Non-GAAP Financial Measures (continued)
Non-GAAP Financial Measures (continued) CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES ADJUSTED EBITDA (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-GAAP financial measures. Non-GAAP financial measures are supplemental and sh
Slide 45: Non-GAAP Financial Measures (continued)
Non-GAAP Financial Measures (continued) CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES ADJUSTED NET (LOSS) INCOME FROM CONTINUING OPERATIONS (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-GAAP financial measures. Non-GAAP fina
Slide 46: Non-GAAP Financial Measures (continued)
Non-GAAP Financial Measures (continued) CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES INSURANCE BENEFITS EXPENSE RATIO (NON-GAAP) AND NORMALIZED INSURANCE BENEFITS EXPENSE RATIO (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-
Slide 47: About Non-GAAP Financial Measures
About Non-GAAP Financial Measures We use non-GAAP financial measures in this presentation, including Adjusted EBITDA, Adjusted Net (loss) income from continuing operations, Adjusted SG&A, Adjusted SG&A as a percentage of Total revenues, Consolidated Gross Profit, Insurance BER, and Normalized Insura
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