Clover Health Investments, Corp. /de (CLOV) · Oct 8, 2026 · Other events

Clover Health 5-star rating unlocks year-round PPO enrollment

5-star PPO rating — 5.0 PPO stars vs 4.5 with court measures included

Clover Health’s Star Ratings filing delivers a 5-star PPO rating for 2027, improving enrollment flexibility and payment economics—but only in 2028.

Clover is scaling a Medicare Advantage business built around wide-network PPO plans while developing Clover Assistant and Counterpart Health as physician-enablement technology. Membership had already reached 153,000 at the start of 2026, and management has framed Medicare Advantage as the current profit engine that funds the slower buildout of Counterpart.

The rating outcome is better than the clearest available baseline. CMS awarded Clover’s PPO plans 5 Stars and its HMO plan 4.5 Stars for 2027, affecting payment year 2028. The filing says the PPO would have scored 4.5 Stars if the 20 disputed measures had remained included, making the 5-star result an incremental win rather than merely a confirmation of the court-driven recalculation. 〔0〕

This directly strengthens the growth model, but the financial benefit is delayed. A 5-star PPO can enroll beneficiaries year-round, expanding beyond the normal annual enrollment window, while higher ratings generally support better plan economics and benefit reinvestment. 〔1〕 The practical payoff therefore lands in the 2028 payment year, not immediately, and the filing does not quantify the resulting revenue or profit lift.

The result is especially relevant because PPO is where Clover’s growth is concentrated. Through the first half of 2026, membership was up roughly 48% year over year to more than 157,000, with about 98% in PPO plans. 〔2〕 That makes the rating economically meaningful to the core business, though it does not by itself prove that the company’s medical-cost performance or profitability will improve.

Bottom line: This advances Clover’s central Medicare Advantage growth strategy: it gets the highest possible PPO rating and more enrollment flexibility, with the main economic benefit arriving in 2028. The news is genuinely better than the 4.5-star outcome implied by the disputed-measure scenario, but part of the direction was already known from the court-driven rating process.

Original filing on SEC EDGAR

More Clover Health Investments, Corp. /de news

• Clover Health earnings beat; 2026 guidance edges higher