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CLOV Q3 Earnings Miss, Stock Falls on Raised Insurance BER View
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Key Takeaways
CLOV posted break-even Q3 EPS, missing estimates, but revenues surged 50.1% year over year.
CLOV's Insurance revenues jumped 48.5% on Medicare Advantage growth, but BER rose to 92.4% from 85.4%.
CLOV raised 2025 Insurance revenue outlook but trimmed income forecast amid cost and utilization pressures.
Clover Health Investments, Corp. (CLOV - Free Report) reported break-even adjusted quarterly earnings per share (EPS) for the third quarter of 2025, missing the Zacks Consensus Estimate of earnings of 2 cents. The company had reported an adjusted loss of 2 cents in the year-ago period.
The company's loss per share from continuing operations was 5 cents compared with a loss of 2 cents in the year-ago period.
CLOV’s Revenues in Detail
Clover Health registered revenues of $496.7 million, up 50.1% year over year. The figure beat the Zacks Consensus Estimate by 4.5%.
The top line gained from robust Insurance revenues.
Clover Health Investments, Corp. Price, Consensus and EPS Surprise
The company derives its revenues from two primary business segments — Insurance and Other income.
Insurance revenues in the quarter totaled $479.1 million, up 48.5% year over year. According to management, this growth was primarily driven by a 35% increase in Medicare Advantage membership, strong member retention and effective cohort management strategies.
Within CLOV’s Insurance segment, the Insurance Benefit Expense Ratio (“BER”) was 92.4%, reflecting a modest year-over-year increase from 85.4% in the year-ago quarter. Insurance BER rose due to a combination of heavy new-member growth, elevated medical utilization, pharmacy cost pressures, higher supplemental benefits usage, one-off dental/DME impacts, and prior-period claims adjustments. Clover expects many of these pressures to moderate as new cohorts mature and more members come under Clover Assistant management.
Other income was $17.5 million, up 108.4% from the prior-year level.
CLOV’s Operational Update
In the quarter under review, Clover Health’s net medical claims increased 70.5% year over year to $428.9million. Salaries and benefits expenses decreased 12.4% to $48.2 million, while general and administrative expenses rose 39.1% to $48.9 million. Total operating expenses of $521 million increased 53.3% on a year-over-year basis.
Total operating loss was $24.4 million compared with the prior-year quarter’s operating loss of $8.9 million.
Clover Health’s Financial Position
The company exited third-quarter 2025 with cash and cash equivalents of $190.1 million compared with $188.6 million at the end of the first quarter.
Net cash provided by operating activities from continuing operations at the end of the third quarter was $1.2 million compared with $129.5 million a year ago.
CLOV’s Guidance
Clover Health raised its sales outlook for 2025 but lowered the income outlook.
For 2025, Insurance revenues are estimated to be in the range of $1.85-$1.88 billion (previously $1.8-$1.875 billion), suggesting 39% year-over-year growth at the midpoint. The company now expects adjusted Net Income to be in the range of $15-$30 million (previously $50-$70 million).
The company raised its projection for Insurance BER to the range of 90-91% (previously 88.5-89.5%). Average Medicare Advantage membership is now likely to be in the band of 106,000-108,000, implying 33% year-over-year growth at the midpoint. The company had previously guided 104,000-108,000 for the metric.
Our Take
Clover Health exited the third quarter of 2025 with mixed performance, with earnings missing estimates but sales beating the same. However, the robust uptick in consolidated revenues and key Insurance segment revenues was encouraging. CLOV emphasized its continued progress in sustaining adjusted EBITDA profitability while delivering robust membership and revenue growth within Medicare Advantage.
Shares of CLOV lost 17.9% during after-hours trading on Nov. 4, following lower-than-expected third-quarter earnings as well as revenue guidance falling below wall street estimates. The company’s shares have gained 11.7% in the year-to-date period compared with the industry’s growth of 26.8%. The S&P 500 Index has increased 18.1% in the same period.
Image Source: Zacks Investment Research
While guidance was lowered due to the higher proportion of new members and broader utilization trends, management outlined a clear path to profitability expansion in 2026. A larger base of returning Clover Assistant-managed members, favorable payment dynamics from a 4-star year, CMS rate updates, and increased Part D subsidies create multiple tailwinds. Continued operating leverage, technology enhancements, stronger pharmacy controls, and disciplined growth channels are expected to support margin improvement further.
Importantly, Clover Assistant continued to deliver industry-leading clinical quality, including the top PPO performance nationally in key HEDIS measures, reinforcing the platform’s ability to reduce disease burden and improve outcomes, particularly for underserved populations. Demand for the technology through Counterpart Health validates its potential beyond Clover’s owned plan footprint, opening a significant long-term opportunity with external payers and providers.
CLOV’s Zacks Rank and Other Key Picks
Clover Health currently has a Zacks Rank #2 (Buy).
Some other top-ranked stocks in the broader medical space are Solventum Corporation (SOLV - Free Report) , Boston Scientific Corporation (BSX - Free Report) and Alcon (ALC - Free Report) .
Solventum, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 4.1%. SOLV’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 13.91%. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Solventum’s shares have gained 3.8% compared with the industry’s 2.6% growth so far this year.
Boston Scientific, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 16.4%. BSX’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 7.36%.
Boston Scientific’s shares have gained 10.9% compared with the industry’s 0.6% growth so far this year.
Alcon, carrying a Zacks Rank of 2 at present, has an estimated long-term growth rate of 10.3%. ALC’s earnings surpassed estimates in three of the trailing four quarters and missed once, with the average surprise being 4.61%.
Alcon’s shares have declined 12.6% compared to a flat industry so far this year.
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CLOV Q3 Earnings Miss, Stock Falls on Raised Insurance BER View
Key Takeaways
Clover Health Investments, Corp. (CLOV - Free Report) reported break-even adjusted quarterly earnings per share (EPS) for the third quarter of 2025, missing the Zacks Consensus Estimate of earnings of 2 cents. The company had reported an adjusted loss of 2 cents in the year-ago period.
The company's loss per share from continuing operations was 5 cents compared with a loss of 2 cents in the year-ago period.
CLOV’s Revenues in Detail
Clover Health registered revenues of $496.7 million, up 50.1% year over year. The figure beat the Zacks Consensus Estimate by 4.5%.
The top line gained from robust Insurance revenues.
Clover Health Investments, Corp. Price, Consensus and EPS Surprise
Clover Health Investments, Corp. price-consensus-eps-surprise-chart | Clover Health Investments, Corp. Quote
Clover Health’s Segmental Details
The company derives its revenues from two primary business segments — Insurance and Other income.
Insurance revenues in the quarter totaled $479.1 million, up 48.5% year over year. According to management, this growth was primarily driven by a 35% increase in Medicare Advantage membership, strong member retention and effective cohort management strategies.
Within CLOV’s Insurance segment, the Insurance Benefit Expense Ratio (“BER”) was 92.4%, reflecting a modest year-over-year increase from 85.4% in the year-ago quarter. Insurance BER rose due to a combination of heavy new-member growth, elevated medical utilization, pharmacy cost pressures, higher supplemental benefits usage, one-off dental/DME impacts, and prior-period claims adjustments. Clover expects many of these pressures to moderate as new cohorts mature and more members come under Clover Assistant management.
Other income was $17.5 million, up 108.4% from the prior-year level.
CLOV’s Operational Update
In the quarter under review, Clover Health’s net medical claims increased 70.5% year over year to $428.9million. Salaries and benefits expenses decreased 12.4% to $48.2 million, while general and administrative expenses rose 39.1% to $48.9 million. Total operating expenses of $521 million increased 53.3% on a year-over-year basis.
Total operating loss was $24.4 million compared with the prior-year quarter’s operating loss of $8.9 million.
Clover Health’s Financial Position
The company exited third-quarter 2025 with cash and cash equivalents of $190.1 million compared with $188.6 million at the end of the first quarter.
Net cash provided by operating activities from continuing operations at the end of the third quarter was $1.2 million compared with $129.5 million a year ago.
CLOV’s Guidance
Clover Health raised its sales outlook for 2025 but lowered the income outlook.
For 2025, Insurance revenues are estimated to be in the range of $1.85-$1.88 billion (previously $1.8-$1.875 billion), suggesting 39% year-over-year growth at the midpoint. The company now expects adjusted Net Income to be in the range of $15-$30 million (previously $50-$70 million).
The company raised its projection for Insurance BER to the range of 90-91% (previously 88.5-89.5%). Average Medicare Advantage membership is now likely to be in the band of 106,000-108,000, implying 33% year-over-year growth at the midpoint. The company had previously guided 104,000-108,000 for the metric.
Our Take
Clover Health exited the third quarter of 2025 with mixed performance, with earnings missing estimates but sales beating the same. However, the robust uptick in consolidated revenues and key Insurance segment revenues was encouraging. CLOV emphasized its continued progress in sustaining adjusted EBITDA profitability while delivering robust membership and revenue growth within Medicare Advantage.
Shares of CLOV lost 17.9% during after-hours trading on Nov. 4, following lower-than-expected third-quarter earnings as well as revenue guidance falling below wall street estimates. The company’s shares have gained 11.7% in the year-to-date period compared with the industry’s growth of 26.8%. The S&P 500 Index has increased 18.1% in the same period.
Image Source: Zacks Investment Research
While guidance was lowered due to the higher proportion of new members and broader utilization trends, management outlined a clear path to profitability expansion in 2026. A larger base of returning Clover Assistant-managed members, favorable payment dynamics from a 4-star year, CMS rate updates, and increased Part D subsidies create multiple tailwinds. Continued operating leverage, technology enhancements, stronger pharmacy controls, and disciplined growth channels are expected to support margin improvement further.
Importantly, Clover Assistant continued to deliver industry-leading clinical quality, including the top PPO performance nationally in key HEDIS measures, reinforcing the platform’s ability to reduce disease burden and improve outcomes, particularly for underserved populations. Demand for the technology through Counterpart Health validates its potential beyond Clover’s owned plan footprint, opening a significant long-term opportunity with external payers and providers.
CLOV’s Zacks Rank and Other Key Picks
Clover Health currently has a Zacks Rank #2 (Buy).
Some other top-ranked stocks in the broader medical space are Solventum Corporation (SOLV - Free Report) , Boston Scientific Corporation (BSX - Free Report) and Alcon (ALC - Free Report) .
Solventum, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 4.1%. SOLV’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 13.91%. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.
Solventum’s shares have gained 3.8% compared with the industry’s 2.6% growth so far this year.
Boston Scientific, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 16.4%. BSX’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 7.36%.
Boston Scientific’s shares have gained 10.9% compared with the industry’s 0.6% growth so far this year.
Alcon, carrying a Zacks Rank of 2 at present, has an estimated long-term growth rate of 10.3%. ALC’s earnings surpassed estimates in three of the trailing four quarters and missed once, with the average surprise being 4.61%.
Alcon’s shares have declined 12.6% compared to a flat industry so far this year.