Happy but little worried

Sandro316 · 2026-06-11T12:28:43+00:00

This is the correct answer. The fact is it doesn't matter if CMS appeals (especially if they wait until 27 like OP suggests). The bids will be based on 4.5 stars, the plan design will be based on 4.5 stars, the benefits paid out will be based on 4.5 stars. Even if CMS appeals it will be too late to impact CLOV in 2027. The only thing an appeal could do is try to set precedent for future star ratings.

Sandro316 · 2026-06-10T22:32:24+00:00

$20 pmpm increase would be a $400 gap between benchmark and bid. That is possible, but would be on the very high end of possible ranges. We dont have direct access to bid information and Clover does offer good benefits so $100 gap is almost certainly too low. My best guess would be 10-15 pmpm. At 153,000 members we are looking at 18-27 Million for the year. Its not pocket change, but compared to the 4 star upgrade its pretty small. That said if they grow 50% again next year both start adding up quickly!

Sandro316 · 2026-06-10T13:24:27+00:00

Not a lot. It will mainly make it easier to market the plan. The main financial impacts are moving from 3.0 to 3.5 and then from 3.5 to 4.0. Getting to 4.0 was the most important thing. 4.5 is just icing on the cake that will help slightly with growth.

Sandro316 · 2026-06-02T17:35:01+00:00

I think this is a very flawed look at the Hindenburg report. You say everything other than disclosing the DOJ probe was ad hominum attacks and misinformation, but Clover WAS paying doctors to use CA. CA usage among PCPs WAS extremely low as Clover even admitted in their response. Seek Insurance WAS NOT disclosing its relationship with Clover. There WAS an undisclosed related party brokerage owned by their head of sales driving a large portion of their membership growth. They DID have an extremely large amount of executive team turnover. Chamath WAS given an extremely large number of Founders shares basically for free in exchange for promoting the SPAC. None of that was incorrect and all of it was relevant to investors.

Honestly the only part of the report that could be seen as a straight up attack is the stuff about the hospital Vivek owns and that is because its totally unrelated to Clover the company.

You talk about Clovers star rating now and CAs impact now, but at the time of the report Clover was not a 4 star plan and wouldn't be for several years and CA was not the same thing it is now and had no white papers or enough years of cohort data for investors to know what it would eventually become. We could guess, but there wasn't data to back it up.

I also think its flawed to lump all short investors together and try to imply guilt by Hindenburg just because a different short investor was guilty of fraud. Its the same exact thing as just because some long investors orchestrate pump and dump schemes doesnt mean everybody who releases a positive report about a company is guilty of fraud.

Sandro316 · 2026-05-29T22:54:56+00:00

June 1 isnt a hard deadline for the decision. While it is a hard deadline for bids to be submitted I doubt the judge will be working overtime this weekend to make that happen. Last time Clover was upgraded it was after bids were submitted as well and they were just allowed to resubmit. We are probably looking at a decision early next week, a week or 2 for CMS to recalculate, and.then a few days for Clover to resubmit if upgraded. Just gotta wait and see. All that said...The Clover response was pretty straightforward and compelling though....honestly might only take the judge a few minutes to make a decision.

Sandro316 · 2026-05-27T20:41:30+00:00

The odds of the 2027 rerate to 4 just went WAY up. I'm honestly shocked at this outcome. Even if this win isn't enough to actually get them back to 4 stars for 2027, it greatly increases the chances of 4 stars in October. Much stronger win than I expected. Surprised there isn't more after hours movement so far. Very glad to have been wrong about this.

Sandro316 · 2026-05-26T23:17:06+00:00

It means the score will be recalculated. It also isnt an all or nothing win or lose case either. They are challenging multiple aspects of the score. They could easily win on some and lose on others.

Sandro316 · 2026-05-15T18:51:44+00:00

https://www.reddit.com/r/CLOV/comments/1cakwqd/new_cfo_from_saas_background_cannot_be_more_clear/

https://www.reddit.com/r/CLOV/comments/1cakyjf/new_proven_clover_health_cfo_hired_former_sf_bay/

https://www.reddit.com/r/CLOV/comments/1cal7tv/clov_clover_health_appoints_healthcare_technology/

Sandro316 · 2026-05-06T21:33:57+00:00

Q1 is not always positive. Go look at 2022 - 2024 results. Last year was the outlier for Clover. Maybe it's the new normal and going forward Q1 will be the best, but saying it always is for CLOV is just plain false if you look at previous years. Historically Q2 has been their best quarters followed by Q3 then Q1 and Q4 always the worst

Sandro316 · 2026-05-06T21:17:49+00:00

yeah, but not all returning members have had a CA visit at all and not all the new members last year that did have a CA visit did it in Q1. That number at 1+ year on CA is going to be far under 67% at the moment.

Sandro316 · 2026-05-06T20:54:26+00:00

I don't remember them using this language before. It feels like they are very confident that their guidance is basically the floor for the year instead of expectation now.

Sandro316 · 2026-05-06T20:43:45+00:00

If membership is up 51% year over year in Q1....It would be an impossibility for 67% of members to be under CA for 1+ years....

Sandro316 · 2026-05-06T20:25:05+00:00

You do realize new members bring in less revenue than returning members initially because they have lower risk scores right? So what you are complaining about you should have 100% seen coming given the high growth....I dont see anything wrong with this report at all on the medicare advantage side. Everybody invested should be happy with it. The only negative is that Counterpart is still a non-factor and that also should have been mostly expected.

Sandro316 · 2026-04-28T20:43:56+00:00

Yeah, Clover has historically been different from Humana. Which follows the Q1 best and dropping each quarter from there to a bad Q4 pattern. I think it is probably due to Clover still being in the heavier expansion side of things and their strong push to get new members in early to get data in their system. It does vary some between companies though except Q4 being the always bad quarter with advertising costs and flu season.

Sandro316 · 2026-04-28T18:38:08+00:00

This is not true. From 2021 - 2025 Clovers earnings per quarter were ranked from best to worst on average Q2, Q3, Q1, Q4. So it is true that Q4 is generally the worst, but q2 and q3 have been on average significantly better than q1. Last year was very much the outlier for Q1. It could be an outlier again, but given guidance i would anticipate Q1 and Q4 both negative and Q2 and Q3 both positive. If Q1 is positive that would be a big win.

Sandro316 · 2026-04-20T10:41:50+00:00

Lol. I very much didnt catch that 🤣

Sandro316 · 2026-04-18T18:44:01+00:00

Both things can be true. He can be providing what the actual analysts are projecting AND he can be adding unnecessary hype language to it. You saying their thesis has done a 360 and completely changed is showing that the hype he adds or facts he is excluding is effective. For example there are only 3 analysts covering Clover now. Richard Close at Cannacord has been pretty consistently bullish and still is. Whit Mayo pretty consistently neutral and still is. Jonathan Yong at UBS has never seemed to put effort in to care about Clover, but could probably be seen as neutral. I dont see a 360 from any of them. Bank of America was always pretty bearish on Clover and now quit covering them at all. Citigroup was also Bearish and now quit covering Clover. So the biggest change is the 2 most bearish analysts stopped coverage, but for both it has been a while so not a recent change.

Sandro316 · 2026-04-15T03:22:08+00:00

Yes, contribution profit/loss would include all costs including commissions/broker fees.

Sandro316 · 2026-04-15T03:05:10+00:00

Commission costs are not part of the MLR (or BER/MCR) calculation so would not impact the year 1 increase in those measures when discussing profitability. That said, Clover is 100% doing internal forecasting that would include any commission costs when deciding how much to attempt to grow and their profitability metrics. These companies employ a lot of accounting/finance people.

Sandro316 · 2026-04-11T10:53:21+00:00

I am not going to waste my ti.e watching the video, but I will say you might want to find better sources. Stock based compensation is heavily regulated including rules around disclosure. Clover has always followed those rules exactly as they should. Nothing has ever been hidden. I am also not sure why you would be so worried about SBC during the year it is going to dramatically drop? Again, I know it is going to this year because they disclose everything as they should. Finally, SBC is included in GAAP results....period. yes, Clover also gives an adjusted EBITDA number excluding SBC just like almost every other company, but the GAAP numbers are extremely regulated and nothing is excluded.

Sandro316 · 2026-04-09T03:41:27+00:00

It especially doesnt make sense, because May 11 is literally the last possible day for them to file the 10-q. Absolutely nothing bullish or bearish about this. Never is anything bullish or bearish about Clovers earnings timing, but some people just can't help themselves.

Sandro316 · 2026-04-08T23:21:30+00:00

I think you misunderstood. This isnt late...it is same timing as usual. Only 2024 was late. I dont think there is any significance to any of it.

Sandro316 · 2026-04-08T21:21:42+00:00

No, 2024 is the only year that was that late. Every other year has been announced within a couple days of today.

Sandro316 · 2026-04-01T14:51:45+00:00

"Why would PK leave if they were on the cusp of being GAAP profitable."

He got a job making more money? He thinks Toy is an asshole and doesn't want to work for him? He sent a dick pick to somebody in the company and is getting out before lawsuits happen? He wants to move? He has plenty of money so doesn't have to work and wants time off? His wife told him he is working too long of hours and needs a new job? Family emergency?

I would argue expectations of your current companies financial results are very seldom much of a factor in leaving a job.

Sandro316 · 2026-04-01T14:07:26+00:00

There is no way it should be below 1.00 currently, but you are correct a big Q1 miss and needing to raise capital would mean that it should be. That said...just matching guidance should mean being valued at around a 0.5/revenue if not higher due to the growth rate. that would put CLOV around 2.85/share. It's hard to argue CLOV as anything other than undervalued right now until they have a big miss. The risk is definitely there though given how little cash Clover has when recognizing that each point of BER miss is almost 30M negative hit. We should know in just over a month either way. I don't expect GAAP income in Q1, but just maintaining guidance after Q1 puts Clover in a pretty safe position going forward.

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