Business Highlights:
- Delivered positive GAAP Net Income in the first quarter of 2026, with strong performance across key metrics: Total revenues, Adjusted EBITDA, and Consolidated Gross Profit
- Market-leading Medicare Advantage membership growth with underlying trends tracking in line with expectations
- Expect to meet or exceed full year 2026 outlook across all metrics, including achieving first full year GAAP Net Income profitability
Financial Results:
- First quarter 2026 GAAP Net Income of
$27 million , an improvement of$29 million year-over-year - First quarter 2026 Medicare Advantage membership of 155,773, up 51% year-over-year, and Total revenues of
$749 million , up 62% year-over-year - First quarter 2026 Consolidated Gross Profit of
$160 million , up 47% year-over-year, and Adjusted EBITDA of$40 million , up 56% year-over-year
Full Year 2026 Guidance:
- Average Medicare Advantage membership of 154,000 - 158,000, representing 46% growth year-over-year at the midpoint
- Total revenues between
$2 .81 billion and$2 .92 billion, representing 49% growth year-over-year at the midpoint - Consolidated Gross Profit between $470 million and $510 million, representing 38% growth year-over-year at the midpoint
- Adjusted EBITDA profitability between $50 million and $70 million
- GAAP Net Income between
$0 million and$20 million
“Our results demonstrate the differentiated model we have built to drive growth and profitability while expanding access to high-quality, affordable care through a wide-network PPO,” said
“We achieved positive GAAP Net Income in the first quarter of 2026 while continuing to grow at a market-leading rate,” said
| Three Months Ended | |||||||||||
| Dollars in Millions | 2026 | 2025 | Change (%) | ||||||||
| Consolidated: | |||||||||||
| Total revenues | $ | 749.2 | $ | 462.3 | 62.1 | % | |||||
| Consolidated Gross profit(1) | $ | 159.5 | $ | 108.9 | 46.5 | % | |||||
| Salaries and benefits plus General and administrative expenses ("SG&A") | $ | 131.7 | $ | 109.7 | 20.1 | % | |||||
| Adjusted Salaries and benefits plus General and administrative expenses ("Adjusted SG&A")(2) | $ | 119.3 | $ | 83.1 | 43.6 | % | |||||
| Adjusted SG&A as a % of Total revenues | 15.9 | % | 18.0 | % | (210) bps | ||||||
| Net income (loss) | $ | 27.3 | $ | (1.3 | ) | N/A* | |||||
| Adjusted EBITDA(2) | $ | 40.3 | $ | 25.8 | 56.2 | % | |||||
| Adjusted Net income(2) | $ | 39.7 | $ | 25.3 | 56.9 | % | |||||
| Total cash, cash equivalents, and investments | $ | 418.2 | $ | 390.8 | 7.0 | % | |||||
| Insurance Segment: | |||||||||||
| Average Medicare Advantage membership(5) | 154,607 | 101,959 | 51.6 | % | |||||||
| Insurance revenue | $ | 744.2 | $ | 456.9 | 62.9 | % | |||||
| Insurance net medical claims incurred | $ | 610.0 | $ | 367.9 | 65.8 | % | |||||
| Insurance BER(3) | 86.5 | % | 86.1 | % | 40 bps | ||||||
*Not presented as a % change 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.
1 Consolidated Gross profit (Non-GAAP) is a non-GAAP financial measure and is calculated by taking net income (loss) before salaries and benefits, general and administrative expenses, depreciation and amortization, premium deficiency reserve expense, restructuring costs, impairment of goodwill and other intangible assets, interest expense, change in fair value of warrants, and loss on investment. A reconciliation of Consolidated Gross profit (Non-GAAP) to Net income, the most directly comparable GAAP measure is provided in the table immediately following the consolidated financial statements below. A reconciliation of projected Consolidated Gross profit is not provided because certain items that are inherently uncertain and difficult to predict, including the reconciliation items included above, which are excluded from Consolidated Gross profit (Non-GAAP), cannot be reasonably calculated or predicted at this time without unreasonable efforts. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.
2 Adjusted SG&A (Non-GAAP), Adjusted EBITDA (Non-GAAP), and Adjusted Net income (Non-GAAP) are Non-GAAP financial measures. Reconciliations of Adjusted SG&A (Non-GAAP) to SG&A, Adjusted EBITDA (Non-GAAP) to Net income, and Adjusted Net income (Non-GAAP) to Net income, respectively, the most directly comparable GAAP measures, are provided in the tables immediately following the consolidated financial statements below. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix A.
3 Insurance Benefits Expense Ratio (“BER”) is a Non-GAAP financial measure. A reconciliation of Insurance BER to Insurance Net medical claims incurred, net, the most directly comparable GAAP measure, is provided in a table immediately following the consolidated financial statements below. Additional information about the Company's Non-GAAP financial measures can be found under the caption "About Non-GAAP Financial Measures" below and in Appendix
4 A reconciliation of projected Adjusted EBITDA (Non-GAAP) to Net income (loss), the most directly comparable GAAP measure, is not provided because Stock-based compensation, which is excluded from Adjusted EBITDA (Non-GAAP), cannot be reasonably calculated or predicted at this time without unreasonable efforts. Additional information about the Company's Non-GAAP financial measures can be found under the caption “About Non-GAAP Financial Measures” below and in Appendix A.
5 Average Medicare Advantage membership represents the average membership during the three months included in the first quarter of 2026.
2026 Financial Guidance
| 2026 Guidance | |
| Total revenues | |
| Consolidated Gross profit(1) | |
| Adjusted EBITDA(4) | |
| GAAP Net income | |
| Average Medicare Advantage membership | 154,000 - 158,000 |
Lives under
| Insurance members | 155,773 | 103,418 | |
Earnings Conference Call Details
Clover Health’s management will host a conference call to discuss its financial results on
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements include statements regarding future events and
About Non-GAAP Financial Measures
We use Non-GAAP measures in this release, including Consolidated Gross profit, Adjusted SG&A, Adjusted SG&A as a percentage of Total revenues, Adjusted EBITDA, Adjusted Net income, and Insurance BER. These Non-GAAP financial measures are provided to enhance the reader's understanding of
For a description of these Non-GAAP financial measures, including the reasons management uses each measure, please see Appendix A: "Explanation of Non-GAAP Financial Measures."
The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
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| CONDENSED CONSOLIDATED BALANCE SHEETS | |||||||
| (Dollars in thousands, except share amounts) | |||||||
| (unaudited) | |||||||
| Assets | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ | 173,265 | $ | 78,301 | |||
| Short-term investments | 4,294 | 17,047 | |||||
| Investment securities, available-for-sale (Amortized cost: 2026: | 24,190 | 23,131 | |||||
| Investment securities, held-to-maturity (Fair value: 2026: | 1,794 | 1,777 | |||||
| Accrued retrospective premiums | 129,215 | 63,875 | |||||
| Healthcare receivables | 73,474 | 94,866 | |||||
| Prepaid expenses | 18,423 | 18,209 | |||||
| Other assets, current | 23,366 | 10,649 | |||||
| Total current assets | 448,021 | 307,855 | |||||
| Investment securities, available-for-sale (Amortized cost: 2026: | 202,240 | 187,092 | |||||
| Investment securities, held-to-maturity (Fair value: 2026: | 12,444 | 12,571 | |||||
| Property and equipment, net | 6,904 | 6,385 | |||||
| Other intangible assets | 2,990 | 2,990 | |||||
| Other assets, non-current | 25,129 | 24,118 | |||||
| Total assets | $ | 697,728 | $ | 541,011 | |||
| Liabilities and Stockholders' Equity | |||||||
| Current liabilities: | |||||||
| Unpaid claims | $ | 260,417 | $ | 153,250 | |||
| Accounts payable and accrued expenses | 39,170 | 36,211 | |||||
| Accrued salaries and benefits | 31,230 | 16,038 | |||||
| Other liabilities, current | 5,766 | 3,324 | |||||
| Total current liabilities | 336,583 | 208,823 | |||||
| Other liabilities, non-current | 21,719 | 23,484 | |||||
| Total liabilities | 358,302 | 232,307 | |||||
| Commitments and Contingencies | |||||||
| Stockholders' equity: | |||||||
| Class A Common Stock, | 43 | 43 | |||||
| Class B Common Stock, | 9 | 9 | |||||
| Additional paid-in capital | 2,695,144 | 2,682,663 | |||||
| Accumulated other comprehensive (loss) income | (672 | ) | 528 | ||||
| Accumulated deficit | (2,261,018 | ) | (2,288,352 | ) | |||
| Less: | (94,080 | ) | (86,187 | ) | |||
| Total stockholders' equity | 339,426 | 308,704 | |||||
| Total liabilities and stockholders' equity | $ | 697,728 | $ | 541,011 | |||
| CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME | |||||||
| (Dollars in thousands, except per share and share amounts) | |||||||
| (unaudited) | |||||||
| Three Months Ended | |||||||
| 2026 | 2025 | ||||||
| Revenues: | |||||||
| Premiums earned, net (Net of ceded premiums of | $ | 744,189 | $ | 456,906 | |||
| Other income | 5,000 | 5,425 | |||||
| Total revenues | 749,189 | 462,331 | |||||
| Operating expenses: | |||||||
| Net medical claims incurred | 589,648 | 353,442 | |||||
| Salaries and benefits | 57,063 | 59,022 | |||||
| General and administrative expenses | 74,629 | 50,675 | |||||
| Depreciation and amortization | 515 | 466 | |||||
| Total operating expenses | 721,855 | 463,605 | |||||
| Income (loss) from operations | 27,334 | (1,274 | ) | ||||
| Net income (loss) | $ | 27,334 | $ | (1,274 | ) | ||
| Per share data: | |||||||
| Basic weighted average number of class A and class B common shares and common share equivalents outstanding | 522,184,385 | 497,056,331 | |||||
| Diluted weighted average number of class A and class B common shares and common share equivalents outstanding | 532,501,448 | 497,056,331 | |||||
| Basic earnings (loss) per share | $ | 0.05 | $ | — | |||
| Diluted earnings (loss) per share | $ | 0.05 | $ | — | |||
| Net unrealized (loss) gain on available-for-sale investments | (1,200 | ) | 1,510 | ||||
| Comprehensive income | $ | 26,134 | $ | 236 | |||
| CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS | |||||||
| (Dollars in thousands) | |||||||
| (unaudited) | |||||||
| Three months ended | |||||||
| 2026 | 2025 | ||||||
| Cash flows from operating activities: | |||||||
| Net income (loss) | $ | 27,334 | $ | (1,274 | ) | ||
| Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: | |||||||
| Depreciation and amortization expense | 515 | 466 | |||||
| Stock-based compensation | 12,271 | 26,437 | |||||
| Accretion, net of amortization | (441 | ) | (437 | ) | |||
| Change in accrued interest earned | 141 | 540 | |||||
| Net realized gains on investment securities | (28 | ) | (42 | ) | |||
| Changes in operating assets and liabilities: | |||||||
| Accrued retrospective premiums | (65,340 | ) | (43,474 | ) | |||
| Prepaid expenses | (214 | ) | (3,415 | ) | |||
| Other assets | (13,730 | ) | (1,147 | ) | |||
| Healthcare receivables | 21,392 | (1,990 | ) | ||||
| Unpaid claims | 107,167 | (5,358 | ) | ||||
| Accounts payable and accrued expenses | 2,959 | (4,011 | ) | ||||
| Accrued salaries and benefits | 15,192 | 11,433 | |||||
| Other liabilities | 677 | 5,979 | |||||
| Net cash provided by (used in) operating activities | 107,895 | (16,293 | ) | ||||
| Cash flows from investing activities: | |||||||
| Purchases of short-term investments, available-for-sale, and held-to-maturity securities | (40,915 | ) | (33,169 | ) | |||
| Proceeds from sales of short-term investments and available-for-sale securities | 33,838 | 16,483 | |||||
| Proceeds from maturities of short-term investments and available-for-sale securities | 2,863 | 25,801 | |||||
| Purchases of property and equipment | (854 | ) | (185 | ) | |||
| Net cash (used in) provided by investing activities | (5,068 | ) | 8,930 | ||||
| Cash flows from financing activities: | |||||||
| Issuance of common stock, net of early exercise liability | 30 | 215 | |||||
| Cash paid for shares withheld related to stock-based compensation | (7,893 | ) | (13,659 | ) | |||
| Repurchases of common stock | — | (18,297 | ) | ||||
| Net cash used in financing activities | (7,863 | ) | (31,741 | ) | |||
| Net increase (decrease) in cash and cash equivalents | 94,964 | (39,104 | ) | ||||
| Cash and cash equivalents, beginning of period | 78,301 | 194,543 | |||||
| Cash and cash equivalents, end of period | $ | 173,265 | $ | 155,439 | |||
| OPERATING SEGMENT | ||||||||
| (in thousands) | ||||||||
| (unaudited) | ||||||||
| Three months ended | ||||||||
| Insurance Segment | 2026 | 2025 | ||||||
| (in thousands) | ||||||||
| Premiums earned, net (net of ceded premiums) | $ | 744,189 | $ | 456,906 | ||||
| Less: | ||||||||
| Net medical claims incurred | 610,001 | 367,887 | ||||||
| Segment gross profit | $ | 134,188 | $ | 89,019 | ||||
| Reconciliation: | ||||||||
| Elimination of intersegment profits | $ | 20,353 | $ | 14,445 | ||||
| Other income | 5,000 | 5,425 | ||||||
| Salaries and benefits | (57,063 | ) | (59,022 | ) | ||||
| General and administrative expenses | (74,629 | ) | (50,675 | ) | ||||
| Depreciation and amortization | (515 | ) | (466 | ) | ||||
| Net income (loss) | $ | 27,334 | $ | (1,274 | ) | |||
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | ||||||
| CONSOLIDATED GROSS PROFIT (NON-GAAP) RECONCILIATION | ||||||
| (in thousands)(1) | ||||||
| (unaudited) | ||||||
| Three Months Ended | ||||||
| 2026 | 2025 | |||||
| Net income (loss) (GAAP): | $ | 27,334 | $ | (1,274 | ) | |
| Adjustments: | ||||||
| Salaries and benefits | 57,063 | 59,022 | ||||
| General and administrative expenses | 74,629 | 50,675 | ||||
| Depreciation and amortization | 515 | 466 | ||||
| Consolidated Gross profit (Non-GAAP) | $ | 159,541 | $ | 108,889 | ||
(1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A.
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | |||||||
| ADJUSTED SG&A (NON-GAAP) RECONCILIATION | |||||||
| (in thousands)(1) | |||||||
| (unaudited) | |||||||
| Three Months Ended | |||||||
| 2026 | 2025 | ||||||
| Salaries and benefits | $ | 57,063 | $ | 59,022 | |||
| General and administrative expenses | 74,629 | 50,675 | |||||
| Total SG&A (GAAP) | 131,692 | 109,697 | |||||
| Adjustments: | |||||||
| Stock-based compensation | (12,271 | ) | (26,437 | ) | |||
| Non-recurring legal expenses and settlements | (137 | ) | (153 | ) | |||
| Adjusted SG&A (non-GAAP) | $ | 119,284 | $ | 83,107 | |||
| Total revenues (GAAP) | $ | 749,189 | $ | 462,331 | |||
| Adjusted SG&A (non-GAAP) as a percentage of Total revenues | 15.9 | % | 18.0 | % | |||
(1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A.
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | ||||||
| ADJUSTED EBITDA (NON-GAAP) RECONCILIATION | ||||||
| (in thousands)(1) | ||||||
| (unaudited) | ||||||
| Three Months Ended | ||||||
| 2026 | 2025 | |||||
| Net income (loss) (GAAP): | $ | 27,334 | $ | (1,274 | ) | |
| Adjustments: | ||||||
| Depreciation and amortization | 515 | 466 | ||||
| Stock-based compensation | 12,271 | 26,437 | ||||
| Non-recurring legal expenses and settlements | 137 | 153 | ||||
| Adjusted EBITDA (non-GAAP) | $ | 40,257 | $ | 25,782 | ||
(1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A.
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | ||||||
| ADJUSTED NET INCOME (NON-GAAP) RECONCILIATION | ||||||
| (in thousands)(1) | ||||||
| (unaudited) | ||||||
| Three Months Ended | ||||||
| 2026 | 2025 | |||||
| Net income (loss) (GAAP): | $ | 27,334 | $ | (1,274 | ) | |
| Adjustments: | ||||||
| Stock-based compensation | 12,271 | 26,437 | ||||
| Non-recurring legal expenses and settlements | 137 | 153 | ||||
| Adjusted Net income (non-GAAP) | $ | 39,742 | $ | 25,316 | ||
(1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A.
| RECONCILIATION OF NON-GAAP FINANCIAL MEASURES | |||||||
| INSURANCE BENEFITS EXPENSE RATIO (NON-GAAP) (NON-GAAP) RECONCILIATION | |||||||
| (in thousands)(1) | |||||||
| (unaudited) | |||||||
| Three Months Ended | |||||||
| 2026 | 2025 | ||||||
| Net medical claims incurred, net (GAAP) | $ | 610,001 | $ | 367,887 | |||
| Adjustments: | |||||||
| Quality improvements | 34,047 | 25,712 | |||||
| Insurance Benefits Expense (non-GAAP) | $ | 644,048 | $ | 393,599 | |||
| Premiums earned, net (GAAP) | $ | 744,189 | $ | 456,906 | |||
| Insurance Benefits Expense Ratio (non-GAAP) | 86.5 | % | 86.1 | % | |||
(1) The table above includes Non-GAAP measures. Non-GAAP financial measures are supplemental and should not be considered a substitute for financial information presented in accordance with GAAP. For a detailed explanation of these Non-GAAP measures, see Appendix A.
Appendix A Explanation of Non-GAAP Financial Measures |
Non-GAAP Definitions
Consolidated Gross profit - A Non-GAAP financial measure defined by us as net income (loss) before salaries and benefits, general and administrative expenses, depreciation and amortization, premium deficiency reserve expense, restructuring costs, impairment of goodwill and other intangible assets, interest expense, change in fair value of warrants, and loss on investment. We believe that Consolidated Gross profit provides management, investors, and others a useful view of consolidated business performance and operational results. Accordingly, we believe that Consolidated Gross profit 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.
Adjusted SG&A - 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.
Adjusted EBITDA - A Non-GAAP financial measure defined by us as net income (loss) before depreciation and amortization, interest expense, change in fair value of warrants, loss on investment, stock-based compensation, premium deficiency reserve benefit, restructuring 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.
Adjusted Net income - A Non-GAAP financial measure defined by us as net income (loss) before stock-based compensation, premium deficiency reserve benefit, restructuring costs, impairment of goodwill and other intangible assets, and non-recurring legal expenses and settlements. Adjusted Net income 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 is helpful to investors in assessing the Company’s financial performance in the same manner as our management and our board of directors.
Insurance Benefits Expense Ratio - A Non-GAAP financial measure defined by us as Benefits Expense Ratio ("BER"). 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
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