Clover Health Investments, Corp.: Form 10-Q for the period ended Sep 30, 2025
Filed with the SEC on Nov 7, 2025 and accepted by EDGAR at Nov 7, 2025, 13:06 ET.
Management's discussion and analysis
As filed, 38,600 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.
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.
Overview
At Clover Health, our vision is to empower every physician with the technology to identify, manage, and treat chronic diseases earlier. Our strategy is to improve the care of people with Medicare, develop wide physician networks, and provide technology to help empower physicians. Our proprietary software platform, Clover Assistant (licensed externally as Counterpart Assistant), helps us execute this strategy by enabling physicians to detect, identify, and manage chronic diseases earlier than they otherwise could. This technology is a cloud-based software platform that provides physicians with access to data-driven and personalized insights for the patients they treat.
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.
Recent Developments
CMS Star Ratings
On October 9, 2025, the Company announced that CMS has decreased the Star rating of its PPO Medicare Advantage plans to 3.5 Stars for 2026, which will affect payment year 2027. Additionally, CMS increased the rating of Clover’s HMO MA plan to 4.0 Stars. As a reminder, currently over 97% of our insurance members are members of our PPO Medicare Advantage Plans.
Key Performance Measures
We manage our operations based on one reportable segment: Insurance. Through our Insurance segment, we provide PPO and HMO plans to Medicare Advantage members in several states. All other clinical services and all corporate overhead not included in the reportable segments are included in Corporate/Other.
The segment grouping is consistent with the information used by our Chief Executive Officer (identified as our chief operating decision maker) ("CODM") to assess performance and allocate the Company's resources.
We review several key performance measures, discussed below, to evaluate our business and results, measure performance, identify trends, formulate plans, and make strategic decisions. We believe that the presentation of such metrics is useful to management and counterparties to model the performance of healthcare companies such as Clover.
Through our Insurance segment, we provide PPO and HMO plans to members in several states. We seek to improve care and lower costs for our members by empowering providers with intuitive data-driven, personalized insights to support treatment of members through our software platform, Clover Assistant.
The following table presents key financial measures for the periods indicated:
(amounts in thousands, except PMPM amounts)
| Three Months Ended September 30, 2025 Total | PMPM (1) | 2024 Total | PMPM (1) | Nine Months Ended September 30, 2025 Total | PMPM (1) | 2024 Total | PMPM (1) | |
|---|---|---|---|---|---|---|---|---|
| Insurance members at period end (#) | 109,226 | N/A | 81,110 | N/A | 109,226 | N/A | 81,110 | N/A |
| Premiums earned, gross | $479,220 | $1,467 | $322,676 | $1,333 | $1,406,144 | $1,485 | $1,014,502 | $1,409 |
| Premiums earned, net | $479,128 | $1,467 | $322,579 | $1,333 | $1,405,860 | $1,484 | $1,014,201 | $1,409 |
| Insurance medical claim expense incurred, gross | $428,882 | $1,321 | $251,856 | $1,041 | $1,191,154 | $1,258 | $767,338 | $1,068 |
| Insurance net medical claims incurred | $428,855 | $1,321 | $251,643 | $1,040 | $1,190,954 | $1,258 | $767,125 | $1,066 |
| Benefits expense ratio, gross | 93.5% | N/A | 82.8% | N/A | 89.4% | N/A | 80.6% | N/A |
| Normalized benefits expense ratio, gross | 92.4% | N/A | 85.4% | N/A | 88.9% | N/A | 84.9% | N/A |
| Benefits expense ratio, net | 93.5% | N/A | 82.8% | N/A | 89.4% | N/A | 80.6% | N/A |
| Normalized benefits expense ratio, net | 92.4% | N/A | 85.4% | N/A | 88.9% | N/A | 84.9% | N/A |
| Adjusted SG&A | $71,066 | N/A | $61,949 | N/A | $236,666 | N/A | $208,593 | N/A |
| Adjusted EBITDA | $2,111 | N/A | $19,263 | N/A | $45,028 | N/A | $62,292 | N/A |
| Adjusted Net income from continuing operations | $1,705 | N/A | $18,924 | N/A | $43,743 | N/A | $60,821 | N/A |
| (1) Calculated per member per month ("PMPM") figures are based on the applicable amount divided by member months in the given period. Member months represents the number of months members are enrolled in a Clover Health plan in the period. |
Membership and associated premiums earned and medical claim expenses
We define new and returning members on a calendar year basis. Any member who is active on July 1 of a given year is considered a returning member in the following year. Any member who joins a Clover plan after July 1 in a given year is considered a new member for the entirety of the following calendar year. We view our number of members and associated PMPM premiums earned and medical claim expenses, in the aggregate and on a PMPM basis, as useful metrics to assess our financial performance. Member growth and retention aligns with our mission, drives our Total revenues, expands brand awareness, deepens our market penetration, creates additional opportunities to inform our data-driven insights to improve care and decrease medical claim expenses, and generates additional data to continue to improve the functioning of Clover Assistant. Among other things, the longer a member is enrolled in one of our insurance plans, the more data we collect and synthesize and the more actionable insights we generate. We believe these data-driven insights lead to better care delivery as well as improved identification, documentation and management of members' chronic conditions, helping to lower PMPM medical claim expenses.
Premiums earned, gross
Premiums earned, gross is the amount received, or to be received, for insurance policies written by us during a specific period of time without reduction for premiums ceded to reinsurance. We believe premiums earned, gross provides useful insight into the gross economic benefit generated by our business operations and allows us to evaluate our underwriting performance without regard to changes in our underlying reinsurance structure. Premiums earned, gross excludes the effects of premiums ceded to reinsurers, and therefore should not be used as a substitute for Premiums earned, net, Total revenues, or any other measure presented in accordance with generally accepted accounting principles in the United States ("GAAP").
Premiums earned, net
Premiums earned, net represents the earned portion of our premiums earned, gross, less the earned portion that is ceded to third-party reinsurers under our reinsurance agreements. Premiums are earned in the period in which members are entitled to receive services, and are net of estimated uncollectible amounts, retroactive membership adjustments, and any adjustments to recognize rebates under the minimum benefit ratios required under the ACA.
We earn premiums through our plans offered under contracts with CMS. We receive premiums from CMS on a monthly basis based on our actuarial bid and the risk-adjustment model used by CMS. Premiums anticipated to be received within twelve months based on the documented diagnostic criteria of our members are estimated and included in revenues for the period, including the member months for which the payment is designated by CMS.
Premiums ceded is the amount of premiums earned, gross ceded to reinsurers. From time to time, we enter into reinsurance contracts to limit our exposure to potential losses as well as to provide additional capacity for growth. Under these agreements, the "reinsurer," agrees to cover a portion of the claims of another insurer, i.e., us, the "primary insurer," in return for a portion of their premium. Ceded earned premiums are earned over the reinsurance contract period in proportion to the period of risk covered. The volume of our ceded earned premium is impacted by the level of our premiums earned, gross and any decision we make to adjust our reinsurance agreements.
Insurance gross medical claims incurred
Insurance gross medical claims incurred reflects claims incurred, excluding amounts ceded to reinsurers, and the costs associated with processing those claims. We believe gross medical claims incurred provides useful insight into the gross medical expense incurred by members and allows us to evaluate our underwriting performance without regard to changes in our underlying reinsurance structure.
Insurance gross medical claims incurred excludes the effects of medical claims and associated costs ceded to reinsurers, and therefore should not be used as a substitute for Net claims incurred, Total operating expenses, or any other measure presented in accordance with GAAP.
Insurance net medical claims incurred
Insurance net medical claims incurred are our medical expenses and consist of the costs of claims, including the costs incurred for claims net of amounts ceded to reinsurers. We enter into reinsurance contracts to limit our exposure to potential catastrophic losses. These expenses generally vary based on the total number of members and their utilization rate of our services.
Non-GAAP Financial Measures
We use non-GAAP measures in this Form 10-Q, including Insurance BER, Adjusted SG&A, Adjusted EBITDA, and Adjusted Net income from continuing operations. These non-GAAP financial measures are provided to enhance the reader's understanding of Clover Health's past financial performance and our prospects for the future. Clover Health's management team uses these non-GAAP financial measures in assessing Clover Health's performance, as well as in planning and forecasting future periods. These non-GAAP financial measures are not computed according to GAAP, and the methods we use to compute them may differ from the methods used by other companies. Non-GAAP financial measures are supplemental to and should not be considered a substitute for financial information presented in accordance with GAAP and should be read only in conjunction with our condensed consolidated financial statements prepared in accordance with GAAP.
For a description of these non-GAAP financial measures, including the reasons management uses such measures, and the reconciliations of these non-GAAP financial measures to the comparable GAAP measures, please see "Benefits expense ratio, gross and net", "Adjusted SG&A", "Adjusted EBITDA", and Adjusted Net income from continuing operations below.
Benefits expense ratio, gross and net
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.
The tables below provide reconciliations of Net medical claims incurred and Premiums earned on a gross and net basis which are GAAP measures, to Insurance BER, a non-GAAP measure.
(in thousands)
| Three Months Ended September 30, 2025 | 2024 | Nine Months Ended September 30, 2025 | 2024 | |
|---|---|---|---|---|
| Net medical claims incurred, gross (GAAP): | $428,882 | $251,856 | $1,191,154 | $767,338 |
| Adjustments | ||||
| Quality improvements | 19,341 | 15,445 | 66,244 | 50,383 |
| Benefits expense, gross (non-GAAP) | $448,223 | $267,301 | $1,257,398 | $817,721 |
| Premiums earned, gross (GAAP) | $479,220 | $322,676 | $1,406,144 | $1,014,502 |
| Benefits expense ratio, gross (non-GAAP) | 93.5% | 82.8% | 89.4% | 80.6% |
| Adjustments | ||||
| Prior period development | (1.1) | 2.6 | (0.5) | 4.3 |
| Normalized benefits expense ratio, gross (non-GAAP) | 92.4% | 85.4% | 88.9% | 84.9% |
(in thousands)
| Three Months Ended September 30, 2025 | 2024 | Nine Months Ended September 30, 2025 | 2024 | |
|---|---|---|---|---|
| Net medical claims incurred, net (GAAP): | $428,855 | $251,643 | $1,190,954 | $767,125 |
| Adjustments | ||||
| Quality improvements | 19,341 | 15,445 | 66,244 | 50,383 |
| Benefits expense, net (non-GAAP) | $448,196 | $267,088 | $1,257,198 | $817,508 |
| Premiums earned, net (GAAP) | $479,128 | $322,579 | $1,405,860 | $1,014,201 |
| Benefits expense ratio, net (non-GAAP) | 93.5% | 82.8% | 89.4% | 80.6% |
| Adjustments | ||||
| Prior period development | (1.1) | 2.6 | (0.5) | 4.3 |
| Normalized benefits expense ratio, net (non-GAAP) | 92.4% | 85.4% | 88.9% | 84.9% |
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Adjusted SG&A
Adjusted Salaries and benefits plus General and Administrative expenses ("SG&A") is a non-GAAP financial measure defined by us as total SG&A less stock-based compensation and non-recurring legal expenses and settlements. We believe that Adjusted SG&A provides management, investors, and others a useful view of our operating spend as it excludes non-cash, stock-based compensation and expenses related to investments that management believes do not reflect the Company's core operating expenses. We believe that Adjusted SG&A as a percentage of Total revenues is useful to management, investors, and others because it allows us to measure our operational leverage as revenue scales.
The table below provides a reconciliation of Total SG&A, a GAAP financial measure, to Adjusted SG&A, a non-GAAP measure:
(in thousands)
| Three Months Ended September 30, 2025 | 2024 | Nine Months Ended September 30, 2025 | 2024 | |
|---|---|---|---|---|
| Salaries and benefits | $48,195 | $54,995 | $168,526 | $169,717 |
| General and administrative expenses | 48,953 | 35,201 | 148,112 | 124,194 |
| Total SG&A (GAAP) | 97,148 | 90,196 | 316,638 | 293,911 |
| Adjustments | ||||
| Stock-based compensation | (26,106) | (27,988) | (78,738) | (84,686) |
| Non-recurring legal expenses and settlements | 24 | (259) | (1,234) | (632) |
| Adjusted SG&A (non-GAAP) | $71,066 | $61,949 | $236,666 | $208,593 |
| Total revenues (GAAP) | $496,650 | $330,986 | $1,436,601 | $1,034,168 |
| Adjusted SG&A (non-GAAP) as a percentage of Total revenues | 14.3% | 18.7% | 16.5% | 20.2% |
Adjusted EBITDA
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.
The table below provides a reconciliation of Net (loss) income from continuing operations, a GAAP financial measure, to Adjusted EBITDA, a non-GAAP financial measure:
(in thousands)
| Three Months Ended September 30, 2025 | 2024 | Nine Months Ended September 30, 2025 | 2024 | |
|---|---|---|---|---|
| Net loss from continuing operations (GAAP): | $(24,377) | $(8,785) | $(36,229) | $(24,785) |
| Adjustments | ||||
| Depreciation and amortization | 406 | 339 | 1,266 | 987 |
| Change in fair value of warrants | — | — | 19 | 17 |
| Loss on investment | — | — | — | 467 |
| Stock-based compensation | 26,106 | 27,988 | 78,738 | 84,686 |
| Restructuring (recoveries) costs | — | (538) | — | 288 |
| Non-recurring legal expenses and settlements | (24) | 259 | 1,234 | 632 |
| Adjusted EBITDA (non-GAAP) | $2,111 | $19,263 | $45,028 | $62,292 |
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Adjusted Net income from continuing operations
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.
(in thousands)
| Three Months Ended September 30, 2025 | 2024 | Nine Months Ended September 30, 2025 | 2024 | |
|---|---|---|---|---|
| Net loss from continuing operations (GAAP) | $(24,377) | $(8,785) | $(36,229) | $(24,785) |
| Adjustments | ||||
| Stock-based compensation | 26,106 | 27,988 | 78,738 | 84,686 |
| Restructuring (recoveries) costs | — | (538) | — | 288 |
| Non-recurring legal expenses and settlements | (24) | 259 | 1,234 | 632 |
| Adjusted Net income from continuing operations (non-GAAP) | $1,705 | $18,924 | $43,743 | $60,821 |
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Results of Operations
Comparison of the Three Months Ended September 30, 2025 and 2024
The following table summarizes our condensed consolidated results of operations for the three months ended September 30, 2025 and 2024. The period-to-period comparison of results is not necessarily indicative of results for future periods.
(in thousands)
| Revenues | Three Months Ended September 30, 2025 | 2024 | Change Between 2025 and 2024 ($) | (%) |
|---|---|---|---|---|
| Premiums earned, net (Net of ceded premiums of $92 and $97 for the three months ended September 30, 2025 and 2024, respectively) | $479,128 | $322,579 | $156,549 | 48.5% |
| Other income | 17,522 | 8,407 | 9,115 | 108.4 |
| Total revenues | 496,650 | 330,986 | 165,664 | 50.1 |
| Operating expenses | ||||
| Net medical claims incurred | 423,473 | 249,774 | 173,699 | 69.5 |
| Salaries and benefits | 48,195 | 54,995 | (6,800) | (12.4) |
| General and administrative expenses | 48,953 | 35,201 | 13,752 | 39.1 |
| Depreciation and amortization | 406 | 339 | 67 | 19.8 |
| Restructuring recoveries | — | (538) | 538 | * |
| Total operating expenses | 521,027 | 339,771 | 181,256 | 53.3 |
| Loss from continuing operations | (24,377) | (8,785) | (15,592) | 177.5 |
| Net loss from continuing operations | (24,377) | (8,785) | (15,592) | 177.5 |
| Net loss from discontinued operations | — | (370) | 370 | * |
| Net loss | $(24,377) | $(9,155) | $(15,222) | 166.3% |
* Not presented because the current or prior period amount is zero or the amount for the line item changed from a gain to a loss (or vice versa) and thus yields a result that is not meaningful.
Premiums earned, net
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%.
Other income
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.
Net medical claims incurred
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.
Salaries and benefits
Salaries and benefits decreased by $6.8 million, or 12%, to $48.2 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. This decrease was primarily driven by a decrease in the Company's variable incentive bonus accruals. This was partially offset by an increase in base salaries driven primarily by headcount growth.
General and administrative expenses
General and administrative expenses increased $13.8 million, or 39%, to $49.0 million for the three months ended September 30, 2025, compared to the three months ended September 30, 2024. The increase was primarily driven by higher professional fees and higher broker fees, with the latter being driven by membership growth during the most recent annual enrollment period.
Comparison of the Nine Months Ended September 30, 2025 and 2024
The following table summarizes our condensed consolidated results of operations for the nine months ended September 30, 2025 and 2024. The period-to-period comparison of results is not necessarily indicative of results for future periods.
(in thousands)
| Revenues | Nine Months Ended September 30, 2025 | 2024 | Change Between 2025 and 2024 ($) | (%) |
|---|---|---|---|---|
| Premiums earned, net (Net of ceded premiums of $284 and $301 for the nine months ended September 30, 2025 and 2024, respectively) | $1,405,860 | $1,014,201 | $391,659 | 38.6% |
| Other income | 30,741 | 19,967 | 10,774 | 54.0 |
| Total revenues | 1,436,601 | 1,034,168 | 402,433 | 38.9 |
| Operating expenses | ||||
| Net medical claims incurred | 1,154,907 | 763,283 | 391,624 | 51.3 |
| Salaries and benefits | 168,526 | 169,717 | (1,191) | (0.7) |
| General and administrative expenses | 148,112 | 124,194 | 23,918 | 19.3 |
| Depreciation and amortization | 1,266 | 987 | 279 | 28.3 |
| Restructuring costs | — | 288 | (288) | * |
| Total operating expenses | 1,472,811 | 1,058,469 | 414,342 | 39.1 |
| Loss from continuing operations | (36,210) | (24,301) | (11,909) | 49.0 |
| Change in fair value of warrants | 19 | 17 | 2 | 28.3 |
| Loss on investment | — | 467 | (467) | * |
| Net loss from continuing operations | (36,229) | (24,785) | (11,444) | 46.2 |
| Net income from discontinued operations | — | 3,868 | (3,868) | * |
| Net loss | $(36,229) | $(20,917) | $(15,312) | 73.2% |
* Not presented because the current or prior period amount is zero or the amount for the line item changed from a gain to a loss (or vice versa) and thus yields a result that is not meaningful.
Premiums earned, net
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%.
Other income
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.
Net medical claims incurred
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.
Salaries and benefits
Salaries and benefits remained materially consistent decreasing by $1.2 million, or 1%, to $168.5 million for the nine months ended September 30, 2025 as compared to the nine months ended September 30, 2024.
General and administrative expenses
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.
Liquidity and Capital Resources
We manage our liquidity and financial position in the context of our overall business strategy. We continually forecast and manage our cash, investments, working capital balances, and capital structure to meet the short-term and long-term obligations of our businesses while seeking to maintain liquidity and financial flexibility.
Historically, we have financed our operations primarily from the proceeds we received through premiums earned under our MA plans. We expect that our cash, cash equivalents, investments, and our current projections of cash flows, taken together, will be sufficient to meet our projected operating and regulatory requirements for the next 12 months based on our current plans. Our future capital requirements will depend on many factors, including our needs to support our business growth, to respond to business opportunities, challenges or unforeseen circumstances, or for other reasons. We may be required to seek additional equity or debt financing to provide the capital required to maintain or expand our operations. Any future equity financing may be dilutive to our existing investors, and any future debt financing may include debt service requirements and financial and other restrictive covenants that may constrain our operations and growth strategies. If additional financing is required from outside sources, we may not be able to raise it on terms acceptable to us, or at all. If we are unable to raise additional capital when desired, our business, results of operations, and financial condition would be adversely affected.
Consolidated Entities
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.
Unregulated Entities
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.
Regulated Entities
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.
For a detailed discussion of our regulatory requirements, including aggregate statutory capital and surplus as well as dividends paid from the subsidiaries to the parent, please refer to Notes 19 "Dividend Restrictions", 20 "Statutory Equity", and 21 "Regulatory Matters" in the 2024 Form 10-K.
Cash Flows
The following table summarizes our condensed consolidated cash flows for the nine months ended September 30, 2025 and 2024.
(in thousands)
| Nine Months Ended September 30, Cash Flows Data: | 2025 | 2024 |
|---|---|---|
| Net cash provided by operating activities from continuing operations | $1,218 | $129,539 |
| Net cash provided by investing activities | 39,071 | 2,004 |
| Net cash used in financing activities | (44,777) | (11,220) |
| (Decrease) increase in cash and cash equivalents from continuing operations | $(4,488) | $120,323 |
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Cash Requirements
Our cash requirements within the next twelve months include medical claims payable, accounts payable and accrued liabilities, current liabilities, purchase commitments, and other obligations. We expect the cash required to meet these obligations to be primarily generated through cash, cash equivalents, short-term investments, and our current projections of cash flows from operations.
Operating Activities from Continuing Operations
Our largest source of operating cash flows is capitated payments from CMS. Our primary uses of cash from operating activities are payments for medical benefits and payments of operating expenses.
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.
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.
Investing Activities
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.
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.
For additional information regarding our investing activities, please refer to Note 3 "Investment Securities" to our condensed consolidated financial statements included in this Form 10-Q.
Financing Activities
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.
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.
Financing Arrangements
There have been no material changes to our financing arrangements at September 30, 2025.
Contractual Obligations and Commitments
We believe that funds from projected future operating cash flows, cash, cash equivalents, and investments will be sufficient for future operations and commitments, and for capital acquisitions and other strategic transactions, over at least the next 12 months.
Material cash requirements from known contractual obligations and commitments at September 30, 2025 include operating lease obligations of $2.8 million. These commitments are associated with contracts that were enforceable and legally binding at September 30, 2025, and that specified all significant terms, including fixed or minimum serves to be used, fixed, minimum, or variable price provisions, and the approximate timing of the actions under the contracts. There were no other material cash requirements from known contractual obligations and commitments at September 30, 2025. For additional information regarding our remaining estimated contractual obligations and commitments, see Note 12 "Commitments and Contingencies" in the accompanying notes to the condensed consolidated financial statements included in this Form 10-Q.
Indemnification Agreements
In the ordinary course of business, we enter into agreements, with various parties (providers, vendors, consultants, etc.), with varying scope and terms, pursuant to which we may agree to defend, indemnify, and hold harmless the other parties from any claim, demand, loss, lawsuit, settlement, judgment, fine, or other liability, and all related expenses that may accrue therefrom (including reasonable attorneys' fees), arising from or in connection with third party claims, including, but not limited to, negligence, recklessness, willful misconduct, fraud, or otherwise wrongful act or omission with respect to our obligations under the applicable agreements.
Off-balance Sheet Arrangements
We do not have any off-balance sheet arrangements, as defined by applicable regulations of the SEC, that are reasonably likely to have a current or future material effect on our financial condition, results of operations, liquidity, capital expenditures, or capital resources.
Critical Accounting Policies and Estimates
We believe that the accounting policies and estimates involve a significant degree of judgment and complexity. There have been no significant changes in our critical accounting policies and estimates during the three months ended September 30, 2025, as compared to the critical accounting policies and estimates disclosed in the section titled "Management's Discussion and Analysis of Financial Condition and Results of Operations" included in the 2024 Form 10-K.
Recently Issued and Adopted Accounting Pronouncements
See Note 2 "Summary of Significant Accounting Policies" in the accompanying notes to the condensed consolidated financial statements included in this Form 10-Q for a discussion of accounting pronouncements recently adopted and recently issued accounting pronouncements not yet adopted and their potential impact to our condensed consolidated financial statements.
Market risk
As filed, 1,139 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.
Market risk is the risk of economic losses due to adverse changes in the estimated fair value of a financial instrument as the result of changes in equity prices, interest rates, foreign currency exchange rates and commodity prices. Our Condensed Consolidated Balance Sheets include assets and liabilities with estimated fair values that are subject to market risk. Our primary market risk has been interest rate risk associated with investments in instruments with fixed maturities. We do not have material exposure to commodity risk.
We are also exposed to credit risk on our investment portfolio. We manage the exposure to credit risk in our portfolio by investing in high quality securities and diversifying our holdings.
We monitor our investment portfolio to ensure that credit risk does not exceed prudent levels. Our investment policy is focused on preservation of capital, liquidity and earning a modest yield. Substantially all of our investment portfolio is invested in U.S. Treasury fixed maturity securities. At September 30, 2025, none of our fixed maturity securities portfolio was unrated or rated below investment grade.
Controls and procedures
As filed, 2,483 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.
Evaluation of Disclosure Controls and Procedures
Disclosure controls are procedures that are designed with the objective of ensuring that information required to be disclosed in our reports filed under the Exchange Act, such as this report, is recorded, processed, summarized, and reported within the time period specified in the SEC's rules and forms. Disclosure controls are also designed with the objective of ensuring that such information is accumulated and communicated to our management, including the chief executive officer and chief financial officer, as appropriate to allow timely decisions regarding required disclosure. Our management evaluated, with the participation of our current chief executive officer and chief financial officer (our "Certifying Officers"), the effectiveness of our disclosure controls and procedures at September 30, 2025, pursuant to Rule 13a-15(b) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Based upon that evaluation, our Certifying Officers concluded that, at September 30, 2025, our disclosure controls and procedures were effective.
We do not expect that our disclosure controls and procedures will prevent all errors and all instances of fraud. Disclosure controls and procedures, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the disclosure controls and procedures are met. Further, the design of disclosure controls and procedures must reflect the fact that there are resource constraints, and the benefits must be considered relative to their costs. Because of the inherent limitations in all disclosure controls and procedures, no evaluation of disclosure controls and procedures can provide absolute assurance that we have detected all our control deficiencies and instances of fraud, if any. The design of disclosure controls and procedures also is based partly on certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions.
Changes in Internal Control over Financial Reporting
There were no changes in our internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) of the Exchange Act) during the most recent fiscal quarter that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
Risk factors
As filed, 1,186 characters, with its headings, lists and tables. Extracted from the main document; charts and exhibits are in the original on sec.gov.
Except as subsequently disclosed in our periodic reports, there have been no material changes in our risk factors from those disclosed in Part I, Item 1A of the 2024 Form 10-K. In the course of conducting our business operations, we are exposed to a variety of recurring and new risks, any of which have affected or could materially adversely affect our business, financial condition, and results of operations. The market price of our Class A common stock could decline, possibly significantly or permanently, if one or more of these risks and uncertainties occurs. Any factor described in this report or in any of our other SEC filings could by itself, or together with other factors, adversely affect our financial results and condition. For a discussion of risk factors that could adversely affect our financial results and condition, and the value of, and return on, an investment in the Company, please see the "Item 1A. Risk Factors" section included in the 2024 Form 10-K, as well as the factors identified under "Cautionary Note Regarding Forward-Looking Statements" at the beginning of Part I, Item 1 of this Form 10-Q and as may be updated in subsequent filings with the SEC.
Figures reported in this filing
Standardized line items from the XBRL in this filing, for the period ended 2025-09-30. Comparative periods it repeats are left out.
| Line item | Period | Value | XBRL concept |
|---|---|---|---|
| Revenue | 3 months2025-07-01 to 2025-09-30 | $496.6m | us-gaap:Revenues |
| Revenue | 9 months2025-01-01 to 2025-09-30 | $1.44bn | us-gaap:Revenues |
| Operating income | 3 months2025-07-01 to 2025-09-30 | −$24.4m | us-gaap:OperatingIncomeLoss |
| Operating income | 9 months2025-01-01 to 2025-09-30 | −$36.2m | us-gaap:OperatingIncomeLoss |
| Net income | 3 months2025-07-01 to 2025-09-30 | −$24.4m | us-gaap:NetIncomeLoss |
| Net income | 9 months2025-01-01 to 2025-09-30 | −$36.2m | us-gaap:ProfitLoss |
| Diluted shares (weighted) | 3 months2025-07-01 to 2025-09-30 | 512,743,521 shares | us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding |
| Diluted shares (weighted) | 9 months2025-01-01 to 2025-09-30 | 510,191,111 shares | us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding |
| Operating cash flow | 9 months2025-01-01 to 2025-09-30 | $1.2m | us-gaap:NetCashProvidedByUsedInOperatingActivities |
| Capital expenditure | 9 months2025-01-01 to 2025-09-30 | $1.4m | us-gaap:PaymentsToAcquirePropertyPlantAndEquipment |
| Share repurchases | 9 months2025-01-01 to 2025-09-30 | $18.3m | us-gaap:PaymentsForRepurchaseOfCommonStock |
| Current assets | At period end2025-09-30 | $330.9m | us-gaap:AssetsCurrent |
| Total assets | At period end2025-09-30 | $559.7m | us-gaap:Assets |
| Current liabilities | At period end2025-09-30 | $193.4m | us-gaap:LiabilitiesCurrent |
| Total liabilities | At period end2025-09-30 | $218.7m | us-gaap:Liabilities |
| Shareholders' equity | At period end2025-09-30 | $340.9m | us-gaap:StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest |
Source: SEC EDGAR, the filing index for accession 0001801170-25-000275. Last ingested by Listed: Oct 24, 2026, 15:15 ET. Listed shows no prices and gives no investment advice.