Research Reports

Prepared Highlights

Medicare Advantage membership grew ~52,000 lives YoY to ~156,000 members; total revenues $749M, up 62% YoY (CFO)
Consolidated gross profit $160M, up 47% YoY; insurance BER 86.5% for Q1 (CFO)
Adjusted SG&A $119M, or 16% of revenue, improving ~200 bps YoY (CFO)
GAAP net income $27M, improving $29M YoY; adjusted EBITDA $40M, up 56% YoY (CFO)
Cash and investments $418M, no debt; cash flow from operations $108M (CFO)
Inpatient utilization lower YoY; flu/COVID contributed ~25–30 bps favorability to margin vs 2025 (CFO)
Clover Care Services enrollment up ~90% YoY; over 1/3 of members received Clover Assistant-powered care in Q1 (CEO, CFO)
Outpatient utilization and cost elevated but in line with expectations; dental cost management improved after 2025 remediation (CFO)
Part D performance developing in line with expectations (CFO)
Official guidance: Expect to meet or exceed full year 2026 outlook across all metrics; will revisit guidance after Q2 results (CFO)
Mgmt quotes:
- “We grew membership 51% year-over-year, while generating GAAP net income of $27 million.” (CEO)
- “We believe the total lifetime value of a Clover member significantly exceeds that of other plans.” (CEO)
- “We delivered positive GAAP net income while continuing to grow at a market-leading rate.” (CFO)
- “We are managing a membership base today that includes a large number of first and second year members… as we move into 2027, we expect a large portion… will be progressing favorably along the lifetime value curve.” (CFO)
- “We expect to deliver full year GAAP net income profitability in 2026 and to continue improving both care and economics over time.” (CEO)

Prepared Metrics

Metric	Value	Speaker/Context
Medicare Advantage membership	~156,000	CFO
Total revenues	$749M	CFO
Revenue growth YoY	62%	CFO
Consolidated gross profit	$160M	CFO
Gross profit growth YoY	47%	CFO
Insurance BER	86.5%	CFO
Adjusted SG&A	$119M	CFO
Adjusted SG&A as % of revenue	16%	CFO
GAAP net income	$27M	CFO
GAAP net income improvement YoY	$29M	CFO
Adjusted EBITDA	$40M	CFO
Adjusted EBITDA growth YoY	56%	CFO
Cash and investments	$418M	CFO
Cash flow from operations	$108M	CFO
Clover Care Services enrollment growth YoY	~90%	CFO
Members receiving Clover Assistant care in Q1	>1/3	CEO

Q&A Batch (1-3 of 3)

Q1 — Richard Close

Topic: 公司模型独特性及SG&A费用波动原因
Key points:
- Clover对会员人口的经济学承担全部风险，不将风险下放给供应商，与大多数同业不同
- 通过Clover Assistant平台与PPO广泛网络互动，驱动临床和经济结果
- 一季度SG&A包含几项一次性非经常性费用，例如理赔调整费用（非现金，为未来赔付设立的准备金），后续季度不会重复
Mgmt stance: bullish，因全风险模型和平台互动具有独特性，且费用改善具可持续性

Q2 — Jonathan Yong

Topic: 新老会员健康趋势、RAF评分及G&A改善指引
Key points:
- 新会员和回归会员的领先指标（住院、牙科）一季度跟踪符合或优于预期
- RAF评分已有2个月MMR数据，自2月提供指引以来，全年趋势符合预期
- 未正式指引G&A比率，但2月承诺2026年SG&A改善100-150个基点（bps）；一季度已实现200bps改善，管理层对达成或超越整体预期感觉良好
Mgmt stance: bullish，因关键指标跟踪良好且SG&A改善超预期

Q3 — Jonathan Yong

Topic: 季度内前期发展（prior year development）
Key points:
- 一季度存在适度的不利前期发展（unfavorability），与2025年的方向相反
- 属于正常的重新估算和准备金调整，收入侧也有轻微不利
Mgmt stance: neutral，指出正常波动，未表达特别担忧或乐观