Clover Health Investments (CLOV) Q1 2026 earnings summary

Executive summary

• Achieved GAAP Net Income of $27.3 million in Q1 2026, a $29 million year-over-year improvement, with total revenues up 62% to $749.2 million and Medicare Advantage membership up 51% to 155,773 members.

• Adjusted EBITDA rose 56% to $40.3 million and Adjusted Net Income increased 57% to $39.7 million, reflecting strong operational leverage and membership growth.

• Clinical model and AI-driven platform drove improved outcomes, retention, and profitability, with #1 PPO plan ranking on HEDIS quality measures for the second consecutive year.

• Focused on expanding technology-driven care management through Clover Assistant and Counterpart Health SaaS offerings, with a 450% YoY increase in third-party customer users.

• Largest PPO in New Jersey outside of special needs and employer retiree plans, with strong integration in core markets.

Financial highlights

• Medicare Advantage membership grew by 51% to 155,773, driving $749.2 million in revenue, up 62% year-over-year.

• Consolidated gross profit was $160 million, up 47% year-over-year, with insurance segment gross profit at $134 million.

• Adjusted SG&A as a percentage of total revenues improved to 15.9% from 18.0% year-over-year, a 210 basis point improvement.

• Insurance Benefits Expense Ratio (BER) was 86.5%, up slightly from 86.1% in Q1 2025.

• Ended Q1 with $418 million in cash, cash equivalents, and investments, and $108 million in operating cash flow.

Outlook and guidance

• Full-year 2026 guidance: total revenues of $2.81–$2.92 billion, consolidated gross profit of $470–$510 million, Adjusted EBITDA of $50–$70 million, and GAAP Net Income of $0–$20 million.

• Average Medicare Advantage membership expected between 154,000–158,000 for FY26.

• Management expects to meet or exceed full-year 2026 outlook across all metrics, with guidance to be revisited after Q2.

• Strong retention, clinical engagement, and scale efficiencies expected to drive favorable cohort mix and margin expansion.

• Model built to thrive across both 3.5 and 4-Star ratings, with flexibility for 2027 growth vs. margin decisions.