Clover Health Investments (CLOV) investor relations material

Business model and differentiation

• Operates a proprietary technology platform, Clover Assistant, enabling both in-network and employed clinicians to engage members at the point of care.

• Maintains full risk on its entire population, not delegating risk to downstream providers.

• Focuses on the PPO market, with 98% of members enrolled in PPO plans, and is structured to succeed where others are exiting.

• High member retention above 95% is driven by benefit stability and technology-enabled engagement.

Industry trends and market environment

• Industry is experiencing pricing discipline and benefit stability, especially for 2026 and 2027, as a response to recent volatility.

• National players are shifting away from $0 PPO offerings, with continued exits expected into 2027.

• Selective disruption is anticipated in specific geographies, rather than nationwide.

Utilization and margin outlook

• Inpatient and skilled nursing facility utilization trends are favorable, while outpatient trend pressures have moderated since March.

• Margin recovery is expected to be driven by pricing discipline and benefit design changes, leading to increased member shopping and growth.

• Cohort maturation is a key driver, with $70 and $85 per member per month gross profit increases from year one to two and two to three, respectively.