Clover Health Investments (CLOV) investor relations material

Business model and technology differentiation

• Focuses on Medicare Advantage PPO plans, enabling physician choice and leveraging proprietary AI-powered software for earlier diagnosis and treatment of chronic diseases.

• Over two-thirds of members are managed using the Clover Assistant platform, which aggregates data from 100+ sources and provides actionable insights to physicians.

• Clinical studies show earlier diagnosis (e.g., diabetes three years earlier) and lower hospital admissions/readmissions for members using the technology.

• Home care business is MD-led, targeting high-acuity patients for improved outcomes.

• Defensive IP position and decade-long technology development create barriers to entry for competitors.

Financial performance and growth

• Achieved 33-35% year-to-date membership growth and $45 million adjusted EBITDA, outperforming a flat industry.

• Maintains cost ratios comparable to industry despite rapid growth; cost trend normalized at 4% versus 7.5-8% for larger peers.

• SG&A as a percentage of revenue reduced by 370 basis points.

• High voluntary member retention over 90% supports profitability as cohorts mature.

• Focused on core markets (New Jersey, Georgia) with targeted marketing and growth strategies.

Profitability drivers and outlook

• Contribution profit per member per month (PMPM) improves from -$110 for new members to $217 for returning members; both expected to rise in 2026.

• Medical cost ratio improves by 700 basis points from year one to two, and another 700 from year two to three.

• Four-star rating in 2025 expected to add nearly 5% to top line; not all will flow to bottom line due to benefit enhancements.

• SG&A leverage and improved vendor rates anticipated as scale increases.

• 2026 targeted for GAAP net income profitability, with focus on contribution profit as a key metric.