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Clover Health Investments, Corp.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 26 February 2026: press release. Guidance figures: 5 new. The quarter’s numbers.

Key takeaways

  • Full-year revenue rose 40%: Full-year 2025 total revenues were $1.9 billion, up 40% from the prior year. The company reported membership growth of 38% for the same year. Source
  • Full-year GAAP loss, positive adjusted measures: Full-year 2025 GAAP net loss was $86 million. Adjusted EBITDA was $22 million and Adjusted Net Income was $20 million for the year. Source
  • Fourth-quarter Adjusted EBITDA turned negative: Q4 Adjusted EBITDA was $(23.3) million against $7.8 million a year earlier. Q4 GAAP net loss from continuing operations was $49.3 million against $21.5 million. Source
  • Medicare Advantage membership rose 38%: Insurance members reached 113,803 at December 31, 2025, against 82,664 a year earlier. Q4 average Medicare Advantage membership was 112,654, up 37.0%. Source
  • 2026 enrollment growth and retention reported: Management reported 53% year-over-year growth in 2026 annual enrollment period membership, with strong returning member retention. Source
  • Adjusted SG&A fell as share of revenue: Adjusted SG&A was $97.5 million in Q4, up 13.2%, and 20.0% of total revenues against 25.5%. Full-year Adjusted SG&A was $334.2 million, or 17.4% of revenues. Source
  • Insurance BER increased year over year: Insurance BER was 95.0% in Q4 against 82.8%, and 90.9% for the full year against 81.2%. Normalized Insurance BER was 97.2% in Q4 and 91.5% for the year. Source
  • Cash and investments declined: Total cash, cash equivalents and investments were $319.9 million at year-end, against $437.6 million, down 26.9%. Source

“Our results in 2025 validate the scalability of our differentiated model, despite some headwinds during the year,”

Clover Health CEO Andrew Toy

Guidance

AreaPeriodFigureAgainst last quarter
Average Medicare Advantage membership Sourcefull year 2026154,000 - 158,000New
Total revenues Sourcefull year 2026$2.81 billion - $2.92 billionNew
Consolidated Gross profit Sourcefull year 2026$470 million - $510 millionNew
Adjusted EBITDA Sourcefull year 2026$50 million - $70 millionNew
GAAP Net Income Sourcefull year 2026$0 million - $20 millionNew

What changed from last quarter

  • New guidance: The company began giving full-year 2026 guidance for total revenues, Consolidated Gross profit, Adjusted EBITDA, GAAP Net Income and average Medicare Advantage membership. Source
  • Guidance withdrawn: Insurance revenue and Insurance Benefits Expense Ratio guidance were replaced by total revenues and Consolidated Gross profit guidance. Source

Results and growth drivers

  • Full-year revenue rose 40%: Full-year 2025 total revenues were $1.9 billion, up 40% from the prior year. The company reported membership growth of 38% for the same year. Source
  • Fourth-quarter revenue rose 45%: Fourth-quarter total revenues were $487.7 million against $337.0 million a year earlier, an increase of 44.7%. Full-year total revenues were $1,924.3 million. Source
  • Full-year GAAP loss, positive adjusted measures: Full-year 2025 GAAP net loss was $86 million. Adjusted EBITDA was $22 million and Adjusted Net Income was $20 million for the year. Source
  • Fourth-quarter Adjusted EBITDA turned negative: Q4 Adjusted EBITDA was $(23.3) million against $7.8 million a year earlier. Q4 GAAP net loss from continuing operations was $49.3 million against $21.5 million. Source
  • Consolidated gross profit declined: Consolidated Gross profit was $74.2 million in Q4, down 21.0% from $93.9 million. Full-year Consolidated Gross profit was $355.9 million, down 2.4%. Source

Insurance segment and gross profit

  • Insurance segment gross profit fell: Insurance segment gross profit was $58.6 million in Q4 against $87.5 million. Full-year segment gross profit was $273.5 million against $334.6 million. Source
  • Intersegment profit eliminations increased: Elimination of intersegment profits was $13.8 million in Q4 against $0.1 million, and $49.8 million for the full year against $4.0 million. Source
  • Insurance medical claims grew faster: Insurance net medical claims incurred were $427.3 million in Q4 against $243.2 million, a rise of 75.7%. Full-year claims were $1,618.2 million, up 60.2%. Source

“During 2025, we demonstrated financial resilience, supported by continued Adjusted EBITDA profitability, a controlled underlying medical cost trend, and Medicare Advantage membership growth significantly above market,”

Clover Health CFO Peter Kuipers

Membership and products

  • Medicare Advantage membership rose 38%: Insurance members reached 113,803 at December 31, 2025, against 82,664 a year earlier. Q4 average Medicare Advantage membership was 112,654, up 37.0%. Source
  • Wide-network PPO is the flagship plan: Clover offers PPO and HMO Medicare Advantage plans in several states. The company's focus is its flagship wide-network, high-choice PPO plans. Source
  • 2026 enrollment growth and retention reported: Management reported 53% year-over-year growth in 2026 annual enrollment period membership, with strong returning member retention. Source
  • Counterpart serves outside providers: Counterpart Health, a subsidiary, extends the company's data-driven technology platform to providers outside Clover's Medicare Advantage plan. Source

Costs and operating leverage

  • Adjusted SG&A fell as share of revenue: Adjusted SG&A was $97.5 million in Q4, up 13.2%, and 20.0% of total revenues against 25.5%. Full-year Adjusted SG&A was $334.2 million, or 17.4% of revenues. Source
  • Stock-based compensation declined: Stock-based compensation was $24.9 million in Q4 against $29.6 million, and $103.7 million for the full year against $114.3 million. Source
  • Quality improvement spending increased: Quality improvements expense was $34.3 million in Q4 against $30.8 million, and $100.6 million for the year against $81.1 million. Source

“Looking to 2026, we expect improving cohort economics, strong returning member retention, a more favorable rate environment, and continued operating leverage as we scale”

Clover Health CFO Peter Kuipers

Medical cost ratio and pricing

  • Insurance BER increased year over year: Insurance BER was 95.0% in Q4 against 82.8%, and 90.9% for the full year against 81.2%. Normalized Insurance BER was 97.2% in Q4 and 91.5% for the year. Source
  • Prior period development was lower: Prior period development was 2.2% in Q4 against 4.6% a year earlier, and 0.6% for the full year against 3.0%. Source
  • 2026 expected to be a 4 Star year: The prior-quarter release described 2025 as a 3.5 Star payment year and said 2026 is a 4 Star payment year.

Cash and shareholder returns

  • Cash and investments declined: Total cash, cash equivalents and investments were $319.9 million at year-end, against $437.6 million, down 26.9%. Source
  • Operating cash used in 2025: Net cash used in operating activities from continuing operations was $66.9 million in 2025, against $82.5 million provided in 2024. Capital expenditure was $2.0 million. Source
  • Buybacks and share withholding: Repurchases of common stock were $18.3 million in 2025 against $1.8 million. Cash paid for shares withheld for stock-based compensation was $36.9 million, and treasury shares rose to 33,412,273. Source
  • Receivables and premiums receivable rose: Healthcare receivables were $94.9 million at year-end against $51.5 million. Accrued retrospective premiums were $63.9 million against $41.3 million. Source

Platform and clinical strategy

  • Clover Assistant platform described: The company describes its strategy as powered by Clover Assistant, a software platform that aggregates patient data to support clinical decisions. Source
  • Clinical data published across conditions: The company said it has published data on the technology's impact on several conditions and populations. Source
  • Quality leadership cited by CEO: The CEO said the company delivered membership growth in its wide-network PPO while continuing to lead on quality. Source

Coming up, as management said on 26 February 2026

  • Leerink conference presentation: Management is scheduled to present at the 2026 Leerink Global Healthcare Conference at 9:20 a.m. Eastern Time on Tuesday, March 10, 2026. Source
  • Clover Assistant care scaling planned: Management said it anticipates scaling Clover Assistant-powered care to more seniors. Source
  • First GAAP net income year expected: Management expects improving cohort economics powered by Clover Assistant to produce the company's first full year of GAAP Net Income profitability in 2026. Source

Risks management discussed

  • Financial: Net cash and cash equivalents decreased by $116.2 million in 2025, against an increase of $18.0 million in 2024. Source
  • External: The CEO referred to headwinds during 2025 without specifying them in the release. Source

Earlier plans management reported on

  • Not stated: The CEO said the company has positioned Clover to achieve this in 2026. The release does not give progress against it. Source
  • Not stated: In the prior-quarter release, management said it believed the company was positioned to achieve updated 2025 guidance. The Q4 release does not state whether it was achieved.

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.