CLOVER HEALTH INVESTMENTS, CORP. /DE

Previous wording

The following discussion and analysis provides information that management believes is relevant to an assessment and understanding of our condensed consolidated results of operations and financial condition. The discussion should be read in conjunction with the unaudited condensed consolidated financial statements and notes thereto for the three and six months ended June 30, 2025, contained in this Quarterly Report on Form 10-Q (the "Form 10-Q") and the audited consolidated financial statements and notes thereto for the year ended December 31, 2024, contained in the Company's Annual Report on Form 10-K for the year ended December 31, 2024, filed with the Securities and Exchange Commission (the "SEC") on March 3, 2025 (the "2024 Form 10-K"). This discussion contains forward-looking statements and involves numerous risks and uncertainties, including, but not limited to, those described in the "Risk Factors" section of the 2024 Form 10-K. Actual results may differ materially from those contained in any forward-looking statements. See "Cautionary Note Regarding Forward-Looking Statements" for additional information. Unless the context otherwise requires, references in this "Management's Discussion and Analysis of Financial Condition and Results of Operations" to "we," "us," "our," "Clover," "Clover Health," and the "Company" mean the business and operations of Clover Health Investments, Corp. and its consolidated subsidiaries.

Current wording

The following discussion and analysis provides information that management believes is relevant to an assessment and understanding of our condensed consolidated results of operations and financial condition. The discussion should be read in conjunction with the unaudited condensed consolidated financial statements and notes thereto for the three and nine months ended September 30, 2025, contained in this Quarterly Report on Form 10-Q (the "Form 10-Q") and the audited consolidated financial statements and notes thereto for the year ended December 31, 2024, contained in the Company's Annual Report on Form 10-K for the year ended December 31, 2024, filed with the Securities and Exchange Commission (the "SEC") on March 3, 2025 (the "2024 Form 10-K"). This discussion contains forward-looking statements and involves numerous risks and uncertainties, including, but not limited to, those described in the "Risk Factors" section of the 2024 Form 10-K. Actual results may differ materially from those contained in any forward-looking statements. See "Cautionary Note Regarding Forward-Looking Statements" for additional information. Unless the context otherwise requires, references in this "Management's Discussion and Analysis of Financial Condition and Results of Operations" to "we," "us," "our," "Clover," "Clover Health," and the "Company" mean the business and operations of Clover Health Investments, Corp. and its consolidated subsidiaries.

Previous wording

We operate Preferred Provider Organization ("PPO") and Health Maintenance Organization ("HMO") Medicare Advantage ("MA") plans for Medicare-eligible individuals. We aim to provide high-quality, affordable healthcare for all Medicare beneficiaries. Among plans with similar major characteristics, we offer most members in our MA plans (the "members") among the lowest average out-of-pocket costs for primary care provider and specialist co-pays in their markets. We strongly believe in providing our members provider choice, and we consider our PPO plans to be our flagship insurance product. An important feature of our MA product is wide network access. We believe the use of Clover Assistant and related data insights allows us to improve clinical decision-making through a highly scalable platform. At June 30, 2025, we operated our MA plans in five states and 200 counties, with 106,323 members.

Current wording

We operate Preferred Provider Organization ("PPO") and Health Maintenance Organization ("HMO") Medicare Advantage ("MA") plans for Medicare-eligible individuals. We aim to provide high-quality, affordable healthcare for all Medicare beneficiaries. Among plans with similar major characteristics, we offer most members in our MA plans (the "members") among the lowest average out-of-pocket costs for primary care provider and specialist co-pays in their markets. We strongly believe in providing our members provider choice, and we consider our PPO plans to be our flagship insurance product. An important feature of our MA product is wide network access. We believe the use of Clover Assistant and related data insights allows us to improve clinical decision-making through a highly scalable platform. At September 30, 2025, we operated our MA plans in five states and 200 counties, with 109,226 members.

Previous wording

Benefits expense ratio ("Insurance BER") is a non-GAAP financial measure. 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. 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.

Current wording

Benefits expense ratio ("Insurance BER") is a non-GAAP financial measure. 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. 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. Furthermore, Normalized Insurance BER adjusts out activity related to prior period development. Prior period development refers to changes in the Company’s Insurance Revenue and Insurance Medical claims levels from previous periods. Management believes that Normalized Insurance BER presents a clearer representation of performance during the current period being presented.

Previous wording

Adjusted EBITDA is a non-GAAP financial measure defined by us as net (loss) income from continuing operations before depreciation and amortization, loss on investment, interest expense, change in fair value of warrants, 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.

Current wording

Adjusted EBITDA is a non-GAAP financial measure defined by us as net loss from continuing operations before depreciation and amortization, loss on investment, interest expense, change in fair value of warrants, stock-based compensation, premium deficiency reserve expense, restructuring (recoveries) 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.

Previous wording

Adjusted Net income from continuing operations is a non-GAAP financial measure defined by us as net (loss) income from continuing operations before stock-based compensation, premium deficiency reserve benefit, restructuring costs, non-recurring legal expenses and settlement, and impairment of goodwill and other intangible assets. Adjusted Net income from continuing operations 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 from continuing operations is helpful to investors in assessing the Company’s financial performance in the same manner as our management and our board of directors.

Current wording

Adjusted Net income from continuing operations is a non-GAAP financial measure defined by us as net loss from continuing operations before stock-based compensation, premium deficiency reserve benefit, restructuring (recoveries) costs, non-recurring legal expenses and settlement, and impairment of goodwill and other intangible assets. Adjusted Net income from continuing operations 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 from continuing operations is helpful to investors in assessing the Company’s financial performance in the same manner as our management and our board of directors.

Previous wording

Premiums earned, net increased $119.9 million, or 34%, to $469.8 million for the three months ended June 30, 2025, compared to the three months ended June 30, 2024. The increase was primarily driven by growth in our average members over the period, which increased approximately 32%.

Current wording

Premiums earned, net increased $156.5 million, or 49%, to $479.1 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. The increase was primarily driven by growth in our average members over the period, which increased approximately 35%.

Previous wording

Other income increased by $1.4 million, or 23%, to $7.8 million for the three months ended June 30, 2025, compared to the three months ended June 30, 2024. The increase was primarily driven by an increase in fair value of our equity investments.

Current wording

Other income increased by $9.1 million, or 108%, to $17.5 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. The increase was primarily driven by an increase in fair value of our equity investments.

Previous wording

Net medical claims incurred increased $129.6 million, or 52%, to $378.0 million for the three months ended June 30, 2025, compared to the three months ended June 30, 2024. The increase was primarily driven by growth in our average members during the period, which increased approximately 32% and an increase in our Part D cost sharing due to changes arising from the Inflation Reduction Act. Additionally, prior year amounts were impacted by more favorable prior period developments as compared to the current year.

Current wording

Net medical claims incurred increased $173.7 million, or 70%, to $423.5 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. The increase was primarily driven by growth in our average members during the period, which increased approximately 35% and an increase in our Part D cost sharing due to changes arising from the Inflation Reduction Act. Additionally, prior year amounts were impacted by more favorable prior period developments as compared to the current year.

Previous wording

General and administrative expenses increased $4.1 million, or 9%, to $48.5 million for the three months ended June 30, 2025, compared to the three months ended June 30, 2024. The increase was primarily driven by higher professional fees and higher broker fees, with the latter being driven by membership growth during the most recent annual enrollment period.

Current wording

General and administrative expenses increased $13.8 million, or 39%, to $49.0 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. The increase was primarily driven by higher professional fees and higher broker fees, with the latter being driven by membership growth during the most recent annual enrollment period.

Previous wording

The following table summarizes our condensed consolidated results of operations for the six months ended June 30, 2025 and 2024. The period-to-period comparison of results is not necessarily indicative of results for future periods.

Current wording

The following table summarizes our condensed consolidated results of operations for the nine months ended September 30, 2025 and 2024. The period-to-period comparison of results is not necessarily indicative of results for future periods.

Previous wording

Premiums earned, net increased $235.1 million, or 34%, to $926.7 million for the six months ended June 30, 2025, compared to the six months ended June 30, 2024. The increase was primarily driven by growth in our average members over the period, which increased approximately 30%.

Current wording

Premiums earned, net increased $391.7 million, or 39%, to $1,405.9 million for the nine months ended September 30, 2025, compared to the nine months ended September 30, 2024. The increase was primarily driven by growth in our average members over the period, which increased approximately 32%.

Previous wording

Other income increased by $1.7 million, or 14%, to $13.2 million for the six months ended June 30, 2025, compared to the six months ended June 30, 2024. The increase was primarily driven by an increase in fair value of our equity investments.

Current wording

Other income increased by $10.8 million, or 54%, to $30.7 million for the nine months ended September 30, 2025, compared to the nine months ended September 30, 2024. The increase was primarily driven by an increase in fair value of our equity investments.

Previous wording

Net medical claims incurred increased $217.9 million, or 42%, to $731.4 million for the six months ended June 30, 2025, compared to the six months ended June 30, 2024. The increase was primarily driven by growth in our average members during the period, which increased approximately 30% and an increase to our Part D cost sharing due to changes arising from the Inflation Reduction Act. Additionally, prior year amounts were impacted by more favorable prior period developments as compared to the current year.

Current wording

Net medical claims incurred increased $391.6 million, or 51%, to $1,154.9 million for the nine months ended September 30, 2025, compared to the nine months ended September 30, 2024. The increase was primarily driven by growth in our average members during the period, which increased approximately 32% and an increase to our Part D cost sharing due to changes arising from the Inflation Reduction Act. Additionally, prior year amounts were impacted by more favorable prior period developments as compared to the current year.

Previous wording

General and administrative expenses increased $10.2 million, or 11%, to $99.2 million for the six months ended June 30, 2025, compared to the six months ended June 30, 2024. The increase was primarily driven by higher professional fees and higher broker fees, with the latter being driven by membership growth during the most recent annual enrollment period.

Current wording

General and administrative expenses increased $23.9 million, or 19%, to $148.1 million for the nine months ended September 30, 2025, compared to the nine months ended September 30, 2024. The increase was primarily driven by higher professional fees and higher broker fees, with the latter being driven by membership growth during the most recent annual enrollment period.

Previous wording

Our cash equivalents and investment securities consist primarily of money market funds, U.S. government debt securities, and corporate debt securities. At June 30, 2025 and December 31, 2024, total cash, cash equivalents, and investments were $389.3 million and $437.6 million, respectively. These totals consist of $200.6 million and $243.1 million at June 30, 2025 and December 31, 2024, respectively, that specifically relate to available-for-sale and held-to-maturity investment securities.

Current wording

Our cash equivalents and investment securities consist primarily of money market funds, U.S. government debt securities, and corporate debt securities. At September 30, 2025 and December 31, 2024, total cash, cash equivalents, and investments were $395.9 million and $437.6 million, respectively. These totals consist of $205.9 million and $243.1 million at September 30, 2025 and December 31, 2024, respectively, that specifically relate to available-for-sale and held-to-maturity investment securities.

Previous wording

At June 30, 2025 and December 31, 2024, total cash, cash equivalents, and investments for the parent company, Clover Health Investments, Corp., and unregulated subsidiaries were $145.9 million and $151.5 million, respectively. We operate as a holding company in a highly regulated industry. As such, we may receive dividends and administrative expense reimbursements from our subsidiaries, two of which are subject to regulatory restrictions. We continue to maintain significant levels of aggregate excess statutory capital and surplus in our state-regulated insurance subsidiaries.

Current wording

At September 30, 2025 and December 31, 2024, total cash, cash equivalents, and investments for the parent company, Clover Health Investments, Corp., and unregulated subsidiaries were $122.9 million and $151.5 million, respectively. We operate as a holding company in a highly regulated industry. As such, we may receive dividends and administrative expense reimbursements from our subsidiaries, two of which are subject to regulatory restrictions. We continue to maintain significant levels of aggregate excess statutory capital and surplus in our state-regulated insurance subsidiaries.

Previous wording

At June 30, 2025 and December 31, 2024 total cash, cash equivalents, and investments for our regulated subsidiaries were $243.4 million and $286.1 million, respectively. Additionally, our regulated insurance subsidiaries held $200.6 million and $243.1 million of available-for-sale and held-to-maturity investment securities at June 30, 2025 and December 31, 2024, respectively. Our use of operating cash derived from our unregulated subsidiaries is generally not restricted by departments of insurance (or comparable state regulatory agencies). Our regulated insurance subsidiaries are subject to regulations and standards in their respective jurisdictions on their ability to declare and pay dividends to the parent. As of June 30, 2025, there have been no dividends paid to the parent. Insurance regulators have broad powers to prevent reduction of statutory surplus to inadequate levels, and there is no assurance that dividends of the maximum amounts calculated under any applicable formula would be permitted. State insurance regulatory authorities that have jurisdiction over the payment of dividends by our regulated insurance subsidiary may in the future adopt statutory provisions more restrictive than those currently in effect.

Current wording

At September 30, 2025 and December 31, 2024 total cash, cash equivalents, and investments for our regulated subsidiaries were $273.0 million and $286.1 million, respectively. Additionally, our regulated insurance subsidiaries held $205.9 million and $243.1 million of available-for-sale and held-to-maturity investment securities at September 30, 2025 and December 31, 2024, respectively. Our use of operating cash derived from our unregulated subsidiaries is generally not restricted by departments of insurance (or comparable state regulatory agencies). Our regulated insurance subsidiaries are subject to regulations and standards in their respective jurisdictions on their ability to declare and pay dividends to the parent. As of September 30, 2025, there have been no dividends paid to the parent. Insurance regulators have broad powers to prevent reduction of statutory surplus to inadequate levels, and there is no assurance that dividends of the maximum amounts calculated under any applicable formula would be permitted. State insurance regulatory authorities that have jurisdiction over the payment of dividends by our regulated insurance subsidiary may in the future adopt statutory provisions more restrictive than those currently in effect.

Previous wording

The following table summarizes our condensed consolidated cash flows for the six months ended June 30, 2025 and 2024.

Current wording

The following table summarizes our condensed consolidated cash flows for the nine months ended September 30, 2025 and 2024.

Previous wording

For the six months ended June 30, 2025, Net cash used in operating activities from continuing operations was $10.9 million, which reflects a Net loss from continuing operations of $11.9 million. Non-cash activities primarily included a $52.6 million charge to Stock-based compensation expense.

Current wording

For the nine months ended September 30, 2025, Net cash used in operating activities from continuing operations was $1.2 million, which reflects a Net loss from continuing operations of $36.2 million. Non-cash activities primarily included a $78.7 million charge to Stock-based compensation expense.

Previous wording

For the six months ended June 30, 2024, Net cash provided by operating activities from continuing operations was $79.7 million, which reflects a Net loss from continuing operations of $7.2 million. Non-cash activities primarily included a $56.7 million charge to Stock-based compensation expense and Unpaid claims increased by $63.5 million.

Current wording

For the nine months ended September 30, 2024, Net cash provided by operating activities from continuing operations was $129.5 million, which reflects a Net loss from continuing operations of $24.8 million. Non-cash activities primarily included a $84.7 million charge to Stock-based compensation expense and Unpaid claims increased by $30.3 million.

Previous wording

Net cash provided by investing activities for the six months ended June 30, 2025 of $44.5 million was primarily due to $105.1 million provided from the sales and maturities of investment securities. This was offset by $59.9 million used to purchase investments.

Current wording

Net cash provided by investing activities for the nine months ended September 30, 2025 of $39.1 million was primarily due to $139.5 million provided from the sales and maturities of investment securities. This was offset by $99.0 million used to purchase investments.

Previous wording

Net cash provided by investing activities for the six months ended June 30, 2024, of $14.1 million was primarily due to $66.7 million provided from the sales and maturities of investment securities. This was offset by $51.7 million used to purchase investments.

Current wording

Net cash provided by investing activities for the nine months ended September 30, 2024, of $2.0 million was primarily due to $156.6 million provided from the sales and maturities of investment securities. This was offset by $153.3 million used to purchase investments.

Previous wording

Net cash used in financing activities for the six months ended June 30, 2025 of $39.5 million was primarily the result of cash paid for shares withheld related to stock-based compensation totaling $22.1 million and share repurchases totaling $18.3 million of Class A Common stock.

Current wording

Net cash used in financing activities for the nine months ended September 30, 2025 of $44.8 million was primarily the result of cash paid for shares withheld related to stock-based compensation totaling $27.7 million and share repurchases totaling $18.3 million of Class A Common stock.

Previous wording

Net cash used in financing activities for the six months ended June 30, 2024 of $6.6 million was primarily the result of cash paid for shares withheld related to stock-based compensation totaling $4.8 million.

Current wording

Net cash used in financing activities for the nine months ended September 30, 2024 of $11.2 million was primarily the result of cash paid for shares withheld related to stock-based compensation totaling $9.7 million and repurchases of $1.8 million of Class A Common stock.