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Clover Health (CLOV) Medicare Advantage plans earn 4.5-Star CMS ratings for 2027

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(Moderate)
Filing Sentiment
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Form Type
8-K

Rhea-AI Filing Summary

Clover Health Investments reported that the Centers for Medicare & Medicaid Services (CMS) has increased key quality ratings for its Medicare Advantage plans, which affect payments for 2027. CMS now shows the company’s PPO contract H5141 at 4.5 Stars for payment year 2027, up from 3.5 Stars in the 2026 Star Rating.

In addition, CMS’s updated guidance and system display that the 2026 Star Rating for Clover’s HMO contract H8010 has risen from 4.0 Stars to 4.5 Stars, also impacting payment year 2027 Quality Bonus Payments. These higher star ratings can support stronger revenue potential and competitiveness in the Medicare Advantage market.

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Insights

CMS upgrades Clover’s star ratings to 4.5 Stars on key Medicare Advantage contracts, improving 2027 payment potential.

The filing explains that CMS recalculated Clover Health’s Medicare Advantage Star Ratings after a court judgment in Clover Insurance Co. v. HHS. The PPO contract H5141 was raised from 3.5 to 4.5 Stars for payment year 2027, and the HMO contract H8010 from 4.0 to 4.5 Stars.

Star Ratings help determine Quality Bonus Payments, so moving both contracts to 4.5 Stars can enhance reimbursement and marketing advantages relative to lower-rated plans. The guidance notes that updated 2027 Quality Bonus Payment ratings are available in the Health Plan Management System, giving operational clarity for Clover’s 2027 Medicare Advantage revenue framework.

Item 8.01 Other Events Other
Voluntary disclosure of events the company deems important to shareholders but not covered by other items.
PPO H5141 new rating 4.5 Stars Payment year 2027 Quality Bonus Payment rating
PPO H5141 prior rating 3.5 Stars 2026 Star Rating before recalculation
HMO H8010 new rating 4.5 Stars 2026 Star Rating impacting payment year 2027
HMO H8010 prior rating 4.0 Stars 2026 Star Rating before CMS update
Payment year 2027 Year for Quality Bonus Payments tied to these ratings
Centers for Medicare & Medicaid Services regulatory
"the Centers for Medicare & Medicaid Services ("CMS") informed Clover Health Investments, Corp."
The Centers for Medicare & Medicaid Services (CMS) is the U.S. federal agency that runs major public health insurance programs and sets rules for what treatments and services are paid for and how much providers receive. Think of it as the rulebook and paymaster for a large portion of the health-care system: its coverage decisions, payment rates, and regulations can quickly change revenues, costs, and market access for hospitals, insurers, drugmakers and medical-device companies, so investors track its actions closely.
Star Rating regulatory
"CMS had recalculated the 2026 Star Rating for the Company's PPO Medicare Advantage contract"
Quality Bonus Payment financial
"it was voluntarily recalculating the 2027 Quality Bonus Payment ratings for certain Medicare Advantage contracts"
Medicare Advantage financial
"the Company's PPO Medicare Advantage contract, H5141, rated at 4.5 Stars"
Medicare Advantage is a type of health insurance plan offered by private companies that covers services traditionally provided by government-run Medicare. Think of it as a bundled package that combines hospital, doctor, and other medical care into one plan, often with added benefits. For investors, it matters because the popularity and profitability of these plans can influence healthcare companies and the broader health insurance industry.
Health Plan Management System (HPMS) technical
"MA organizations can view their recalculated 2027 QBP ratings in the Health Plan Management System (HPMS)"

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FAQ

How did CMS change Clover Health (CLOV) Star Ratings for 2027?
CMS recalculated Clover Health’s Medicare Advantage ratings, showing its PPO contract H5141 and HMO contract H8010 at 4.5 Stars impacting payment year 2027. These higher ratings are used in determining Quality Bonus Payments and can support stronger future Medicare Advantage revenue.

Which Clover Health (CLOV) contracts received 4.5 Star Ratings?
Clover Health’s PPO Medicare Advantage contract H5141 now appears at 4.5 Stars for payment year 2027. CMS’s system also shows the HMO Medicare Advantage contract H8010 at 4.5 Stars, following an increase from 4.0 Stars in the 2026 Star Rating cycle.

What prior Star Ratings did Clover Health (CLOV) contracts have?
Before the recalculation, Clover’s PPO contract H5141 carried a 3.5 Star Rating for 2026, and its HMO contract H8010 held a 4.0 Star Rating. CMS’s updated guidance and system now display both contracts at 4.5 Stars impacting payment year 2027 Quality Bonus Payments.

Why are Clover Health (CLOV) Star Ratings important for 2027 payments?
Medicare Advantage Star Ratings help determine Quality Bonus Payments for each payment year. By achieving 4.5 Stars on both PPO H5141 and HMO H8010 for metrics affecting payment year 2027, Clover Health can benefit from more favorable reimbursement tied to these higher-quality scores.

What triggered CMS to recalculate Clover Health (CLOV) ratings?
CMS acted consistent with a court judgment in Clover Insurance Co. v. HHS, which led to recalculation of the 2026 Star Rating for PPO H5141. CMS then issued broader guidance to recalculate certain 2027 Quality Bonus Payment ratings, including Clover’s affected contracts.
FALSE0001801170CLOVER HEALTH INVESTMENTS, CORP. /DE00018011702026-06-172026-06-17

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): June 17, 2026

CLOVER HEALTH INVESTMENTS, CORP.

(Exact name of Registrant as Specified in Its Charter)

Delaware
001-3925298-1515192
(State or Other Jurisdiction
(Commission File Number)
(IRS Employer
of Incorporation)
Identification No.)
Address Not Applicable(1)
Address Not Applicable(1)
(Address of Principal Executive Offices)(Zip Code)
Not Applicable(1)
(Registrant’s Telephone Number, Including Area Code)

Not Applicable

(Former Name or Former Address, if Changed Since Last Report)


Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

☐ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

☐ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

☐ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))


Securities registered pursuant to Section 12(b) of the Act:

Trading
Title of each class
Symbol(s)
Name of each exchange on which registered
Class A Common Stock, par value $0.0001 per shareCLOVThe NASDAQ Stock Market LLC
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§ 230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§ 240.12b-2 of this chapter).
Emerging growth company ☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
(1) We are a remote-first company. Accordingly, we do not maintain a headquarters. For purposes of compliance with applicable requirements of the Securities Act of 1933, as amended, and the Securities Exchange Act of 1934, as amended, stockholder communications required to be sent to our principal executive offices may be directed to the email address: secretary@cloverhealth.com, or to our agent for service of process at The Corporation Trust Company, 1209 Orange Street, Wilmington, Delaware 19801.




Item 8.01. Other Events.
As previously disclosed, on June 9, 2026, the Centers for Medicare & Medicaid Services ("CMS") informed Clover Health Investments, Corp. (the "Company") that, consistent with a court judgment in Clover Insurance Co. V. HHS, Civ. A. No. 25-142 (S.D. Ga), CMS had recalculated the 2026 Star Rating for the Company's PPO Medicare Advantage contract, H5141, from 3.5 Stars to 4.5 Stars for payment year 2027.
On June 17, 2026, CMS issued updated guidance informing all Medicare Advantage Organizations that it was voluntarily recalculating the 2027 Quality Bonus Payment ratings for certain Medicare Advantage contracts as a result of the preceding decision.
CMS’s guidance stated that MA organizations can view their recalculated 2027 QBP ratings in the Health Plan Management System (HPMS). HPMS displays the Company's PPO Medicare Advantage contract, H5141, rated at 4.5 Stars for payment year 2027, and also displays that the 2026 Star Rating for the Company's HMO Medicare Advantage contract, H8010, increased from 4.0 Stars to 4.5 Stars, which also impacts payment year 2027.




SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
Clover Health Investments, Corp.
Date:June 18, 2026By:/s/ Clay Thornton
Name:Clay Thornton
Title:Interim Chief Financial Officer (Principal Financial Officer)

Source: View Original Filing on SEC EDGAR

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