Clover Health Investments, Corp. · NASDAQ:CLOV
Clover Health Investments — Q3 2025 Earnings Presentation
42 slides from Clover Health Investments's earnings presentation, Nov 4, 2025
Slide 1: Third Quarter 2025 Earnings Conference Call
Third Quarter 2025 Earnings Conference Call November 4, 2025
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 Adjusted EBITDA, Adjusted Ne
Slide 3: Third Quarter 2025 Business Update
Third Quarter 2025 Business Update Growth + Profitability Medicare Advantage Performance ● 3Q Medicare Advantage membership +35% YoY ● 3Q margin pressures from higher-than-expected ● 3Q Insurance revenue +49% YoY mix of new members, relative to returning base ● 3Q Adj. EBITDA & Adj. Net income of $2
Slide 4: Well Positioned for Above-Market Growth & Profitability Expansion in 2026 & Beyond
Well Positioned for Above-Market Growth & Profitability Expansion in 2026 & Beyond Clover Drivers Industry Tailwinds SG&A Optimization Anticipate strong retention & continued improvement Favorable impact from Fixed / Growth / Variable of larger, profitable returning member cohort CMS final rate noti
Slide 5: Poised for Continued Growth
Poised for Continued Growth Average Medicare Advantage Membership(1) Average Membership by Type(2) +33% >90% Historical retention and industry disruption positions Clover for strong 2026 returning member retention and continued growth (1) Expected year ended 2025 average Medicare Advantage membershi
Slide 6: Clinical Model Drives Strong Cohort Performance
Clinical Model Drives Strong Cohort Performance Average MCR Differential by Cohort Year(1) Returning member cohorts perform increasingly better, with strong long-term value, establishing foundation for continued MA success (1) Clover Health cohort information represents incurred membership data from
Slide 7: Clinical Model Drives Strong Cohort Performance (continued)
Clinical Model Drives Strong Cohort Performance (continued) Contribution Profit (Loss) ($PMPM)(1) Strong returning cohort performance expected to improve, reinforcing confidence to drive future earnings growth & margin expansion in 2026 & beyond (1) Represents Incurred contribution profit (loss) for
Slide 8: Confident to Grow Above-Market and Expand Profitability in 2026 & Beyond
Confident to Grow Above-Market and Expand Profitability in 2026 & Beyond Anticipate Larger Cohort of Returning Members via Strong Retention Expect Increasingly Better Performing Returning Member Cohorts Expect Contribution Profit-Positive Returning Members to Fund Future New Member Growth Anticipate
Slide 9: 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 10: 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 11: Guidance
Guidance On the following slides, Clover Health presents an overview of its full year 2025 guidance, including certain non-GAAP measures.
Slide 12: Updated Full Year 2025 Guidance
Updated Full Year 2025 Guidance Updated FY25 Guidance Prior FY25 Guidance (11/4/25) (8/5/25) Insurance Revenue $1.85B - $1.88B $1.800B - $1.875B Adjusted SG&A(1) $325M - $335M $335M - $345M Adjusted SG&A 17% - 18% 18% - 19% as a % of Total Revenues Adjusted EBITDA(1) $15M - $30M $50M - $70M Adjusted
Slide 13: Full Year 2025 Profitability Drivers
Full Year 2025 Profitability Drivers Illustrative – Not to Scale FY24 Prior FY25 Updated FY25 Adj. EBITDA(1) Adj. EBITDA(1) Adj. EBITDA(1) Results Guidance Guidance Loss Ratio Impact SG&A Further Increased from Returning Optimization via SG&A Investment Member Cohort Cost Efficiency Optimization Inc
Slide 14: Third Quarter 2025 Financial Supplement
Third Quarter 2025 Financial Supplement
Slide 15: Financial Summary
Financial Summary ● 3Q25 MA membership of 109,226, up 35% YoY Growth & ● 3Q25 GAAP Net loss of ($24M), Adj. EBITDA(1) of $2M, and Adj. Net income(2) of $2M Profitability ● Year-to-date GAAP Net loss of ($36M) ● Year-to-date Adj. EBITDA(1) of $45M and Adj. Net income(2) of $44M ● 3Q25 Insurance reven
Slide 16: 3Q25 Financial Performance: Insurance
3Q25 Financial Performance: Insurance In millions, except BER Insurance Revenue +39% +49% BER: 82.8% 93.5% BER: 80.6% 89.4% Insurance: Insurance: $71M $50M $247M $215M Gross Profit: Gross Profit: ● 3Q & YTD 2025 revenue and BER performance driven by continued intra-year MA membership growth and rete
Slide 17: 3Q25 Financial Performance: Profitability Metrics
3Q25 Financial Performance: Profitability Metrics In millions, except MA membership Adjusted Net Income(1) Avg. MA: 80,753 108,231 80,011 105,228 Membership: ● 3Q & YTD 2025 Adjusted Net Income as a result of strong MA membership growth, cohort management, and continued focus on SG&A optimization, o
Slide 18: 3Q25 Financial Performance: Profitability Metrics
3Q25 Financial Performance: Profitability Metrics In millions, except MA membership Adjusted EBITDA(1) Avg. MA: 80,753 108,231 80,011 105,228 Membership: ● 3Q & YTD 2025 Adjusted EBITDA as a result of strong MA membership growth, cohort management, and continued focus on SG&A optimization, offset by
Slide 19: 3Q25 Financial Performance: Adjusted SG&A
3Q25 Financial Performance: Adjusted SG&A(1) In millions, except % Adjusted SG&A as % of Total Revenue (5%) (3%) Adj. SG&A: $62M $71M $209M $237M ● 3Q & YTD 2025 Adjusted SG&A reflects our ability to gain operating leverage amidst increased variable & growth SG&A to support new membership growth and
Slide 20: Appendix
Appendix
Slide 21: Investment Highlights
Investment Highlights Leading Physician Enablement Technology Company: Offering Medicare Advantage plans focused on affordability, accessibility, and choice AI-Powered Platform: Clover Assistant (CA) technology empowers physicians with AI-driven clinical recommendations to support better decisions &
Slide 22: 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 23: Our Vision: Empower Every Physician with Technology to Identify, Manage & Treat Chronic Diseases Earlier
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 23
Slide 24: Clover's Next Phase: Profitable Growth
Clover’s Next Phase: Profitable Growth 2018 2022 2025 & Beyond Growth Profitability Innovation 24
Slide 25: 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 26: 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 27: 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 27
Slide 28: 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 29: 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 30: 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 31: 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 32: 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 33: 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 34: Financial Statements: Condensed Consolidated Balance Sheets
Financial Statements Condensed Consolidated Balance Sheets (Dollars in thousands, except share amounts) (unaudited) 34
Slide 35: Financial Statements: Statements of Operations and Comprehensive Loss
Financial Statements Condensed Consolidated Statements of Operations and Comprehensive Loss (Dollars in thousands, except per share and share amounts) (unaudited) 35
Slide 36: Financial Statements: Statements of Cash Flows
Financial Statements Condensed Consolidated Statements of Cash Flows (Dollars in thousands) (unaudited) 36
Slide 37: Financial Statements: Operating Segments
Financial Statements Operating Segments (Dollars in thousands) (unaudited) 37
Slide 38: Non-GAAP Financial Measures
Non-GAAP Financial Measures 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 measures. Non-GAAP financial measures are supplemental and should not be considered a
Slide 39: 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 measures. Non-GAAP financial measures are supplemental and should not b
Slide 40: Non-GAAP Financial Measures (continued)
Non-GAAP Financial Measures (continued) CLOVER HEALTH INVESTMENTS, CORP. RECONCILIATION OF NON-GAAP FINANCIAL MEASURES ADJUSTED NET INCOME FROM CONTINUING OPERATIONS (NON-GAAP) RECONCILIATION (in thousands)(1) (unaudited) (1) The table above includes non-GAAP measures. Non-GAAP financial measures ar
Slide 41: 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 42: About Non-GAAP Financial Measures
About Non-GAAP Financial Measures We use non-GAAP measures in this presentation, including Adjusted EBITDA, Adjusted Net income from continuing operations, Adjusted SG&A, Insurance BER, and Normalized Insurance BER. These non-GAAP financial measures are provided to enhance the reader’s understanding
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